User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

Content validity and inter-rater reliability of an instrument to characterize unintentional medication discrepancies

Primary tabs

Claeys, C. Nève, J. Tulkens, P.M. Spinewine, Anne [UCL]

Background: Medication discrepancies are medication-related problems (MRPs) that frequently occur when patients are transferred between settings of care. Older patients are at high risk for several reasons, including high consumption of medicines, and physical and cognitive deficiencies that can impair the communication process. Most previous studies that have evaluated medication discrepancies used instruments designed for clinical practice, but a well-validated and reliable instrument for clinical research is still lacking. Objectives: The aims of this study were to (i) develop an instrument to characterize medication discrepancies that fulfils quality requirements for classification of MRPs related to continuity of care and (ii) assess its content validity and inter-rater reliability. Methods: The instrument was developed based on three main inputs: (i) a literature review to collect information about the quality requirements of instruments to characterize MRPs; (ii) another literature review to identify existing instruments to characterize MRPs and, more specifically, medication discrepancies; and (iii) previous experience from a pilot study on Belgian patients discharged from surgical and medical wards. Content validity was assessed using a modified Delphi technique with 11 healthcare professionals. Content validity indexes were calculated. For inter-rater reliability, three pharmacists (one experienced and two naive) were asked to identify and categorize (type and cause of) unintentional medication discrepancies for 21 patients discharged from hospital into the community. The intra-class correlation coefficient was calculated to compare the number of discrepancies identified, and a paradox-resistant index (AC1) was used to determine the inter-rater reliability for the type and cause of the discrepancy. Results: The instrument had 54 items classified in three sections (type of discrepancy, cause and intervention), with detailed specifications on how to use it. All evaluations relative to content validity met predefined cut-off values, except for two of them. Intra-class correlation coefficients of ≥0.76 and AC1 coefficients of ≥0.89 were found for the number and the type of discrepancies, respectively. Regarding evaluation of the specific causes of medication discrepancies, final AC1 results of ≥0.86 were obtained, except for three items (which had values between 0.62 and 0.79). Conclusion: The validity and reliability of the instrument developed to assess unintentional medication discrepancies at patient transition from the hospital to the community setting was found to be satisfactory. Adis © 2012 Springer International Publishing AG. All rights reserved.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2012
Language Anglais
Journal information "Drugs & Aging" - Vol. 29, no. 7, p. 577-591 (2012)
Peer reviewed yes
Publisher Adis International Ltd. ((New Zealand) Auckland)
issn 1170-229X
Publication status Publié
Affiliations UCL - (MGD) Département de pharmacie
UCL - SSS/LDRI - Louvain Drug Research Institute
Keywords Community-care ; Elderly ; Hospitalisation ; Medication-errors.
Links
  1. Boockvar K S, Liu S, Goldstein N, Nebeker J, Siu A, Fried T, Prescribing discrepancies likely to cause adverse drug events after patient transfer, 10.1136/qshc.2007.025957
  2. Forster Alan J., Murff Harvey J., Peterson Josh F., Gandhi Tejal K., Bates David W., Adverse drug events occurring following hospital discharge, 10.1111/j.1525-1497.2005.30390.x
  3. Williams E. I., Fitton F., Factors affecting early unplanned readmission of elderly patients to hospital., 10.1136/bmj.297.6651.784
  4. Tam V. C., Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review, 10.1503/cmaj.045311
  5. Coleman Eric A., Smith Jodi D., Raha Devbani, Min Sung-joon, Posthospital Medication Discrepancies : Prevalence and Contributing Factors, 10.1001/archinte.165.16.1842
  6. Wong JD, Bajcar JM, Wong GG, et al. Medication reconciliation at hospital discharge: evaluating discrepancies. Ann Pharmacother 2008; 42 (10): 1373–9.
  7. Tjia Jennifer, Bonner Alice, Briesacher Becky A., McGee Sarah, Terrill Eileen, Miller Kathleen, Medication Discrepancies upon Hospital to Skilled Nursing Facility Transitions, 10.1007/s11606-009-0948-2
  8. Lee Justin Y, Leblanc Kori, Fernandes Olavo A, Huh Jin-Hyeun, Wong Gary G, Hamandi Bassem, Lazar Neil M, Morra Dante, Bajcar Jana M, Harrison Jennifer, Medication Reconciliation During Internal Hospital Transfer and Impact of Computerized Prescriber Order Entry, 10.1345/aph.1p314
  9. Stitt Danielle M., Elliott David P., Thompson Stephanie N., Medication Discrepancies Identified at Time of Hospital Discharge in a Geriatric Population, 10.1016/j.amjopharm.2011.06.002
  10. Unroe Kathleen Tschantz, Pfeiffenberger Trista, Riegelhaupt Sarah, Jastrzembski Jennifer, Lokhnygina Yuliya, Colón-Emeric Cathleen, Inpatient medication reconciliation at admission and discharge: A retrospective cohort study of age and other risk factors for medication discrepancies, 10.1016/j.amjopharm.2010.04.002
  11. Gleason KM, Groszek JM, Sullivan C, et al. Reconciliation of discrepancies in medication histories and admission orders of newly hospitalized patients. Am J Health Syst Pharm 2004; 61 (16): 1689–95.
  12. Coleman EA, Berenson RA. Lost in transition: challenges and opportunities for improving the quality of transitional care. Ann Intern Med 2004; 141 (7): 533–6.
  13. van Mil JW Foppe, Westerlund LO Tommy, Hersberger Kurt E, Schaefer Marion A, Drug-Related Problem Classification Systems, 10.1345/aph.1d182
  14. Schaefer Marion, 10.1023/a:1019543029936
  15. Smith Jodi D., Coleman Eric A., Min Sung-Joon, A new tool for identifying discrepancies in postacute medications for community-dwelling older adults, 10.1016/s1543-5946(04)90019-0
  16. Taylor CT, Stewart LM, Byrd DC, et al. Reliability of an instrument for evaluating antimicrobial appropriateness in hospitalized patients. Am J Health Syst Pharm 2001; 58 (3): 242–6.
  17. Stuijt Clementine C. M., Franssen Eric J. F., Egberts Antoine C. G., Hudson Stephen A., Reliability of the medication appropriateness index in Dutch residential home, 10.1007/s11096-009-9283-2
  18. Spinewine Anne, Dumont Christophe, Mallet Louise, Swine Christian, MEDICATION APPROPRIATENESS INDEX: RELIABILITY AND RECOMMENDATIONS FOR FUTURE USE : LETTERS TO THE EDITOR, 10.1111/j.1532-5415.2006.00668_8.x
  19. Tully Mary P., Cantrill Judith A., Inter-rater Reliability of Explicit Indicators of Prescribing Appropriateness, 10.1007/s11096-005-2453-y
  20. Forrey R. A., Pedersen C. A., Schneider P. J., Interrater agreement with a standard scheme for classifying medication errors, 10.2146/ajhp060109
  21. Grant Joan S., Davis Linda L., Selection and use of content experts for instrument development, 10.1002/(sici)1098-240x(199706)20:3<269::aid-nur9>3.0.co;2-g
  22. Polit Denise F., Beck Cheryl Tatano, Owen Steven V., Is the CVI an acceptable indicator of content validity? Appraisal and recommendations, 10.1002/nur.20199
  23. Lynn MR. Determination and quantification of content validity. Nurs Res 1986; 35 (6): 382–5.
  24. Burke Michael J., Dunlap William P., Estimating Interrater Agreement with the Average Deviation Index: A User’s Guide, 10.1177/1094428102005002002
  25. Pit Sabrina Winona, Byles Julie Ellen, Cockburn Jill, Accuracy of Telephone Self-Report of Drug Use in Older People and Agreement with Pharmaceutical Claims Data : , 10.2165/00002512-200825010-00008
  26. Cicchetti DV, Sparrow SA. Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior. Am J Ment Defic 1981; 86 (2): 127–37.
