Validation of an updated French national tool for reporting pharmacist interventions for all healthcare products.

introductionIn France, two validated tools (collectively referred to as "Act-IP©") are commonly used to report pharmacist interventions in both community and hospital pharmacy settings. These tools were designed primarily for drug-related pharmacist interventions and are less suited to those related to medical devices. To address this limitation, the French Clinical Pharmacy Society and the French Medical Device Pharmacy Society are jointly developing a rating tool that encompasses all healthcare products.

aimTo assess inter-rater agreement for "product-related problem" and "pharmacist intervention" items in a revised version of the Act-IP© during validation by internal and external panels and to evaluate the tool's feasibility and acceptability.

methodThe revised Act-IP© was based on two previously validated tools; items were revised or added to encompass interventions involving medical devices and drugs. Six expert hospital pharmacists were recruited for the internal validation, and pharmacists attending a national congress were recruited for the external validation. In both validation processes, 60 scenarios had to be rated using the new tool. Each scenario included a case report, a product-related problem, and the corresponding pharmacist interventions. The Clinical, Economic, and Organizational Scale was also used to rate the impacts of each pharmacist intervention. Inter-rater agreement was evaluated using Fleiss's kappa (κ, interpreted according to Landis and Koch's conventions).

resultsThe revised Act-IP© included 11 product-related problem items (10 revised and one new) and eight pharmacist intervention items (5 revised and one new). In the internal validation, the mean κ values were 0.63 for product-related problems and 0.77 for pharmacist interventions. In the external validation, the mean κ values were lower: 0.42 for product-related problems and 0.52 for pharmacist interventions; this reflecting time constraints, real-world assessment conditions, and greater variability among raters. The level of inter-rater agreement for the Clinical, Economic, and Organizational Scale was low and - despite the tool's usability and applicability - highlighted variability in the raters' judgements.

conclusionThe present findings validate the revised Act-IP© for reporting pharmacist interventions. Further work is needed to optimize the tool's implementation and develop specific training programs for hospital pharmacists.