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Pharmacy World and Science

, Volume 28, Issue 4, pp 222–232 | Cite as

Validation of a comprehensive classification tool for treatment-related problems

  • Salah M. AbuRuzEmail author
  • Nailya R. Bulatova
  • Almoatasem M. Yousef
Original Paper

Abstract

Objective

Several drug-related problem classification systems can be found in the literature. However, it is generally agreed that a comprehensive, well constructed and validated instrument is currently lacking. The aim of this study is the development and validation of a comprehensive treatment-related problems assessment and classification tool for use in teaching, practicing and researching pharmaceutical care and to improve identification, resolving and preventing of treatment-related problems.

Method

The development and validation involved five steps starting with literature search to define a treatment related problem and also to form a database of treatment-related problems identified in the literature. In the next step, all problems that were identified in the first step and passed the evaluation of the three authors were pooled together and then divided into groups according to their common or shared construct, in the third step a suitable assessment method was developed according to the construct of the different problems, in the next step the developed instrument was validated for content, internal and external validity. Finally the tool was finalized and tested for reproducibility and inter-rater agreement.

Results

The final validated version included six main categories for treatment-related problems (Indication, Effectiveness, Safety, Knowledge, Adherence and Miscellaneous). These categories include a total of nine subcategories and a total of 29 treatment related problems.

Conclusion

The treatment-related problems assessment and classification tool introduced in this paper was applied to actual patient cases and proved to be valid. This tool also has several features that are new.

Keywords

Clinical pharmacy Drug-related problem Drug therapy problem Medication therapy problem Pharmaceutical care Treatment related problem 

Notes

Acknowledgements

The authors wish to acknowledge the Deanship of Academic Research at the University of Jordan for funding this research which was part of the Pharmaceutical Care Project in Jordan.

References

  1. 1.
    Hepler CD, Srand LM. Opportunities and responsibilities in Pharmaceutical Care. Am J Hosp Pharm 1990;47:533–43.PubMedGoogle Scholar
  2. 2.
    ASHP guidelines on a standardized method for pharmaceutical care. Am J Health Syst Pharm 1996;53:1713–6.Google Scholar
  3. 3.
    American Society of Hospital Pharmacists. ASHP statement on pharmaceutical care. Am J Hosp Pharm 1993;50:1720–3.Google Scholar
  4. 4.
    National Academy of Sciences Institute of Medicine. To err is human. Washington, DC: National Academy Press; 1999.Google Scholar
  5. 5.
    Prince BS, Goetz CM, Rihn TL, Olsky M. Drug-related emergency department visits and hospital admissions. J Am Hosp Pharm 1992;49:1696–700.Google Scholar
  6. 6.
    Hallas J, Gram LF, Grodum E. Drug-related admissions to medical wards: a population based survey. Br J Clin Phamacol 1992;33:61–8.Google Scholar
  7. 7.
    Pirmohamed M, Breckenridge M, Kitteringham NR, Park BK. Adverse drug reactions. Br Med J 1998;316:1295–8.Google Scholar
  8. 8.
    Schneider PJ, Gift M. Cost of medication errors. Int Pharm J 1996;10:S1–11.Google Scholar
  9. 9.
    Einarson TR. Drug-related hospital admissions. Ann Pharmacother 1993;27:832–40.PubMedGoogle Scholar
  10. 10.
    Neville RG, Robertson F, Livingstone S, Crombie IK. A classification of prescription errors. J Roy Coll Gen Pract 1989;39:110–2Google Scholar
  11. 11.
    Zermansky A. Who controls repeats? Br J Gen Pract 1996;46:643–7.PubMedGoogle Scholar
  12. 12.
    Johnson JA, Bootman JL. Drug-related morbidity and mortality: a cost-of-illness model. Ann Intern Med 1995;155:1949–56.CrossRefGoogle Scholar
  13. 13.
    Van Mil JW, Westerlund TLO, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother 2004;38:859–67.PubMedCrossRefGoogle Scholar
  14. 14.
    Currie JD, Doucette WR, Kuhle J, Sobotka J, Miller WA, McDonough RP, et al. Identification of essential elements in the documentation of pharmacist-provided care. J Am Pharm Assoc 2003;43:41–9.CrossRefGoogle Scholar
  15. 15.
    Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice. New York: McGraw-Hill; 1998. ISBN 0070120463.Google Scholar
  16. 16.
    Pharmaceutical Care Network Europe. PCNE Classification for drug related problems v5.00. In drug related problems, Pharmaceutical Care Network Europe. http://www.pcne.org/dokumenter/PCNE%20classification%20V5.00.pdf (01 Nov. 2005).Google Scholar
  17. 17.
    Meyboom RHB, Lindquist M, Egberts ACG. An ABC of drug-related problems. Drug Saf 2000;22:415–23.PubMedCrossRefGoogle Scholar
  18. 18.
    Hanlon JT, Schmader KE, Samsa GP, Weinberger M, Uttech KM, Lewis IK, et al. A method for assessing drug therapy appropriateness. J Clin Epidemiol 1992;45:1045–51.PubMedCrossRefGoogle Scholar
  19. 19.
    Van Mil JWF, Tromp ThFJ. Coding frequently asked questions during the pharmaceutical care process with the Pas System. J Appl Ther 1997;1:351–5.Google Scholar
  20. 20.
    Schaefer M. Discussing basic principles for a coding system of drug-related problems: the case of PI-Doc. Pharm World Sci 2002;24:120–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Krska J, Jamieson D, Arris F, McGuire A, Abbott S, Hansford D, et al. A classification system for issues identified in pharmaceutical care practice. Int J Pharm Pract 2002;10:91–100.Google Scholar
  22. 22.
    Llimos F, Faus M. From “drug-related problems" to “negative clinical outcomes". Am J Hosp Pharm 2005;62:2348–50.Google Scholar
  23. 23.
    Consensus Committee. Second consensus of granada on drug therapy problems. Ars Pharm 2002;43:179–87.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Salah M. AbuRuz
    • 1
    Email author
  • Nailya R. Bulatova
    • 1
  • Almoatasem M. Yousef
    • 1
  1. 1.Department of Clinical Pharmacy, Faculty of PharmacyUniversity of JordanAmmanJordan

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