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Practical, reliable, comprehensive method for characterizing pharmacists' clinical activities.

J M Overhage1, A Lukes

  • 1Regenstrief Institute for Health Care, Indiana University School of Medicine, Indianapolis 46202, USA. marc@falcon.iupui.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|December 14, 1999
PubMed
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A new instrument reliably measures the value of pharmacists

Area of Science:

  • Pharmacoeconomics
  • Health Services Research
  • Medication Safety

Background:

  • Assessing the clinical and economic value of pharmacist-provided services is crucial for healthcare system optimization.
  • Existing methods for evaluating pharmacist interventions may lack comprehensive metrics for error severity and service value.
  • A validated instrument is needed to systematically capture the impact of pharmacists' clinical activities.

Purpose of the Study:

  • To develop and validate a literature-based instrument for simultaneously assessing medication error severity and the value of pharmacist interventions.
  • To evaluate the reliability and usability of the developed instrument in a real-world hospital pharmacy setting.

Main Methods:

  • A novel instrument was created to quantify medication error severity and pharmacist intervention value.

Related Experiment Videos

  • Pharmacists utilized the instrument during intervention documentation; a second pharmacist and an expert panel (2 clinical pharmacists, 2 physicians) independently scored interventions.
  • Kappa statistics and symmetry tests were employed to assess inter-rater agreement and identify rating biases.

    • Main Results:

    • Substantial agreement was observed among raters for both overall scores and individual dimensions.
    • Physicians tended to assign lower scores for error severity and service value compared to pharmacists.
    • A clear, though non-linear, relationship was found between error severity and intervention value; high-value services were identifiable even without prescribing errors.

    Conclusions:

    • The developed instrument is a reliable and practical tool for evaluating pharmacists' clinical services in a hospital setting.
    • The findings support the distinct value of pharmacist interventions, which can be high even in the absence of prescribing errors.
    • The instrument facilitates a nuanced understanding of the relationship between medication errors and the value of clinical pharmacy services.