Development and validation of the RASP list (Rationalization of Home Medication by an Adjusted STOPP list in Older Patients): A novel tool in the management of geriatric polypharmacy - 13/06/14
Abstract |
Background |
Inappropriate prescribing is prevalent in older people. One of the interventions is to optimize geriatric pharmacotherapy with a screening tool to detect potentially inappropriate prescribing. The aim of this study was to develop a novel instrument, the RASP list, which was adapted from The Screening Tool of Older Persons’ potentially inappropriate Prescriptions criteria.
Methods |
Face validity, usability and time investment were determined. Content validity was verified with the Content Validity Index (CVI) and the modified kappa index (κ*). Cohen's kappa (κ) was used to determine the inter-rater reliability. Content and reproducibility validation were to be repeated if consensus (κ*≥0.74) could not be reached in the first round or if new compelling evidence was published.
Results |
Ten experts validated the content of RASP 1.0. The scale-CVI/Average (S-CVI/Ave) was 0.936, Three items did not reach κ*≥0.74. Median time to complete a patient case with RASP 1.0 was 316seconds. Inter-rater reliability was determined by 9 pharmacists (κ=0.71) and 10 geriatricians (κ=0.63). In a second validation round, 15 items were added to and 3 items deleted from RASP 1.0. Nine experts validated the new content of RASP 2.0. All new items but one reached a κ*≥0.74. The S-CVI/Ave was 0.923. Inter-rater reliability of RASP 2.0 was performed by 14 pharmacists (κ=0.77). The final version of the RASP list contained 76 items.
Conclusions |
The RASP list is a reliable (κ=0.77) and valid (S-CVI/Ave=0.92) screening tool to identify polypharmacy in older persons. Further research concerning clinical relevancy is warranted.
Le texte complet de cet article est disponible en PDF.Keywords : Potentially inappropriate prescribing, Validation, Patient safety, Quality improvement, Older, Persons
Plan
Vol 5 - N° 3
P. 175-180 - juin 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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