Development and reliability testing of the clinical pharmacist recommendation taxonomy.
OBJECTIVE
To evaluate the reliability of a newly developed taxonomy--the Clinical Pharmacist Recommendation (CPR) taxonomy--to classify clinical pharmacy interventions.


METHODS
The CPR taxonomy was developed and refined in three phases. In each phase, reviewers independently reviewed recommendations made by a clinical pharmacist-physician team and categorized them into mutually exclusive categories: priority, problem, and response. Interrater reliability was assessed for all categories during each development phase.


METHODS
Primary care clinics of a Veterans Affairs Medical Center.


METHODS
Fifty-three patients enrolled in the Veterans Affairs Enhanced Pharmacy Outpatient Clinic (EPOC) trial.


RESULTS
Interrater reliability was assessed using the kappa statistic. A total of 423 recommendations were evaluated during the three testing phases. In the final testing phase, agreement was moderate for pharmacotherapy problem subcategories (kappa = 0.57), substantial for pharmacotherapy problem primary categories (kappa = 0.64), and almost perfect for response categories (kappa = 0.85). Taxonomy completion time/patient averaged 4.6 minutes (range 1-11 min).


CONCLUSIONS
The CPR taxonomy provides a reliable method to systematically evaluate clinical pharmacy recommendations based on the therapeutic problem identified and specific action recommended to resolve the problem.
Hoth
Angela B
AB
Center for Research in the Implementation of Innovative Strategies in Practice, Veterans Affairs Iowa City Health Care System, Iowa City, Iowa 52246, USA. Angela.Hoth@med.va.gov
Carter
Barry L
BL
Ness
Jose
J
Bhattacharyya
Anjan
A
Shorr
Ronald I
RI
Rosenthal
Gary E
GE
Kaboli
Peter J
PJ
D000368:Aged; D004358:Drug Therapy / Q000145:classification; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000145:classification* / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D011320:Primary Health Care; D024382:Professional Role; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D014481:United States