Korean J Clin Pharm.
2022 Sep;32(3):260-269. 10.24304/kjcp.2022.32.3.260.
Development of Eligibility Criteria for Comprehensive Medication Management Programs in Long-term Care Facilities Using RAND/UCLA Appropriateness Method
- Affiliations
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- 1College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon 21936, Republic of Korea
- 2Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
- 3College of Pharmacy, Yeungnam University, Gyeongsangbuk-do 38541, Republic of Korea
- 4College of Pharmacy, Seoul National University, Seoul 08826, Republic of Korea
- 5College of Medicine, Chung-Ang University, Seoul 06974, Republic of Korea
- KMID: 2533905
- DOI: http://doi.org/10.24304/kjcp.2022.32.3.260
Abstract
- Background
Comprehensive medication management is essential to achieve safe and optimal drug use for the elderly in long-term care facilities (LTCF). This study aimed to develop eligibility criteria for ”Comprehensive medication management program in LTCF” using the RAND/UCLA Appropriateness Method (RAM). Furthermore, we attempted to estimate the number of beneficiaries who met the criteria by analyzing the National Health Insurance claims data.
Methods
Twelve criteria were selected initially. We composed a panel of 14 experts with expertise in long-term care. We conducted two survey rounds to reach a consensus. Rating for appropriateness and decision regarding agreement were applied per RAM. We analyzed the National Health Insurance data to estimate the number of LTCF residents who met each eligibility criterion.
Results
Of the 11 items agreed upon, ten items were determined to be appropriate. In 2018, 83.6% of 165,994 residents of LTCF met one or more eligibility criteria. The largest number of subjects met the “New residents of LTCF” criterion, followed by “Take high-alert drugs” and “Chronic excessive polypharmacy.” Since the items evaluated as most appropriate by the expert panel and those with a large number of subjects were similar, we confirmed the external validity of our criteria.
Conclusion
It is worth noting that this is the first attempt to establish the eligibility criteria for medication management in LTCF. Further preliminary research is needed to identify the selected subjects' drugrelated problems and revise the criteria according to the results.
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