Development and content validation of an instrument to document the dispensing of prescribed medicines

Abstract

Summary What is known and objective Qualified dispensing is fundamental for the promotion of the rational use of medicines. Documentation is an indicator of quality and one of the essential steps in the care process. However, in Brazil, there are no models of clinical documentation applicable to dispensing practices. Thus, the objective of this study was to develop and validate an instrument to document the dispensing process of prescribed medicines. Methods A methodological development study was carried out from February 2017 to October 2017 in two stages, which were (i) the development of the instrument and (ii) content validation of the proposed instrument. The development phase comprised three stages, which were (i) the elaboration of the prototype based on a previously performed systematic review, (ii) academic brainstorming and (iii) a pre‐Delphi consensus. The content validation process was performed using the Delphi technique. The instrument was sent to 40 experts with experience in dispensing, and the consensus among them was calculated using the content validity index (CVI). The study was approved by the Ethics Committee, and all participants signed an informed consent document detailing the terms of the study. Results In the development stage, three versions of the instrument were generated, which were the prototype, version 1 (changed after academic brainstorming) and version 2 (changed after the pre‐Delphi). In the content validation process of version 2 of the instrument, 23 experts returned their evaluation in the first round of the Delphi process and 17 in the second. All the items obtained a CVI >0.83, which resulted in the validation of the instrument. The final instrument comprised the following sections: general information, the identification of technical and legal problems of prescriptions, the conduct for the resolution of the technical and legal problems of prescriptions, medication dispensed, suspected drug‐related problems, verbal guidance, written guidance, referral and the referral result. What is new and conclusion The developed and validated instrument presents the main variables that should be documented during the dispensing process.

Does drug dispensing improve the health outcomes of patients attending community pharmacies? A systematic review

“…Studies that address drug dispensing usually assess the quality of the practice showing a non-systematized and undocumented process [ 26 , 30 , 58 ]. Several strategies have been proposed to qualify this service, such as the development of instruments to support the practice and training pharmacists and pharmacy teams [ 27 , 38 , 59 ]. Another important point to be considered in quality assessment is knowing which health outcomes can be impacted by the services [ 39 ].…”

“…The second one involves the patient care process: (i) assessment of individual health needs of the patient, (ii) elaboration of the care plan with the performance of interventions in the process of medicine use that includes pharmaceutical counseling, and (iii) evaluation of the health outcomes of patients. This process should be documented and also involves frequent communication and collaboration with the patient and other health professionals [27,[36][37][38].…”

A new comprehensive oral health literacy scale: development and psychometric evaluation

“…Conventional methods for appropriate and accurate item pool generation include literature review, focus groups and semi-structured interviews [ 33 , 34 ]. There is no recognized ‘best practice’ for item pool generation, but literature reviews are widely used [ 14 ], and produce reliable findings and a high level of scientific evidence [ 35 ]. We used the translation–back-translation procedure for linguistic and cross-cultural adaptation of the OHL-AQ scale, which was similar to other studies [ 15 , 36 ].…”

“…Expert panel discussions were used to identify redundant and inappropriate items, and these were discarded and replaced by equivalent items. The involvement of experts in the panel discussions was an efficient strategy because those involved have experience in the field and can contribute effectively to this process [ 35 ]. The item pool was confirmed and reduced to 37 items.…”

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“…Recently, some studies have identi ed the need to improve drug dispensing with de ned and documented work processes [17,18]. It is therefore necessary to re ect on the processes related to the dispensing practice and its implementation in relation to the actors involved.…”