Document Detail

Reliability testing of a case-leveling framework for assigning level of difficulty of pharmacist's initial patient medication assessments.
MedLine Citation:
PMID:  18826903     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To develop and test the reliability of a case-leveling framework for assigning level of difficulty of the pharmacist's task for initial medication assessments conducted by pharmacists integrated into family physician offices. DESIGN: Descriptive study. SETTING: Seven family practice sites in Ontario from June 2004 to July 2006. PATIENTS: Patients referred by their family physician for pharmacist assessment. INTERVENTION: Individual medication assessments, monitoring, and follow-up by pharmacists. A case-leveling framework was developed with three levels of complexity (graded as I, II, or III) including specific descriptors and practice-based examples. Reliability was assessed between two standardized assessors and between one assessor and project pharmacists. Project pharmacist feedback was elicited through an e-mail survey. Reliability is reported using the kappa statistic. MAIN OUTCOME MEASURES: Reliability of a case-leveling framework and helpfulness of the framework as reported by pharmacists. RESULTS: 53 patient cases were evaluated for interrater reliability between standardized assessors. The mean (+/- SD) case level assigned was 1.8 +/- 0.68, and the kappa was 0.62 (95% CI 0.44-0.79), indicating a substantial strength of agreement between raters. For the second reliability test, 52 cases were rated, with a level of agreement between project pharmacists and the external assessor of 0.46 (95% CI 0.27-0.65), indicating moderate agreement. Feedback resulted in slight revisions to the original framework. CONCLUSION: The case-leveling framework was a reliable method and can be used to determine the level of difficulty of patient cases in primary care.
Natalie Kennie; Lisa Dolovich
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Pharmacists Association : JAPhA     Volume:  48     ISSN:  1544-3450     ISO Abbreviation:  J Am Pharm Assoc (2003)     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-10-01     Completed Date:  2009-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101176252     Medline TA:  J Am Pharm Assoc (2003)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  640-7     Citation Subset:  IM    
Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.
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MeSH Terms
Data Collection
Data Interpretation, Statistical
Delivery of Health Care, Integrated / organization & administration
Family Practice / organization & administration
Medication Therapy Management / organization & administration*
Observer Variation
Pharmaceutical Services / organization & administration*
Pharmacists / organization & administration*
Primary Health Care / organization & administration
Professional Role*
Referral and Consultation
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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