Development, validation and usability of software to calculate the drug burden index: a pilot study. — The Association Specialists
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Development, validation and usability of software to calculate the drug burden index: a pilot study. (243)

Lisa Kouladjian 1 2 , Danijela Gnjidic 1 2 3 , Timothy Chen 3 , Sarah Hilmer 1 2
  1. Clinical Pharmacology and Aged Care, Royal North Shore Hospital & Kolling Institute of Medical Research, St Leonards, NSW, Australia
  2. Sydney Medical School, University of Sydney, Sydney, NSW, Australia
  3. Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia

Introduction: The Drug Burden Index (DBI), a novel pharmacologic risk assessment tool that measures an individual’s total exposure to anticholinergic and sedative medicines, has been associated with impaired functional outcomes in older adults.

Aims: (1) Develop software which calculates and generates reports on DBI; (2) Use published case-study data to test the DBI software for accuracy; (3) Test the software for usability and functionality.

Methods: Microsoft Access 2010 was used to build and design The DBI Calculator©. Twenty-five drug regimens from patient case studies published in the Australian Journal of Pharmacy were used to compare DBI scores computed using The DBI Calculator© and those computed manually (gold standard). Cohen’s Kappa statistics were used to calculate the degree of concordance between manual and automated DBI scores. Ten pharmacists accredited to perform medication management reviews, were randomly selected from online pharmacist contact lists to participate in the usability testing. Participants were timed to perform a DBI calculation with the software based on a drug regimen from the case studies. A survey was used to rate the interface, functionality, clinical applications and satisfaction of software.

Results: (1) The software has been designed to allow for ease of uploading onto a secured, de-identified, password-protected website. The user enters patient data and clicks “Calculate DBI” to immediately receive a report of the DBI with information on the significance of the calculation for the patient. (2) Results indicate good agreement between the software and manual calculation (Cohen’s Kappa 0.95) amongst the 16/25 drug regimens from patient case studies tested with DBI>0. (3) During usability testing, 90% of respondents were satisfied with the software and agreed the content in the software was accurate.

Conclusion: We have developed a reliable calculator to report DBI in older patients taking multiple medications. Further studies will assess application of The DBI Calculator© in clinical settings.