Snyder Margie E, Pater Karen S, Frail Caitlin K, Hudmon Karen Suchanek, Doebbeling Brad N, Smith Randall B
Purdue University College of Pharmacy, 640 Eskenazi Ave., Indianapolis, IN 46202, USA.
University of Pittsburgh School of Pharmacy, 3501 Terrace St., Pittsburgh, PA 15261, USA.
Res Social Adm Pharm. 2015 Mar-Apr;11(2):253-64. doi: 10.1016/j.sapharm.2014.08.005. Epub 2014 Oct 8.
Medication therapy management (MTM) services position pharmacists to prevent, detect, and resolve medication-related problems (MRPs.) However, selecting patients for MTM who are most at risk for MRPs is a challenge. Using self-administered scales that are practical for use in clinical practice are one approach.
The objective of this study was to estimate the psychometric properties of a brief self-administered scale as a screening tool for MRPs.
This was a non-randomized study utilizing questionnaires administered cross-sectionally. In Phase 1, patients (n = 394) at community pharmacies and outpatient clinics completed 78 items, provided to the study team by item authors, assessing perceived MRPs. These data were used to select items for further investigation as a brief, self-administered scale, and estimate the reliability and construct validity of the resulting instrument. In Phase 2, a convenience sample of patients (n = 200) at community pharmacies completed a nine-item, self-administered scale. After completion, they were engaged in a comprehensive medication review by their pharmacist who was blinded to questionnaire responses. The main outcome measure for estimating the criterion-related validity of the scale was the number of pharmacist-identified medication-related problems (MRPs.) Item statistics were computed as well as bivariate associations between scale scores and other variables with MRPs. A multivariate model was constructed to examine the influence of scale scores on MRPs after controlling for other significant variables.
Higher scores on the questionnaire were positively correlated with more pharmacist-identified MRPs (r = 0.24; P = 0.001) and scores remained as a significant predictor (P = 0.031) when controlling for other relevant variables in a multivariate regression model (R(2) = 0.21; P < 0.001).
Patient responses on the scale may have a modest role in predicting MRPs. The use of self-administered questionnaires such as this may supplement other available patient data in developing patient eligibility criteria for MTM, however, additional research is warranted.
药物治疗管理（MTM）服务使药剂师能够预防、发现并解决与药物相关的问题（MRP）。然而，选择最易出现MRP的患者接受MTM是一项挑战。使用适用于临床实践的自我管理量表是一种方法。
本研究的目的是评估一种简短的自我管理量表作为MRP筛查工具的心理测量特性。
这是一项利用横断面问卷调查的非随机研究。在第1阶段，社区药房和门诊诊所的患者（n = 394）完成了由项目作者提供给研究团队的78个项目，评估感知到的MRP。这些数据用于选择项目以进一步研究作为简短的自我管理量表，并估计所得工具的信度和结构效度。在第2阶段，社区药房的便利样本患者（n = 200）完成了一个九项自我管理量表。完成后，他们由对问卷回答不知情的药剂师进行全面的药物审查。估计量表与标准相关效度的主要结局指标是药剂师识别的与药物相关的问题（MRP）数量。计算项目统计数据以及量表得分与其他MRP变量之间的双变量关联。构建多变量模型以在控制其他显著变量后检查量表得分对MRP的影响。
问卷得分越高与药剂师识别的更多MRP呈正相关（r = 0.24；P = 0.001），并且在多变量回归模型中控制其他相关变量时，得分仍然是一个显著预测因子（P = 0.031）（R² = 0.21；P < 0.001）。
患者在量表上的回答在预测MRP方面可能起适度作用。使用这样的自我管理问卷可能会在制定MTM患者资格标准时补充其他可用的患者数据，然而，仍需要进一步研究。
