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Domiciliary medication review (ReMeDo): development, reliability and acceptability of a tool for community
Patricia Quintana-Barcena1,2,3,4, Caroline Sinner2,3, Jérôme Berger1,2,3,4
1Community Pharmacy of the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Objectives:
Polymedication and medication hoarding in patients' homes may increase the risk of drug-related problems (DRPs). Community pharmacists can prevent DRPs through medication reconciliation and review. This study aims to (1) develop a tool for community pharmacists to perform domiciliary medication review (ReMeDo) and (2) assess the interrater and test-retest reliability and acceptability of the tool.
Methods:
The ReMeDo tool was first developed 6 years before this study to perform medication review during pharmacist home visits. A literature review was performed to update the content of the existing tool. Ten pharmacy students participated in the assessment of the interrater and test-retest reliability using three vignettes based on former ReMeDo patients. Test-retest reliability coefficients were calculated for the entire tool and each segment. Global and individual interrater reliability coefficients were also computed. Acceptability was assessed through a satisfaction survey.
Key Findings:
The ReMeDo tool was structured to guide the collection of information before, during and after the pharmacist home visit. The global kappa coefficients for interrater and test-retest reliability were 0.70 (95% confidence interval (CI), 0.67 to 0.73) and 0.71 (95% CI, 0.68 to 0.74), respectively. The test-retest reliability coefficients for each segment and the interrater reliability coefficients for participants were higher than 0.60 (except for one participant), demonstrating a moderate to substantial level of agreement. The tool was deemed acceptable by participants.
Conclusions:
The ReMeDo tool proved to be reliable and acceptable for use by community pharmacists to perform medication review in patients' homes.
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