Development and validation of criteria for classifying severity of drug-related problems in chronic kidney disease: A community pharmacy perspective

Quintana-Bárcena, Patricia; Lord, Anne; Lizotte, Annie; Berbiche, Djamal; Jouini, Ghaya; Lalonde, Lyne

doi:10.2146/ajhp140765

Cited by 8 publications

(7 citation statements)

References 29 publications

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“…The severity of the identified DRPs was assessed using the Severity Categorization for Pharmaceutical Evaluation (SCOPE) criteria. 17 According to these criteria, severity is determined by the intensity of the pharmaceutical intervention required to appropriately manage DRPs. These criteria propose 3 categories followed in 6 ambulatory CKD clinics, and (b) assess the effect of a training-and-communication network program in nephrology for community pharmacists on DRP prevalence, when classified by severity level.…”

Section: Assessment Of Drp Severitymentioning

confidence: 99%

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Prevalence and Management of Drug-Related Problems in Chronic Kidney Disease Patients by Severity Level: A Subanalysis of a Cluster Randomized Controlled Trial in Community Pharmacies

Quintana-Bárcena

Lord

Lizotte

et al. 2018

JMCP

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This study was supported by the Canadian Institutes of Health Research (grant number: MOP-230207). Part of the study was also funded by Pfizer Canada, Leo Pharma, and Amgen. The authors declare that they have no relevant financial interests. Study concept and design were contributed by Quintana-Bárcena, Lord, and Lalonde. Quintana-Bárcena, Lord, and Lizotte were responsible for the data analysis, and Quintana-Bárcena and Berbiche performed the statistical analysis. The manuscript was written by Quintana-Bárcena and Lalonde and revised by Quintana-Bárcena and Lalonde, along with the other authors.

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Section: Assessment Of Drp Severitymentioning

confidence: 99%

“…The testretest reliability and the interrater reliability of the SCOPE criteria varied from 0.79 to 0.90 and 0.72 to 0.82, respectively. 17 The SCOPE criteria were applied by 1 of 3 pharmacists to all DRPs identified at T0 and/or T12. Considering the good…”

Section: Profil Programmentioning

confidence: 99%

Prevalence and Management of Drug-Related Problems in Chronic Kidney Disease Patients by Severity Level: A Subanalysis of a Cluster Randomized Controlled Trial in Community Pharmacies

Quintana-Bárcena

Lord

Lizotte

et al. 2018

JMCP

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“…10 Quintana-Bárcena developed a validated process to rate severity of DTPs in chronic kidney disease patients in community pharmacies based on interventions required to manage DTPs, but is not generalizable due to limitations of contextual design and population. 12 Dean and Barber created a validated tool to assess severity of medication errors using a 1 to 10 scale, as assessed by various health care professionals, but it is not clear if this can be applied more broadly to DTP severity. 13 The primary objective of this study was to describe the number, classification, and severity of DTPs in patients transitioning from hospital to home.…”

Section: Introductionmentioning

confidence: 99%

Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge

Westberg

Derr

Weinhandl

et al. 2017

Journal of Pharmacy Technology

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Background: Pharmacists influence health care outcomes through the identification and resolution of drug therapy problems (DTPs). Objective: The objectives of this study were to describe number, type, and severity of DTPs based on clinical significance and likelihood of harm in patients transitioning from hospital to home as assessed during a comprehensive medication management (CMM) visit with a pharmacist. Secondary objectives were to assess intrarater reliability in severity ratings and assess likelihood of harm for adverse drug reactions (ADR) by drug classes. Methods: Retrospective review of 408 patients having a face-to-face, telephonic, or virtual CMM visit within the Fairview Health System. Teams of 3 investigators reviewed each DTP from the electronic medical record for each of the 408 patients and assigned a severity score (0-10) for clinical significance and likelihood of harm. Main Results: The highest severity DTP classes were adherence and ADR. The lowest severity DTP class was unnecessary drug therapy. An average of 2.5 DTPs was found per patient at the index CMM visit following hospital discharge. The most common DTP classes were needs additional therapy and dose too low. There were statistically significant differences in DTP severity scoring between reviewer types, though differences were <5%. Drug classes with the highest severity ADR included diabetes, cardiovascular, and anticoagulant/antiplatelet agents. Conclusions: The DTP severity ratings indicated that reviewers found ADR and adherence DTPs were potentially the most severe. There were differences in DTP ratings between reviewer types, though clinical significance of these differences is unclear.

