• Orrin Ware, Mary Lynn McPherson, Joshua S Barclay, Leslie Blackhall, Catherine P Emmett, Russell Hilliard, Yael Schenker, Joseph W Shega, Jack Guralnik, and John G Cagle.
• Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
• J Pain Symptom Manage. 2021 Dec 1; 62 (6): 1175-1187.

ContextRecommendations are needed to help minimize the risks of medication diversion and misuse in the hospice setting.ObjectiveTo identify recommendations that could help prevent medication diversion and misuse in hospice care.MethodsA modified Delphi method was utilized. An interdisciplinary panel of ten experts engaged in three phases of online and in-person voting regarding recommendations. Consensus for recommendations required a minimum of 80% endorsement by the panel experts. After two rounds of voting and several rounds of informal voting, 15 total recommendations were endorsed.ResultsFifteen recommendations achieved at least 80% endorsement during the final round of voting. Each of the following recommendation topics received ≥ 80% endorsement, the need to balance prevention efforts with quality care, screening clinical job candidates, family education and screening, medication monitoring, responding to missing/diverted medications, and medication disposal. Panelists rated the Patient & Family Education recommendation as most important (M = 9.7; SD = 0.7) followed closely by Responding to Medication Diversion or Misuse (M = 9.5; SD = 1.1).ConclusionThese recommendations were created by experts in the field to reduce the risk of medication diversion and misuse. Further steps towards implementation may appropriately reduce these risks.Copyright © 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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