Consensus Building Research Articles

Priority setting for nutrition research in individuals with spinal cord injury: A protocol for Delphi study among health professionals.

A protocol for Delphi Consensus Study. To identify a top ten list of priorities for future nutrition research in individuals with spinal cord injury (SCI). The International Spinal Cord Society (ISCoS) Nutrition Specialist Interest Group (SIG) priority setting partnership was established in 2024 to conduct this international Delphi study through online surveys and a hybrid meeting. The study involves THREE key stages: topic generation, priority ranking, and consensus building. In phase 1, participants will generate potential research topics via an online survey. Phase 2 involves ranking the top 10 research priorities on a 9-point Likert scale. Phase 3 consists of a consensus meeting where stakeholders will engage in discussions and vote on the final priorities using interactive tools. For Phases 1 and 2, both ISCoS Nutrition SIG members and their professional contacts will be invited to participate, ensuring a diverse pool of expertise. Phase 3 will be limited to Nutrition SIG members to facilitate focused decision-making. Data will be collected through secure Qualtrics surveys and analysed using descriptive statistics in STATA or SPSS. The study adheres to the Conducting and Reporting of DElphi Studies (CREDES) recommendations and employs rigorous data management practices compliant with City St George's, University of London standards. Ethics approval has been granted (ref: ETH2425-0192, Health Services Research & Management Proportionate Review Committee, City St George's, University of London). The findings will be disseminated through ISCoS website, professional conferences and a peer-reviewed journal.

The Challenge of Legitimacy and Governance in Fragile States: A Case Study of Afghanistan

ABSTRACT Why – despite decades of effort and investment by state and non-state actors – has the Afghan state suffered repeated legitimacy crises? This paper aims to address this question by theorizing the unique importance of performance legitimacy in creating consensus and support for state institutions in a fragile context. The concept of performance- legitimacy is contrasted with traditional views of state legitimacy – social contract theories, Weberian approaches, and process-based legitimacy, deepening our understanding of what legitimacy is and how it is built in fragile states. The study explores the case of Afghanistan, particularly after 2001 state formation, demonstrating how a Western focus on the wrong “types” of legitimation led to a state that could not develop sustainable public legitimacy in the eyes of citizen. This, in turn, highlights some of the key obstacles to building consensus and legitimacy in Afghanistan – namely the challenges of local governance, corruption, and the provision of basic services. In doing so, this paper aims to deepen our understanding of state legitimacy by demonstrating the importance of public service provision and the challenges created by misplaced legitimation efforts, while raising important points for both scholars and practitioners working in areas of statebuilding and legitimacy building in the field of international relations and comparative politics.

UN Model Laws: What Role Do They Play in Harmonizing International Law?

The role of UN Model Laws in the harmonization of international law is examined. These laws, designed to address specific issues, provide a common normative framework that States can adopt and adapt according to their local needs. Their flexibility facilitates the creation of a more harmonized global legal system, reducing disparities and promoting consistency in the application of international norms. In addition, these laws promote the protection of human rights and universal values, foster international dialogue and contribute to building consensus among States. In a context of global challenges, they emerge as valuable tools for establishing a more equitable and coordinated international legal order.

Is social theory losing its relevance? A call for social impact and cocreation from dialogic sociology

Currently, the interest in and use of social theory by policy-makers, organizations, and citizens have decreased worldwide. While excellent research focuses on the social influences of social theory and teaching methods, the research often neglects the link between social theory and contemporary societal needs. This gap is addressed by examining the social impact and effects on the motivation for using dialogic theory, which emphasizes dialog and consensus building. Following a communicative methodology approach, this study includes nine communicative interviews and three participatory observations: two in seminars with readers of The Dialogic Society (TDS) (“duihuashehui (《对话社会》)”) by Flecha, and one in an online, international debate about the book. The findings reveal a fourfold impact: First, increased motivation for sociology and social theory; second, deeper comprehension of the theory; third, potential for transforming social contexts; and fourth a shift toward cocreation and social impact. This study highlights key aspects of dialogic theory to address contemporary needs and to bridge the gap between theory and practice to revitalize the field of social theory in diverse contexts, highlighting the way the dialogic theory contributes and could contribute to different countries, including China. In doing so, this study helps advance the development of an independent knowledge system in philosophy and social science in China, which China proposed in 2024.

