PMID: 9161644May 1, 1997Paper

Reliability of drug utilization evaluation as an assessment of medication appropriateness

The Annals of Pharmacotherapy
P S SheltonM Weinberger

Abstract

To test the reliability of drug utilization evaluation (DUE) applied to medications commonly used by the ambulatory elderly. A DUE model was developed for four domains: (1) justification for use, (2) critical process indicators, (3) complications, and (4) clinical outcomes. DUE criteria specific to use in the elderly were developed for angiotensin-converting enzyme (ACE) inhibitors and histamine2 (H2)-antagonists, and consensus was reached by an external expert panel. After pilot testing, two clinical pharmacists independently evaluated these medications, applying the DUE criteria and rating each item as appropriate or inappropriate. Interrater and intrarater reliability was assessed by using kappa statistics. In a sample of 208 ambulatory elderly veterans, 42 (20.2%) were taking an ACE inhibitor and 56 (26.9%) an H2-antagonist. The interrater agreement for individual domains, represented by kappa statistics, were 0.10-0.58 and 0-0.83 for ACE inhibitors and H2-antagonists, respectively. The kappa statistic for overall agreement, which considered ratings from all criteria across all domains, was 0.24 for ACE inhibitors and 0.18 for H2-antagonists. Intrarater reliability was assessed 3 months later, and kappa statistics were 0.61...Continue Reading

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Citations

Jan 27, 2004·The Annals of Pharmacotherapy·Priti S FlanaganSusan A Kirkland
Oct 18, 2005·Pharmacy World & Science : PWS·Mary P Tully, Judith A Cantrill
Jun 22, 2000·The Annals of Pharmacotherapy·B L Carter, D K Helling
Jan 18, 2006·Annual Review of Medicine·David Bachman, Peter Rabins
May 1, 1997·The Annals of Pharmacotherapy·L S FitzgeraldM E Williams
Sep 16, 2010·British Journal of Clinical Pharmacology·Norul Badriah HassanAbdul Rashid Abdul Rahman

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