Purpose: Chronic non-cancer pain (CNCP) affects up to 88% of older adults. Pharmacological therapies are frequently prescribed long-term despite being considered second-line treatments and carrying significant risks, particularly for older adults. The present study aimed to clinically validate a set of quality indicators (QIs) that are used to improve the detection of medication-related problems during medication reviews performed by pharmacists for older adult inpatients with CNCP. Patients and Methods: We evaluated a set of medication review QIs—with previously established face and content validity—for a population of older adult inpatients diagnosed with CNCP. Subjects were in geriatrics wards in a tertiary hospital in Switzerland. Over two phases, pre- and post-QI implementation (Phase 1: July 2023 to April 2024, Phase 2: January to May 2025), pharmacists evaluated QIs for their applicability to the population, potential to improve medication reviews, acceptability by pharmacists, implementation issues and impact. These domains were used to evaluate the measurement properties of QIs in clinical practice, acting as proxies for clinical validity. Evaluations were interpreted using descriptive statistics. Results: We included 89 patients in phase 1 and 48 in phase 2. Of the 38 QIs evaluated, 27 (71%) were applicable to ≥ 5% of patients, 21 (55%) showed the potential to improve medication reviews, 12 (32%) revealed relevant treatment discrepancies that pharmacists accepted, 6 (16%) were rated as problematic to implement, 10 (37%) were impactful according to our predefined criterion and 6 (16%) met all criteria. Conclusion: The clinical evaluation of our set of previously developed QIs could help pharmacists to efficiently detect medication-related problems among vulnerable older adult populations with CNCP. The fact that only a few of the QIs were clinically valid means that future research is required, including the measurement of the influence of these QIs on patient-reported outcomes. Keywords: medication safety, chronic non-cancer pain, older adults, clinical pharmacy, quality indicators
Abderhalden et al. (Sun,) studied this question.