Development of Indicators and Criteria of Primary Care Pharmacy for Sub-district Primary Care by Modified Delphi Method Primary Care Pharmacy Indicators & Assessment Criteria by Delphi

Abstract

Indicators and criteria used for evaluating performance of primary care pharmacy in primary care are formulated by several policy makers but they have some limitations and are difficult to use. No evidence has been found to prove whether such indicators and criteria have been developed systematically. Objective: To develop appropriate indicators and criteria for evaluation of primary care pharmacy in sub-district primary care. Materials and Methods: This study used modified Delphi method. A drafted indicators and criteria was developed from three national evaluation forms. The drafted indicators covered fours domains of primary care pharmacy (drug system development, pharmacy service in primary care, home pharmaceutical care, and consumer protection) and composed of 3 indicator types (input, process, and output indicator). Twenty-five indicators with 4-point-criteria (score of 0, 1, 2, 3) with explanation of indicator’s definition and scoring guideline were proposed and sent out to fourteen experts in primary care pharmacy. Experts rated the appropriateness of each indicator and criteria by using 5-point-scale: 1 (least appropriate) to 5 (most appropriate). Consensus was obtained when the median score was of at least 3.50 and the interquartile range was below 1.50. Results: A draft of indicators and criteria was considered by all experts twice. Consensus was reached for most of indicators and criteria. Only the criteria of the indicator 5.8, namely participation of community networks in order to solve problems regarding consumer protection locally, had the interquartile range greater than 1.50 with diverse opinions of experts, resulted in being removed from the final draft. Eventually, 24 indicators with 96 criteria were considered as appropriate: 9 input indicators, 12 process indicators and 3 output indicators. Conclusion: Twenty-four indicators are appropriate for evaluation of primary care pharmacy in sub-district primary care. A further pilot study should be conducted in order to assure its reliability.