Table 1

Top 15 solutions based on their ranking score (and their category)

SolutionScore
1Physicians should discuss the wishes, treatment goals and priorities regarding medication management at the end of life with the patient in a timely manner. (Roles)133
2A medication review should be an integral part of the care for patients at the end of life. (Awareness)130
3Physicians should discuss the end of life with the patient in a timely manner. (Roles)90
4Medication management at the end of life should be individualised, based on the patient's clinical situation. (Awareness – newly added in round 1)89
5Healthcare professionals should be trained in communicating with patients and/or their family about decision making on medication management at the end of life. (Education)74
6Education in medication management at the end of life should be incorporated in all medical training (nursing school, medical students, residencies and fellowships). (Education – newly added in round 1)71
7It should be discussed with the patient and/or family that the goal of medication management at the end of life is improving/maintaining the quality of life. (Communication)70
8Education in medication management at the end of life should be organised for healthcare professionals. (Education)61
9Healthcare professionals should be trained in the pharmacological treatment of symptoms at the end of life. (Education)60
10Palliative care specialists should be available for consultation regarding medication management for patients at the end of life. (Awareness)56
11A list of drugs with a high risk of inappropriateness at the end of life should be developed. (Research)54
12In communicating about medication management at the end of life nurses and physicians should take into account the norms and values of the patient and/or family. (Communication)52
13It should be discussed with the patient and/or family how the medication can be adjusted at the end of life and what can be expected of these changes. (Communication)37
14Patient or proxy based assessment tools (eg, ESAS, EORTC, symptom diary, PPS and PPI) should be used to aid symptom assessment and treatment at the end of life. (Tools)36
14At the end of life each drug should be revised for its potential congruence with the clinical aims of the specific situation in a specific patient. (Research – newly added in round 1)36
  • EORTC, European Organization for Research and Treatment of Cancer ; ESAS, Edmonton Symptom Assessment Scale; PPI, Palliative Prognostic Index; PPS, Palliative Performance Scale.