Documentation of pharmaceutical care: development of an intervention oriented classification system

Area of Science:

• Pharmacy Practice
• Health Informatics
• Medication Management

Background:

• Hospitals use a standardized pharmaceutical interventions (PI) classification system, but community pharmacies lack one.
• A compatible system is needed to improve information exchange between hospital and community pharmacy settings.

Purpose of the Study:

• To develop PharmDISC, an intervention-oriented classification system for community pharmacies, based on the existing hospital system.
• To evaluate PharmDISC's interrater reliability, validity (appropriateness, interpretability, face, and content), and gather pharmacists' feedback.

Main Methods:

• A modified classification system was developed and tested by 77 pharmacy students after a 2-hour training.
• Interrater reliability was assessed using Fleiss-Kappa coefficients on 3 model PIs.
• Pharmacists (n=9) provided feedback via a focus group, with transcripts analyzed thematically.

Main Results:

• The PharmDISC system comprises 5 categories and 52 subcategories.
• 94.6% of 725 classified PIs were fully categorized, with substantial overall user agreement (Kappa = 0.61).
• Pharmacists expressed satisfaction, recognizing the system's potential for traceability, communication, and quality improvement.

Conclusions:

• The PharmDISC system is valid and achieved substantial interrater reliability.
• Pharmacist feedback led to refinements, with a final version planned for an observational study.
• PharmDISC facilitates standardized documentation of pharmaceutical interventions in community pharmacies.