Drug Therapy Management Complexity Score Index

In 2013, the ASHP Foundation awarded a major research contract to Almut G. Winterstein, Ph.D., Professor, Department of Pharmaceutical Outcomes and Policy in the University of Florida (UF) College of Pharmacy, to develop and validate a complexity score that prospectively flags patients at greatest need for pharmacist medication therapy management (MTM). This was following explicitly outlined expectations in ASHP/ASHP Foundation’s request for applications.

UF operationalized the “need for pharmacist MTM” as a composite construct, including risk for a variety of preventable adverse drug events (pADEs). Accordingly, this study’s overarching objective was to develop a Complexity Score (C-score) that allows ranking of admissions according to their predicted risk for pADEs that are amenable to pharmacist intervention. The research project was completed in June 2016.

The UF research team, led by Almut Winterstein, successfully developed and validated a C-Score that can accurately identify patients at highest risk for pADEs. Aggregation of individual prediction models into a single score resulted for most pADEs in reduced discriminant validity compared to the individual 16 risk models, but concentrated the identified population to admissions with high probability for at least one pADE. The researchers advocate that the C-Score algorithm, including electronic health record data retrieval and prediction modeling, should be replicated in local data before implementation.

Three articles covering the rigorous research in the development and validation of the C-Score are slated for publication in AJHP in fall 2017.

Development and Validation of a Complexity Score to Identify Hospitalized Patients at High Risk for Preventable Adverse Drug Events
Principal Investigator: Almut G. Winterstein, Ph.D., Professor, Department of Pharmaceutical Outcomes and Policy
University of Florida College of Pharmacy, Shands at University of Florida, Sands at Jacksonville

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Biography: Almut Winterstein
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