Abstract
Aim
Develop a set of prescribing safety indicators related to mental health disorders and medications and to estimate the risk of harm associated with each indicator.
Method
A modified two‐stage electronic Delphi. The first stage consisted of two rounds, where 31 experts rated their agreement with a set of 101 potential mental health related prescribing safety indicators using a 5‐point scale and given the opportunity to suggest other indicators. Indicators that achieved 80% agreement were accepted. The second stage comprised a single round, where 29 members estimated the risk of harm for each accepted indicator by assessing the occurrence likelihood and outcome severity using two 5‐point scales. Indicators were considered high or extreme risk when at least 80% of participants rated each indicator as high or extreme.
Results
Seventy‐five indicators were accepted in the first stage. Following the second stage, 42 (56%) were considered to be high or extreme risk for patient care. The 42 indicators comprised different types of hazardous prescribing, including drug‐disease interactions (n=12), drug‐drug interactions (n=9), inadequate monitoring (n=5), inappropriate duration (n=4), inappropriate dose (n=4), omissions (n=4), potentially inappropriate medications (n=3), and polypharmacy (n=1). These indicators also covered different mental health related medication classes, including antipsychotics (n=14), mood stabilisers (n=8), antidepressants (n=6), sedative, hypnotics and anxiolytics (n=6), anticholinergic (n=6) and non‐specific psychotropics (n=2).
Conclusion
This study has developed the first suite of prescribing safety indicators related to mental health disorders and medications, which could inform the development of future safety improvement initiatives and interventional studies.
Develop a set of prescribing safety indicators related to mental health disorders and medications and to estimate the risk of harm associated with each indicator.
Method
A modified two‐stage electronic Delphi. The first stage consisted of two rounds, where 31 experts rated their agreement with a set of 101 potential mental health related prescribing safety indicators using a 5‐point scale and given the opportunity to suggest other indicators. Indicators that achieved 80% agreement were accepted. The second stage comprised a single round, where 29 members estimated the risk of harm for each accepted indicator by assessing the occurrence likelihood and outcome severity using two 5‐point scales. Indicators were considered high or extreme risk when at least 80% of participants rated each indicator as high or extreme.
Results
Seventy‐five indicators were accepted in the first stage. Following the second stage, 42 (56%) were considered to be high or extreme risk for patient care. The 42 indicators comprised different types of hazardous prescribing, including drug‐disease interactions (n=12), drug‐drug interactions (n=9), inadequate monitoring (n=5), inappropriate duration (n=4), inappropriate dose (n=4), omissions (n=4), potentially inappropriate medications (n=3), and polypharmacy (n=1). These indicators also covered different mental health related medication classes, including antipsychotics (n=14), mood stabilisers (n=8), antidepressants (n=6), sedative, hypnotics and anxiolytics (n=6), anticholinergic (n=6) and non‐specific psychotropics (n=2).
Conclusion
This study has developed the first suite of prescribing safety indicators related to mental health disorders and medications, which could inform the development of future safety improvement initiatives and interventional studies.
| Original language | English |
|---|---|
| Journal | British Journal of Clinical Pharmacology |
| Early online date | 20 May 2020 |
| DOIs | |
| Publication status | E-pub ahead of print - 20 May 2020 |
Keywords
- prescribing indicators
- quality indicators
- consensus
- medication safety
Access to Document
- Khawagi_et_al_Development_of_prescribing_safety_indicators_related_to_mental_health_BJCP_2020
This is the peer reviewed version of the following article: Khawagi, WY, Steinke, DT, Nguyen, J, Pontefract, S, Keers, RN. Development of prescribing safety indicators related to mental health disorders and medications: modified e‐Delphi study. Br J Clin Pharmacol. 2020. https://doi.org/10.1111/bcp.14391, which has been published in final form at https://bpspubs.onlinelibrary.wiley.com/doi/abs/10.1111/bcp.14391. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.