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Related Experiment Videos

A method for assessing drug therapy appropriateness.

J T Hanlon1, K E Schmader, G P Samsa

  • 1Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC 27710.

Journal of Clinical Epidemiology
|October 1, 1992
PubMed
Summary

A new medication appropriateness index demonstrates high reliability for assessing elderly patients' drug therapy. This tool is valuable for quality of care outcome measures in health services research and quality assurance programs.

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Area of Science:

  • Geriatrics
  • Pharmacology
  • Health Services Research

Background:

  • Assessing medication appropriateness in elderly patients is crucial for optimizing health outcomes and preventing adverse drug events.
  • Existing methods for evaluating drug therapy may lack comprehensive reliability and standardization.
  • The development of validated tools is essential for quality improvement initiatives in geriatric pharmacotherapy.

Purpose of the Study:

  • To evaluate the reliability of a novel medication appropriateness index.
  • To determine the index's consistency in assessing chronic medication use in ambulatory elderly males.
  • To establish the index's potential utility as a quality of care outcome measure.

Main Methods:

  • Independent assessments of chronic medications were conducted by a clinical pharmacist and an internist-geriatrician for 10 elderly male patients.

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  • Inter-rater and intra-rater reliability for medication appropriateness (ppos) and inappropriateness (pneg) were calculated using kappa statistics.
  • A second evaluation involved two different clinical pharmacists assessing medications for another cohort of 10 elderly male patients.

    • Main Results:

    • High inter-rater agreement was observed between the clinical pharmacist and internist-geriatrician (kappa = 0.83).
    • Excellent intra-rater agreement was found for both raters (kappa = 0.92).
    • Inter-rater agreement among two clinical pharmacists was also substantial (kappa = 0.59), indicating consistent application of the index.

    Conclusions:

    • The new medication appropriateness index is a reliable tool for assessing drug therapy.
    • The index demonstrates strong potential for application in health services research and institutional quality assurance programs.
    • Its use can contribute to improving the quality of medication management in elderly populations.