naa a22 4500 510786618 CHVBK 20180411083304.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s12603-013-0011-1 doi (NATIONALLICENCE)springer-10.1007/s12603-013-0011-1 Inter-rater reliability of the assessment of adverse drug reactions in the hospitalised elderly [Elektronische Daten] [B. Tangiisuran, V. Auyeung, L. Cheek, C. Rajkumar, J. Davies] Background: The identification and assessment of adverse drug reactions (ADRs) is very challenging especially among the older person. Inter observer reliability of an ADR classification system by different healthcare providers is vital to establish the validity of the reaction. Objective: To assess the inter-rater reliability of an ADR classification system in hospitalised elderly patients and to investigate the differences in reliability by different professions. Methods: From a cohort of 330 elderly patients, patients who experienced a suspected medication related incident (n=87) were selected. The data were analysed by four healthcare professionals (2 pharmacists and 2 physicians) who independently classified the events into event type, types of adverse drug reactions, severity and preventability after a standardised induction based on previously published criteria. Fleiss' kappa was used to assess the level of agreement between the four raters. The difference in level of agreement between the professions was assessed using the weighted least-squares approach for comparing correlated kappa of Barnhart et al. Results: Pharmacists and physicians showed high agreement in the identification and on the type and causality of ADRs. However there was lower (moderate) agreement for the severity (kappa = 0.61) and preventability of ADR (kappa = 0.48). Statistically significant differences were also noted between the professions; pharmacists have higher agreement in the classification of preventability (p=0.03) whereas the physicians pairs showed stronger agreement for classifying severity (p<0.001). Conclusion: Despite the high agreement in the identification, type and causality of ADRs, physicians and pharmacists have difficulties in classifying preventability and severity in a reliable way. A multi-disciplinary approach would enable each profession to share their expert knowledge in order to facilitate better or safer patient care. Serdi and Springer-Verlag France, 2013 Adverse drug reactions nationallicence inter-rater reliability nationallicence elderly nationallicence assessment nationallicence Tangiisuran B. Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Minden, Pulau Pinang, Malaysia aut Auyeung V. Institute of Pharmaceutical Science, King's College London, London, UK aut Cheek L. School of Computing Engineering and Mathematics, University of Brighton, Brighton, UK aut Rajkumar C. Brighton and Sussex Medical School, University of Sussex, Sussex, UK aut Davies J. Institute of Pharmaceutical Science, King's College London, 5th Floor, Franklin-Wilkins Building, 150 Stamford Street, SE1 9NH, London, UK aut The journal of nutrition, health & aging Springer Paris 17/8(2013-10-01), 700-705 1279-7707 17:8<700 2013 17 12603 https://doi.org/10.1007/s12603-013-0011-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12603-013-0011-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tangiisuran B. Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Minden, Pulau Pinang, Malaysia aut NATIONALLICENCE 700 1- Auyeung V. Institute of Pharmaceutical Science, King's College London, London, UK aut NATIONALLICENCE 700 1- Cheek L. School of Computing Engineering and Mathematics, University of Brighton, Brighton, UK aut NATIONALLICENCE 700 1- Rajkumar C. Brighton and Sussex Medical School, University of Sussex, Sussex, UK aut NATIONALLICENCE 700 1- Davies J. Institute of Pharmaceutical Science, King's College London, 5th Floor, Franklin-Wilkins Building, 150 Stamford Street, SE1 9NH, London, UK aut NATIONALLICENCE 773 0- The journal of nutrition, health & aging Springer Paris 17/8(2013-10-01), 700-705 1279-7707 17:8<700 2013 17 12603 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer