TY - JOUR
T1 - Healthcare professionals’ agreement on clinical relevance of drug-related problems among elderly patients
AU - Bech, Christine Flagstad
AU - Frederiksen, Tine
AU - Villesen, Christine Tilsted
AU - Højsted, Jette
AU - Nielsen, Per Rotbøll
AU - Kjeldsen, Lene Juel
AU - Nørgaard, Lotte Stig
AU - Christrup, Lona Louring
N1 - Funding Information:
Funding This study was funded by Actavis Foundation and an unrestricted research grant from Grünenthal Denmark to the University of Copenhagen.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Background Disagreement among healthcare professionals on the clinical relevance of drug-related problems can lead to suboptimal treatment and increased healthcare costs. Elderly patients with chronic non-cancer pain and comorbidity are at increased risk of drug related problems compared to other patient groups due to complex medication regimes and transition of care. Objective To investigate the agreement among healthcare professionals on their classification of clinical relevance of drug-related problems in elderly patients with chronic non-cancer pain and comorbidity. Setting Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen, Denmark. Method A pharmacist performed medication review on elderly patients with chronic non-cancer pain and comorbidity, identified their drug-related problems and classified these problems in accordance with an existing categorization system. A five-member clinical panel rated the drug-related problems’ clinical relevance in accordance with a five-level rating scale, and their agreement was compared using Fleiss’ κ. Main outcome measure Healthcare professionals’ agreement on clinical relevance of drug related problems, using Fleiss’ κ. Results Thirty patients were included in the study. A total of 162 drug related problems were identified, out of which 54% were of lower clinical relevance (level 0–2) and 46% of higher clinical relevance (level 3–4). Only slight agreement (κ = 0.12) was found between the panellists’ classifications of clinical relevance using a five-level rating scale. Conclusion The clinical pharmacist identified drug related problems of lower and higher clinical relevance. Poor overall agreement on the severity of the drug related problems was found among the panelists.
AB - Background Disagreement among healthcare professionals on the clinical relevance of drug-related problems can lead to suboptimal treatment and increased healthcare costs. Elderly patients with chronic non-cancer pain and comorbidity are at increased risk of drug related problems compared to other patient groups due to complex medication regimes and transition of care. Objective To investigate the agreement among healthcare professionals on their classification of clinical relevance of drug-related problems in elderly patients with chronic non-cancer pain and comorbidity. Setting Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen, Denmark. Method A pharmacist performed medication review on elderly patients with chronic non-cancer pain and comorbidity, identified their drug-related problems and classified these problems in accordance with an existing categorization system. A five-member clinical panel rated the drug-related problems’ clinical relevance in accordance with a five-level rating scale, and their agreement was compared using Fleiss’ κ. Main outcome measure Healthcare professionals’ agreement on clinical relevance of drug related problems, using Fleiss’ κ. Results Thirty patients were included in the study. A total of 162 drug related problems were identified, out of which 54% were of lower clinical relevance (level 0–2) and 46% of higher clinical relevance (level 3–4). Only slight agreement (κ = 0.12) was found between the panellists’ classifications of clinical relevance using a five-level rating scale. Conclusion The clinical pharmacist identified drug related problems of lower and higher clinical relevance. Poor overall agreement on the severity of the drug related problems was found among the panelists.
KW - Care transition
KW - Clinical relevance
KW - DRP classification
KW - Drug-related problems
KW - Inter-rater agreement
KW - Medication review
KW - Care transition
KW - Clinical relevance
KW - DRP classification
KW - Drug-related problems
KW - Inter-rater agreement
KW - Medication review
U2 - 10.1007/s11096-017-0572-x
DO - 10.1007/s11096-017-0572-x
M3 - Journal article
C2 - 29248987
AN - SCOPUS:85038107073
SN - 2210-7703
VL - 40
SP - 119
EP - 125
JO - International Journal of Clinical Pharmacy
JF - International Journal of Clinical Pharmacy
IS - 1
ER -