Content validation of explicit clinical criteria for deprescribing antihypertensive medications in older adults: a modified Delphi study.

PURPOSE: Deprescribing antihypertensive medications in older adults can prevent potentially serious adverse effects, especially in those who are frail. However, explicit clinical criteria to guide healthcare providers in making such complex decisions are lacking. The aim of this study was to validate a set of proposed explicit clinical criteria for supporting the deprescribing of antihypertensive medications in older adults.

METHODS

The modified Delphi consensus technique was employed in two stages using questionnaires to systematically gather and analyse expert opinions on explicit antihypertensive deprescribing criteria.

RESULTS

Eight experts completed the first round of the Delphi technique and seven completed the second round. A strong consensus among the expert panel was achieved for most of the proposed clinical criteria. No consensus was reached on criteria involving target blood pressure levels for individuals aged 75 years and older, the presence of asymptomatic orthostatic hypotension, and the use of calcium channel blockers in cases of chronic constipation.

CONCLUSION

The criteria validated in this study can be considered a decision support tool to avoid aggressive treatment and symptoms of hypotension in older adults.