Development and validation of the Medication-Related Consultation Framework (MRCF)

Objectives

To develop and test a framework for evaluating the consultation skills of practitioners undertaking medication-related consultations.

Methods

Key components of medication-related consultations were identified through a literature review and compiled to form an initial consultation skills framework. This was iteratively refined through consultation with experts (n = 21) to form the Medication-Related Consultation Framework (MRCF). Psychometric testing was undertaken by analyzing pharmacists’ (n = 10) assessment of fifteen pre-recorded simulated consultations.

Results

The MRCF consisted of 46 consultation behaviors, grouped into five sections. Performance was rated at individual behavior, framework section and global consultation levels. The MRCF discriminated between good, satisfactory and poor consultations at the global rating level (p < 0.01) with good test-retest reliability (rho = 0.59-0.95) and moderate inter-assessor reliability (Kendall's W = 0.67). There was also good internal consistency for the five sections (Cronbach's alphas = 0.58-0.97).

Conclusions

The MRCF demonstrated good psychometric properties at the global and section rating levels. Some inconsistencies in assessors’ ratings of individual consultation behaviors were indentified, which may represent a future training need.

Practice implications

The MRCF provides healthcare professionals with a patient-centered consultation structure, serving to identify medication-related needs and potentially support adherence. It also allows the quality of a practitioner's consultation to be evaluated.