Development of prescribing safety indicators related to mental health disorders and medications: modified e-Delphi study

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Development of prescribing safety indicators related to mental health disorders and medications : modified e-Delphi study. / Khawagi, Wael Y. ; Steinke, Douglas T. ; Nguyen, Joanne ; Pontefract, Sarah; Keers, Richard N. .

In: British Journal of Clinical Pharmacology, 20.05.2020.

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@article{f02ade4094c94233b7fc65bd935d75cb,
title = "Development of prescribing safety indicators related to mental health disorders and medications: modified e-Delphi study",
abstract = "AimDevelop a set of prescribing safety indicators related to mental health disorders and medications and to estimate the risk of harm associated with each indicator.MethodA 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.ResultsSeventy‐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).ConclusionThis 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.",
keywords = "prescribing indicators, quality indicators, consensus, medication safety",
author = "Khawagi, {Wael Y.} and Steinke, {Douglas T.} and Joanne Nguyen and Sarah Pontefract and Keers, {Richard N.}",
year = "2020",
month = may,
day = "20",
doi = "10.1111/bcp.14391",
language = "English",
journal = "British Journal of Clinical Pharmacology",
issn = "0306-5251",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Development of prescribing safety indicators related to mental health disorders and medications

T2 - modified e-Delphi study

AU - Khawagi, Wael Y.

AU - Steinke, Douglas T.

AU - Nguyen, Joanne

AU - Pontefract, Sarah

AU - Keers, Richard N.

PY - 2020/5/20

Y1 - 2020/5/20

N2 - AimDevelop a set of prescribing safety indicators related to mental health disorders and medications and to estimate the risk of harm associated with each indicator.MethodA 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.ResultsSeventy‐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).ConclusionThis 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.

AB - AimDevelop a set of prescribing safety indicators related to mental health disorders and medications and to estimate the risk of harm associated with each indicator.MethodA 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.ResultsSeventy‐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).ConclusionThis 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.

KW - prescribing indicators

KW - quality indicators

KW - consensus

KW - medication safety

U2 - 10.1111/bcp.14391

DO - 10.1111/bcp.14391

M3 - Article

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

SN - 0306-5251

ER -