Premium
Development of a classification system for drug‐related problems in the hospital setting (APS‐Doc) and assessment of the inter‐rater reliability
Author(s) -
Hohmann C.,
Eickhoff C.,
Klotz J. M.,
Schulz M.,
Radziwill R.
Publication year - 2012
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2011.01281.x
Subject(s) - reliability (semiconductor) , drug , reliability engineering , inter rater reliability , medicine , emergency medicine , intensive care medicine , pharmacology , statistics , engineering , mathematics , physics , quantum mechanics , power (physics) , rating scale
Summary What is known and Objective: Identifying, preventing and resolving drug‐related problems (DRP) is an important issue in the pharmaceutical care process. Because DRPs have been detected in a more systematic way, the need for a classification system to document, classify and evaluate the collected data has become necessary. The objective was to develop a classification system for DRPs within the hospital setting, to evaluate the practicality and to assess the inter‐rater reliability. Methods: All DRPs defined in PI‐Doc and PCNE, which are relevant in the hospital setting, were included. Further relevant DRPs identified in other projects in a hospital setting as well as DRPs from the daily work on the ward were collected, and a short description of each DRP was written. A prospective study was conducted at Klinikum Fulda, Germany, in both a non‐surgical and a surgical setting to explore whether the new classification system is suitable to classify DRPs in clinics with different specifications. For assessing the inter‐rater reliability, 24 standardized case reports were provided. All participants classified them independently. The inter‐rater reliability was analysed using Kappa coefficient. Results and Discussion: A classification system for DRPs in the hospital setting (APS‐Doc) was established with 10 main categories and 48 subcategories. Practicality was assessed in 250 patients in a non‐surgical ward as well as in 100 patients in a surgical ward. The inter‐rater agreement was 0·68 (95% CI, 0·66–0·69) for main categories, which comprises substantial agreement. Moderate agreement (κ = 0·58; 95% CI, 0·58–0·59) was demonstrated for the subcategories. What is new and Conclusion: A new hierarchical classification system for DRPs in the hospital setting has been developed. APS‐Doc seems suitable for various parts of the medication process such as medication reconciliation and drug therapy within both non‐surgical and surgical wards. Inter‐rater reliability was found to be substantial in the main categories and moderate in the subcategories.