Preventing drug-related morbidity - the development of quality indicators

Objective: To describe the process that has been undertaken to (i) validate further UK indicators for preventable drug-related morbidity (PDRM) generated by a previous study and (ii) develop additional new indicators derived from UK clinical practice. Design: A two-round Delphi questionnaire survey. Setting: A UK study based in primary care. Participants: A purposively selected sample of primary care pharmacists (n = 9) and general practitioners (n = 8). Outcome measures: The establishment of consensus among the panel as to whether an indicator represented a PDRM. Results: The pre-defined level of consensus was achieved for 24 indicators (59%; 24 of 41). Conclusions: We have identified that although mechanisms exist for identifying 'the outcome' component of PDRM indicators, identifying the 'pattern of care' that is needed to prevent their occurrence is far more challenging. Nonetheless, we have taken considerable steps along the path of validating such indicators. Future operationalization in a general practice setting should help to facilitate improvements in medicine management in primary care and ultimately benefit patients.