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Expert consensus on clinical applicability of the American Geriatrics Society‐Beers Criteria to older persons in Africa: An exploratory validation study
Author(s) -
Saka Sule Ajibola,
Oosthuizen Frasia,
Nlooto Manimbulu
Publication year - 2020
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13339
Subject(s) - beers criteria , geriatrics , context (archaeology) , medicine , likert scale , family medicine , health care , delphi method , pharmacy , psychology , psychiatry , paleontology , developmental psychology , statistics , mathematics , economics , biology , economic growth
Rationale, aims and objectives There are currently no criteria to guide appropriate prescribing to older persons in Africa. Although the American Geriatrics Society‐Beers (AGS‐Beers) Criteria appear to be favoured by African researchers, there is a need to adapt its recommendations to the continent's health care systems. This study aimed to adapt the AGS‐Beers recommendations to Nigerian and South African health care contexts. Methods A modified Delphi technique was used to explore Nigerian and South African experts' consensus on the applicability of the 2015 AGS‐Beers Criteria recommendations to older persons in Africa. Thirty‐two recommendations, 21 from the parent Criteria and 11 modified, were explored among 10 purposively selected medical and pharmacy experts in a predetermined two‐round survey that utilized a 5‐point Likert scale. Consensus was defined as a lower‐limit 95% CI mean ratings of ≥3.0. Results Overall, the experts reached consensus on 62.5% (20/32) of the recommendations and 76.2% (16/21) of the parent AGS‐Beers' recommendations specifically. While the experts consensually agreed that medications with strong anticholinergic effects should be generally avoided in older persons, mean = 4.11 (SD = ±1.27, 95% CI, 3.14‐5.09), they could not reach a consensus on the context‐specific recommendation to avoid amitriptyline in neuropathic pain mean = 3.11 (SD = ±1.05, 95% CI, 2.30‐3.92). Conclusions The 2015 AGS‐Beers Criteria were adapted to the Nigerian and South African health care contexts. The adapted and the parent recommendations differed in their context specificity. The recommendations may serve as a guide to clinicians when prescribing medications to older persons in Nigeria and South Africa.