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“…To better identify patients seen in our adult medicine clinic, the CP2 score was modified as shown in Table . Modifications were made to further delineate the effect of the degree of renal impairment upon the need for pharmacist involvement, as the prevalence of drug‐related problems increases as the stage of chronic kidney disease (CKD) worsens . Two practice‐related factors were added which the investigators previously used to successfully target interventions: Presence of high‐risk medications—multiple studies investigating the prevalence of adverse drug reactions resulting in ED visits, hospitalizations, or other markers of morbidity have repeatedly identified specific classes of medications as being “high‐risk” (antiepileptics, anticoagulants, antidiabetics, and medications with a narrow therapeutic index) …”

Section: Methodsmentioning

confidence: 99%

Evaluation of clinical pharmacy priority scoring methods in an adult medicine residency clinic

Krasniak

Szymaniak

Conn

et al. 2019

J Am Coll Clin Pharm

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Background: Patients with higher clinical pharmacy priority (CP2) scores are more likely to receive a medication recommendation from a pharmacist to resolve an identified medication related problem (MRP) in a family medicine clinic.Objective: The objective of this study was to compare a modified CP2 score to the original CP2 score in an adult medicine residency clinic and assess whether a modified CP2 score more appropriately captured patients in need of recommendations from a clinical pharmacist.Methods: A convenience sample of patients scheduled for visits in an adult medicine clinic had a comprehensive medication review (CMR) performed. All patients had the original CP2 score and modified CP2 score calculated retrospectively. Both versions of the CP2 scores were compared using Pearson correlation. The relationship between a recommendation from a pharmacist and each CP2 score was evaluated using Pearson correlation and t test.Results: In total, 148 patients who received a CMR by a clinical pharmacist were included in the retrospective chart review. Overall, there was a strong positive correlation between the CP2 score and the modified CP2 score (correlation coefficient (r) 0.968, P < 0.001); thus, as the CP2 scores increase, the modified CP2 score increases.Patients with higher CP2 and modified CP2 scores were more likely to receive a recommendation from a pharmacist (P < 0.001 and P < 0.001, respectively). There was a moderate correlation between both scores and number of recommendations made (CP2: r = 0.436 [P < 0.001], modified CP2: r = 0.456 [P < 0.001]) which did not differ significantly. Conclusions:The CP2 score and the modified CP2 score were both associated with pharmacist recommendations in an adult medicine clinic. Refinement of the CP2 score did not better capture patients in an adult medicine residency clinic with a recommendation from a clinical pharmacist. K E Y W O R D Shealth care systems, health services research, medication therapy management, pharmacists, pharmacy service, hospital

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Development and validation of criteria for classifying severity of drug-related problems in chronic kidney disease: A community pharmacy perspective

Abstract: A set of criteria developed for use in the community pharmacy setting for evaluating the severity of DRPs in CKD proved to be reliable and correlated with clinical implicit judgment.

Cited by 8 publications

References 29 publications

Prevalence and Management of Drug-Related Problems in Chronic Kidney Disease Patients by Severity Level: A Subanalysis of a Cluster Randomized Controlled Trial in Community Pharmacies

Prevalence and Management of Drug-Related Problems in Chronic Kidney Disease Patients by Severity Level: A Subanalysis of a Cluster Randomized Controlled Trial in Community Pharmacies

Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge

Evaluation of clinical pharmacy priority scoring methods in an adult medicine residency clinic

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