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Development of a standardized chart review method to identify drug-related hospital admissions in older people
- Source :
- British Journal of Clinical Pharmacology (Online), British Journal of Clinical Pharmacology
- Publication Year :
- 2018
- Publisher :
- Wiley-Blackwell Publishing Ltd., 2018.
-
Abstract
- Aims We aimed to develop a standardized chart review method to identify drug-related hospital admissions (DRA) in older people caused by non-preventable adverse drug reactions and preventable medication errors including overuse, underuse and misuse of medications: the DRA adjudication guide. Methods The DRA adjudication guide was developed based on design and test iterations with international and multidisciplinary input in four subsequent steps: literature review; evaluation of content validity using a Delphi consensus technique; a pilot test; and a reliability study. Results The DRA adjudication guide provides definitions, examples and step-by-step instructions to measure DRA. A three-step standardized chart review method was elaborated including: (i) data abstraction; (ii) explicit screening with a newly developed trigger tool for DRA in older people; and (iii) consensus adjudication for causality by a pharmacist and a physician using the World Health Organization-Uppsala Monitoring Centre and Hallas criteria. A 15-member international Delphi panel reached consensus agreement on 26 triggers for DRA in older people. The DRA adjudication guide showed good feasibility of use and achieved moderate inter-rater reliability for the evaluation of 16 cases by four European adjudication pairs (71% agreement, κ = 0.41). Disagreements arose mainly for cases with potential underuse. Conclusions The DRA adjudication guide is the first standardized chart review method to identify DRA in older persons. Content validity, feasibility of use and inter-rater reliability were found to be satisfactory. The method can be used as an outcome measure for interventions targeted at improving quality and safety of medication use in older people.
- Subjects :
- Male
medicine.medical_specialty
Delphi Technique
Drug-Related Side Effects and Adverse Reactions
Psychological intervention
Pharmacist
Delphi method
Adverse drug reactions
Pilot Projects
030204 cardiovascular system & hematology
Medication safety
03 medical and health sciences
Patient safety
0302 clinical medicine
Elderly
Medication errors
medicine
Content validity
Humans
Medication Errors
Pharmacology (medical)
030212 general & internal medicine
Adjudication
Aged
Pharmacology
Geriatrics
Observer Variation
business.industry
Reproducibility of Results
Original Articles
medicine.disease
3. Good health
Test (assessment)
Hospitalization
adverse drug reactions
elderly
medication errors
medication safety
patient safety
Feasibility Studies
Female
Medical emergency
Clinical pharmacology
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- British Journal of Clinical Pharmacology (Online), British Journal of Clinical Pharmacology
- Accession number :
- edsair.doi.dedup.....5d663b0cde89ed3edb4b9fb81a9251fb