Open AccessIdentifying medication‐related readmissions: Two students using tools vs a multidisciplinary panel
Author(s) -
Coppes Tristan,
Kloes Jozien,
Dalleur Olivia,
KarapinarÇarkit Fatma
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.14768
Subject(s) - medicine , multidisciplinary approach , polypharmacy , pharmacy , medline , adjudication , family medicine , confidence interval , social science , sociology , political science , law
Abstract Background Polypharmacy may result in medication‐related readmissions (MRRs). Identifying MRRs is time consuming. Screening of readmissions by students could increase efficiency for healthcare professionals. Recently, two screening tools have been published: the Assessment Tool for identifying Hospital Admissions Related to Medications (AT‐HARM10) tool and the Drug‐Related Admission (DRA) adjudication guide. It is unknown whether pharmacy students could identify MRRs with these tools. Objective To compare the agreement between two pharmacy students applying the AT‐HARM10 tool and DRA adjudication guide in identifying MRRs vs a multidisciplinary panel. Methods A retrospective study was conducted from February to July 2020 at OLVG hospital. Readmissions within 30 days after discharge from seven departments were reviewed by a multidisciplinary panel (pharmacists and physicians). MRRs were defined as readmission where medication was the main cause or medication significantly contributed to the readmission. Two 5th year pharmacy‐students volunteered to blindly apply both tools individually on all MRRs and a random sample of non‐MRRs. The consensus results of the students and the multidisciplinary panel were compared and displayed as a percentage and Cohen's kappa (κ). Results Three hundred sixty‐six readmission cases were selected in total, consisting of 181 MRRs and 185 non‐MRRs. The agreement between the students using the AT‐HARM10 tool vs the multidisciplinary panel was moderate (80%, κ = 0.60 (95% confidence interval (CI): 0.52‐0.68)). The DRA adjudication guide had a moderate agreement (81%, κ = 0.62 (CI: 0.54‐0.70)). Students misclassified MRRs mainly because the multidisciplinary panel found disease progression more profound than a contribution of medication. Conclusions Two students have an overall agreement of 80% in comparison with the multidisciplinary panel with a moderate Cohen's kappa. Students are more often overestimated, but they may be a good option to preselect potential MRRs to save time for healthcare professionals. However, some MRRs will be missed.