Development of a Standardized Chart Review Method to Identify Drug-Related Hospital Admissions in Older People.

Thevelin, Stefanie; Spinewine, Anne; Beuscart, Jean-Baptiste; Boland, Benoit; Marien, Sophie; Vaillant, Fanny; Wilting, Ingeborg; Vondeling, Ariel; Floriani, Carmen; Schneider, Claudio; Donzé, Jacques; Rodondi, Nicolas; Cullinan, Shane; O'Mahony, Denis; Dalleur, Olivia (2018). Development of a Standardized Chart Review Method to Identify Drug-Related Hospital Admissions in Older People. British journal of clinical pharmacology, 84(11), pp. 2600-2614. Wiley-Blackwell 10.1111/bcp.13716

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AIM We aimed to develop a standardized chart review method to identify drug-related hospital admissions (DRA) in older people caused by non-preventable adverse drug reactions and preventable medication errors including overuse, underuse and misuse of medications: the DRA adjudication guide. METHODS The DRA adjudication guide was developed based on design and test iterations with international and multidisciplinary input in 4 subsequent steps: literature review, evaluation of content validity using a Delphi consensus technique, a pilot test and a reliability study. RESULTS The DRA adjudication guide provides definitions, examples and step-by-step instructions to measure DRA. A 3-step standardized chart review method was elaborated including 1) data abstraction, 2) explicit screening with a newly developed trigger tool for DRA in older people and 3) consensus adjudication for causality by a pharmacist and a physician using the World Health Organization-Uppsala Monitoring Centre and Hallas criteria. A 15-member international Delphi panel reached consensus agreement on 26 triggers for DRA in older people. The DRA adjudication guide showed good feasibility of use and achieved moderate inter-rater reliability for the evaluation of 16 cases by 4 European adjudication pairs (71% agreement, kappa = 0.41). Disagreements arose mainly for cases with potential underuse. CONCLUSIONS The DRA adjudication guide is the first standardized chart review method to identify DRA in older persons. Content validity, feasibility of use and inter-rater reliability were found to be satisfactory. The method can be used as an outcome measure for interventions targeted at improving quality and safety of medication use in older people.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Floriani, Carmen; Schneider, Claudio; Donzé, Jacques and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0306-5251

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

07 Aug 2018 12:08

Last Modified:

24 Oct 2019 14:28

Publisher DOI:

10.1111/bcp.13716

PubMed ID:

30007041

Uncontrolled Keywords:

Adverse Drug Reactions Clinical Pharmacology Elderly Geriatrics Medication Errors Medication safety Patient safety

BORIS DOI:

10.7892/boris.119130

URI:

https://boris.unibe.ch/id/eprint/119130

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