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(European Journal of Clinical Pharmacology, 2014-05-14) Dimitrow, Maarit S.; Mykkänen, Sanna I.; Saija N. S., Leikola; Kivelä, Sirkka-Liisa; Lyles, Alan; Airaksinen, Marja S. A.
Purpose Home care services are becoming a critically
important part of health care delivery as populations
are aging. Those using home care services are increasingly
older, more frail than previously, and use multiple
medications, making them vulnerable to drug-related
problems (DRPs). Practical nurses (PN) visit homedwelling
aged clients frequently and, thus, are ideally
situated to identify potential DRPs and, if needed, to
communicate them to physicians for resolution. This
study developed and validated the content of a tool to
be used by PNs for assessing DRP risks for their homedwelling
clients aged ≥65 years.
Methods The first draft of the tool was based on two systematic
literature reviews and clinical experience of our research
group. Content validity of the tool was determined by a threeround
Delphi survey with a panel of 18 experts in geriatric
care and pharmacotherapy. An agreement by ≥80 % of the
panel on an item was required.
Results The final tool consists of 18 items that assess risks for
DRPs in home-dwelling aged clients. It is divided into four
sections: (1) Basic Client Data, (2) Potential Risks for DRPs in
Medication Use, (3) Characteristics of the Client’s Care and
Adherence, and (4) Recommendations for Actions to Resolve
Conclusions The Delphi process resulted in a structured DRP
Risk Assessment Tool that is focused on the highest priority
DRPs that should be identified and resolved. The tool also
assists the PNs to identify solutions to these problems, which
is a unique feature compared to similarly purposed prior tools.