quality and safety of medication use in primary care consensus validation of a new set of explicit medication assessment criteria and prioritisation of topics for improvement质量和安全的药物在初级保健中使用一致的验证一组新的明确的药物评估标准和改进的优先顺序的话题.pdfVIP

Dreischulte et al. BMC Clinical Pharmacology 2012, 12:5 /1472-6904/12/5 RESEARCH ARTICLE Open Access Quality and safety of medication use in primary care: consensus validation of a new set of explicit medication assessment criteria and prioritisation of topics for improvement 1* 2 2 3 2 Tobias Dreischulte , Aileen M Grant , Colin McCowan , John J McAnaw and Bruce Guthrie Abstract Background: Addressing the problem of preventable drug related morbidity (PDRM) in primary care is a challenge for health care systems internationally. The increasing implementation of clinical information systems in the UK and internationally provide new opportunities to systematically identify patients at risk of PDRM for targeted medication review. The objectives of this study were (1) to develop a set of explicit medication assessment criteria to identify patients with sub-optimally effective or high-risk medication use from electronic medical records and (2) to identify medication use topics that are perceived by UK primary care clinicians to be priorities for quality and safety improvement initiatives. Methods: For objective (1), a 2-round consensus process based on the RAND/UCLA Appropriateness Method (RAM) was conducted, in which candidate criteria were identified from the literature and scored by a panel of 10 experts for ‘appropriateness’ and ‘necessity’. A set of final criteria was generated from candidates accepted at each level. For objective (2), thematically related final criteria were clustered into ‘topics’, from which a panel of 26 UK primary care clinicians identified priorities for quality improvement in a 2-round Delphi exercise. Results: (1) The RAM process yielded a final set of 176 med