Development and validation of the medication regimen complexity index
Development and validation of the medication regimen complexity index
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DOI：
10.1345/aph.1d479
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发表时间：
2004-09-01
影响因子：
2.9
通讯作者：
Stewart, K
中科院分区：
文献类型：
--
作者：
George, J;Phun, YT;Stewart, K
背景技术背景：药物治疗方案属性，如药物数量、给药频率、给药说明和处方剂型，已被证明会影响患者结局。没有单一的工具，量化的复杂性一般药物治疗方案已公布在medical literature.Objective：开发和验证一种工具，以量化的复杂性处方medications.METHODS：文献的发现和专业知识的作者被用于开发的工具。八名药学研究人员帮助建立了该工具的表面和内容有效性。这项新工具在134种中重度慢性阻塞性肺疾病患者的药物治疗方案中进行了测试。六个方案与工具上的分数分布，提交给一个5人专家小组，主观排名这些方案，以确认该工具的标准相关的有效性。通过对量表得分与各自变量之间的关系进行检验，判断量表的结构效度。两名评分员使用该工具对25个方案进行评分，以检验其评分员间和重测信度。专家小组对6种方案的个体排名有很强的一致性（Kendall's W = 0.8; p = 0.001）。专家组的共识排名与MRCI排名完全相关。MRCI总评分与治疗方案中的药物数量显著相关（斯皮尔曼Rho = 0.9; p < 0.0001），但与患者的年龄和性别无关。MRCI总分和各部分评分的评分者间信度和重测信度均>= 0.9。结论：MRCI是一种可靠、有效的药物方案复杂性量化工具，具有潜在的应用价值。
BACKGROUND: Medication regimen attributes, such as the number of drugs, dosage frequency, administration instructions, and the prescribed dosage forms, have been shown to influence patient outcomes. No single tool for quantifying the complexity of general medication regimens has been published in the medical literature.OBJECTIVE: To develop and validate a tool to quantify the complexity of prescribed medication regimens.METHODS: Literature findings and the expertise of the authors were used for developing the tool. Eight pharmacy researchers helped in establishing the tool's face and content validity. The new tool was tested on 134 medication regimens from patients with moderate to severe chronic obstructive pulmonary disease. Six regimens with a spread of scores on the tool were presented to a 5-member expert panel that subjectively ranked these regimens to confirm the tool's criterion-related validity. The relationships between scores on the tool and various independent variables were tested to judge the tool's construct validity. Two raters scored 25 regimens using the tool to test its inter-rater and test-retest reliabilities.RESULTS: A 65-item Medication Regimen Complexity Index (MRCI) was developed. The expert panel had strong agreement (Kendall's W = 0.8; p = 0.001) on their individual rankings of the 6 regimens. The panel's consensus ranking had perfect correlation with the MRCI ranking. The total MRCI score had significant correlation with the number of drugs in the regimen (Spearman's Rho = 0.9; p < 0.0001), but not with the age and gender of the patients. Inter-rater and test-retest reliabilities for the total score and scores for individual sections on the MRCI were >= 0.9.CONCLUSIONS: The MRCI is a reliable and valid tool for quantifying drug regimen complexity with potential applications in both practice and research.