Classification of drugs with different risk profiles

Area of Science:

• Pharmacovigilance and Drug Safety
• Clinical Pharmacy
• Health Services Research

Background:

• Medication errors pose a significant risk, necessitating a robust approach to identify high-risk patients requiring medication review.
• Current methods lack effective risk stratification for drugs causing serious adverse reactions due to errors.

Purpose of the Study:

• To perform risk stratification of drugs based on their potential to cause harm and clinically relevant drug-drug interactions.
• To develop categorized lists (low, medium, high-risk) to aid in prioritizing medication reviews.

Main Methods:

• A modified Delphi technique involving a panel of 36 experts was employed.
• Experts evaluated drugs identified through a systematic literature search on a 1-9 scale for harm potential and drug interactions.
• Consensus was reached for over 50% of drugs, with remaining decisions based on median scores.

Main Results:

• Two stratified lists were created: one for drugs causing harm and another for drug-drug interactions.
• Drugs were categorized into low-risk, medium-risk, and high-risk groups.
• Consensus was achieved for 51% of drugs regarding harm and 56% regarding interactions.

Conclusions:

• The study successfully stratified drugs into risk categories using a Delphi technique.
• These stratified lists can be integrated into risk-scoring tools to optimize medication review processes.
• The findings support a more targeted approach to patient care, reducing adverse drug events.