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Developing a questionnaire comprising clinically useful patient-reported outcome measures in software-assisted medication reviews

  • At: PPR 2022 (2022)
  • Type: Poster
  • By: MAIERHöFER, Stefan (Department Of Pharmaceutical And Medicinal Chemistry – Clinical Pharmacy, Westfaelische Wilhelms-University Muenster)
  • Co-author(s): Stefan Maierhöfer, Doctoral Researcher, Department Of Pharmaceutical And Medicinal Chemistry – Clinical Pharmacy, Westfaelische Wilhelms-University Muenster, Germany
    Isabell Waltering, Postdoctoral researcher, Viandar GmbH, Germany
    Mareike Jacobs, Pharmacist
    Meike Appelrath, Managing director
    Georg Hempel, Professor


  • Abstract:

    Background information
    The before-after study OPtiMed aims to evaluate effects of community pharmacist-led and decision support software-assisted medication reviews on medication-related and patient-reported outcomes (PRO). As the study relies on routine documentation within the medication review software, there was a need for easy and quick to use PRO measures (PROM) that were equally practical to collect outcome data as well as information relevant to a medication review in clinical practice. For various outcomes (e.g. perceived changes), we did not identify validated PROM fitting the needs of pharmacists and their patients in the latter regard.

    Purpose
    The aim of this project is to develop a software-integrable questionnaire comprising clinically useful instruments for measuring PRO in the context of structured medication reviews.

    Methods
    The questionnaire and included PROM were developed in four phases: literature review; expert rounds involving pharmacists, a physician, and a public health scientist; item generation; pretests in elderly patients (≥ 65 years of age) with polypharmacy (≥ 5 medicines in long-term use). The pretest procedure followed a cognitive interview approach.

    Results
    We designed a questionnaire consisting of six PROM, three newly designed: (1) A rating scale for the assessment of symptom burden, encompassing 18 symptoms / symptom categories frequently associated with adverse drug reactions. Patients rate the degree of symptoms experienced over the last four weeks on a four-point scale at baseline (t0) and follow-up (t1). (2) A three-point scale to measure the extent of achievement of health-related goals stated by a patient at t0. The instrument contains eight individualizable categories of goals, which were selected based on previous research and an evaluation of data from a medication therapy safety training program (Apo-AMTS-program). (3) An instrument (five items) to assess perceived changes and benefit attributed to the medication review service on a 5-point Likert-Scale.

    Conclusion
    With a partial lack of instruments both suitable for an ongoing study and clinical practice, we developed tools that have become an integral component of the medication review software Medinspector®. Although we did not have the capacities to validate the instruments, the questionnaire was thoroughly designed and pretested. Positive feedback from software-users indicates its clinical usefulness for performing medication reviews.

Last update 4 October 2019

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