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利益相关者对老年患者合理使用多种药物的依从性相关挑战、策略及重要结果的看法——一项定性研究

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

作者信息

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

机构信息

School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom.

Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan.

出版信息

Explor Res Clin Soc Pharm. 2024 Jul 18;15:100479. doi: 10.1016/j.rcsop.2024.100479. eCollection 2024 Sep.

Abstract

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.

OBJECTIVES

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 ( = 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.

摘要

背景

老年患者在服用多种药物时面临挑战。研究已采用不同干预措施来提高对多种药物治疗的依从性。然而,结果的不一致阻碍了证据的综合。为了开展高质量研究并选择性报告结果,提倡使用核心结局集(COS)。

目的

本研究探讨了利益相关者对老年患者服用多种药物时面临的挑战、克服每种挑战的策略以及可能有助于制定COS的重要结局的看法。

方法

对学者、医疗保健专业人员和公众参与者进行了半结构式访谈。一系列开放式问题调查了老年患者在坚持多种药物治疗方面的挑战以及克服这些挑战的策略。向参与者展示了一份从先前与坚持多种药物治疗相关的研究中汇编的结局列表(n = 7),以征求他们的意见。进行了内容分析,以确定参与者提出的关键主题和结局。

结果

参与者提出了11个与医疗保健系统、药物、患者和社会经济相关的多维度挑战,以及16种与老年患者坚持多种药物治疗相关的教育和行为策略。参与者认同所展示的7个结局的重要性,并提出了另外6个他们认为对旨在提高老年患者对适当多种药物治疗依从性的试验很重要的结局。

结论

坚持多种药物治疗被认为具有挑战性,需要支持性干预措施。确定了一份在老年患者坚持适当多种药物治疗背景下的13个结局列表,为未来一项研究提供参考,该研究将为针对改善老年患者对适当多种药物治疗依从性的干预措施的临床试验制定COS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63d5/11327598/5b7f60f8e6ff/gr1.jpg

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