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Assessing psychotropic medication side effects among children. A reliability study.

C A Garvey, D Gross, L Freeman

    Journal of Child and Adolescent Psychiatric and Mental Health Nursing
    |October 1, 1991
    PubMed
    Summary
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    This pilot study refined the Dosage Record Treatment Emergent Symptom Scale (DOTES) for measuring psychotropic medication side effects. Inter-rater reliability was assessed, identifying areas for improved training and instrument clarity.

    Area of Science:

    • Psychiatry
    • Clinical Pharmacology
    • Psychometric Evaluation

    Background:

    • The Dosage Record Treatment Emergent Symptom Scale (DOTES) is crucial for assessing psychotropic medication side effects.
    • No prior studies have evaluated the reliability of the DOTES scale.

    Purpose of the Study:

    • To develop a rater training protocol for the DOTES.
    • To assess inter-rater agreement on DOTES ratings.
    • To refine the DOTES instrument and training for clinical and research use.

    Main Methods:

    • Five nurses were trained to use the DOTES.
    • Trained raters assessed medication side effects on a videotaped interview.
    • Process tracings were used to understand rater decision-making.

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    Main Results:

    • Agreement was reached on the intensity of 67% of present symptoms and 89% of absent symptoms.
    • Process tracings identified ambiguities in training and symptom definitions.
    • Results informed improvements to the DOTES training protocol.

    Conclusions:

    • The pilot study successfully developed a training protocol and assessed inter-rater agreement for the DOTES.
    • Identified ambiguities were addressed to enhance the scale's reliability and usability.
    • Further refinement of the DOTES is recommended for clinical and research applications.