Abstract:Objective To establish a drug-related problems (DRPs) classification system for outpatients and home patients and provide healthcare staff with tools for standardized recording of DRPs. Methods DRPs classification systems-related literature were collected by searching foreign databases. The selected DRPs classification systems were compared and analyzed, and the initial DRPs classification system was formed by integrating the characteristics of pharmaceutical care for outpatients and home patients in China. The expert consultation form of DRPs classification system was made, expert consultation was performed for 2 rounds using Delphi method, and the final DRPs classification system was formed through modification and adjustment according to expert opinions. Results A total of 25 DRPs classification systems were obtained, of which 16 were selected and then integrated to form the initial version of the DRPs classification system. The primary structure of the initial DRPs classification system consisted of 5 parts: problem state, problem type, problem cause, problem intervention, and intervention result. Each part had different number of items, among which there were different number of secondary structure items in problem cause, problem intervention, and intervention result. In the first round of consultation, 32 experts were invited and 30 consultation forms were collected, with a recovery rate of 94%. In the second round of consultation, 30 experts were invited and 30 consultation forms were collected, with a recovery rate of 100%. After 2 rounds of consultation, the acceptance rates of experts for the question state, problem type, problem cause, question intervention, and intervention result in the primary structure were 100%, 90%, 83%, 83%, and 97%, respectively. For the evaluation of 5 categories of drug treatment (indications, effectiveness, safety, economy, and compliance) in DRPs classification system, except for that the expert authority coefficient of economics was 0.79, the expert authority coefficient of the other 4 categories of issues was all >0.8. In the first and second round of consultation, the coordination coefficient of expert opinions was 0.386 (χ2=995.258, P<0.001) and 0.364 (χ2=971.232, P<0.001), respectively. After modifying with expert opinions, a final version of DRPs classification system was formed, which included 38 primary structure items in 5 categories and 90-secondary structure items in 3 categories. Conclusion A DRPs classification system for outpatients and home patients suitable for China′s national conditions has been initially established, which can be used as a standardized recording tool for DRP.
刘清扬,白向荣,王可,苏甦,褚燕琦,曾艳,唐静,沈江华,张青霞,刘洋,杨军,王海莲,姜德春,闫素英. 门诊和居家患者药物相关问题分类系统的研制[J]. 药物不良反应杂志, 2021, 23(3): 120-127.
Liu Qingyang, Bai Xiangrong, Wang Ke, Su Su, Chu Yanqi, Zeng Yan, Tang Jing, Shen Jianghua, Zhang Qingxia, Liu Yang, Yang Jun, Wang Hailian, Jiang Dechun, Yan Suying. Development of drug?related problems classification system for outpatients and home patients. Adverse Drug Reactions Journal, 2021, 23(3): 120-127.