From Discourse to Action: Party Publicity Work and Consensus Building from a Social Construction Perspective

Drawing on the theoretical paradigm of social construction, this study endeavors to deconstruct the functional transformation and operating mechanism of political communication in modern governance. By establishing a three - dimensional analytical framework of “symbol system - media ecology - governance practice”, it uncovers the internal logic of political communication from meaning production to action transformation. The research findings indicate that the cultural encoding of the symbol system constructs a collective cognitive schema; the ecological reconstruction of the media matrix boosts the efficiency of government - public interaction; and the innovative mechanism of governance practice achieves the synergy between value guidance and behavior motivation. This progressive mechanism of “cognitive construction - relationship reshaping - action synergy” reflects the core tenet of interaction and community awareness in social construction theory, highlighting the interaction between individuals and the collective during the policy promotion process.

Centring Water in Impact Assessment: Reconsidering Environmental and Cultural Flows in Development Decision-Making in Canada.

Considering regional impacts on downstream communities and ecosystems is challenging in impact assessments. We suggest that environmental and cultural flows have the potential to be applied to protect water more comprehensively in assessment but are currently underutilized. Environmental and cultural flows refer to adequate water quantity and quality for the environment and Indigenous rights. Through interviews and a scoping review of legislation and assessments, we address how these concepts are and could be embedded within Canadian impact assessments. To date, environmental flows have been considered in assessments involving dams, oil and gas, and mining, and the focus has been on fish and habitat, rather than Indigenous rights and cumulative withdrawals. We propose Regional Readiness through water councils, change, and consensus (three Cs) to prepare watershed actors to protect environment and cultural flows in impact assessments. The three Cs are: (1) Advisory councils dedicated to creating regional objectives and rules for ecosystem and rights-based needs, (2) Assessing hydrologic and water quality change with regional data and relationships to water, and (3) Building consensus on the cultural and ecological significance and sensitivity of water bodies. Development of this framework follows examples from Canadian water-related assessments and initiatives: Wolastoq Ecological Limits of Hydrological Alteration, Athabasca Chipewyan and Mikisew Cree assessments, Yinka Dene Water Management Policy, Grand Council Treaty #3 Nibi Declaration, Slave Watershed Environmental Effects Program, and Strategic Assessment of Wood Buffalo National Park. These cases demonstrate how the inclusion of environmental and cultural flows processes in assessment could enable greater water protection.

Developing Balanced Quality Indicators for Monitoring Virtual Care in Ambulatory Care Environments: Modified Delphi Panel Process

