Validation of a Drug-Related Problem Classification System for the Intermediate and Long-Term Care Setting in Singapore

Abstract

Background: This study aims to evaluate the inter-rater reliability and perceived usability of a newly developed drug-related problem (DRP) classification system for use by pharmacists in the intermediate and long-term care (ILTC) setting in Singapore. Methods: This was a cross-sectional survey study involving the use of a self-administered questionnaire. All 55 pharmacists affiliated to the Pharmaceutical Society of Singapore (PSS) ILTC Pharmacists Workgroup who were above 21 years old and not authors of the classification system were invited to participate. The inter-rater reliability of participants’ classification of 46 mock DRP cases using the new DRP classification system was determined using Fleiss’s kappa (κ). Participants’ perceived usability of the classification system was evaluated using six items with five-point Likert scales (1—“strongly disagree”, 5—“strongly agree”). Results: Thirty-three pharmacists responded to the survey. Overall inter-rater reliability was found to be substantial (κ = 0.614; 95% CI: 0.611–0.617). All usability items received positive ratings (“strongly agree” or “agree”) from at least 69% of participants. Conclusion: The new DRP classification system has substantial external validity and appears to be suitable for use by pharmacists to document and report DRPs in the ILTC setting in Singapore and facilitate evaluation of the impact of pharmaceutical care in the ILTC setting.

The Translation Process of Pharmaceutical Care Network Europe v9.00 to Bahasa Indonesia: An Instrument to Detect Drug-Related Problem

“…The kappa statistics showed a high degree of agreement on both ‘problem’ and ‘causes’ domains. The value was higher compared to others such as DOCUMENT (0.53 versus 0.615) ( 19 ) and GSASA V2 (0.52 versus 0.615) ( 20 ), lower than APS-Doc (0.68 versus 0.615) ( 21 ) and similar with the classification developed by the Pharmaceutical Society of Singapore (ILTC DRP Classification System) (0.614 versus 0.615) ( 8 ). Furthermore, it is believed that the low value of kappa in this study is because the raters are not too familiar with the instrument.…”

“…A DRP classification system needs to have an open hierarchical structure with clear definitions for each category described in the instrument to reduce ambiguity or multiple interpretations when carrying out the coding process ( 8 ). Furthermore, the ease of use is also a specific requirement of the DRP classification system, which must be acceptable.…”

“…Furthermore, the ease of use is also a specific requirement of the DRP classification system, which must be acceptable. Therefore, the DRP classification system needs to be validated before it is widely used ( 8 – 9 ).…”

Drug-related problems in Ethiopian public healthcare settings: Systematic review and meta-analysis

“…In addition, modification of the adopted classification system should be considered for special groups of patients such as the elderly. 49 …”

An Overview on Patient-Centered Clinical Services

“…Drug-related problems (DRPs) have often been a systemic concern that must be recognized, avoided, and handled as soon as possible. Any cure for the problem isn't new 8 . Different terms are proposed; for instance, 'drug-treatment issue' is regularly utilized as well, and Various reports have come forward which enlists "druginduced problem" since many efforts have been put forward to optimize the rational usage of the drug and medical preparations 12 .…”