Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, 1295 N. Martin Ave., P.O. Box 210202, Tucson, AZ 85721, USA.
Res Social Adm Pharm. 2011 Mar;7(1):16-26. doi: 10.1016/j.sapharm.2010.01.001. Epub 2010 Apr 10.
It is essential that current and future health professionals be able to evaluate for possible clinically significant drug-drug interactions (DDIs) and when detected, determine appropriate management strategies to prevent patient harm.
Assess the validity of a DDI knowledge assessment instrument in a health professional student population.
This study recruited health professional students (medical, nurse practitioner, and pharmacy) beginning experiential training at the University of Arizona. Students were given a knowledge assessment instrument that included 15 medication pairings selected on the basis of clinical importance and were asked to select the most appropriate DDI management strategy for each pair by selecting "avoid combination," "usually avoid combination," "take precautions," or "no special precautions." Data were analyzed in 2 ways because of the subjective nature of classifying DDIs into specific management categories. In the first analysis, respondents were given credit for a correct item only if they selected the management strategy deemed appropriate (management strategy analysis). In another analysis, students were given credit for an item only if they correctly identified specific DDIs (DDI recognition analysis). Rasch analysis was used to assess the validity of the knowledge instrument.
A total of 165 of the 226 eligible health professional students completed the DDI knowledge assessment (73% response rate). The mean score for management strategy analysis was 3.82 out of 15, whereas DDI recognition analysis produced a higher average (mean=6.55). Good reliability was demonstrated in both strategies, and no ceiling or floor effects were observed. Some construct underrepresentation occurred with both scoring strategies, and some mistargeting was identified when analyzing the management strategy.
Although improvements in construct representation may be beneficial, the instrument used demonstrated good reliability and validity and could be used by educators to assess and improve DDI knowledge. The ability of the participants to identify DDIs and select an appropriate management strategy was low. These results support the need for additional DDI education in this institution's health curricula.
当前和未来的医疗专业人员必须能够评估可能存在的临床显著药物相互作用（DDI），并且在发现时确定适当的管理策略以防止患者受到伤害。
评估一种在医疗专业学生群体中进行 DDI 知识评估的工具的有效性。
本研究招募了在亚利桑那大学开始体验式培训的医疗专业学生（医学生、护士从业者和药剂师）。学生们接受了一项知识评估工具，其中包括 15 对药物组合，这些组合是根据临床重要性选择的，并要求他们通过选择“避免联合”、“通常避免联合”、“采取预防措施”或“无需特殊预防措施”来为每对药物组合选择最合适的 DDI 管理策略。由于将 DDI 分类为特定管理类别具有主观性，因此数据进行了两种方式的分析。在第一种分析中，只有当学生选择了被认为是适当的管理策略时，他们才能获得正确项目的分数（管理策略分析）。在另一种分析中，只有当学生正确识别出特定的 DDI 时，学生才能获得项目的分数（DDI 识别分析）。Rasch 分析用于评估知识工具的有效性。
共有 226 名符合条件的医疗专业学生中的 165 名完成了 DDI 知识评估（73%的响应率）。管理策略分析的平均得分为 15 分中的 3.82 分，而 DDI 识别分析的平均得分为 6.55 分。两种策略都表现出良好的可靠性，并且没有出现天花板或地板效应。在这两种评分策略中都存在一些结构代表性不足的情况，并且在分析管理策略时还发现了一些目标错位的情况。
尽管改进结构代表性可能是有益的，但所使用的工具表现出良好的可靠性和有效性，教育者可以使用它来评估和提高 DDI 知识。参与者识别 DDI 和选择适当管理策略的能力较低。这些结果支持在该机构的健康课程中增加 DDI 教育的必要性。