BackgroundWhile the volume of virtual visits increased with the COVID-19 pandemic, little is still known regarding the quality of virtual visits. Furthermore, there is limited guidance on how best to evaluate the quality of virtual care initiatives.ObjectiveThe objective of this study was to curate a balanced set of quality indicators grounded in the Quintuple Aim quality framework and the National Academy of Medicine domains of quality, including sustainability, to monitor the quality of virtual care in ambulatory environments.MethodsPhase 1 involved curating a list of ambulatory virtual care quality indicators from published and grey literature, along with knowledge user feedback generated through a pre-Delphi survey; these indicators were mapped and categorized to the Quintuple Aim and National Academy of Medicine (NAM) Quality Domains. In phase 2, a 19-member pan-Canadian panel was convened as part of a 3-round modified Delphi panel process to rate and rank the quality indicators. The panel included clinicians, individuals with lived experience with the health care system, policy makers, academics, and administrators. Panelists rated indicators using the Agency for Healthcare Research and Quality measure attributes on a 9-point Likert scale in round 1, followed by a virtual Delphi panel meeting to discuss indicators before round 2 of re-rating, then a final round 3 of ranking which assessed the importance of indicators within each quality domain and subdomain. To address gaps in the literature, novel quality indicators of virtual care were identified and discussed in panel discussions, patient group consultations, and a pre-Delphi survey. For indicator advancement during the rating exercises, 75% or more of the panelists’ responses in the top tertile (scores of 7-9) with a median composite score of 7 or greater was required.ResultsThere were 140 quality indicators identified in the literature which progressed through the 3 Delphi panel rounds. There was minimal attrition among Delphi panel members (17/19, 89% participated in all 3 rounds). After round 3, 25 indicators were included in the final scorecard. Aligned with the Quintuple Aim, there are 13 quality indicators on patient experience, 6 on provider experience, 2 on population health, 2 on health equity, and 2 on health system costs.ConclusionsA balanced set of 25 quality indicators of ambulatory virtual care was developed based on literature and consensus building from knowledge users across the health system. This curated set of indicators will support more comprehensive evaluations of virtual care. Organizations can use the set of indicators as part of a scorecard to compare across jurisdictions, identify priority areas, and ensure their virtual care initiatives are delivering high-quality care based on multiple domains of quality.

Consensus recommendations for hyperpolarized [1-13C]pyruvate MRI multi-center human studies.

MRI of hyperpolarized (HP) [1-13C]pyruvate allows in vivo assessment of metabolism and has translated into human studies across diseases at 15 centers worldwide. To determine consensus on best practice for multi-center studies for development of clinical applications. This paper presents the results of a two-round formal consensus building exercise carried out by experts with HP [1-13C]pyruvate human study experience. Twenty-nine participants from 13 sites brought together expertise in pharmacy methods, MR physics, translational imaging, and data analysis with the goal of providing recommendations and best practice statements on conduct of multi-center human studies of HP [1-13C]pyruvate MRI. Overall, the group reached consensus on approximately two-thirds of 246 statements in the questionnaire, covering HP 13C-pyruvate preparation; MRI system setup, calibration, and phantoms; acquisition and reconstruction; and data analysis and quantification. Consensus was present across categories. Examples include: (i) Different HP pyruvate preparation methods could be used in human studies, but the same release criteria have to be followed; (ii) site qualification and quality assurance must be performed with phantoms and the same field strength must be used, but the rest of the system setup and calibration methods could be determined by individual sites; (iii) the same pulse sequence and reconstruction methods were preferable, but the exact choice should be governed by the anatomical target; (iv) normalized metabolite area-under-curve values and metabolite area under curve were the preferred metabolism metrics. The consensus proces revealed that HP[1-13C] pyruvate MRI as a technology has progressed sufficiently to plan multi-center studies. The work confirmed areas of consensus for multi-center study conduct and identified where further research is required to ascertain best practice.

Multilevel Decision‐Making and Protected Area Prioritization

ABSTRACTConservation initiatives depend on interactions among organizations and communities that have different goals. Multilevel hierarchies provide a common decision‐making structure with different actors responsible for conservation decisions over nested spatial scales. We examine consequences of hierarchical decision‐making for spatial prioritization of new protected areas. We combine insights from general theory, an algebraic example, and a numerical application, the latter motivated by federal‐to‐state grant‐giving in the western United States. Working through a decision‐making hierarchy means fewer species can be protected for a given budget than suggested by analyses that ignore the role of conservation institutions in decision‐making. This efficiency cost results from higher level decision‐makers—the federal government in our numerical application—giving up control to lower level actors—state governments in this case. Ensuring close agreement over spatial priorities between actors can limit potential losses in how much biodiversity can be protected. By reallocating funds among lower level actors, the higher level actor can mitigate remaining losses. Spatial optimization approaches that ignore the integral role of institutions in conservation, like decision‐making hierarchies, overestimate what protected area programs can achieve and risk misallocating limited conservation funds. Accounting for multilevel decision‐making reveals where building consensus among actors will be particularly important and suggests alternative strategies that conservation funders can pursue.

