Preventing drug-related morbidity - Determining valid indicators

Caroline Morris, J. A. Cantrill, C. D. Hepler, P. R. Noyce

    Research output: Contribution to journalArticlepeer-review


    Objective. To describe the process that is being undertaken to validate a series of indicators for preventable drug-related morbidity - originally developed in the US - for application in the UK health care system. Design. A two-round Delphi questionnaire survey after a preliminary validation of the indicators within the University of Manchester School of Pharmacy. Setting. A primary care study set in the UK. Study participants. A purposively selected sample of general practitioners with a specific responsibility for prescribing-related issues (n = 6) and pharmacists actively involved in medication review in primary care (n = 10). Main outcome measures. The establishment of consensus among the participants that an indicator reflected preventable drug-related morbidity in primary care. Results. After preliminary validation, 37 of the original 57 US indicators were retained. The Delphi panel generated 16 additional new indicators in the first round. At the end of the second round, the pre-defined level of consensus was reached for 29 indicators (19 of the US generated indicators; 10 generated by the panel in the first round). Conclusions. The Delphi results highlighted differences in both the clinical perspective and, possibly, philosophical viewpoints of health professionals practising in the UK and US health care systems. Further work, located in both primary and secondary care, is now in progress to operationalize the indicators. This process will form a key part of the refining, and hence further validation, of the indicators. The future development of prospective medical-record-based indicators should facilitate a reduction in the human, clinical, and economic burden of drug-related morbidity.
    Original languageEnglish
    Pages (from-to)183-198
    Number of pages15
    JournalInternational Journal for Quality in Health Care
    Issue number3
    Publication statusPublished - 2002


    • Adverse drug events
    • Delphi technique
    • Preventable drug-related morbidity
    • Primary care
    • United Kingdom
    • United States


    Dive into the research topics of 'Preventing drug-related morbidity - Determining valid indicators'. Together they form a unique fingerprint.

    Cite this