Table 4 Consensus on the inappropriateness of modified prescribing scenarios rated in the second round of the e-Delphi survey
No | Modified scenario | Round 2 | Round 2 modified | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Median (30th, 70th) | Number of ratings | Agreement (index) | Median (30th, 70th) | Number of ratings | Agreement (index) | ||||||
1–3 | 4–6 | 7–9 | 1–3 | 4–6 | 7–9 | ||||||
2 | Persistent prescription of opioid analgesics during pregnancy | 3 (2, 3) | 17 | 2 | 0 | A/IA (0.330) | 2 (2, 2) | 18 | 0 | 1 | A/IA (0.203) |
3 | Persistent prescription of opioid analgesics for a patient with untreated hypothyroidism | 5 (4, 6) | 4 | 12 | 3 | Neutral (0.599) | 4 (2, 4) | 9 | 8 | 2 | Neutral (0.479) |
6 | Persistent prescription of opioid analgesics to a patient with severe chronic obstructive pulmonary disease or asthma | 4 (3, 4) | 9 | 9 | 1 | Neutral (0.440) | 3 (2, 3) | 14 | 5 | 0 | A/IAa (0.330) |
7 | Persistent prescription of tramadol or tapentadol with carbamazepine, phenytoin, or phenobarbital in a patient with epilepsy | 3 (3, 5) | 10 | 8 | 1 | A/IA (0.359) | 2 (2, 3) | 15 | 4 | 0 | A/IA (0.220) |
9 | Persistent prescription of tramadol, tapentadol, fentanyl, dextromethorphan, and pethidine with selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors | 4 (3, 5) | 6 | 11 | 2 | Neutral (0.479) | 3 (2, 3) | 14 | 4 | 1 | A/IAa (0.330) |
Prescription of tramadol, tapentadol, fentanyl, dextromethorphan, and pethidine with a monoamine oxidase inhibitor (MAOI), including the 14 days following the withdrawal of an MAOI | 2 (2, 4) | 13 | 3 | 3 | A/IAa (0.240) | ||||||
10 | Persistent prescription of opioid analgesics with a benzodiazepine | 3 (2, 3) | 14 | 4 | 1 | A/IA (0.330) | 2 (2, 3) | 17 | 1 | 1 | A/IA (0.220) |
11 | Persistent prescription of opioid analgesics with a gabapentinoid, i.e. gabapentin or pregabalin | 4 (3, 4) | 9 | 10 | 0 | Neutral (0.440) | 3 (2, 4) | 12 | 7 | 0 | A/IAa (0.359) |
12 | Prescription of opioid analgesics to a patient with galactose intolerance, lactase deficiency, or glucose-galactose malabsorption | 5 (3, 5) | 6 | 13 | 0 | Neutral (0.599) | 5 (5, 5) | 5 | 14 | 0 | Neutral (0.508) |
13 | Persistent prescription of opioid analgesics without a concurrently prescribed laxative | 2 (2, 2) | 18 | 1 | 0 | A/IA (0.203) | 2 (2, 3) | 14 | 5 | 0 | A/IA (0.220) |
16 | Persistent prescription of one or more opioid analgesics at a total morphine equivalent load above 120 mg per day | 2 (2, 2) | 19 | 0 | 0 | A/IA (0.203) | 2 (2, 2) | 19 | 0 | 0 | A/IA (0.203) |
17 | Persistent prescription of opioid analgesics following the patient’s discharge from the hospital after surgery | 2 (2, 2) | 19 | 0 | 0 | A/IA (0.203) | 2 (2, 2) | 19 | 0 | 0 | A/IA (0.203) |
19 | Persistent prescription of opioid analgesics in a patient aged over 65 years with a medical history of falling | 2 (2, 2) | 18 | 1 | 0 | A/IA (0.203) | 2 (2, 3) | 17 | 2 | 0 | A/IA (0.220) |