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

Article Article scientifique Article Practical evaluation of the drug-related problem management process in Swiss community pharmacies eng 2008-04-06 2008-12 author Krähenbühl Jean-Marc Ambulatory Care and Community Medicine Department, Community Pharmacy Unit, Rue du Bugnon 44, 1011 Lausanne, Switzerland. author Kremer Bertha Elisabeth author Guignard Bertrand 0009-0002-4328-0375 604263 author Bugnon Olivier 691565 777-786 10.1007/s11096-008-9217-4 18392732 0928-1231 https://link.springer.com/article/10.1007/s11096-008-9217-4 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. Adverse Drug Reaction Reporting Systems / statistics & numerical data Community Pharmacy Services / organization & administration Dose-Response Relationship, Drug Drug Interactions Drug-Related Side Effects and Adverse Reactions Humans Pharmaceutical Preparations / administration & dosage Pharmacists Professional Role Quality of Health Care Software Switzerland Dewey 615 31 Section des sciences pharmaceutiques 17 false 887 Pharmacie hospitalière et clinique Pharmacy world & science 30 6 35a220de-636a-4df4-bfb4-e517d2ae78eb Article (Published version) Restricted s11096-008-9217-4.pdf 376594 application/pdf 84cb9a53c6873acf174a432445639e036903769925cdaf86716a7dc706a65314 restrictedAccess Faculté des sciences / Section des sciences pharmaceutiques

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