Interrater reliability of a tool to assess omission of prescription and inappropriate prescriptions in paediatrics

  • Aurore Berthe-AucejoEmail author
  • N. P. K. Khan Nguyen
  • François Angoulvant
  • Rym Boulkedid
  • Xavier Bellettre
  • Thomas Weil
  • Corinne Alberti
  • Olivier Bourdon
  • Sonia Prot-Labarthe
Research Article


Background Potentially inappropriate medication (PIM) and potential prescription omission (PPO) are common issues in pharmacotherapy in vulnerable populations. A first tool to assess PIM’s and PPO’s targeting pediatric populations: POPI «Pediatrics Omission of Prescriptions and Inappropriate Prescriptions» was created in 2014. Objective This study aimed to evaluate inter-rater reliability between healthcare professionals who apply POPI. Setting: Mother and child emergency ward of a university hospital. Method Twenty cases with or without PIM or PPO were identified in a previous retrospective PIM-PPO prevalence study on 15,973 patients. One doctor and one pharmacist, who participated in the creation of POPI tool, identified PIM and PPO (“gold standard response”). These cases were reviewed independently by eleven clinicians (generalists, pediatricians, pharmacists, residents), with no previous experience of this tool. Interrater agreement was calculated by using the Kappa agreement test. Main outcome measure: Inter-clinician agreement. Results A high level of agreement of PIM and PPO detection was recorded (PIM: median = 0.80; PPO: median = 0.71). Conclusion POPI demonstrated a good interrater reliability. This validation by many clinicians proves that POPI is a reliable tool. Other multicenter and prospective studies should be conducted to evaluate economical and clinical impacts of POPI.


France Inappropriate prescription Inter-rater reliability Pharmacist Physician 



We would like to thank Dr Dominique Navas, Dr Henri Hollenberg, Dr Lila Alloing, Dr Romain Basmaci, Dr Dominique Girardon, Dr Lucie Vuillemin, Dr Philippe Zerr, Dr Marie-Aliette Dommergues, Dr Sandrine Masseron, Dr Julie Sommet, Dr Lise Durand for their participation in this study.


This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Conflicts of interest

All authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 23 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Aurore Berthe-Aucejo
    • 1
    • 2
    Email author
  • N. P. K. Khan Nguyen
    • 1
  • François Angoulvant
    • 2
    • 3
  • Rym Boulkedid
    • 2
    • 4
  • Xavier Bellettre
    • 5
  • Thomas Weil
    • 1
  • Corinne Alberti
    • 2
    • 4
  • Olivier Bourdon
    • 1
    • 6
    • 7
    • 8
  • Sonia Prot-Labarthe
    • 1
    • 2
    • 6
  1. 1.Department of PharmacyRobert-Debré Hospital AP-HPParisFrance
  2. 2.U1123, INSERM ECEVEParisFrance
  3. 3.Department of Pediatric EmergencyNecker-Enfants Malades Hospital AP-HP, Paris Descartes UniversityParisFrance
  4. 4.Clinical Epidemiology UnitRobert-Debré Hospital AP-HPParisFrance
  5. 5.Emergency UnitRobert-Debré Hospital AP-HPParisFrance
  6. 6.Groupe Pédiatrie de la Société Française de Pharmacie CliniqueParisFrance
  7. 7.Clinical PharmacyParis Descartes UniversityParisFrance
  8. 8.Laboratoire Educations et Pratiques de SantéParis XIII UniversityBobignyFrance

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