Drug-related problems and pharmacy interventions in community practice

Abstract

Abstract Objectives (1) To document types and number of drug-related problems identified by community pharmacy personnel in Sweden; (2) to determine relationships among the types and number of problems identified and the gender, age and number of prescribed drugs in patients; and (3) to document the interventions made by pharmacy personnel with patients and prescribers. Method Random samples of pharmacists, prescriptionists and pharmacy technicians were drawn nationwide in Sweden; 144 (63 per cent) of the employees fulfilling the inclusion criteria agreed to take part. The participants documented drug-related problems, interventions and patient variables on a data collection form, and tallied the number of patients they served on another form. Setting One hundred and sixteen community pharmacies and 12 outpatient hospital pharmacies. Key findings One problem or more was identified among 2.5 per cent of the patients. The median number of problems identified per 100 patients was greater for pharmacists (6.1) than for prescriptionists (2.6) and pharmacy technicians (1.1). About one in three problems was presented to the participants by their patients, while two thirds were detected by the pharmacy staff. One in four problems was related to dosage, and one in five to uncertainty about the aim or function of the medication. Problems were over-represented among children and the younger middle-aged and under-represented in the elderly. Patient medication counselling was the most common type of intervention. When contacted, the physician nearly always approved the recommendation made by the pharmacy staff. Conclusion The results led to suggestions as to how pharmacy practitioners can augment pharmaceutical care through drug-related problem detection.