Format

Send to

Choose Destination
See comment in PubMed Commons below
BMJ Open. 2017 Jul 31;7(7):e016070. doi: 10.1136/bmjopen-2017-016070.

PIM-Check: development of an international prescription-screening checklist designed by a Delphi method for internal medicine patients.

Author information

1
Department of Pharmacy, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
2
Department of Pharmacy, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
3
Department of Pharmacy, Hôpitaux de l'Est Lémanique, Vevey, Switzerland.
4
Department of Infectious and Tropical Diseases, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
5
UMR996-Inflammation, Chemokines and Immunopathology, Inserm, Clamart, France.
6
Department of Clinical Pharmacology and Toxicology, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
7
Section of Pharmaceutical Sciences, Université de Genève, Université de Lausanne, Geneva, Switzerland.
8
Department of General Internal Medicine, Hôpitaux Universitaires de Genève, Geneva, Switzerland.

Abstract

OBJECTIVES:

Potentially inappropriate medication (PIM) occurs frequently and is a well-known risk factor for adverse drug events, but its incidence is underestimated in internal medicine. The objective of this study was to develop an electronic prescription-screening checklist to assist residents and young healthcare professionals in PIM detection.

DESIGN:

Five-step study involving selection of medical domains, literature review and 17 semistructured interviews, a two-round Delphi survey, a forward/back-translation process and an electronic tool development.

SETTING:

22 University and general hospitals from Canada, Belgium, France and Switzerland.

PARTICIPANTS:

40 physicians and 25 clinical pharmacists were involved in the study.Agreement with the checklist statements and their usefulness for healthcare professional training were evaluated using two 6-point Likert scales (ranging from 0 to 5).

PRIMARY AND SECONDARY OUTCOME MEASURES:

Agreement and usefulness ratings were defined as: >65% of the experts giving the statement a rating of 4 or 5, during the first Delphi-round and >75% during the second.

RESULTS:

166 statements were generated during the first two steps. Mean agreement and usefulness ratings were 4.32/5 (95% CI 4.28 to 4.36) and 4.11/5 (4.07 to 4.15), respectively, during the first Delphi-round and 4.53/5 (4.51 to 4.56) and 4.36/5 (4.33 to 4.39) during the second (p<0.001). The final checklist includes 160 statements in 17 medical domains and 56 pathologies. An algorithm of approximately 31 000 lines was developed including comorbidities and medications variables to create the electronic tool.

CONCLUSION:

PIM-Check is the first electronic prescription-screening checklist designed to detect PIM in internal medicine. It is intended to help young healthcare professionals in their clinical practice to detect PIM, to reduce medication errors and to improve patient safety.

KEYWORDS:

Clinical Practice Guidelines; Evidence-based Medicine; Internal Medicine; Medical Education; Pharmacology and Toxicology

PMID:
28760793
DOI:
10.1136/bmjopen-2017-016070
Free full text

Conflict of interest statement

Competing interests: None declared.

PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center