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A Delphi process to address medication appropriateness for older persons with multiple chronic conditions

Overview of attention for article published in BMC Geriatrics, March 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (80th percentile)
  • Good Attention Score compared to outputs of the same age and source (73rd percentile)

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15 X users

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Title
A Delphi process to address medication appropriateness for older persons with multiple chronic conditions
Published in
BMC Geriatrics, March 2016
DOI 10.1186/s12877-016-0240-3
Pubmed ID
Authors

Terri R. Fried, Kristina Niehoff, Jennifer Tjia, Nancy Redeker, Mary K. Goldstein

Abstract

Frameworks exist to evaluate the appropriateness of medication regimens for older patients with multiple medical conditions (MCCs). Less is known about how to translate the concepts of the frameworks into specific strategies to identify and remediate inappropriate regimens. Modified Delphi method involving iterative rounds of input from panel members. Panelists (n = 9) represented the disciplines of nursing, medicine and pharmacy. Included among the physicians were two geriatricians, one general internist, one family practitioner, one cardiologist and two nephrologists. They participated in 3 rounds of web-based anonymous surveys. The panel reached consensus on a set of markers to identify problems with medication regimens, including patient/caregiver report of non-adherence, medication complexity, cognitive impairment, medications identified by expert opinion as inappropriate for older persons, excessively tight blood sugar and blood pressure control among persons with diabetes mellitus, patient/caregiver report of adverse medication effects or medications not achieving desired outcomes, and total number of medications. The panel also reached consensus on approaches to address these problems, including endorsement of strategies to discontinue medications with known benefit if necessary because of problems with feasibility or lack of alignment with patient goals. The results of the Delphi process provide the basis for an algorithm to improve medication regimens among older persons with MCCs. The algorithm will require assessment not only of medications and diagnoses but also cognition and social support, and it will support discontinuation of medications both when risks outweigh benefits and when regimens are not feasible or do not align with goals.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 100 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 1%
Unknown 99 99%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 14 14%
Student > Master 13 13%
Student > Bachelor 10 10%
Other 9 9%
Researcher 7 7%
Other 24 24%
Unknown 23 23%
Readers by discipline Count As %
Nursing and Health Professions 19 19%
Medicine and Dentistry 17 17%
Pharmacology, Toxicology and Pharmaceutical Science 8 8%
Psychology 7 7%
Social Sciences 5 5%
Other 12 12%
Unknown 32 32%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 April 2016.
All research outputs
#3,642,228
of 23,128,387 outputs
Outputs from BMC Geriatrics
#917
of 3,270 outputs
Outputs of similar age
#57,331
of 300,197 outputs
Outputs of similar age from BMC Geriatrics
#13
of 46 outputs
Altmetric has tracked 23,128,387 research outputs across all sources so far. Compared to these this one has done well and is in the 84th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,270 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.4. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 300,197 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 80% of its contemporaries.
We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.