The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE)
Abstract Background The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical healt...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-022-04235-0 |
| _version_ | 1817994129088446464 |
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| author | Aoife Carolan Dolores Keating Stephen McWilliams Caroline Hynes Mary O’Neill Fiona Boland Sharon Holland Judith Strawbridge Cristín Ryan |
| author_facet | Aoife Carolan Dolores Keating Stephen McWilliams Caroline Hynes Mary O’Neill Fiona Boland Sharon Holland Judith Strawbridge Cristín Ryan |
| author_sort | Aoife Carolan |
| collection | DOAJ |
| description | Abstract Background The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical health of people with SMI. The aim of our research was to design and validate a medicines optimisation tool (OPTIMISE) to help clinicians to optimise physical health in people with SMI. Methods A review of existing published guidelines, PubMed and Medline was carried out. Literature was examined for medicines optimisation recommendations and also for reference to the management of physical illness in people with mental illness. Potential indicators were grouped according to physiological system. A multidisciplinary team with expertise in mental health and the development of screening tools agreed that 83 indicators should be included in the first draft of OPTIMISE. The Delphi consensus technique was used to develop and validate the contents. A 17-member multidisciplinary panel of experts from the UK and Ireland completed 2 rounds of Delphi consensus, rating their level of agreement to 83 prescribing indicators using a 5-point Likert scale. Indicators were accepted for inclusion in the OPTIMISE tool after achieving a median score of 1 or 2, where 1 indicated strongly agree and 2 indicated agree, and 75th centile value of ≤ 2. Interrater reliability was assessed among 4 clinicians across 20 datasets and the chance corrected level of agreement (kappa) was calculated. The kappa statistic was interpreted as poor if 0.2 or less, fair if 0.21–0.4, moderate if 0.41–0.6, substantial if 0.61–0.8, and good if 0.81–1.0. Results Consensus was achieved after 2 rounds of Delphi for 62 prescribing indicators where 53 indicators were accepted after round 1 and a further 9 indicators were accepted after round 2. Interrater reliability of OPTIMISE between physicians and pharmacists indicated a substantial level of agreement with a kappa statistic of 0.75. Conclusions OPTIMISE is a 62 indicator medicines optimisation tool designed to assist decision making in those treating adults with SMI. It was developed using a Delphi consensus methodology and interrater reliability is substantial. OPTIMISE has the potential to improve medicines optimisation by ensuring preventative medicines are considered when clinically indicated. Further research involving the implementation of OPTIMISE is required to demonstrate its true benefit. Trial registration This article does not report the results of a health care intervention on human participants. |
| first_indexed | 2024-04-14T01:47:46Z |
| format | Article |
| id | doaj.art-81fe0c965b0e4de09c8edf6866871aa0 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-14T01:47:46Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-81fe0c965b0e4de09c8edf6866871aa02022-12-22T02:19:27ZengBMCBMC Psychiatry1471-244X2022-09-0122111510.1186/s12888-022-04235-0The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE)Aoife Carolan0Dolores Keating1Stephen McWilliams2Caroline Hynes3Mary O’Neill4Fiona Boland5Sharon Holland6Judith Strawbridge7Cristín Ryan8Saint John of God HospitalSaint John of God HospitalSaint John of God HospitalSaint John of God HospitalTallaght University HospitalData Science Centre, Royal College of Surgeons in IrelandNorthumberland, Tyne and Wear NHS Foundation TrustSchool of Pharmacy and Biomolecular Science, Royal College of Surgeons IrelandSchool of Pharmacy and Pharmaceutical SciencesAbstract Background The life expectancy of people with severe mental illness (SMI) is shorter than those without SMI, with multimorbidity and poorer physical health contributing to health inequality. Screening tools could potentially assist the optimisation of medicines to protect the physical health of people with SMI. The aim of our research was to design and validate a medicines optimisation tool (OPTIMISE) to help clinicians to optimise physical health in people with SMI. Methods A review of existing published guidelines, PubMed and Medline was carried out. Literature was examined for medicines optimisation recommendations and also for reference to the management of physical illness in people with mental illness. Potential indicators were grouped according to physiological system. A multidisciplinary team with expertise in mental health and the development of screening tools agreed that 83 indicators should be included in the first draft of OPTIMISE. The Delphi consensus technique was used to develop and validate the contents. A 17-member multidisciplinary panel of experts from the UK and Ireland completed 2 rounds of Delphi consensus, rating their level of agreement to 83 prescribing indicators using a 5-point Likert scale. Indicators were accepted for inclusion in the OPTIMISE tool after achieving a median score of 1 or 2, where 1 indicated strongly agree and 2 indicated agree, and 75th centile value of ≤ 2. Interrater reliability was assessed among 4 clinicians across 20 datasets and the chance corrected level of agreement (kappa) was calculated. The kappa statistic was interpreted as poor if 0.2 or less, fair if 0.21–0.4, moderate if 0.41–0.6, substantial if 0.61–0.8, and good if 0.81–1.0. Results Consensus was achieved after 2 rounds of Delphi for 62 prescribing indicators where 53 indicators were accepted after round 1 and a further 9 indicators were accepted after round 2. Interrater reliability of OPTIMISE between physicians and pharmacists indicated a substantial level of agreement with a kappa statistic of 0.75. Conclusions OPTIMISE is a 62 indicator medicines optimisation tool designed to assist decision making in those treating adults with SMI. It was developed using a Delphi consensus methodology and interrater reliability is substantial. OPTIMISE has the potential to improve medicines optimisation by ensuring preventative medicines are considered when clinically indicated. Further research involving the implementation of OPTIMISE is required to demonstrate its true benefit. Trial registration This article does not report the results of a health care intervention on human participants.https://doi.org/10.1186/s12888-022-04235-0Mental IllnessMedicines OptimisationPhysical HealthScreening ToolSevere Mental Illness |
| spellingShingle | Aoife Carolan Dolores Keating Stephen McWilliams Caroline Hynes Mary O’Neill Fiona Boland Sharon Holland Judith Strawbridge Cristín Ryan The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE) BMC Psychiatry Mental Illness Medicines Optimisation Physical Health Screening Tool Severe Mental Illness |
| title | The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE) |
| title_full | The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE) |
| title_fullStr | The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE) |
| title_full_unstemmed | The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE) |
| title_short | The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE) |
| title_sort | development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness optimise |
| topic | Mental Illness Medicines Optimisation Physical Health Screening Tool Severe Mental Illness |
| url | https://doi.org/10.1186/s12888-022-04235-0 |
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