Comparison of drug-related problem risk assessment tools for older adults: a systematic review

Abstract

Purpose This study aims to systematically review studies describing screening tools that assess the risk for drug-related problems (DRPs) in older adults (≥ 60 years). The focus of the review is to compare DRP risks listed in different tools and describe their development methods and validation. Methods The systematic search was conducted using evidence-based medicine, Medline Ovid, Scopus, and Web of Science databases from January 1, 1985, to April 7, 2016. Publications describing general DRP risk assessment tools for older adults written in English were included. Disease, therapy, and drug-specific tools were excluded. Outcome measures included an assessment tool's content, development methods, and validation assessment. Results The search produced 15 publications describing 11 DRP risk assessment tools. Three major categories of risks for DRPs included (1) patient or caregiver related risks; (2) pharmacotherapy-related risks; and (3) medication use process-related risks. Of all the risks included in the tools only 8 criteria appeared in at least 4 of the tools, problems remembering to take the medication being the most common (n=7). Validation assessments varied and content validation was the most commonly conducted (n = 9). Reliability assessment was conducted for 6 tools, most commonly by calculating internal consistency (n = 3) and inter-rater reliability (n = 2). Conclusions The considerable variety between the contents of the tools indicates that there is no consensus on the risk factors for DRPs that should be screened in older adults taking multiple medicines. Further research is needed to improve the accuracy and timeliness of the DRP risk assessment tools.

Drug-Related Problems of Patients in Primary Health Care Institutions: A Systematic Review

“…The result of this research suggested that the number of medicines, age, and disease condition might be risk factors for the occurrence of DRPs, but most of the included studies involved middle-aged and elderly patients as study subjects, which might result in an incomplete summary of risk factors. DRPs are preventable (Pereira et al, 2012), and clinical pharmacists can use DRP risk assessment tools that have been developed (Puumalainen et al, 2020) (Freyer et al, 2018;Ylä-Rautio et al, 2020).…”

Clinical usefulness of prediction tools to identify adult hospitalized patients at risk of drug‐related problems: A systematic review of clinical prediction models and risk assessment tools

“…A number of published systemic reviews have summarized available prediction tools used to identify hospitalized patients at risk of adverse medication‐related outcomes 44–48 . While these reviews focused on assessing the methodological quality of development or validation studies, less emphasis has been placed on tool performance and clinical usefulness.…”

“…38,44 A number of published systemic reviews have summarized available prediction tools used to identify hospitalized patients at risk of adverse medication-related outcomes. [44][45][46][47][48] While these reviews focused on assessing the methodological quality of development or validation studies, less emphasis has been placed on tool performance and clinical usefulness. Furthermore, there is no guidance on the optimum tool for particular populations or settings, making it challenging to select the most useful tool for routine use in adult hospitalized patients.…”

Development and consensus testing of quality indicators for geriatric pharmacotherapy in primary care using a modified Delphi study

“…A large proportion of QIs was mapped to the c–DRP taxonomy including drug selection and monitoring related QIs. This may be explained by the fact that pharmacists play a critical role in resolving DRPs in these areas, considering the scope of pharmacy practice [ 41 , 49 , 50 ]. The majority of preventable DRPs are attributed to these categories [ 42 ].…”