Development and validation of standardized severity rating scale to assess the consistency of drug-drug interaction severity among various drug information resources |
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| Institution: | 1. UPMC Centers for High-Value Health Care and Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, PA, USA;2. Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA;3. Evernorth Holding Company, St. Louis, MO, USA;4. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA;1. Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal;2. Pharmacy Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil;3. Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, Brazil;1. School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Private Bag 26, Hobart, Tasmania, 7001, Australia;2. Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, Tasmania, 7001, Australia;3. Royal Hobart Hospital, GPO Box 1061, Hobart, Tasmania, 7001, Australia;1. Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, Australia;2. Frankston Mornington Peninsula Primary Care Partnership, Peninsula Health, Australia;3. Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia;4. Pharmacotherapy Mediation, Advocacy, and Support (PAMS), Harm Reduction Victoria, Australia;5. Centre for Health Economics, Monash Business School, Caulfield East, Victoria, Australia;6. Monash Health Drug and Alcohol Service, Monash Health, Melbourne, Victoria, Australia;1. UNC Eshelman School of Pharmacy, 301 Pharmacy Lane, Chapel Hill, NC, 27599-7574, USA;2. UNC School of Medicine, Division of Geriatric Medicine, 5003 Old Clinic Bldg. Chapel Hill, NC, 27599-7550, USA;3. UNC Center for Aging and Health, 5003 Old Clinic Bldg. Chapel Hill, NC, 27599-7550, USA |
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| Abstract: | BackgroundThe consistency in reporting the severity of drug interactions across the drug information resources is important in guiding the appropriate clinical use of drug-pairs, to minimize the associated adverse events. This necessitates the need of a standardized severity rating scale, that can accommodate the different severity ratings of the same interacting drug-pair into a reasonable severity category, that can ease the consistency assessment among different drug information resources.ObjectiveTo develop and validate a standardized severity rating scale that can ease the consistency assessment among the various drug information resources.MethodsThe definitions of various severity rating categories as documented in the eight drug information resources was consolidated to develop a standardized severity rating scale. Thus developed rating scale was validated using twenty commonly used drug-pairs. Fleiss' kappa score was used as an indicator for assessing overall consistency among various drug information resources, whereas, Cohen's kappa was used as an indicator of level of consistency between two drug information resources and between individual drug information resource and newly developed standardized severity rating scale.ResultsThe newly developed standardized severity rating scale classifies the severity of drug-drug interactions into three categories namely mild, moderate and major. The Fleiss' kappa score was improved from 0.047 to 0.176, indicating improved strength of agreement Average pairwise agreement: 16% Vs 36.7%] among various drug information resources. The average pairwise Cohen's kappa was 0.082 Strength of agreement: poor] in original severity ratings whereas it was improved to 0.198 Strength of agreement: almost equal to fair] in standardized severity rating scale.ConclusionThe newly developed standardized severity rating scale can be used as a tool to assess the consistency of severity rating categories among the various drug information resources. |
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| Keywords: | Drug-drug interactions Consistency assessment Adverse events Drug information resources Drug interaction severity Severity rating scale |
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