Development and validation of RhMAT, as medication assessment tool specifically designed for rheumatoid arthritis management

Abstract

Objectives The implementation of individualised pharmaceutical care plans based on the identification of pharmaceutical care issues for rheumatoid arthritis patients presenting at outpatient clinic service has been proven to be effective in improving the quality of life of these patients. However, the identification and classification of pharmaceutical care issues into drug therapy problems does not give room to assessment of prescribing trends and adherence to international guidelines. The novel concept of medication assessment tools, is a concept which integrates pharmaceutical care issues within a larger context, that of evaluating the prescribing trends. The objective of this research was to design, and validate medication assessment tools specifically for rheumatoid arthritis patients. Methods A thorough literature review was carried out to identify the latest evidence‐based guidelines on rheumatoid arthritis pharmacotherapy. The rheumatoid arthritis medication assessment tool (RhMAT) was compiled and validated. Key findings The RhMAT consists of 11 general sections with a total of 54 criteria. For every criteria given, the researcher has an option of four responses ranging from criterion not applicable (N/A), criterion adherence (yes), criterion non‐adherence (no) and insufficient data to comment on the criterion. In cases where the criterion is not adhered to this can be justified adherence or unjustified and insufficient data for the researcher to be able to tick appropriately. The expert panel agreed with the final version of the RhMAT. Conclusion The innovative RhMAT was designed to act as a tool used by pharmacists to be able to detect gaps within patients' pharmacotherapy against evidence‐based guidelines thereby improving the quality of service offered to patients.

Assessing appropriateness of drug therapy in older persons: Development and application of a medication assessment tool for long-term management of atrial fibrillation

“…Review criteria defining appropriate drug therapy were constructed as a ‘qualifying statement’ followed by a ‘standard’, based on the format of previously published MATs. 14 - 21 For example, ‘patient with atrial fibrillation who has a CHA 2 DS 2 VASc score of ≥1 (≥2 if female)’ is the qualifying statement and ‘is prescribed warfarin (INR 2.0-3.0) or other oral anticoagulant’ is the standard. Response options include ‘not applicable’ when the criterion is not applicable, ‘yes’ for adherence, ‘no’ for non-adherence and ‘justified no’ when there is a justified reason for non-adherence to the standard.…”

“… 13 Medication assessment tools (MATs) are disease-specific, evidence-based instruments designed to assess appropriateness of drug therapy and have been developed and applied in various diseases including heart failure, diabetes mellitus, coronary heart disease, cancer pain, asthma, pneumonia and rheumatoid arthritis. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 A MAT that is specific for AF, taking into consideration different management strategies, concurrent multiple morbidities and monitoring for safe use of therapeutic agents, provides an assessment of appropriateness of drug therapy for this disease state.…”

Clinical pharmacist implementation of a medication assessment tool for secondary prevention of stroke in older persons

“…Drug utilisation review tools are generally categorised as implicit or explicit, the former considered as more patient‐specific and the latter as more drug or disease‐oriented . Medication assessment tools (MATs) offer a hybrid of these two categories with the advantage of being specific to the patient, disease state and drug therapy . MAT‐CVA is a tool for the secondary prevention of stroke in older persons previously developed by the research group and comprises criteria to assess appropriateness of drug therapy (refer to Table ) .…”

“…[13,14] Medication assessment tools (MATs) offer a hybrid of these two categories with the advantage of being specific to the patient, disease state and drug therapy. [15][16][17][18][19] MAT-CVA is a tool for the secondary prevention of stroke in older persons previously developed by the research group and comprises criteria to assess appropriateness of drug therapy (refer to Table S1). [20] Criteria consist of two components, a qualifying statement and a standard, sectioned into antithrombotic, lipid-lowering, antihypertensive and glycaemic therapy.…”