VALIDATION OF THE QUALIPRESC INSTRUMENT FOR ASSESSING THE QUALITY OF THE PRESCRIPTION OF MEDICINES IN THE PRIMARY HEALTH CARE
quality of health care. patient safety. prescription of medicines. validation study.
INTRODUCTION: Adverse events related to drug prescription is the main patient safety issue in primary health care, but there is a lack of validated instruments for assessing the quality of prescription medications under technical and structural aspects. OBJECTIVE: Develop and validate the QualiPresc instrument to assess the quality of prescription medications in the primary care, accompanied by a self-instruction direction. METHODOLOGY: Validation study conducted in the Brazilian context with six steps: 1) construction of the conceptual model based on relevant literature; 2) QualiPresc prototype development; 3) Analysis of content validity of each indicator (relevance and adequacy); 4) Analysis of reliability via intra and inter-rater agreement of each indicator; 5) Analysis of the utility of each indicator; 6) Construction and analysis of the reliability of a weighted composite indicator based on effectiveness and safety scores for each indicator.. RESULTS: The prototype included 29 indicators, but only 13 were approved for validity, reliability and usefulness. 12 indicators were excluded because of validity (<90% validity index) and four because they were not useful in the context of the study. Three weighted composite indicators were tested, but only one was approved for reliability and usefulness. The validated instrument contains 13 indicators and 1 weighted composite indicator. CONCLUSION: This study demonstrates validity, reliability and usefulness of QualiPresc for the evaluation of technical-structural aspects of prescription medication in the context of primary care. Educators, managers and health care professionals can access it free of charge online to assess performance and provide feedback involving future prescriptors as well as professional drug prescribers.