A national drug related problems database: evaluation of use in practice, reliability and reproducibility.

Background: A drug related problems database (DRP-database) was developed on request by clinical pharmacists. The information from the DRP-database has only been used locally e.g. to identify focus areas and to communicate identified DRPs to the hospital wards. Hence the quality of the data at the n...

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Published in:International Journal of Clinical Pharmacy Vol. 36; no. 4; pp. 742 - 750
Main Authors: Kjeldsen, Lene Juel, Birkholm, Trine, Fischer, Hanne, Graabæk, Trine, Hansen, Merete Kjær, Kibsdal, Karina Porsborg, Ravn-Nielsen, Lene Vestergaard, Truelshøj, Tania Holtum
Format: research Journal Article
Published: Springer Nature Aug2014
Online Access:View this record in EBSCOhost
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      dt: Aug2014
      vid: 36
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s11096-014-9957-2
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        atl: A national drug related problems database: evaluation of use in practice, reliability and reproducibility.
      aug:
        au:
          Kjeldsen, Lene Juel
          Birkholm, Trine
          Fischer, Hanne
          Graabæk, Trine
          Hansen, Merete Kjær
          Kibsdal, Karina Porsborg
          Ravn-Nielsen, Lene Vestergaard
          Truelshøj, Tania Holtum
        affil: The Danish Research Unit for Hospital Pharmacy, Amgros I/S, Dampfærgevej 22, 2100, Copenhagen, Denmark, ljk@amgros.dk.
      sug:
        subj:
          Adverse Drug Event
          Medication Reconciliation
          National Health Programs
          Pharmacy and Pharmacology Labor Supply
          Pharmacy Service Labor Supply
          Drugs, Prescription Adverse Effects
          Quality of Health Care
          Denmark
          Drug Monitoring
          Drug Therapy, Combination Adverse Effects
          Electronic Health Records
          Prospective Studies
          Guideline Adherence
          Human
          Practice Patterns
          Practice Guidelines
          Drugs, Prescription Administration and Dosage
          Drugs, Prescription Therapeutic Use
          Reproducibility of Results
      ab: Background: A drug related problems database (DRP-database) was developed on request by clinical pharmacists. The information from the DRP-database has only been used locally e.g. to identify focus areas and to communicate identified DRPs to the hospital wards. Hence the quality of the data at the national level is unknown, which may compromise national analyses for benchmarking and identification of national focus areas.Objective: The aim of the study was to evaluate the use in practice, reliability and reproducibility of the DRPs documented in the Danish drug related problems database.Setting: Danish hospital pharmacies.Methods: Practice use of the DRP-database was explored by an electronic questionnaire distributed to hospital pharmacies, and consisted of questions regarding current and previous use of the DRP-database. The reliability was evaluated by comparing the categorization of 24 cases by clinical pharmacists with categorization performed by the project group. Reproducibility was explored by re-categorization of a sample of existing records in the DRP-database by two project group members individually.Main Outcome Measures: Observed proportion of agreement and Fleiss' kappa as measures of inter-rater reliability and reproducibility.Results: The practice use study of 12 hospital pharmacy locations revealed that when implementing the DRP-database, the majority of identified DRPs are documented in the DRP-database, however, some variations throughout the country exist. The interrater reliability study of 34 clinical pharmacists showed high inter-rater reliability with the project group (Fleiss' kappa = 0.79 with 95 % CI (0.70; 0.88)), and the reproducibility study also documented high inter-rater reliability of a sample of 379 records from the DRP-database re-categorized by two project group members (Fleiss' kappa = 0.81 with 95 % CI (0.78; 0.85)).Conclusion: The study showed high reliability and reproducibility of the DRP-database, however, some local variation in the use of the DRP-database throughout the country existed affecting the overall quality. These findings indicate that data in the DRP-database may be pooled, and national analyses may be conducted to explore development areas for common interest.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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