Recommendations for Preventing Medication Diversion and Misuse in Hospice Care: A Modified Delphi Study

Recommendations are needed to help minimize the risks of medication diversion and misuse in the hospice setting. To identify recommendations that could help prevent medication diversion and misuse in hospice care. A modified Delphi method was utilized. An interdisciplinary panel of ten experts engag...

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Bibliographic Details
Published in:Journal of pain and symptom management 2021-12, Vol.62 (6), p.1175-1187
Main Authors: Ware, Orrin, McPherson, Mary Lynn, Barclay, Joshua S., Blackhall, Leslie, Emmett, Catherine P., Hilliard, Russell, Schenker, Yael, Shega, Joseph W., Guralnik, Jack, Cagle, John G.
Format: Article
Language:English
Subjects:
Consensus
Controlled substances
Delphi
Delphi method
Delphi Technique
Diversion
Drug administration
Drugs
Endorsements
Experts
Health education
Hospice
Hospice Care
Hospices
Humans
Interdisciplinary aspects
Job applicants
Medical malpractice
Medical screening
Misuse
Patient safety
Prevention
Prevention programs
Quality of care
Recommendations
Risk reduction
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Summary:Recommendations are needed to help minimize the risks of medication diversion and misuse in the hospice setting. To identify recommendations that could help prevent medication diversion and misuse in hospice care. A modified Delphi method was utilized. An interdisciplinary panel of ten experts engaged in three phases of online and in-person voting regarding recommendations. Consensus for recommendations required a minimum of 80% endorsement by the panel experts. After two rounds of voting and several rounds of informal voting, 15 total recommendations were endorsed. Fifteen recommendations achieved at least 80% endorsement during the final round of voting. Each of the following recommendation topics received ≥ 80% endorsement, the need to balance prevention efforts with quality care, screening clinical job candidates, family education and screening, medication monitoring, responding to missing/diverted medications, and medication disposal. Panelists rated the Patient & Family Education recommendation as most important (M = 9.7; SD = 0.7) followed closely by Responding to Medication Diversion or Misuse (M = 9.5; SD = 1.1). These recommendations were created by experts in the field to reduce the risk of medication diversion and misuse. Further steps towards implementation may appropriately reduce these risks.
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2021.06.004