gms | German Medical Science

Background: Medication Reviews in nursing homes can reduce drug-related problems and improve quality of medication therapy [1], [2]. To date, they are not part of standard care in Germany. For supporting pharmacists in conducting structured reviews, an algorithm and tool is developed and evaluated in the AMBER-study (Development and evaluation of an algorithm in Medication Management for best practice. Effectiveness of the intervention and translation into standard care for nursing home residents) [3]. Focusing on frequent and relevant problems and providing a guidance for pharmacists is believed to reach a higher implementation of medication review in nursing homes [4].

To determine aspects of the algorithm, interviews with experts were performed in phase I of the study. In phase II, a systematic review of current literature was conducted. Results of this research were merged and edited for a modified Delphi-survey. The aim of this survey was to verify the chosen aspects and to refine the developed algorithm. Results of round one are presented here.

Materials and Methods: We created 9 statements, which were rated by the experts on a 5-point Likert scale (with 1 as strongly disagree and 5 as strongly agree). An open-end question offered the possibility to supplement missing aspects. The survey was performed using the software SurveyMonkey and was open in July 2017. We invited 23 international pharmacists, who are outstanding experts in medication safety.

Results: Overall, 15 experts took part in the survey. The aspect “polymedication as selection criterion” was rated lowest (2,6) and the aspect “recording and considering patients´ chief complaints” was rated highest (4,3). Highest consensus among the experts was achieved on the aspects “recording and considering patient´s chief complaints” and “inappropriate dosing and drug selection at antibiotic regimens as an important issue”. Nine experts mentioned supplementary aspects.

Conclusion: Dissent of experts was surprisingly high, given the intense preceding research. Annotations and ratings of experts need to be considered and the algorithm has to be adapted. A second Delphi-round will be conducted.