OPTIMA-ID: development and validation of a medicine optimization tool for older adults with intellectual disability.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI:10.1080/17512433.2024.2390913

Juliette O'Connell, Ashleigh Gorman, Éilish Burke, Shoumitro Deb, Martin Charles Henman, Philip McCallion, Mary McCarron, Tara Mullally, Niamh Mulryan, Máire O'Dwyer, Cristín Ryan

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引用次数: 0

Abstract

Background: Older people (i.e. ≥40 years) with intellectual disability have unique medication needs and may experience high levels of potentially inappropriate prescribing. Despite the availability of tools to optimize older adults' prescriptions, there is no comprehensive tool specifically for use in older adults with intellectual disability. We aimed to develop a tool for this purpose: Optimizing Pharmaco-Therapy and Improving Medication for Ageing with Intellectual Disability (OPTIMA-ID).

Research design and methods: A draft tool was developed based on literature review and clinical expertise. Focus groups with healthcare professionals and people with intellectual disability were conducted to refine the tool. The tool was presented electronically to an expert panel for Delphi validation. Median level of agreement and 75^th percentile values were used to establish if consensus was reached. Criteria were accepted, rejected, revised or removed to develop the final tool.

Results: Following two Delphi rounds, consensus on the content of OPTIMA-ID was reached for 67 prescribing criteria, 63 of which were agreed upon after Round 1 and a further 4 criteria accepted after Round 2.

Conclusions: OPTIMA-ID contains 67 criteria that can optimize medications for older people with intellectual disability. Its effectiveness, feasibility and impact on patient outcomes need to be established.

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OPTIMA-ID：开发和验证针对智障老年人的药物优化工具。

背景：智障老年人（即年龄≥40 岁）有独特的用药需求，可能会出现大量潜在的不当处方。尽管目前已有一些优化老年人处方的工具，但还没有专门用于智障老年人的综合工具。我们旨在为此开发一种工具：智障老年人优化药物治疗和改善用药（OPTIMA-ID）：研究设计与方法：根据文献综述和临床专业知识开发了工具草案。为完善该工具，与医护人员和智障人士开展了焦点小组讨论。该工具以电子形式提交给专家小组进行德尔菲验证。采用协议中值和第 75 百分位值来确定是否达成共识。对标准进行接受、拒绝、修改或删除，以制定最终工具：经过两轮德尔菲验证，就 67 项处方标准达成了共识，其中 63 项标准在第一轮验证后达成一致，另有 4 项标准在第二轮验证后被接受：结论：OPTIMA-ID 包含 67 项标准，可优化智障老年人的用药。结论：OPTIMA-ID 包含 67 项可优化智障老年人用药的标准，其有效性、可行性和对患者预后的影响有待确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.