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Prospective survey-based study on the categorization quality of hospital pharmacists’ interventions using DokuPIK

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Abstract

Background There is a growing need to categorize pharmacists’ interventions (PIs) in Germany to document their impact on solving or avoiding drug-related problems. Objective To validate the categorization of drug-related problems—one aspect of the categorical internet database DokuPIK, designed for recording routinely PIs. To identify case-specific predictive values. Setting German hospitals. Methods Within a prospective, nationwide survey-based study, 37 of 498 registered database users volunteered to evaluate 24 standardized case reports independently. Case evaluation was restricted to classify problems, based on 26 given categories with no limit on the number of item choices. Ratings were conducted electronically and anonymously. A gold standard of one or more problems per case was developed by majority consensus of five senior clinical pharmacists. Agreement of raters’ case classification with the gold standard was assessed by calculating sensitivity, specificity and positive and negative predictive value and was reported as median and range. Main outcome Level of agreement. Results Independent assessment yielded a median agreement of 90% [79–94%]. Sensitivity and specificity were 37% [21–57%] and 99% [97–100%], respectively. Median positive and negative predicted value were both 90% [60–100%] and 90% [78–95%]. Mean case-specific agreement was robust (≥ 79%) with respect to a majority and maximum consensus (three and five out of five raters). Conclusion DokuPIK seems to have a high level of agreement and a good specificity according to the majority of clinical pharmacists in a panel of assessors. Despite the allowance of multiple choices, predictive values were high and indicated a well-constructed classification by pharmacists.

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References

  1. Basger BJ, Moles RJ, Chen TF. Application of drug-related problem (DRP) classification systems: a review of the literature. Eur J Clin Pharmacol. 2014;70(7):799–815.

    Article  PubMed  Google Scholar 

  2. Melchiors AC, Correr CJ, Venson R, Pontarolo R. An analysis of quality of systematic reviews on pharmacist health interventions. Int J Clin Pharm. 2012;34(1):32–42.

    Article  PubMed  Google Scholar 

  3. Patterson SM, Cadogan CA, Kerse N, Cardwell CR, Bradley MC, Ryan C, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2014;10:Cd008165.

    Google Scholar 

  4. Christensen M, Lundh A. Medication review in hospitalised patients to reduce morbidity and mortality. Cochrane Database Syst Rev. 2016;2:Cd008986.

    PubMed  Google Scholar 

  5. Guerin A, Tanguay C, Lebel D, Bussieres J-F. Website on the impact of pharmacists. Eur J Hosp Pharm. 2014;21:192.

    Article  Google Scholar 

  6. Batty R BE. Prescription monitoring interventions—is recording justified? Hospital Pharmacy. 1994;1.

  7. Brady DFB. An evaluation of the contribution of the medical admissions pharmacist at a London Teaching Hospital. Int J Pharm Pract. 2004;1:1–6.

    Article  Google Scholar 

  8. Correr CJ, Melchiors AC, de Souza TT, Rotta I, Salgado TM, Fernandez-Llimos F. A tool to characterize the components of pharmacist interventions in clinical pharmacy services: the DEPICT project. Ann Pharmacother. 2013;47(7–8):946–52.

    Article  PubMed  Google Scholar 

  9. Frontini R, Miharija-Gala T, Sykora J. EAHP Survey 2010 on hospital pharmacy in Europe: Part 1. General frame and staffing. Eur J Hosp Pharm. 2012;19:385–7.

    Article  Google Scholar 

  10. EAHP. European Statements of Hospital Pharmacy. Survey Results 2014–15 http://www.eahp.eu/publications/survey/content/2015-eahp-survey-results2016.

  11. Frontini R, Miharija-Gala T, Sykora J. EAHP Survey 2010 on hospital pharmacy in Europe: arts 4 and 5. Clinical services and patient safety. Eur J Hosp Pharm. 2013;20:69–73.

    Article  Google Scholar 

  12. Kantelhardt P, Langebrake C. DokuPik—a new database for the documentation of medication errors and pharmaceutical interventions (part I medication errors). Krankenhauspharmazie. 2009;30(2):63–8.

    Google Scholar 

  13. Langebrake C, Kantelhardt P. DokuPik—a new database for the documentation of medication errors and pharmaceutical interventions (part II interventions). Krankenhauspharmazie. 2009;30(9):149–55.

    Google Scholar 

  14. van Mil JW, Westerlund LO, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother. 2004;38(5):859–67.

    Article  PubMed  Google Scholar 

  15. Europe PCN. PCNE Classification for Drug-Related Problems V5.01. http://www.pcne.org/sig/drp/documents/PCNE%20classification%20V5.01.pdf2006 [cited 2014 2014-08-25].

  16. Hohmann C, Eickhoff C, Klotz JM, Schulz M, Radziwill R. Development of a classification system for drug-related problems in the hospital setting (APS-Doc) and assessment of the inter-rater reliability. J Clin Pharm Ther. 2012;37(3):276–81.

    Article  CAS  PubMed  Google Scholar 

  17. Schaefer M. Discussing basic principles for a coding system of drug-related problems: the case of PI-Doc. Pharm World Sci. 2002;24(4):120–7.

    Article  PubMed  Google Scholar 

  18. Wolf C, Pauly A, Nutt S, Mangartz L, Friedland K, Langebrake C. Comparison of two documentation systems for drug-related problems: DokuPIK and PIE-System. Krankenhauspharmazie. 2015;36(2):69–78.

    Google Scholar 

  19. Methodology WCCfDS. ATC/DDD Index 2016 http://www.whocc.no/atc_ddd_index/[updated 2015-04-23. Last updated: 2013-12-19.

  20. Reporting NCCoME, Prevention. a. NCC MERP Taxonomy of Medication Errors. http://www.nccmerp.org/sites/default/files/taxonomy2001-07-31.pdf2016.

