Development of a classification system for drug-related problems in the hospital setting (APS-Doc) and assessment of the inter-rater reliability

Abstract

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.

Development of an Aggregated System for Classifying Causes of Drug-Related Problems

“…15 The use of differing terminology to describe similar DRPs and causes of DRPs (Supplementary Table 1) may compromise the requirement for clear definitions, leading to only one choice of coding-a stated requirement for classification systems. 6,11 These findings were not restricted to the 7 chosen systems 9,[11][12][13]17,18,39,55,[134][135][136] and appear to make reports of interrater results difficult to interpret. 10 Whereas we have reported results from our study, which show good agreement at the first 2 hierarchical levels, it appears that until a standardized form of assessment is specified addressing these issues, validation using interrater indices may be a questionable method of judging consistency of application of classification systems.…”

“…1,9,16,17,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] For example, categories identified as causes of DRPs have varied in number from six 39 to 37, 40 and the number of DRP cause subcategories have varied from nine 9 to 48. 12 As stated, there has also been variability in the definition of DRPs, and in categories identified as causes of DRPs or as DRPs themselves, 17,19,31,33,34,36,37,41,42 with some classification systems containing categories identified only as DRPs, [9][10][11][12][13][15][16][17][18]43 whereas others contain categories identified as both causes of DRPs and DRPs. 1,14,…”

Clinical Usefulness of Electronic Drug-Drug Interaction Checking in the Care of Cardiovascular Surgery Inpatients

“…However, there are no established ‘gold standards’ in this field. For a simple 10-category system for classifying DRPs, the inter-rater agreement was found to be 0.68 [11]. The CDSS system used here is one which is more widespread in Europe than in the USA, where systems capable of alerting on DRPs not solely arising from drug-drug interactions are commonly in place.…”

A comparison of the version 4 and version 5 service quality standards in terms of the medication safety in hospitals

“…İlaçların yönetimi ile ilgili eğitimler artırılmalı, ilaç bilgisine kolay ulaşım için gerekli teknoloji sağlanmalı ve sağlık personeli iletişim becerilerinin artırılması hedeflenmelidir. Ayrıca, her hastanede ilaç güvenliği konusunda uygun bireylerin "örneğin eczacı ya da farmakologların" eğitilerek, yetkilendirilmesi de birçok yayında önerilmekte, bu durum sahiplenmeyi artırdığı için yararına dikkat çekilmektedir [40][41][42][43] . Sağlıkta Dönüşüm Projesi kapsamında başlatılan kalite yönetimi çalışmaları, performansa dayalı bir ödeme sistemi üzerine kurulu olduğundan, personelin katılımı aşamasında teşvik edici, hatta belki biraz da zorlayıcıdır.…”