TABLE 1.
Consensus barrier statements with high importance
| TDF | Statements | Minimum | Median | Maxi‐mum | IQR |
|---|---|---|---|---|---|
| Physician‐related barriers | |||||
| Skills | Lack of research on older adults with multimorbidity.26 | Slightly (5%) | Very (60%) | Extremely (15%) | 1 |
| Environmental context and resources | Hesitancy in changing medications that have been prescribed in their current dosage for a long period, or when not the original prescriber.20 | Low (5%) | Very (35%) | Extremely (20%) | 1 |
| Intentions | Easier to maintain the status quo rather than interfere with drug regimens in a stable patient.27 | Neutral (5%) | Very (45%) | Extremely (15%) | 1 |
| Professional/social role and identity | Reluctance to interfere with medications that have been prescribed by a colleague or specialist (ie, hesitation in discontinuing medications prescribed by another physician).21 | Slightly (5%) | Very (45%) | Extremely (15%) | 1 |
| Patient‐related Barriers | |||||
| Knowledge | Patients do not understand what medications they are taking.17 | Slightly (5%) | Very (50%) | Extremely (10%) | 1 |
| Healthcare System–related Barriers | |||||
| Environmental context and resources | Patients follow up with multiple hospitals and receive medications from multiple providers.22 | Moderately (10%) | Very (55%) | Extremely (35%) | 1 |
| Increased specialization in healthcare (ie, focus on subspecialty‐based care instead of overall management).28 | Slightly (5%) | Very (50%) | Extremely (20%) | 1 | |
| Fragmentation of care, lack of a specific or unified physician to follow up with23 | Moderately (20%) | Very (55%) | Extremely (25%) | 1 | |
| Lack of coordination or communication between transitions and various levels of care across healthcare settings.21, 29 | Slightly (5%) | Very (40%) | Extremely (20%) | 1 | |
| Exclusion of multimorbid older adults in clinical trials.21 | Neutral (20%) | Very (55%) | Very (55%) | 1 | |
| Lack of ownership to assume responsibility for optimizing a specific patient's care plans.24 | Neutral (5%) | Very (65%) | Extremely (25%) | 1 | |