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Published on: August 30, 2018
Pharmacist Interventions and Drug-Related Problems Classification Systems in the Inpatient Setting: A Systematic
Karine Dal Paz1,2, Ana Paula Callejo de Souza2, Patrícia Coelho de Soárez1
1Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
Summary
Pharmacist interventions (PI) and drug-related problem (DRP) classification systems show good reliability. However, most systems lack robust validity evidence and rigorous methodology, necessitating further research for reliable hospital pharmacy tools.
Area of Science:
- Pharmacy Practice
- Health Services Research
- Clinical Informatics
Background:
- Pharmacist intervention (PI) is crucial for mitigating drug-related problems (DRP), enhancing healthcare quality, and reducing costs.
- Systematic reviews are vital for evaluating the validity and methodological rigor of PI and DRP classification systems.
- Inpatient hospital settings are key environments for implementing and assessing these interventions.
Purpose of the Study:
- To systematically review and analyze studies validating PI and/or DRP classification systems in hospitals.
- To assess the methodological quality and validity evidence of these classification systems.
Main Methods:
- Systematic review following Cochrane Handbook recommendations.
- Comprehensive literature search across multiple databases (MEDLINE, Embase, etc.) without restrictions.
- Independent study selection, data extraction, quality assessment, and narrative synthesis by two authors.
Main Results:
- Seventeen articles identified 14 distinct PI/DRP classification systems, predominantly from Europe.
- Most studies lacked conceptualization, literature review support, and content validity evidence.
- While reliability was often demonstrated, crucial details on sample representativeness, confounding variables, and blinding were frequently omitted.
Conclusions:
- Most PI/DRP classification instruments exhibit acceptable reliability.
- Significant methodological limitations and insufficient validity evidence were identified in the reviewed studies.
- Further research with rigorous methods is required to develop valid and reliable instruments for hospital pharmacy practice.
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