Table 7 |
||||
|
Delphi study priority ratings by the 26 panellists |
||||
|
Topic |
Median |
Mean |
Priority |
|
|
|
||||
|
Accepted as priorities |
||||
|
|
||||
|
Quality |
||||
|
Q 16 |
Not using inhaled corticosteroids in patients with uncontrolled asthma |
8 |
8.0 |
++ |
|
Q 15 |
Not using oral anticoagulants in patients with AF and high risk of stroke |
8 |
7.9 |
++ |
|
Q 11 |
Not using ACEIs or ARBs in patients with a history of chronic heart failure |
8 |
7.9 |
++ |
|
Q 14 |
Not using thrombo-embolic prophylaxis in AF patients at low/moderate risk of stroke |
8 |
7.7 |
++ |
|
Q 5 |
Not using ACEIs or ARBs in patients with DM and renal complications |
8 |
7.7 |
++ |
|
Q 12 |
Not using beta blockers in patients with a history of chronic heart failure |
8 |
7.7 |
++ |
|
Q 4 |
Not using metformin as first line antidiabetic in overweight type 2 diabetics |
8 |
7.6 |
++ |
|
Q 8 |
Not using antiplatelets in patients at risk of vascular events |
7 |
7.5 |
+ |
|
Q 6 |
Not using statins in patients at high risk of cardiovascular events |
7 |
7.4 |
+ |
|
Q 17 |
Not using bone sparing agents in female patients at high risk of fractures |
7 |
7.3 |
+ |
|
Q 3 |
Low intensity antidiabetic treatment despite suboptimal HbA1c control |
7 |
7.2 |
+ |
|
Q 10 |
Not using ACEIs or ARBs in patients with a history of ACS |
7 |
7.0 |
+ |
|
Q 2 |
Low intensity antihypertensive treatment despite suboptimal BP control |
7 |
6.9 |
+ |
|
Q 9 |
Not using beta blockers in coronary heart disease |
7 |
6.8 |
+ |
|
Q 7 |
Underdosing of statins in patients at high risk of cardiovascular events |
7 |
6.7 |
+ |
|
Safety |
||||
|
S 20 |
Using MTX without taking precautionary action to prevent patient overdosing |
9 |
8.4 |
++ |
|
S 1 |
Not using gastro-protection in oral NSAIDs/antiplatelets users at high risk of bleeding |
8 |
8.2 |
++ |
|
S 3 |
Using oral NSAIDs in patients at increased risk of renal failure |
8 |
7.9 |
++ |
|
S 21 |
Inconsistent monitoring of FBC in patients on DMARDs |
8 |
7.8 |
++ |
|
S 27 |
Using sedatives, antipsychotics, anticholinergics in elderly patients |
7 |
7.3 |
+ |
|
S 19 |
Using bone protection in users of long term oral corticosteroids |
7 |
7.3 |
+ |
|
S 23 |
Excess duration of female hormones in patients at risk of gynaecological cancer |
7 |
7.3 |
+ |
|
S 10 |
Excess duration of potassium supplements and potassium sparing diuretics |
7 |
7.2 |
+ |
|
S 28 |
Using drugs to avoid in patients with heart failure |
7 |
7.1 |
+ |
|
S 18 |
Excessive dosing of digoxin in patients susceptible to digoxin toxicity |
7 |
7.1 |
+ |
|
S 24 |
Inconsistent monitoring of thyroid function in patients prescribed amiodarone |
7 |
7.0 |
+ |
|
S 6 |
Inconsistent monitoring of U&Es in patients at risk of electrolyte imbalance |
7 |
7.0 |
+ |
|
S 14 |
Co-prescribing beta blockers and rate-limiting calcium channel blockers |
7 |
6.9 |
+ |
|
S 25 |
Using theophylline in elderly COPD patients without a compelling indication |
7 |
6.9 |
+ |
|
S 15 |
Using beta blockers in patients with active asthma |
7 |
6.8 |
+ |
|
S 13 |
Not using of laxatives in strong opioid users |
7 |
6.8 |
+ |
|
S 29 |
Using drugs to avoid in children and young adults |
7 |
6.7 |
+ |
|
S 5 |
Using COX II inhibitors in patients at high risk of cardiovascular events |
7 |
6.6 |
+ |
|
S 7 |
Using thiazide diuretics in patients with a history of CKD |
7 |
6.6 |
+ |
|
S 17 |
Using long acting sulphonylureas in patients at risk of hypoglycaemia |
7 |
6.6 |
+ |
|
S 4 |
Using COX II inhibitors without compelling indication (low dose aspirin users) |
7 |
6.4 |
+ |
|
S 16 |
Using metformin in patients with CKD |
7 |
6.4 |
+ |
|
S 26 |
Excessive dosing of statins in patients on interacting drugs |
7 |
6.3 |
+ |
|
|
||||
|
Not scored as priorities for medication improvement |
||||
|
|
||||
|
Quality |
||||
|
Q 13 |
Inadequate dose titration of ACEI, ARBs and BBs in chronic heart failure |
6 |
6.2 |
|
|
Q 1 |
Not using first line antihypertensives when initiating treatment for high blood pressure |
6 |
6.4 |
|
|
Q 18 |
Not using calcium/vitamin D supplementation in female elderly patients |
6 |
6.4 |
|
|
Safety |
||||
|
S 2 |
Using oral NSAIDs in the elderly without compelling indication (no previous trial of full dose paracetamol) |
6 |
6.6 |
|
|
S 9 |
Using of aldosterone antagonists in patients with a history of CKD |
6 |
6.5 |
|
|
S 11 |
Co-prescribing anti-infectives with high risk of affecting INR in patients on warfarin |
6 |
6.4 |
|
|
S 12 |
Using warfarin without a compelling indication in AF with low risk of stroke |
6 |
6.3 |
|
|
S 22 |
Using HRT in female patients at high risk of cardiovascular events |
6 |
6.2 |
|
|
S 8 |
Not using allopurinol in thiazide users with a history of gout |
6 |
5.8 |
|
|
|
||||
|
Topics are ranked by median scores. Clusters of topics with the same median are ranked in descending order of mean score. Topics with a median of 8 or higher ('high priority') are coded '++' and those with a median of 7 ('priority') '+'. |
||||
|
Dreischulte et al. BMC Clinical Pharmacology 2012 12:5 doi:10.1186/1472-6904-12-5 |
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