Reliability of a questionnaire for pharmacological treatment appropriateness in patients with multiple chronic conditions

Galván-Banqueri, Mercedes; Higuera-Vila, L. de la; Vega-Coca, María Dolores; Nieto-Martín, María Dolores; Pérez‐Guerrero, Concepción; Santos-Ramos, Bernardo

doi:10.1016/j.ejim.2013.01.020

Cited by 4 publications

(3 citation statements)

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“…Unlike the other studies, in our study there was no standard reference to compare the results with after applying the LESS-CHRON criteria. 25 In those studies, the results of the observers were compared with those obtained by an expert panel, 20 academic researchers 26 or the creator of the criteria 27 when they applied the criteria to the same patients. Thus, the kappa value in our study is the concordance between two clinicians after applying the tool, but does not mean that the tool is poorly applied and that it is similar to what occurred in the first validation study of the STOPP criteria.…”

Section: Discussionmentioning

confidence: 99%

“…It might have been better if prior to the study they had participated in a training session driven by the researchers to apply the tool. 25 The application of LESS-CHRON using only clinical histories is another limitation. There are several criteria which need to utilise a clinical scale or to check some clinical judgements that are not always well recorded in clinical histories.…”

Section: Discussionmentioning

confidence: 99%

“…Taking into account this value and the number of patients previously used in similar studies, 20 25-27 However, the sample size used to determine intraobserver reliability was 15 patients, which is the proportion from the sample used by similar studies. 25 The proportion of positive agreement (ppos), interpreted as the likelihood that the criterion was fulfilled, and the proportion of negative agreement (pneg), interpreted as the likelihood that the criterion was not fulfilled, were calculated. Moreover, the global per cent agreement was calculated.…”

Section: Statistical Analysis and Secondary Outcomesmentioning

confidence: 99%

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Validation of the LESS-CHRON criteria: reliability study of a tool for deprescribing in patients with multimorbidity

et al. 2018

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Objective The 'LESS-CHRON criteria' (List of Evidence-Based Deprescribing for Chronic Patients criteria) is a newly created tool with 27 criteria to guide deprescribing. It was developed using a Delphi methodology. Each criterion consists of drugs and their indications, conditions under which deprescribing would be considered, a health variable to be monitored after deprescribing and a follow-up period. The aim of our study was to evaluate the reliability of the LESS-CHRON criteria in a population of patients with multimorbidity to determine the possible usefulness of this tool in clinical practice. Methods We selected chronic patients with multimorbidity from an internal medicine unit who were older than 80 years old and were alive at the time of the study. To determine interobserver reliability, each professional (internist or hospital pharmacy specialist) applied the questionnaire under the same conditions and with the same resources. To determine intraobserver reliability, each health professional applied the tool at baseline and 2 months later. We measured interobserver and intraobserver reliability using the kappa coefficient. The proportion of overall agreement was also determined. results We obtained a moderate overall kappa (ĸ=0.46, 95% CI 0.36 to 0.55) for interobserver reliability, and good (ĸ=0.65, 95% CI 0.57 to 0.78) and moderate (ĸ=0.59, 95% CI 0.49 to 0.74) values for intraobserver reliability for the internist and pharmacist, respectively. The proportion of overall agreement was very high: 92% (range: 62%-100%) for the interobserver, and 94% (80%-100%) and 93% (63%-100%) for the internist and pharmacist, respectively. Conclusions The LESS-CHRON criteria shows early promise as a reliable method to help guide deprescribing in patients with multimorbidity. Further, more complete testing with a larger sample of prescribers is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysis and Secondary Outcomesmentioning

confidence: 99%

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