Department of Pharmacy, Uppsala University, Uppsala, Sweden.
Primary Care and Health, Uppsala County Council, Uppsala, Sweden.
Int J Clin Pharm. 2022 Aug;44(4):1078-1082. doi: 10.1007/s11096-022-01456-x. Epub 2022 Jul 15.
AT-HARM10 is a research tool to identify possible drug-related hospital admissions. It is unclear whether the tool can be applied to emergency department visits as well.
The aim of this study was to investigate the applicability and reliability to identify drug-related emergency department visits in older patients with AT-HARM10.
A random sample of 400 patients aged 65 years or older from a clinical trial in four Swedish hospitals was selected. All patients' emergency department visits within 12 months after discharge were assessed with AT-HARM10. The main outcome measures were the percentage of successfully assessed visits for applicability and the interrater reliability (Cohen's kappa).
Of the initial sample (n = 400), 113 patients [median age (interquartile range): 81 (76-88) years] had at least one emergency department visit within 12 months. The patients had in total 184 visits, of which 179 (97%) were successfully assessed. Fifty-three visits (29%) were possibly drug-related. The Cohen's kappa value was 0.70 (substantial).
It seems applicable and reliable to identify possible drug-related emergency department visits in addition to hospital admissions in older patients with AT-HARM10. As a consequence, the tool has been updated to support its novel use in clinical research.
AT-HARM10 是一种用于识别可能与药物相关的住院的研究工具。目前尚不清楚该工具是否也可应用于急诊科就诊。
本研究旨在调查 AT-HARM10 在识别老年患者药物相关急诊科就诊方面的适用性和可靠性。
从瑞典四家医院的一项临床试验中随机抽取 400 名年龄在 65 岁及以上的患者作为样本。在出院后 12 个月内，对所有患者的急诊科就诊情况使用 AT-HARM10 进行评估。主要结局指标为评估适用性的成功就诊比例和评分者间可靠性（Cohen's kappa）。
在初始样本（n=400）中，113 名患者[中位年龄（四分位距）：81（76-88）岁]在 12 个月内至少有一次急诊科就诊。这些患者共有 184 次就诊，其中 179 次（97%）成功评估。53 次就诊（29%）可能与药物有关。Cohen's kappa 值为 0.70（中等）。
AT-HARM10 似乎可用于识别老年患者药物相关急诊科就诊以及住院，具有适用性和可靠性。因此，该工具已进行更新，以支持其在临床研究中的新用途。