  21. Bourne RS, Shulman R, Tomlin M, Borthwick M, Berry W, Mills GH. Reliability of clinical impact grading by healthcare professionals of common prescribing error and optimisation cases in critical care patients. Int J Qual Health Care. 2017;29(2):250–5.

    Article  PubMed  Google Scholar 

  22. Ganso M, Areschin S, Lange P, Emser A, Rössler J, Krämer I. Verlässlichkeit eines Klassifikationssystems für pharmazeutische Interventionen. Krankenhauspharmazie. 2007;28(7):273–83.

    Google Scholar 

  23. Q-SET, Design of on-line surveys http://www.q-set.de/: Goldecker GmbH.

  24. Langebrake C, Ihbe-Heffinger A, Leichenberg K, Kaden S, Kunkel M, Lueb M, et al. Nationwide evaluation of day-to-day clinical pharmacists’ interventions in German hospitals. Pharmacotherapy. 2015;35(4):370–9.

    Article  PubMed  Google Scholar 

  25. Gisev N, Bell JS, Chen TF. Interrater agreement and interrater reliability: key concepts, approaches, and applications. Res Social Adm Pharm. 2013;9(3):330–8.

    Article  PubMed  Google Scholar 

  26. Rehling M. Visualizing the impact of prevalence on a diagnostic test. Scand J Clin Lab Invest. 2010;70(6):458–61.

    Article  PubMed  Google Scholar 

  27. Team RC. R: A language and environment for statistical computing Vienna, Austria: R Foundation for Statistical Computing; 2015 [Available from: http://www.R-project.org/.

  28. Rudall N, McKenzie C, Landa J, Bourne RS, Bates I, Shulman R. PROTECTED-UK—Clinical pharmacist interventions in the UK critical care unit: exploration of relationship between intervention, service characteristics and experience level. Int J Pharm Pract. 2017;25(4):311–9.

    Article  PubMed  Google Scholar 

  29. Akobeng AK. Understanding diagnostic tests 1: sensitivity, specificity and predictive values. Acta Paediatrica (Oslo, Norway: 1992). 2007;96(3):338–41.

    Article  Google Scholar 

  30. Landis JRKG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.

    Article  CAS  PubMed  Google Scholar 

  31. Nielsen TR, Andersen SE, Rasmussen M, Honore PH. Clinical pharmacist service in the acute ward. Int J Clin Pharm. 2013;35(6):1137–51.

    Article  PubMed  Google Scholar 

  32. Allenet B, Bedouch P, Rose FX, Escofier L, Roubille R, Charpiat B, et al. Validation of an instrument for the documentation of clinical pharmacists’ interventions. Pharm World Sci. 2006;28(4):181–8.

    Article  PubMed  Google Scholar 

  33. Wirtz M, Kutschmann M. Analyzing interrater agreement for categorical data using Cohen’s kappa and alternative coefficients. Die Rehabil. 2007;46(6):370–7.

    Article  CAS  Google Scholar 

  34. Ruths S, Viktil KK, Blix HS. Classification of drug-related problems. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke. 2007;127(23):3073–6.

    Google Scholar 

  35. Williams M, Peterson GM, Tenni PC, Bindoff IK, Stafford AC. DOCUMENT: a system for classifying drug-related problems in community pharmacy. Int J Clin Pharm. 2012;34(1):43–52.

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to thank the survey participants. Angela Ihbe-Heffinger, Claudia Langebrake, Carina Hohmann, Katja Leichenberg, Heike Hilgarth, Mareike Kunkel, and Michael Lueb for the Pharmacists’ interventions working group of the German Association of Hospital Pharmacists, ADKA.

Funding

This study did not receive funding.

Conflicts of interest

All authors declared no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Family Medicine, McGill University, Montreal, QC, Canada

    Tibor Schuster

  2. Department of Gynecology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Angela Ihbe-Heffinger

  3. Hospital Pharmacy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Angela Ihbe-Heffinger

  4. Hospital Pharmacy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

    Claudia Langebrake & Heike Hilgarth

  5. Department of Stem Cell Transplantation, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

    Claudia Langebrake

  6. Hospital Pharmacy Unit, Klinikum Fulda AG, Fulda, Germany

    Carina Hohmann

  7. Hospital Pharmacy Unit, Universitätsklinikum der Friedrich-Schiller-Universität Jena, Jena, Germany

    Katja Leichenberg

  8. Hospital Pharmacy Unit, Klinikum der Johannes Gutenberg-Universität Mainz, Mainz, Germany

    Mareike Kunkel

  9. Hospital Pharmacy Unit, SLK-Kliniken Heilbronn, Heilbronn, Germany

    Michael Lueb

  10. Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Tibor Schuster

  11. Hospital Pharmacy, Klinikum Starnberg GmbH, Academic Teaching Hospital of the Ludwig-Maximilians-Universität München, Oßwaldstraße 1, 82319, Starnberg, Germany

    Angela Ihbe-Heffinger

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  1. Angela Ihbe-Heffinger
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  2. Claudia Langebrake
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  3. Carina Hohmann
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  4. Katja Leichenberg
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  5. Heike Hilgarth
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  6. Mareike Kunkel
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  7. Michael Lueb
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  8. Tibor Schuster
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Correspondence to Angela Ihbe-Heffinger.

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Ihbe-Heffinger, A., Langebrake, C., Hohmann, C. et al. Prospective survey-based study on the categorization quality of hospital pharmacists’ interventions using DokuPIK. Int J Clin Pharm 41, 414–423 (2019). https://doi.org/10.1007/s11096-019-00785-8

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  • DOI: https://doi.org/10.1007/s11096-019-00785-8

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