Solution | Score | |
1 | Physicians 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 |
2 | A medication review should be an integral part of the care for patients at the end of life. (Awareness) | 130 |
3 | Physicians should discuss the end of life with the patient in a timely manner. (Roles) | 90 |
4 | Medication management at the end of life should be individualised, based on the patient's clinical situation. (Awareness – newly added in round 1) | 89 |
5 | Healthcare 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 |
6 | Education 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 |
7 | It 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 |
8 | Education in medication management at the end of life should be organised for healthcare professionals. (Education) | 61 |
9 | Healthcare professionals should be trained in the pharmacological treatment of symptoms at the end of life. (Education) | 60 |
10 | Palliative care specialists should be available for consultation regarding medication management for patients at the end of life. (Awareness) | 56 |
11 | A list of drugs with a high risk of inappropriateness at the end of life should be developed. (Research) | 54 |
12 | In 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 |
13 | It 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 |
14 | Patient 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 |
14 | At 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.