Redefining Mentorship in Medical Education with Artificial Intelligence: A Delphi Study on the Feasibility and Implications

In the dynamically evolving field of medicine, mentorship is crucial for educating students, and Artificial Intelligence (AI) potentially revolutionizes this process through automated and data-enhanced guidance. This study aims to investigate AI’s potential in mentoring medical students by collecting expert opinions, assessing its potential benefits and limitations, and developing a consensus-driven framework for the effective integration of AI-based mentorship into medical education. Specifically, it addresses ethical concerns such as data security, algorithmic bias, and the potential for reduced human interaction. Using a structured online Delphi technique, this interdisciplinary research involved 27 experts in medical education and AI to investigate the intersection of AI with medical mentorship. The study employed both qualitative (e.g., expert interviews) and quantitative (e.g., survey data) research methods, with consensus measured via descriptive and inferential statistics, including Fleiss’ kappa and the Intraclass Correlation Coefficient (ICC). Detailed methodological steps, including the selection criteria for experts and the iterative feedback process across the four Delphi rounds, were meticulously followed to ensure robust consensus building. Conducted over four rounds, the Delphi technique achieved substantial consensus among panelists regarding the AI mentors’ capabilities and the critical aspects requiring attention, with a kappa value of .79 ([.73–.85]) and high reliability (ICC=.873). The study also compared traditional mentorship roles with those enhanced by AI, highlighting areas where AI can complement and extend human mentorship rather than replace it. Panelists recognized AI mentors’ potential to enhance learning processes, while also identifying limitations in areas requiring deep human judgment, emphasizing the need for careful application. AI mentors can significantly guide students across various aspects of medical training, from career planning to achieving academic goals, through personalized learning experiences. They hold promise for improving clinical skills and decision-making abilities through real-time feedback and adaptive learning modules. However, their limitations and the potential risks of overreliance necessitate balanced and cautious application. Ethical considerations, such as ensuring data integrity and preventing bias, are paramount in the deployment of AI mentors. These insights advocate the strategic implementation of AI mentors in medical education, suggesting phased integration and interdisciplinary oversight to harness their full educational potential while mitigating possible drawbacks. Furthermore, the study proposes a hybrid mentorship model that combines AI-driven insights with human empathy and ethical oversight to create a more comprehensive and effective mentorship framework. This study lays the groundwork for future research into the optimal integration of AI in medical mentorship, ensuring ethical standards and maximizing educational benefits, thereby fostering a more effective and humane educational environment.

A model training curriculum for psychedelic, psycholytic, and entactogen-assisted psychotherapy.

The authors offer a model for curriculum for education and training in substance-assisted psychotherapy (SAP), that is, psychedelic, psycholytic, and entactogen/MDMA (3,4-methylenedioxymethamphetamine)-assisted psychotherapy, addressing both the detailed contents of training and the question of experiential training. All authors of this model have an abiding interest and extensive experience in both the theory and practical aspects of SAP and questions relating to training. The model curriculum has been written through an international consensus building process and represents a consensus statement about the topic. The model includes an enumeration of theoretical themes and topics, which we suggest for inclusion in an SAP curriculum. The practical part of the curriculum includes experiential training with the following components: (1) apprenticeship observation: learning from observing experienced therapists, (2) ongoing clinical supervision: conducting treatment under direct supervision of experienced SAP therapists, and (3) a proposal for the inclusion of self-experiences for the trainees. Other parts address the use of peer supervision and conventional supervision. The authors are aware of the abiding need for respect of intercultural differences. We are conscious that the proposed model is one largely adapted to western industrialized countries with established graduate level education and training procedures for psychotherapists. However, the model curriculum includes teachings about the use of related substances and treatment techniques in indigenous cultures and traditions. This curriculum model may be valuable to psychedelic researchers, those endeavoring to train therapists for research studies, and those preparing for the clinical work to follow, once SAP is conducted outside of research settings.

