Basger Benjamin Joseph, Chen Timothy Frank, Moles Rebekah Jane
Faculty of Pharmacy, The University of Sydney, Sydney, Australia.
BMJ Open. 2012 Sep 14;2(5). doi: 10.1136/bmjopen-2012-001431. Print 2012.
To further develop and validate previously published national prescribing appropriateness criteria to assist in identifying drug-related problems (DRPs) for commonly occurring medications and medical conditions in older (≥65 years old) Australians.
RAND/UCLA appropriateness method.
A panel of medication management experts were identified consisting of geriatricians/pharmacologists, clinical pharmacists and disease management advisors to organisations that produce Australian evidence-based therapeutic publications. This resulted in a round-one panel of 15 members, and a round-two panel of 12 members.
Agreement on all criteria.
Forty-eight prescribing criteria were rated. In the first rating round via email, there was disagreement regarding 17 of the criteria according to median panel ratings. During a face-to-face second round meeting, discussion resulted in retention of 25 criteria after amendments, agreement for 14 criteria with no changes required and deletion of 9 criteria. Two new criteria were added, resulting in a final validated list of 41 prescribing appropriateness criteria. Agreement after round two was reached for all 41 criteria, measured by median panel ratings and the amount of dispersion of panel ratings, based on the interpercentile range.
A set of 41 Australian prescribing appropriateness criteria were validated by an expert panel. Use of these criteria, together with clinical judgement and other medication review processes such as patient interview, is intended to assist in improving patient care by efficiently detecting potential DRPs related to commonly occurring medicines and medical conditions in older Australians. These criteria may also contribute to the medication management education of healthcare professionals.
进一步完善并验证之前发布的国家处方适宜性标准，以协助识别澳大利亚老年（≥65岁）人群中常见药物和医疗状况的药物相关问题（DRP）。
兰德/加州大学洛杉矶分校适宜性方法。
确定了一个药物管理专家小组，成员包括老年病学家/药理学家、临床药师以及为澳大利亚循证治疗出版物制作机构提供疾病管理建议的人员。这产生了一个由15名成员组成的第一轮小组和一个由12名成员组成的第二轮小组。
对所有标准的一致性。
对48条处方标准进行了评级。在通过电子邮件进行的第一轮评级中，根据小组中位数评级，有17条标准存在分歧。在第二轮面对面会议期间，经过讨论，修订后保留了25条标准，14条标准无需更改达成一致，9条标准被删除。新增了两条标准，最终形成了一份经过验证的41条处方适宜性标准清单。根据小组中位数评级和基于百分位数范围的小组评级离散程度衡量，第二轮后对所有41条标准均达成了一致。
一组41条澳大利亚处方适宜性标准经专家小组验证。使用这些标准，结合临床判断和其他药物审查流程（如患者访谈），旨在通过有效检测与澳大利亚老年人群中常见药物和医疗状况相关的潜在DRP来协助改善患者护理。这些标准也可能有助于医疗保健专业人员的药物管理教育。
