Priority Setting to Address the Geriatric Pharmacoparadox for Pain Management: A Nursing Home Stakeholder Delphi Study

For which topic were research priorities identified?

pain management

In which location was the research priority setting conducted?

North America - USA

Why was it conducted at all?

Evidence to guide clinical decision making for pain management in nursing home residents is scant.Given the numerous analgesic regimens, potential adverse effects, and comorbid conditions in nursing home residents, prioritizing the generation of knowledge that would be most useful to clinicians caring for these patients is necessary.

What was the objective?

to explore the extent of consensus among expert stakeholders regarding what analgesic issues should be prioritized for comparative-effectiveness studies of beneficial and adverse effects of analgesic regimens in nursing home residents

What was the outcome?

a ranking list of 6 research areas

How long did the research prioritization take?

No information provided.

Which methods were used to identify research priorities?


How were the priorities for research identified exactly?

Step 1: Delphi round 1: two stakeholder panels (nurses only and a mix of clinicians/researchers), participants rated the need for new evidence on 50 research topics. Step 2: Delphi round 2: participants asked to re-rate based on group mean ratings of round 2. Step 3: Delphi round 3: participants asked to re-rate

Which stakeholders took part?

Nurses, clinicians, researchers. 48 participants in at least one round (6 geriatricians, 4 nursing home administrators, 6 nurse practitioners, 18 nurses, 5 pain specialists, 3 pharmacists, 6 researchers): Delphi round 1: 42 participants. Delphi round 2: 28 participants. Delphi round 3: 17 participants.

How were stakeholders recruited?

A purposive quota sampling strategy was used. To recruit eligible experts and clinicians, the project team created a short online survey asking potential participants to express their interest in participation and to provide answers to basic demographic questions. The screening survey links were sent to participants either directly or through professional societies. The professional societies (or, in some cases, a member of that professional society) assisting the recruitment efforts included the American Geriatric Society (state affiliates), the Society for Post-Acute and Long-Term Care Medicine, the Gerontological Advanced Practice Nurses Association, the American Association of Colleges of Pharmacy, the Society of Pain and Palliative Care Phar macists, Academy Health, the Gerontological Society of America, and the Hospice and Palliative Nurses Association.

Were stakeholders actively involved or did they just participate?

Stakeholders were mere participants of the research prioritization process; they were not actively involved in the process.