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Development and Reliability Testing of the Clinical Pharmacist Recommendation Taxonomy
Author(s) -
Hoth Angela B.,
Carter Barry L.,
Ness Jose,
Bhattacharyya Anjan,
Shorr Ronald I.,
Rosenthal Gary E.,
Kaboli Peter J.
Publication year - 2007
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.27.5.639
Subject(s) - inter rater reliability , veterans affairs , pharmacist , medicine , taxonomy (biology) , clinical pharmacy , pharmacy , outpatient clinic , psychological intervention , family medicine , psychology , nursing , developmental psychology , rating scale , botany , biology
Study Objective . To evaluate the reliability of a newly developed taxonomy—the Clinical Pharmacist Recommendation (CPR) taxonomy—to classify clinical pharmacy interventions. Design . The CPR taxonomy was developed and refined in three phases. In each phase, reviewers independently reviewed recommendations made by a clinical pharmacist‐physician team and categorized them into mutually exclusive categories: priority, problem, and response. Interrater reliability was assessed for all categories during each development phase. Setting . Primary care clinics of a Veterans Affairs Medical Center. Patients . Fifty‐three patients enrolled in the Veterans Affairs Enhanced Pharmacy Outpatient Clinic (EPOC) trial. Measurements and Main Results . Interrater reliability was assessed using the κ statistic. A total of 423 recommendations were evaluated during the three testing phases. In the final testing phase, agreement was moderate for pharmacotherapy problem subcategories (κ=0.57), substantial for pharmacotherapy problem primary categories (κ=0.64), and almost perfect for response categories (κ=0.85). Taxonomy completion time/patient averaged 4.6 minutes (range 1–11 min). Conclusion . The CPR taxonomy provides a reliable method to systematically evaluate clinical pharmacy recommendations based on the therapeutic problem identified and specific action recommended to resolve the problem.