Development of a standardized chart review method to identify drug-related hospital admissions in older people
Thevelin, Stefanie; Spinewine, Anne; Beuscart, Jean-Baptiste; Boland, Benoît; Marien, Sophie; Vaillant, Fanny; Wilting, Ingeborg; Vondeling, Ariel; Floriani, Carmen; Schneider, Claudio; Donzé, Jacques; Rodondi, Nicolas; Cullinan, Shane; O'Mahony, Denis; Dalleur, Olivia
Date:
2018-07-14
Copyright:
© 2018, the British Pharmacological Society. Published by John Wiley & Sons, Inc. This is the peer reviewed version of the following article: Thevelin, S., Spinewine, A., Beuscart, J.-B., Boland, B., Marien, S., Vaillant, F., Wilting, I., Vondeling, A., Floriani, C., Schneider, C.,Donzé J., Rodondi, N., Cullinan, S., O'Mahony, D. and Dalleur, O. (2018) 'Development of a standardized chart review method to identify drug-related hospital admissions in older people', British Journal of Clinical Pharmacology. doi: 10.1111/bcp.13716, which has been published in final form at https://doi.org/10.1111/bcp.13716. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
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Access to this article is restricted until 12 months after publication by request of the publisher.
Restriction lift date:
2019-07-14
Citation:
Thevelin, S., Spinewine, A., Beuscart, J.-B., Boland, B., Marien, S., Vaillant, F., Wilting, I., Vondeling, A., Floriani, C., Schneider, C.,Donzé J., Rodondi, N., Cullinan, S., O'Mahony, D. and Dalleur, O. (2018) 'Development of a standardized chart review method to identify drug-related hospital admissions in older people', British Journal of Clinical Pharmacology. doi: 10.1111/bcp.13716
Abstract:
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.
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