  27. Gwet KL. The definitive guide to measuring extent of agreement among multiple raters. 2nd ed. Gaithersburg (MD): Advanced Analytics, LLC, 2010.
  28. Gwet KL. AgreeStat 2011.2 for MS Excel [Excel workbook; online]. Available from URL: http://www.agreestat.com/agreestat.html [Accessed 2010 Jul 2].
  29. Landis J. Richard, Koch Gary G., The Measurement of Observer Agreement for Categorical Data, 10.2307/2529310
  30. Cicchetti Domenic V., Feinstein Alvan R., High agreement but low kappa: II. Resolving the paradoxes, 10.1016/0895-4356(90)90159-m
  31. Classification for drug related problems. V5.01. Pharmaceutical Care Network Europe Foundation, 2006 [online]. Available from URL: http://www.pcne.org/sig/drp/documents/drp/PCNE%20classification%20V5.01.pdf [Accessed 2008 Aug 13].
  32. Pippins Jennifer R., Gandhi Tejal K., Hamann Claus, Ndumele Chima D., Labonville Stephanie A., Diedrichsen Ellen K., Carty Marcy G., Karson Andrew S., Bhan Ishir, Coley Christopher M., Liang Catherine L., Turchin Alexander, McCarthy Patricia C., Schnipper Jeffrey L., Classifying and Predicting Errors of Inpatient Medication Reconciliation, 10.1007/s11606-008-0687-9
  33. Stuffken Rutger, Heerdink Eibert R, Koning Fred HP de, Souverein Patrick C, Egberts Antoine CG, Association Between Hospitalization and Discontinuity of Medication Therapy Used in the Community Setting in the Netherlands, 10.1345/aph.1l062
  34. Leape LL, Bates DW, Cullen DJ, et al. Systems analysis of adverse drug events. ADE Prevention Study Group. JAMA 1995; 274 (1): 35–43.
  35. Schmitt E, Antier D, Bernheim C, et al. Dictionnaire français de l’erreur médicamenteuse. 1st ed. Montry: Société Française de Pharmacie Clinique, 2006 [online]. Available from URL: http://adiph.asso.fr/sfpc/Dictionnaire_SFPC_EM.pdf [Accessed 2008 Jul 9].
  36. Rantucci MJ, Pigot-Renou D, Renou G, et al. Le dialogue pharmacien-patient. Rueil-Malmaison: Pro-officina, 2008.
  37. Mallet L, Grenier L, Guimond J, et al. Manuels de soins pharmaceutiques en gériatrie. Saint Nicolas: Les Presses de l’Université de Laval, 2003.
  38. 5 Million Lives Campaign. Getting Started Kit: prevent adverse drug events (medication reconciliation) how-to guide. Cambridge (MA): Institute for Healthcare Improvement, 2008 [online]. Available from URL: http://www.ihi.org/IHI/Programs/Campaign/ADEsMedReconciliation.htm [Accessed 2008 Sep 8].
  39. Getting Started Kit: medication reconciliation: prevention of adverse drug events: how-to guide. The Institute for Safe Medication Practices Canada, 2007 [online]. Available from URL: http://www.saferhealthcarenow.ca/Default.Aspx? [Accessed 2008 Sep 8].
  40. Allenet Benoît, Bedouch Pierrick, Rose François-Xavier, Escofier Laurence, Roubille Renaud, Charpiat Bruno, Juste Michel, Conort Ornella, Validation of an instrument for the documentation of clinical pharmacists’ interventions, 10.1007/s11096-006-9027-5
  41. Kripalani Sunil, Jackson Amy T., Schnipper Jeffrey L., Coleman Eric A., Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists, 10.1002/jhm.228
Bibliographic reference Claeys, C. ; Nève, J. ; Tulkens, P.M. ; Spinewine, Anne. Content validity and inter-rater reliability of an instrument to characterize unintentional medication discrepancies. In: Drugs & Aging, Vol. 29, no. 7, p. 577-591 (2012)
Permanent URL http://hdl.handle.net/2078.1/126960