Hanlon J T, Schmader K E, Samsa G P, Weinberger M, Uttech K M, Lewis I K, Cohen H J, Feussner J R
Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC 27710.
J Clin Epidemiol. 1992 Oct;45(10):1045-51. doi: 10.1016/0895-4356(92)90144-c.
This study evaluated the reliability of a new medication appropriateness index. Using the index, independent assessments were made of chronic medications taken by 10 ambulatory, elderly male patients by a clinical pharmacist and an internist-geriatrician. Their overall inter-rater agreement for medication appropriateness (ppos) was 0.88, and for medication inappropriateness (pneg) was 0.95; the overall kappa was 0.83. Their intra-rater agreement for ppos was 0.94 overall, for pneg was 0.98 overall while the overall kappa was 0.92. The chronic medications taken by 10 different ambulatory elderly male patients were independently evaluated by two different clinical pharmacists. Their overall inter-rater agreement for ppos was 0.76, and for pneg was 0.93, while the overall kappa was 0.59. This new index provides a reliable method to assess drug therapy appropriateness. Its use may be applicable as a quality of care outcome measure in health services research and in institutional quality assurance programs.
本研究评估了一种新的用药合理性指数的可靠性。使用该指数，由一名临床药剂师和一名内科老年病医生对10名门诊老年男性患者服用的慢性药物进行独立评估。他们在用药合理性（ppos）方面的总体评分者间一致性为0.88，在用药不当性（pneg）方面为0.95；总体kappa值为0.83。他们在ppos方面的评分者内一致性总体为0.94，在pneg方面总体为0.98，而总体kappa值为0.92。由两名不同的临床药剂师对10名不同的门诊老年男性患者服用的慢性药物进行独立评估。他们在ppos方面的总体评分者间一致性为0.76，在pneg方面为0.93，而总体kappa值为0.59。这个新指数提供了一种评估药物治疗合理性的可靠方法。它的应用可作为卫生服务研究和机构质量保证项目中护理质量结果的衡量指标。
