Pharmacoepidemiology and Prescription

European Journal of Clinical Pharmacology

, Volume 70, Issue 8, pp 991-1002

First online:

Content validation of a tool for assessing risks for drug-related problems to be used by practical nurses caring for home-dwelling clients aged ≥65 years: a Delphi survey

  • Maarit S. DimitrowAffiliated withClinical Pharmacy Group, Faculty of Pharmacy, University of Helsinki Email author 
  • , Sanna I. MykkänenAffiliated withClinical Pharmacy Group, Faculty of Pharmacy, University of Helsinki
  • , Saija N. S. LeikolaAffiliated withClinical Pharmacy Group, Faculty of Pharmacy, University of Helsinki
  • , Sirkka-Liisa KiveläAffiliated withClinical Pharmacy Group, Faculty of Pharmacy, University of HelsinkiDepartment of Family Medicine, Institute of Clinical Medicine, University of TurkuUnit of Family Medicine, Turku University HospitalSatakunta Hospital District
  • , Alan LylesAffiliated withClinical Pharmacy Group, Faculty of Pharmacy, University of HelsinkiSchool of Health and Human Services, University of Baltimore
  • , Marja S. A. AiraksinenAffiliated withClinical Pharmacy Group, Faculty of Pharmacy, University of Helsinki

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Abstract

Purpose

Home care services are becoming a critically important part of health care delivery as populations are aging. Those using home care services are increasingly older, more frail than previously, and use multiple medications, making them vulnerable to drug-related problems (DRPs). Practical nurses (PN) visit home-dwelling aged clients frequently and, thus, are ideally situated to identify potential DRPs and, if needed, to communicate them to physicians for resolution. This study developed and validated the content of a tool to be used by PNs for assessing DRP risks for their home-dwelling clients aged ≥65 years.

Methods

The first draft of the tool was based on two systematic literature reviews and clinical experience of our research group. Content validity of the tool was determined by a three-round Delphi survey with a panel of 18 experts in geriatric care and pharmacotherapy. An agreement by ≥80 % of the panel on an item was required.

Results

The final tool consists of 18 items that assess risks for DRPs in home-dwelling aged clients. It is divided into four sections: (1) Basic Client Data, (2) Potential Risks for DRPs in Medication Use, (3) Characteristics of the Client’s Care and Adherence, and (4) Recommendations for Actions to Resolve DRPs.

Conclusions

The Delphi process resulted in a structured DRP Risk Assessment Tool that is focused on the highest priority DRPs that should be identified and resolved. The tool also assists the PNs to identify solutions to these problems, which is a unique feature compared to similarly purposed prior tools.

Keywords

Geriatric pharmacotherapy Adverse drug reactions Drug-related problems Risk management Patient safety Primary care