Benchmarking drug-related problem instruments: A systematic review of measurement properties

Drug-Related Problems can interfere with the desired clinical outcomes, posing a global public health challenge. Despite this, several instruments to identify DRPs lack adequate evaluation of their measurement properties. The primary objective of the study was to investigate the measurement properties of these instruments. A systematic review was conducted following the COSMIN guidelines for conducting systematic reviews of measurement properties. Articles were included if they assessed at least one measurement property of an instrument, defined the construct, and were not secondary studies. Selection involved title and abstract screening, full-text reading, followed by data extraction and study appraisal by three independent authors. Evidence quality was evaluated using the GRADE approach to support instrument recommendations. Overall, 36 studies met the inclusion criteria. Thirty-three instruments were identified. Content validity, reliability, and hypothesis testing for construct validity were the measurement properties most evaluated. PIM-Check, EDUP, and REMEDI[e]S demonstrated sufficient content validity with high-quality evidence. Regarding reliability, instruments based on explicit criteria showed greater consistency than those based on implicit criteria. Furthermore, PAIR 1, PAIR-Brazil, and PART demonstrated sufficient construct validity. Instruments for DRPs identification showed heterogeneous measurement properties. Few instruments, including PIM-Check, EDUP, and REMEDI[e]S, showed sufficient content validity with high-quality evidence. While explicit-criteria instruments were generally more reliable, the overall variability in measurement properties and methodology remains high. These findings can support clinicians and researchers in selecting appropriate DRPs identification tools; however, they underscore the critical need for standardizing constructs and validation methods to enhance the quality and comparability of future instruments.