The use of goal attainment scaling during clinical medication review in older persons with polypharmacy

Sanne Verdoorn; Jeanet Blom; Timo Vogelzang; Henk-Frans Kwint; Jacobijn Gussekloo; Marcel L Bouvy

doi:10.1016/j.sapharm.2018.11.002

The use of goal attainment scaling during clinical medication review in older persons with polypharmacy

Sanne Verdoorn, Jeanet Blom, Timo Vogelzang, Henk-Frans Kwint, Jacobijn Gussekloo, Marcel L Bouvy

Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Studies have shown that a clinical medication review (CMR) reduces drug-related problems (DRPs), but the effects on clinical outcomes are less clear. Perhaps, CMRs in older persons could me more effective when they focus on patients' personal goals and health-related complaints.

OBJECTIVE: The aim of this study was to investigate whether goal attainment scaling (GAS) is a useful tool for determining goals and monitoring their attainment during CMR.

METHODS: This study was an analysis based on data of the intervention group of the DREAMeR-study; a randomised controlled trial investigating the effects of CMR in primary care. 315 persons aged ≥70 years using ≥7 drugs were randomised to the intervention: a CMR focused on personal goals using GAS. Outcome measures were: percentage of persons with health-related goals, attainment of goals measured with GAS-scores after three and six months, type of health-related goals and implementation rates of recommendations for GAS-related DRPs and other DRPs.

RESULTS: A total of 406 health-related goals were set for 283 of 315 included persons (90%). Of the 350 evaluated goals (86%), 37% was attained after three months and 43% after six months. The goals 'reduce pain' (n = 66, 16%), 'improve mobility' (n = 57, 14%) and 'reduce number of pills' (n = 37, 9.1%) were most prevalent. The implementation rate of recommendations for GAS-related DRPs was 81% compared to 62% for not GAS-related DRPs (p < 0.05).

CONCLUSION: Goal setting is important for prioritizing the most important problems during clinical medication review and Goal Attainment Scaling seems to be a useful tool for monitoring the attainment of these goals.

Original language	English
Pages (from-to)	1259-1265
Number of pages	7
Journal	Research in Social and Administrative Pharmacy
Volume	15
Issue number	10
DOIs	https://doi.org/10.1016/j.sapharm.2018.11.002
Publication status	Published - Oct 2019

Keywords

Older persons
Clinical medication review
Polypharmacy
Goal attainment scaling
Drug-related problems
Patient-centred care

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10.1016/j.sapharm.2018.11.002

attainmentFinal published version, 339 KBLicence: Taverne

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title = "The use of goal attainment scaling during clinical medication review in older persons with polypharmacy",

abstract = "BACKGROUND: Studies have shown that a clinical medication review (CMR) reduces drug-related problems (DRPs), but the effects on clinical outcomes are less clear. Perhaps, CMRs in older persons could me more effective when they focus on patients' personal goals and health-related complaints.OBJECTIVE: The aim of this study was to investigate whether goal attainment scaling (GAS) is a useful tool for determining goals and monitoring their attainment during CMR.METHODS: This study was an analysis based on data of the intervention group of the DREAMeR-study; a randomised controlled trial investigating the effects of CMR in primary care. 315 persons aged ≥70 years using ≥7 drugs were randomised to the intervention: a CMR focused on personal goals using GAS. Outcome measures were: percentage of persons with health-related goals, attainment of goals measured with GAS-scores after three and six months, type of health-related goals and implementation rates of recommendations for GAS-related DRPs and other DRPs.RESULTS: A total of 406 health-related goals were set for 283 of 315 included persons (90%). Of the 350 evaluated goals (86%), 37% was attained after three months and 43% after six months. The goals 'reduce pain' (n = 66, 16%), 'improve mobility' (n = 57, 14%) and 'reduce number of pills' (n = 37, 9.1%) were most prevalent. The implementation rate of recommendations for GAS-related DRPs was 81% compared to 62% for not GAS-related DRPs (p < 0.05).CONCLUSION: Goal setting is important for prioritizing the most important problems during clinical medication review and Goal Attainment Scaling seems to be a useful tool for monitoring the attainment of these goals.",

keywords = "Older persons, Clinical medication review, Polypharmacy, Goal attainment scaling, Drug-related problems, Patient-centred care",

author = "Sanne Verdoorn and Jeanet Blom and Timo Vogelzang and Henk-Frans Kwint and Jacobijn Gussekloo and Bouvy, {Marcel L}",

year = "2019",

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T1 - The use of goal attainment scaling during clinical medication review in older persons with polypharmacy