Co-creating a strategy for transforming person centred cultures

IntroductionTransforming healthcare systems to support person-centred practice reflects environments where individual values and beliefs are respected and where healthful cultures can flourish. However, there are significant challenges within healthcare systems that impact on the development of healthful workplace cultures. The nursing and midwifery professions need to play an influential role in formulating health policy and decision-making to contribute to health and social care systems that are underpinned by person-centredness. This paper reports the use of a practice development approach underpinned by the Person-Centred Practice Framework to co-create a strategy for nurses and midwives that will enable the development of person-centred healthcare practices. The key objectives are to demonstrate the processes that support co-creation to build consensus on what is strategically important to nurses and midwives; to gain an understanding of the value of external facilitation throughout the process and exploring the challenges encountered during the development of the strategy.MethodsPractice Development methodology was the approach used with skilled facilitation adopted to enable the working with values and beliefs, defining purpose and vision and establishing agreed working principles and behaviours. Consensus building methods were used to co-create draft strategy priorities further defined by wider stakeholder engagement.ResultsA 5-year strategy was co-created with senior nursing and midwifery leaders, inclusive of key strategic priority areas and strategic actions. The seven priority areas align to the Person-Centred Practice Framework with underpinning shared purpose and values. (1) Developing Person-Centred Cultures, (2) Creating a Supportive Practice Environment, (3) Building Research Capacity, (4) Building a Dynamic Workforce, (5) Fostering Leadership at all Levels, (6) Enhancing Digital Informatics and New Technologies, (7) Delivering High Quality, (8) Safe Person-Centred Care. Together they provide a roadmap for implementation across the many nursing and midwifery contexts providing a solid foundation for leading and supporting person-centred practice across a large local health district with a focus on what matters most while continuing to be innovative in approaches to practice. The development of a clear shared purpose of person-centred practice and the exploration of values were critical first steps in the development of the strategy and provided a clear foundation from which the nursing and midwifery leaders could utilise for the ongoing strategic priorities and action discussions.Implications for practiceThe development of nursing and midwifery strategy using Practice Development Methodology and the Person-centred Practice Framework enables critical dialogue that supports nursing and midwifery leaders identify key influences over nursing and midwifery practice. This approach not only fosters a sense of ownership and engagement among nurses and midwives but also ensures that their values, beliefs, and professional insights are integral to the strategic direction of healthcare practices. By aligning the strategy with the Person-Centred Practice Framework, nurses and midwives are better able to develop a shared understanding of person-centred practice where the individual needs and preferences of patients, families and staff are acknowledged. Overall, this strategy represents a significant step forward in supporting the professional development of nurses and midwives, enhancing the quality of patient care, and fostering a healthful culture where continuous improvement and innovation are at the forefront of the healthcare system.

Is it a local community-centered plan? Community participation in the Dodoma master planning and implementation processes

Abstract The participatory planning approach is centered on inclusive idea generation, consensus building, and consideration of socioeconomic and cultural aspects. Currently, there is limited knowledge regarding whether the 2019 Dodoma master plan reflects the needs and interests of the local communities. A mixed research approach and case study strategy were deployed. Interviews, documents reviews, and Focus Group Discussions (FGDs) were the main data collection methods. Content analysis and descriptive statistics were used to analyse qualitative and quantitative data respectively. The findings indicate that the 2019 Dodoma master plan marginally reflects the needs and interests of the Madukani and Msalato wards communities. This was evidenced by a lack of harmonisation of needs and interests between the City Council of Dodoma (CCD) and the local communities. The local communities prioritised individual interests (tenure security) while CCD focused on the complex public interests (sustainable city). Regardless of the importance of safeguarding public interests, the process was subjected to ineffective communication, negotiation, orientation of earmarked land uses, commitment, and inclusive decision-making. The participation practice signifies either non-participation (manipulation/therapy) or tokenism (informing/consultation) of Sherry Arnstein’s Ladder of Citizen Participation. This was proved by the power imbalance of the technocrats in accommodating the suggestions of the local communities. Again, denial of the local communities’ suggestions and ineffective information dissemination counter with the Communicative and Collaborative Planning Theory. The findings, therefore; call for inclusive decision-making to ensure the 2019 Dodoma master plan is effectively understood, owned, and observed by the local communities.

