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[用于识别儿科不适当处方的工具(POPI)的共识验证]

[Consensus validation of a tool to identify inappropriate prescribing in pediatrics (POPI)].

作者信息

Prot-Labarthe S, Weil T, Nguyen N P K, Berthe-Aucejo A, Angoulvant F, Boulkedid R, Alberti C, Bourdon O

机构信息

Département de pharmacie, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Inserm ECEVE unité 1123, 75019 Paris, France; Groupe pédiatrie de la Société française de pharmacie clinique, France.

Département de pharmacie, hôpital Robert-Debré, AP-HP, 75019 Paris, France.

出版信息

Arch Pediatr. 2016 May;23(5):481-90. doi: 10.1016/j.arcped.2016.02.010. Epub 2016 Apr 8.

Abstract

OBJECTIVE

Medication errors including inappropriate prescriptions and drug omissions are one of the causes of adverse drug events in children. Our aim was to develop a preliminary screening tool to detect omissions and inappropriate prescriptions in pediatrics based on French and international guidelines.

MATERIEL AND METHODS

Disease classification was based on the prevalence rate of pathology and hospital statistics. The criteria were obtained by reviewing many French and international references. The Delphi consensus technique was used to establish the content validity of POPI. The level of agreement and the proposals of healthcare professionals was noted on a nine-point Likert scale.

RESULTS

The criteria were categorized according to the main physiological systems (gastroenterology, respiratory infections, pain, neurology, dermatology, and miscellaneous). They were distributed to 16 French pediatric panelists (eight pharmacists, eight pediatricians who were hospital-based [50%] or working in the community [50%]). After two rounds of the Delphi process, 101 of 108 criteria were chosen with strong consensus (76 inappropriate prescriptions and 25 omissions).

CONCLUSIONS

POPI is the first screening tool to detect inappropriate prescriptions and omissions in pediatrics. It is now necessary to conduct a prospective study to determine inter-rater reliability and the tool's detection capacity.

摘要

目的

用药错误,包括不适当的处方和漏用药物,是儿童药物不良事件的原因之一。我们的目的是基于法国和国际指南开发一种初步筛查工具,以检测儿科中的漏用药物和不适当处方。

材料与方法

疾病分类基于疾病患病率和医院统计数据。通过查阅众多法国和国际参考文献获取标准。采用德尔菲共识技术确定儿科用药不当指标(POPI)的内容效度。医疗保健专业人员的一致程度和建议采用九点李克特量表记录。

结果

标准根据主要生理系统(胃肠病学、呼吸道感染、疼痛、神经学、皮肤病学和其他)进行分类。这些标准分发给了16名法国儿科专家小组成员(8名药剂师、8名儿科医生,其中50%为医院医生,50%为社区医生)。经过两轮德尔菲过程,从108条标准中选出了101条,达成了强烈共识(76条不适当处方和25条漏用)。

结论

POPI是首个用于检测儿科不适当处方和漏用药物的筛查工具。现在有必要进行一项前瞻性研究,以确定评分者间信度和该工具的检测能力。

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