AU - Verdoorn, Sanne

AU - Blom, Jeanet

AU - Vogelzang, Timo

AU - Kwint, Henk-Frans

AU - Gussekloo, Jacobijn

AU - Bouvy, Marcel L

PY - 2019/10

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N2 - BACKGROUND: Studies have shown that a clinical medication review (CMR) reduces drug-related problems (DRPs), but the effects on clinical outcomes are less clear. Perhaps, CMRs in older persons could me more effective when they focus on patients' personal goals and health-related complaints.OBJECTIVE: The aim of this study was to investigate whether goal attainment scaling (GAS) is a useful tool for determining goals and monitoring their attainment during CMR.METHODS: This study was an analysis based on data of the intervention group of the DREAMeR-study; a randomised controlled trial investigating the effects of CMR in primary care. 315 persons aged ≥70 years using ≥7 drugs were randomised to the intervention: a CMR focused on personal goals using GAS. Outcome measures were: percentage of persons with health-related goals, attainment of goals measured with GAS-scores after three and six months, type of health-related goals and implementation rates of recommendations for GAS-related DRPs and other DRPs.RESULTS: A total of 406 health-related goals were set for 283 of 315 included persons (90%). Of the 350 evaluated goals (86%), 37% was attained after three months and 43% after six months. The goals 'reduce pain' (n = 66, 16%), 'improve mobility' (n = 57, 14%) and 'reduce number of pills' (n = 37, 9.1%) were most prevalent. The implementation rate of recommendations for GAS-related DRPs was 81% compared to 62% for not GAS-related DRPs (p < 0.05).CONCLUSION: Goal setting is important for prioritizing the most important problems during clinical medication review and Goal Attainment Scaling seems to be a useful tool for monitoring the attainment of these goals.

AB - BACKGROUND: Studies have shown that a clinical medication review (CMR) reduces drug-related problems (DRPs), but the effects on clinical outcomes are less clear. Perhaps, CMRs in older persons could me more effective when they focus on patients' personal goals and health-related complaints.OBJECTIVE: The aim of this study was to investigate whether goal attainment scaling (GAS) is a useful tool for determining goals and monitoring their attainment during CMR.METHODS: This study was an analysis based on data of the intervention group of the DREAMeR-study; a randomised controlled trial investigating the effects of CMR in primary care. 315 persons aged ≥70 years using ≥7 drugs were randomised to the intervention: a CMR focused on personal goals using GAS. Outcome measures were: percentage of persons with health-related goals, attainment of goals measured with GAS-scores after three and six months, type of health-related goals and implementation rates of recommendations for GAS-related DRPs and other DRPs.RESULTS: A total of 406 health-related goals were set for 283 of 315 included persons (90%). Of the 350 evaluated goals (86%), 37% was attained after three months and 43% after six months. The goals 'reduce pain' (n = 66, 16%), 'improve mobility' (n = 57, 14%) and 'reduce number of pills' (n = 37, 9.1%) were most prevalent. The implementation rate of recommendations for GAS-related DRPs was 81% compared to 62% for not GAS-related DRPs (p < 0.05).CONCLUSION: Goal setting is important for prioritizing the most important problems during clinical medication review and Goal Attainment Scaling seems to be a useful tool for monitoring the attainment of these goals.

KW - Older persons

KW - Clinical medication review

KW - Polypharmacy

KW - Goal attainment scaling

KW - Drug-related problems

KW - Patient-centred care

U2 - 10.1016/j.sapharm.2018.11.002

DO - 10.1016/j.sapharm.2018.11.002

M3 - Article

C2 - 30425008

SN - 1551-7411

VL - 15

SP - 1259

EP - 1265

JO - Research in Social and Administrative Pharmacy

JF - Research in Social and Administrative Pharmacy

IS - 10

ER -

The use of goal attainment scaling during clinical medication review in older persons with polypharmacy

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Keywords

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