title: A national drug related problems database: evaluation of use in practice, reliability and reproducibility.
abstract: BACKGROUND
  A drug related problems database (DRP-database) was developed on request by clinical pharmacists. The information from the DRP-database has only been used locally e.g. to identify focus areas and to communicate identified DRPs to the hospital wards. Hence the quality of the data at the national level is unknown, which may compromise national analyses for benchmarking and identification of national focus areas.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the use in practice, reliability and reproducibility of the DRPs documented in the Danish drug related problems database.
  
  
  METHODS
  Danish hospital pharmacies.
  
  
  METHODS
  Practice use of the DRP-database was explored by an electronic questionnaire distributed to hospital pharmacies, and consisted of questions regarding current and previous use of the DRP-database. The reliability was evaluated by comparing the categorization of 24 cases by clinical pharmacists with categorization performed by the project group. Reproducibility was explored by re-categorization of a sample of existing records in the DRP-database by two project group members individually.
  
  
  METHODS
  Observed proportion of agreement and Fleiss' kappa as measures of inter-rater reliability and reproducibility.
  
  
  RESULTS
  The practice use study of 12 hospital pharmacy locations revealed that when implementing the DRP-database, the majority of identified DRPs are documented in the DRP-database, however, some variations throughout the country exist. The interrater reliability study of 34 clinical pharmacists showed high inter-rater reliability with the project group (Fleiss' kappa = 0.79 with 95 % CI (0.70; 0.88)), and the reproducibility study also documented high inter-rater reliability of a sample of 379 records from the DRP-database re-categorized by two project group members (Fleiss' kappa = 0.81 with 95 % CI (0.78; 0.85)).
  
  
  CONCLUSIONS
  The study showed high reliability and reproducibility of the DRP-database, however, some local variation in the use of the DRP-database throughout the country existed affecting the overall quality. These findings indicate that data in the DRP-database may be pooled, and national analyses may be conducted to explore development areas for common interest.
authors.affiliation: The Danish Research Unit for Hospital Pharmacy, Amgros I/S, Dampfærgevej 22, 2100, Copenhagen, Denmark, ljk@amgros.dk.
authors.forename: Lene Juel
authors.initials: LJ
authors.lastname: Kjeldsen
authors.forename: Trine
authors.initials: T
authors.lastname: Birkholm
authors.forename: Hanne
authors.initials: H
authors.lastname: Fischer
authors.forename: Trine
authors.initials: T
authors.lastname: Graabæk
authors.forename: Merete Kjær
authors.initials: MK
authors.lastname: Hansen
authors.forename: Karina Porsborg
authors.initials: KP
authors.lastname: Kibsdal
authors.forename: Lene Vestergaard
authors.initials: LV
authors.lastname: Ravn-Nielsen
authors.forename: Tania Holtum
authors.initials: TH
authors.lastname: Truelshøj
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D003718:Denmark; D016903:Drug Monitoring; D004359:Drug Therapy, Combination / Q000009:adverse effects; D057286:Electronic Health Records; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D059065:Medication Reconciliation; D009313:National Health Programs; D019982:Organizational Case Studies; D010601:Pharmacology, Clinical; D010607:Pharmacy Service, Hospital; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011787:Quality of Health Care; D015203:Reproducibility of Results; D000078329:Workforce
chemical_list: D055553:Prescription Drugs