Validation of an instrument for the documentation of clinical pharmacists’ interventions

Abstract

Objective

To validate an instrument for documentation of clinical pharmacy interventions in French speaking hospitals in France and outside of France.

Method

A panel of 12 French speaking clinical pharmacists (six from France; six from French speaking countries) was asked to analyse a set of 60 pharmacist’s interventions on drug prescription. They used a form including (1) the identification of the drug related problems (DRPs) (10 items), (2) the pharmacist’s intervention (7 items). We assessed the level of agreement between the 12 pharmacists on the test DRPs and on the interventions.

Main outcome measures

Kappa coefficient of concordance was used to assess the level of agreement between experts for DRPs and interventions. We also assessed the userfriendliness of the instrument using Likert scales.

Results

The level of concordance observed in the validation was 0.76 for DRPs and 0.89 for the type of intervention. Eleven experts out of 12 were “very satisfied” or “satisfied” and one “not satisfied” with the tool. Ten out of the 12 experts were ready to use it in daily practise.

Conclusion

The present instrument proposed by the French Society of Clinical Pharmacy (SFPC) is the first coding system for pharmacist’s interventions with a French interface. The validation process using a standard statistical methodology helps support the external validity of our tool. The level of concordance between users can be considered as satisfactory, allowing the use of the tool in daily clinical pharmacy practise. To enhance the diffusion of the instrument and of the general process of routine documentation of interventions, a spreadsheet is provided on the French Society of Clinical Pharmacy website.

Appendices

Appendix 1: Description of drug related problems

⇒ Identification of DRP is based on the analysis of a drug prescription taking into account the available clinical and paraclinical data on the patient.

⇒ Only one problem intervention per form: If the patient’s drug regimen analysis reveals several problems, fill out as many intervention forms as there are problems.

⇒ Question(s)—Is this patient developing or is he susceptible to develop a symptom linked to a specific drug or is there a drug related problem requiring an intervention to avoid the unnecessary mobilization of resources?

Table 1

Appendix 2: Description of the pharmacist’s interventions

Only one choice per chart

Table 2

Appendix 3: Experts’ characteristics

 

Table 3

Appendix 4: The Pharmacist intervention form