Exploratory Research in Clinical and Social Pharmacy (Sep 2024)

Stakeholders' perspectives about challenges, strategies and outcomes of importance associated with adherence to appropriate polypharmacy in older patients – A qualitative study

  • Hanadi A. Al Shaker,
  • Heather E. Barry,
  • Carmel M. Hughes

DOI
https://doi.org/10.1016/j.rcsop.2024.100479
Journal volume & issue
Vol. 15
p. 100479

Abstract

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Background: Older patients experience challenges when taking polypharmacy. Studies have applied different interventions to improve adherence to polypharmacy. However, inconsistencies in outcomes have impeded the synthesis of evidence. To generate high-quality studies and selectively report outcomes, a Core Outcome Set (COS) is advocated. Objective(s): This study explored stakeholders' perspectives about the challenges older patients face when taking polypharmacy, strategies to overcome each challenge, and outcomes of importance that may contribute to COS development. Methods: Semi-structured interviews were undertaken with academics, healthcare professionals, and public participants. A series of open-ended questions investigated challenges with adherence to polypharmacy in older patients and strategies to overcome these challenges. A list of outcomes (n = 7) compiled from previous studies associated with adherence to polypharmacy was presented to participants for their views. Content analysis was conducted to identify key themes and outcomes proposed by participants. Results: Participants suggested 11 multidimensional healthcare system-related, medication-related, patient-related, and socioeconomic-related challenges and 16 educational and behavioural strategies associated with adherence to polypharmacy in older patients. Participants agreed with the importance of the seven outcomes presented and suggested a further six outcomes they deemed to be important for use in trials aimed at improving adherence to appropriate polypharmacy in older patients. Conclusions: Adherence to polypharmacy was deemed challenging, requiring supportive interventions. A list of 13 outcomes in the context of adherence to appropriate polypharmacy in older patients was identified to inform a future study that will develop a COS for clinical trials targeting interventions to improve adherence to appropriate polypharmacy in older patients.

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