Leaders in Social Movements: Evidence from Unions in Myanmar

Social movements are catalysts for crucial institutional changes. To succeed, they must coordinate members’ views (consensus building) and actions (mobilization). We study union leaders within Myanmar’s burgeoning labor movement. Union leaders are positively selected on both ability and personality traits that enable them to influence others, yet they earn lower wages. In group discussions about workers’ views on an upcoming national minimum wage negotiation, randomly embedded leaders build consensus around the union’s preferred policy. In an experiment that mimics individual decision-making in a collective action setup, leaders increase mobilization through coordination. (JEL D91, J38, J51, O15)

Building consensus on prescribing self‐directed occupational therapy activities: A Delphi study

BackgroundOccupational therapy practice focuses on occupation‐based interventions, considering the interaction between the person, environment, and task. In Australia, combining supervised therapy with self‐directed practice is feasible, even for health‐care consumers with cognitive impairments. This study aims to explore the self‐practice programs developed by occupational therapists and delivered in inpatient rehabilitation and develop core recommendations for such interventions.MethodsEthical approval for this Delphi consensus study was granted by Monash University Human Research Ethics Committee. The study involved an online survey and two focus groups with Australian occupational therapists. Participants were recruited via snowball sampling and required to meet specific experience criteria. Content analysis was used to analyse data, and consensus was reached on core recommendations for prescribing self‐practice in inpatient rehabilitation.Consumer and community involvementOccupational therapists who prescribe self‐practice to health‐care consumers were the community of interest and directly involved in the Delphi consensus process to inform study findings. Consumers using self‐practice activities were not included in the study.ResultsIn Round 1 of the Delphi process, 21 occupational therapists participated in an anonymous online survey about prescribing self‐practice in inpatient rehabilitation. The survey identified key recommendations across various categories. Round 2 focus groups further refined these recommendations, and Round 3 achieved consensus, incorporating additional feedback and suggestions for implementing self‐practice programs. It found variability in implementation, with neurological and general rehabilitation health‐care consumers most likely to receive self‐practice tasks.ConclusionThis Australian study explored how occupational therapists prescribe self‐practice during inpatient rehabilitation. The study emphasised the importance of clinical reasoning and environmental factors, offering recommendations to guide goal‐focused, client‐centred self‐practice interventions for better health‐care consumer outcomes.PLAIN LANGUAGE SUMMARYWe looked at occupational therapists in Australia. We wanted to know how therapists gave self‐practice activities to people. Our focus was on people in recovery hospitals. People do self‐practice activities without a therapist. People do these activities outside therapy sessions. This study used a survey and focus groups. Skilled therapists agreed on ideas for self‐practice. The results showed differences in self‐practice methods. Self‐practice is common in stroke and general recovery. The study gave self‐practice tips for therapists. It included what, how, and why they prescribe these activities. Therapists should think about each person's goals. They should understand what helps self‐practice. We know what therapists are doing. We support therapists to include self‐practice programs in regular care.

