Literature DB >> 18392732

Practical evaluation of the drug-related problem management process in Swiss community pharmacies.

Jean-Marc Krähenbühl1, Bertha Kremer, Bertrand Guignard, Olivier Bugnon.   

Abstract

OBJECTIVE: To develop and evaluate a coding system integrated into pharmaceutical software to routinely report and assess the process of community pharmacists' interventions related to medical prescriptions.
SETTING: A convenient sample of 20 Swiss community pharmacies.
METHOD: Pharmacists documented their interventions concerning all drug-related problems (DRPs) related to medical prescriptions during four consecutive weeks in 2005. The coding system assesses each step of the DRP management process; that is, the type of problem, possible negative outcomes, pharmaceutical decisions, and individuals involved. In order to be comprehensive, the management process of technical problems related to prescriptions and clinical DRPs was analysed separately. MAIN OUTCOME MEASURE: DRP intervention rate and characterization of each step of the process.
RESULTS: Of 38,663 prescriptions, 287 clinical DRPs required interventions. This corresponds to a mean intervention rate of 0.77% per pharmacy (SD = 0.61%). There was a large variability among pharmacies (0-2.6%). Most of the clinical DRPs were associated with dosage problems (n = 91) and drug-drug interactions (n = 45). The most frequent potential negative outcomes reported were quantitative inefficacy (n = 101) and quantitative safety (n = 94). Two-thirds of clinical DRPs required a prescription modification (n = 186), the most frequent being a change in dosage or drug regimen. In 110 interventions (38%), physicians were immediately contacted to take part in the decision. In 122 interventions (43%), pharmacists managed the interventions alone. However, in 55 interventions (19%), pharmacists managed the DRPs with the patient. From these 287 clinical interventions, 134 different codes were reported. Seven hundred and thirty-six technical problems related to prescriptions required intervention, which corresponded to a mean intervention rate of 1.90% per pharmacy. The main type of problem was a discrepancy with the medication record (n = 208). There were 494 instances that required a prescription modification. Pharmacists resolved 45% of all technical problems by themselves.
CONCLUSION: The developed coding system could describe the management process for DRPs. The observed intervention rate and the frequency of steps involved were comparable to those previously observed for pharmacists' interventions. Data regarding the entire process used to manage drug-related problems can be useful in improving medication safety, education, and collaborative care.

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Year:  2008        PMID: 18392732     DOI: 10.1007/s11096-008-9217-4

Source DB:  PubMed          Journal:  Pharm World Sci        ISSN: 0928-1231


  19 in total

1.  Clinical pharmacy interventions by community pharmacists during the dispensing process.

Authors:  G M Hawksworth; A J Corlett; D J Wright; H Chrystyn
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2.  Economic impact of increased clinical intervention rates in community pharmacy. A randomised trial of the effect of education and a professional allowance.

Authors:  S I Benrimoj; J H Langford; G Berry; D Collins; R Lauchlan; K Stewart; M Aristides; M Dobson
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Journal:  Pharm World Sci       Date:  1999-12

4.  Prescribing problems and pharmacist interventions in community practice.

Authors:  M T Rupp; M DeYoung; S W Schondelmeyer
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5.  Comment: drug-related problem classification systems.

Authors:  Fernando Fernandez-Llimos; Maria J Faus
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Review 6.  Drug-related problem classification systems.

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10.  Drug related problems identified by European community pharmacists in patients discharged from hospital.

Authors:  Ema I Paulino; Marcel L Bouvy; Miguel A Gastelurrutia; Mara Guerreiro; Henk Buurma
Journal:  Pharm World Sci       Date:  2004-12
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  13 in total

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Review 2.  Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review.

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Review 8.  Application of drug-related problem (DRP) classification systems: a review of the literature.

Authors:  Benjamin J Basger; Rebekah J Moles; Timothy F Chen
Journal:  Eur J Clin Pharmacol       Date:  2014-05-02       Impact factor: 2.953

9.  Impact of an interactive workshop on community pharmacists' beliefs toward patient care.

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10.  A retrospective analysis of drug-related problems documented in a national database.

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