The e-Delphi method is a computerized version of the Delphi method that depends on an internet-based platform offering tremendous savings in time and cost, and advantages in data management. The Delphi method has been used to establish consensus in emergency medicine, including antidote stocking. It is well adapted for building consensus, with a succession of questionnaires, to procure data from a group of selected members. The Delphi method was developed in the 1950s and became extensively accepted for gathering and merging opinions on a particular topic to set goals and investigate policies. In the absence of a rigorous HVA, the list of essential antidotes can be created by reaching consensus within expert groups, by employing methods such as the Delphi technique, the nominal group technique or through a consensus development conference. It requires collaboration between hospitals and other institutions as each hospital is challenged with its own specific geographic, political and social features. Organizing a meticulous HVA is challenging as it is resource-intensive and time-consuming, requiring comprehensive face-to-face interactions. It is also highly recommended that the list should be determined by the concerned stakeholders consisting of physicians, pharmacists, and other healthcare professionals associated with emergency care. It is advocated that this list must be modified and adopted by each healthcare institute based on a hazard vulnerability assessment (HVA) to meet local antidote needs. A globally recognized consensus guideline recommended a “list” of antidotes to be stocked for timely delivery of essential antidotes to the emergency department. Countries have conducted regular audits on antidotes stocking, and many researchers have recommended the development of a national list and stocking guidelines to standardize care. Unfortunately, the stocking of antidotes has been a “persistent concern” for over 35 years. Studies have reported inadequate availability of antidotes in emergency care facilities, which experts warn will lead to increased morbidity and mortality. Antidotes have a critical role in the emergency care of a patient admitted for poisoning or drug overdose, as it prevents death, and decreases the duration of therapy and hospital stay. Effective management of poisoning requires adequate availability of antidotes, with supportive measures, in hospitals that provide effective emergency care. Poisoning is a paramount public health issue that is responsible for frequent visits to the emergency department and hospital admissions. This is the first study that the authors are aware of that demonstrates that the e-Delphi technique can consolidate recommendations of experts in emergency medicine to provide a list of essential antidotes. The development of an essential antidote list, with expert consensus, is one of the initial steps in securing a foundation for appropriate provision of antidotes at all healthcare institutions. The optimal approach for ensuring adequate availability of antidotes is continuous monitoring of local poisoning incidence and antidote requirements through collaborations between academic researchers and emergency care clinicians. This resulted in the development of an essential antidote list with 43 antidotes. Round 3 was a confirmatory round, where the expert group agreed on their previous rounds’ opinions. Round 2 had two antidotes (out of seven newly suggested ones) reaching consensus. Round 1 of the e-Delphi resulted in 41 antidotes reaching consensus and seven new antidotes suggested by the expert panel. Consensus was gained if ≥75% of the expert panel agreed on the inclusion of the antidote, without any strong disagreements. A purposive sample of healthcare professionals from governmental and private hospitals were selected for this study (n = 30). The e-Delphi method was used, with three rounds of voting, to determine expert consensus on an essential antidote list for hospitals in Kuwait. An electronic survey with 47 essential antidotes was developed. The aim of our study is to generate a nationally relevant essential antidote list for emergency care hospitals in Kuwait using the e-Delphi method by establishing consensus through a multidisciplinary expert group of healthcare providers. In order to assist hospitals to reduce costs and improve patient care, an essential antidote list can be used as an initial foundation for securing sufficient antidote availability at healthcare institutions. Antidote stocking represents a major challenge to hospitals all over the world, including Kuwait.
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