Preventing drug-related morbidity--determining valid indicators.
OBJECTIVE
To describe the process that is being undertaken to validate a series of indicators for preventable drug-related morbidity - originally developed in the US - for application in the UK health care system.


METHODS
A two-round Delphi questionnaire survey after a preliminary validation of the indicators within the University of Manchester School of Pharmacy.


METHODS
A primary care study set in the UK.


METHODS
A purposively selected sample of general practitioners with a specific responsibility for prescribing-related issues (n = 6) and pharmacists actively involved in medication review in primary care (n = 10).


METHODS
The establishment of consensus among the participants that an indicator reflected preventable drug-related morbidity in primary care.


RESULTS
After preliminary validation, 37 of the original 57 US indicators were retained. The Delphi panel generated 16 additional new indicators in the first round. At the end of the second round, the pre-defined level of consensus was reached for 29 indicators (19 of the US generated indicators; 10 generated by the panel in the first round).


CONCLUSIONS
The Delphi results highlighted differences in both the clinical perspective and, possibly, philosophical viewpoints of health professionals practising in the UK and US health care systems. Further work, located in both primary and secondary care, is now in progress to operationalize the indicators. This process will form a key part of the refining, and hence further validation, of the indicators. The future development of prospective medical-record-based indicators should facilitate a reduction in the human, clinical, and economic burden of drug-related morbidity.
Morris
C J
CJ
The Drug Usage and Pharmacy Practice Group, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, UK. caroline.j.morris@man.ac.uk
Cantrill
J A
JA
Hepler
C D
CD
Noyce
P R
PR
D001291:Attitude of Health Personnel; D003657:Decision Making; D003697:Delphi Technique; D011307:Drug Prescriptions / Q000592:standards; D004358:Drug Therapy / Q000592:standards*; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D010595:Pharmacists / Q000523:psychology; D010821:Physicians, Family / Q000523:psychology; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom