Evaluation of a method for drug-related problems identification and classification in hospital setting: applicability and reliability

• Published in: International journal of clinical pharmacy 2020-02, Vol.42 (1), p.193-200
• Main Authors: Modesto, Ana Carolina Figueiredo, Ribeiro, Allyne Marques, Pereira, Jhonata Lima, Silva, Lunara Teles, Provin, Mércia Pandolfo, Ferreira, Paula Sofia Lima Antonino Iglesias, Amaral, Rita Goreti, Ferreira, Tatyana Xavier Almeida Matteucci
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adverse Drug Reaction Reporting Systems - classification; Adverse Drug Reaction Reporting Systems - standards; Brazil - epidemiology; Classification; Drug therapy; Drug-Related Side Effects and Adverse Reactions - classification; Drug-Related Side Effects and Adverse Reactions - epidemiology; Female; Humans; Identification; Internal Medicine; Male; Medication Errors - classification; Medication Errors - prevention & control; Medication Reconciliation - methods; Medication Reconciliation - standards; Medicine; Medicine & Public Health; Middle Aged; Pharmacists; Pharmacists - standards; Pharmacy; Pharmacy Service, Hospital - methods; Pharmacy Service, Hospital - standards; Reproducibility of Results; Research Article; Retrospective Studies; Young Adult
• ISSN: 2210-7703; 2210-7711
• DOI: 10.1007/s11096-019-00957-6

Background Prescription evaluation by pharmacists has potential to improve pharmacotherapy management. It requires the use of robust methods to identify drug-related problems (DRP), which are important issues in pharmacotherapy. Objective To evaluate the applicability and reliability of Grupo de Investigação em Cuidados Farmacêuticos (GIGUF) method for prescription analysis, identification and classification of drug-related problems in inpatients prescriptions. Setting Department of Medical Clinic of a tertiary and teaching Brazilian hospital. Method An observational and retrospective study of identification and classification of drug-related problems. GIGUF method was used to evaluate prescriptions of hematological patients hospitalized between August and October 2015. The problems were categorized using GICUF-method classification. Three pharmacists performed inter-rater agreement analysis of the method using Kappa. Differences in prevalence of DRP was calculated by age, sex, pharmacotherapy complexity, length of stay and number of drugs. Main outcome measure (a) frequency and characteristics and (b) inter-rater agreement in identification and classification of the drug-related problems. Results A total of 211 problems were identified and ‘inadequate dosing' was the most common problem. There was an association between the occurence of a drug-reklated problem and complexity of pharmacotherapy ( p  = 0.001) and number of drugs used ( p  = 0.010). The overall inter-rater agreement was moderate ( k  = 0.44 IC 95% 0.34–0.55) and the problem ‘not suitable drug' ( k  = 0.55 IC 95% 0.44–0.66) had greater inter-rater agreement. Conclusion The method “Evaluation Drug Use Process” was useful for prescription analysis since it made the identification and classification of DRPs possible. The method demonstrated a moderate inter-rater agreement, and can contribute to pharmacotherapy management by hospital pharmacists.