Enhancing diversity in oncology trials: Key strategies from the ACORI community oncology inclusive clinical trial design summit.

e23027 Background: Oncology clinical trials often lack ethnic and regional diversity , limiting the generalizability of findings across real-world patient populations. The Association of Cancer Care Centers (ACCC) Community Oncology Research Institute (ACORI) hosted the ACORI Community Oncology Inclusive Clinical Trial Design Summit on October 29–30, 2024 to convene multidisciplinary stakeholders to identify and address barriers to participation among underrepresented groups in clinical trials in the community settings. Methods: The summit featured didactic sessions, case-based presentations, and moderated interactive discussions with 76 participants, including 24 cancer center practitioners and researchers, 17 professional and patient advocacy organizations, industry representatives, and leaders from the FDA, NCORP, and the National Cancer Institute. The summit focused on identifying actionable solutions to expand access to clinical trials by enhancing clinical trial design, employing innovative operational delivery of trial opportunities, and building consensus on effective strategies around engagement, recruitment, and retention of participants and communities. Results: Discussions yielded the following recommendations to increase trial diversity: Strengthening the clinical trial workforce: Expand APP and clinical pharmacist roles as principal investigators through education and advocacy and strengthen training pathways for trial navigators/coordinators. Optimizing trial design and infrastructure for diverse populations: Broaden eligibility criteria, simplify protocols, and incorporate patient-friendly tools like e-consent and multilingual resources. Fostering community engagement: Build trust through local partnerships, establish patient education programs, and address systemic biases in trial recruitment. Advancing Decentralized Clinical Trials (DCTs): Advocate for flexible regulatory frameworks, educate practitioners through a DCT implementation playbook, and utilize community-based healthcare infrastructure. Leveraging AI and digital tools for trial efficiency: Apply AI for patient matching, protocol simplification, and remote monitoring, while improving transparency and interoperability with EHRs. Conclusions: Inclusive trial design and delivery of trial opportunities are essential to achieving equitable cancer care. Addressing systemic barriers and adopting innovative approaches can enhance diversity and improve the generalizability of clinical research. Through ACORI, ACCC will continue to foster collaboration among stakeholders. This remains critical to ensuring sustainable progress in community oncology research.

Competencies in Context: Adapting the World Health Organization Rehabilitation Competency Framework for Entry-Level Physical Therapist Practice.

Competencies in Context: Adapting the World Health Organization Rehabilitation Competency Framework for Entry-Level Physical Therapist Practice.

A game theoretic analysis of geothermal development consensus building in Japan

A game theoretic analysis of geothermal development consensus building in Japan

Local authorities need tailored research ethics processes to support research capacity building.

Local authorities need tailored research ethics processes to support research capacity building.

Guidelines on Assistive Products Useful in Pharmacy Practice to Optimize and Ensure Medication Use by Individuals With Visual Impairment: An Interdisciplinary Delphi Consensus.

Visual impairment represents a significant public health challenge that can affect patients ability to accurately identify medications and access essential information about them. A potential solution to address these difficulties is the utilization of assistive products. Consequently, guidelines have been developed in French for Belgian community pharmacists to enhance the safety of individuals with a visual impairment when utilizing medications. To build an interdisciplinary consensus on guidelines for the utilization of assistive products in pharmacy practice, with the aim of ensuring the safe administration of medications by individuals with a visual impairment. A Delphi survey for consensus building was conducted by a national panel of experts. The interdisciplinary panel was constituted of ophthalmologists with a specialization in low vision, orthoptists, ergotherapists, psychologists, and community pharmacists. The recommendations were encoded in the form of an online questionnaire and the experts were invited to indicate their degree of agreement on a 9-point Likert scale. Descriptive statistics were produced using IBM SPSS 27 software. This process was repeated until a consensus was reached between all the experts. Four rounds of the Delphi method were necessary to the panel of 10 experts to evaluate the 47 recommendations initially submitted. Ultimately, an introduction to the guidelines and 39 recommendations, grouped into six main categories, were validated. The consensus process has enabled us to obtain consolidated recommendations and to ensure their relevance, thus facilitating the dissemination of high-quality content to community pharmacists practising their profession in Belgian pharmacies.