1508 OLDER PATIENTS’ ADHERENCE TO APPROPRIATE POLYPHARMACY: CHALLENGES, STRATEGIES AND OUTCOMES OF IMPORTANCE TO STAKEHOLDERS

Introduction Older patients often struggle to manage and take polypharmacy. Intervention studies have measured a variety of outcomes to improve adherence to polypharmacy. However, the scarcity of well-designed trials and inconsistencies in outcomes reported and measured have resulted in low-quality evidence. It is now recommended that researchers consider using a Core Outcome Set (COS); the minimum number of outcomes that should be measured and reported in all studies in a specific area. This study explored stakeholders’ perspectives regarding the challenges older patients face when taking polypharmacy, potential strategies to address such challenges, and outcomes of importance with a view to developing a COS for studies focusing on adherence to appropriate polypharmacy. Method Semi-structured virtual and telephone interviews were convened with relevant stakeholders, recruited through several approaches. Interview topic guides sought information on challenges and strategies associated with adherence to polypharmacy. A list of potential outcomes (n=7) associated with adherence research (derived from a previous Cochrane review and two other relevant studies) was presented to participants for comment. Content analysis of audio-recorded and transcribed interviews identified key themes on challenges, strategies and outcomes. Results Participants (15 academics, eight healthcare professionals, and six public participants) identified 11 challenges (encompassing medication, healthcare system, patient and socioeconomic issues) and 16 educational and behavioural strategies relevant to polypharmacy. They agreed that the seven outcomes presented to them were important and suggested six additional outcomes, generating a final list of 13 outcomes for potential use in trials focusing on adherence to appropriate polypharmacy. Conclusion(s) A range of challenges associated with polypharmacy was reported by participants, and a suite of strategies was suggested to address these challenges. The list of 13 outcomes will be used to inform the development of a COS for trials targeting interventions aiming to improve adherence to appropriate polypharmacy in older patients.