title: Utility of a brief screening tool for medication-related problems.
abstract: BACKGROUND
  Medication therapy management (MTM) services position pharmacists to prevent, detect, and resolve medication-related problems (MRPs.) However, selecting patients for MTM who are most at risk for MRPs is a challenge. Using self-administered scales that are practical for use in clinical practice are one approach.
  
  
  OBJECTIVE
  The objective of this study was to estimate the psychometric properties of a brief self-administered scale as a screening tool for MRPs.
  
  
  METHODS
  This was a non-randomized study utilizing questionnaires administered cross-sectionally. In Phase 1, patients (n = 394) at community pharmacies and outpatient clinics completed 78 items, provided to the study team by item authors, assessing perceived MRPs. These data were used to select items for further investigation as a brief, self-administered scale, and estimate the reliability and construct validity of the resulting instrument. In Phase 2, a convenience sample of patients (n = 200) at community pharmacies completed a nine-item, self-administered scale. After completion, they were engaged in a comprehensive medication review by their pharmacist who was blinded to questionnaire responses. The main outcome measure for estimating the criterion-related validity of the scale was the number of pharmacist-identified medication-related problems (MRPs.) Item statistics were computed as well as bivariate associations between scale scores and other variables with MRPs. A multivariate model was constructed to examine the influence of scale scores on MRPs after controlling for other significant variables.
  
  
  RESULTS
  Higher scores on the questionnaire were positively correlated with more pharmacist-identified MRPs (r = 0.24; P = 0.001) and scores remained as a significant predictor (P = 0.031) when controlling for other relevant variables in a multivariate regression model (R(2) = 0.21; P < 0.001).
  
  
  CONCLUSIONS
  Patient responses on the scale may have a modest role in predicting MRPs. The use of self-administered questionnaires such as this may supplement other available patient data in developing patient eligibility criteria for MTM, however, additional research is warranted.
authors.affiliation: Purdue University College of Pharmacy, 640 Eskenazi Ave., Indianapolis, IN 46202, USA. Electronic address: snyderme@purdue.edu.
authors.forename: Margie E
authors.initials: ME
authors.lastname: Snyder
authors.affiliation: University of Pittsburgh School of Pharmacy, 3501 Terrace St., Pittsburgh, PA 15261, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Pater
authors.affiliation: University of Minnesota College of Pharmacy, 7-174 Weaver-Densford Hall, 308 Harvard St., SE, Minneapolis, MN 55455, USA.
authors.forename: Caitlin K
authors.initials: CK
authors.lastname: Frail
authors.affiliation: Purdue University College of Pharmacy, 640 Eskenazi Ave., Indianapolis, IN 46202, USA.
authors.forename: Karen Suchanek
authors.initials: KS
authors.lastname: Hudmon
authors.affiliation: Department of Biohealth Informatics, Indiana University and Purdue University Indianapolis, School of Informatics & Computing, 719 Indiana Ave, WK 303, Indianapolis, IN 46202, USA.
authors.forename: Brad N
authors.initials: BN
authors.lastname: Doebbeling
authors.affiliation: University of Pittsburgh School of Pharmacy, 3501 Terrace St., Pittsburgh, PA 15261, USA.
authors.forename: Randall B
authors.initials: RB
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D015999:Multivariate Analysis; D010595:Pharmacists / Q000458:organization & administration*; D011594:Psychometrics; D012044:Regression Analysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Administration; Medication therapy management; Outcomes; Pharmaceutical care; Pharmacy practice