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Development of a standardized chart review method to identify drug‐related hospital admissions in older people
Author(s) -
Thevelin Stefanie,
Spinewine Anne,
Beuscart JeanBaptiste,
Boland Benoit,
Marien Sophie,
Vaillant Fanny,
Wilting Ingeborg,
Vondeling Ariel,
Floriani Carmen,
Schneider Claudio,
Donzé Jacques,
Rodondi Nicolas,
Cullinan Shane,
O'Mahony Denis,
Dalleur Olivia
Publication year - 2018
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13716
Subject(s) - adjudication , medicine , delphi method , pharmacist , chart , delphi , family medicine , pharmacy , computer science , statistics , mathematics , political science , law , artificial intelligence , operating system
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.