title: Determination of risk factors for drug-related problems: a multidisciplinary triangulation process.
abstract: OBJECTIVE
  Drug-related problems (DRPs) constitute a frequent safety issue among hospitalised patients leading to patient harm and increased healthcare costs. Because many DRPs are preventable, the specific risk factors that facilitate their occurrence are of considerable interest. The objective of our study was to assess risk factors for the occurrence of DRPs with the intention to identify patients at risk for DRPs to guide and target preventive measures where they are needed most in patients.
  
  
  METHODS
  Triangulation process using a mixed methods approach.
  
  
  METHODS
  We conducted an expert panel, using the nominal group technique (NGT) and a qualitative analysis, to gather risk factors for DRPs. The expert panel consisted of two consultant hospital physicians (internal medicine and geriatrics), one emergency physician, one independent general practitioner, one clinical pharmacologist, one clinical pharmacist, one registered nurse, one home care nurse and two independent community pharmacists. The literature was searched for additional risk factors. Gathered factors from the literature search and the NGT were assembled and validated in a two-round Delphi questionnaire.
  
  
  RESULTS
  The NGT resulted in the identification of 33 items with 13 additional risk factors from the qualitative analysis of the discussion. The literature search delivered another 39 risk factors. The 85 risk factors were refined to produce 42 statements for the Delphi online questionnaire. Of these, 27 risk factors were judged to be 'important' or 'rather important'.
  
  
  CONCLUSIONS
  The gathered risk factors may help to characterise and identify patients at risk for DRPs and may enable clinical pharmacists to guide and target preventive measures in order to limit the occurrence of DRPs. As a further step, these risk factors will serve as the basis for a screening tool to identify patients at risk for DRPs.
authors: Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland Clinical Pharmacy, Kantonsspital Baselland, Bruderholz, Switzerland.
authors: Carole P
authors: CP
authors: Kaufmann
authors: Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland.
authors: Dominik
authors: D
authors: Stämpfli
authors: Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland.
authors: Kurt E
authors: KE
authors: Hersberger
authors: Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland Clinical Pharmacy, Kantonsspital Baselland, Bruderholz, Switzerland.
authors: Markus L
authors: ML
authors: Lampert
mesh_terms: D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007400:Interprofessional Relations; D010607:Pharmacy Service, Hospital; D036301:Qualitative Research; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires