Background: 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. Objective: The objective of this study was to estimate the psychometric properties of a brief self-administered scale as a screening tool for MRPs. Methods: 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. Results: 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 (R2=0.21; P<0.001). Conclusions: 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.
Bibliographical noteFunding Information:
This study was funded by the Community Pharmacy Foundation (grant # 68 ). Dr. Snyder's effort was partially supported by KL2 RR025760 (A. Shekhar, PI). A portion of Dr. Snyder's effort was supported by grant number K08HS022119 from the Agency for Healthcare Research and Quality . The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. The funding agencies were not involved in the collection or analysis of data or manuscript preparation. The authors thank Richard Lennox and Dennis Devine for assistance with psychometric analyses; Susan Blalock for providing information about the Drug Therapy Concerns Scale; the numerous colleagues who provided input throughout stages of this project; Harrison Smith, Anna Bartoshek, Ryan Hill, Cami Douglas, and Megan Kline for assistance with data collection and data entry; Puja Patel for her assistance with preparing this manuscript, and the pharmacists and staff who facilitated data collection.
© 2015 Elsevier Inc.
- Medication therapy management
- Pharmaceutical care
- Pharmacy practice