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Erschienen in: International Journal of Clinical Pharmacy 3/2010

01.06.2010 | Research Article

Classification of drug-related problems with new prescriptions using a modified PCNE classification system

verfasst von: Patrick M. Eichenberger, Markus L. Lampert, Irene Vogel Kahmann, J. W. Foppe van Mil, Kurt E. Hersberger

Erschienen in: International Journal of Clinical Pharmacy | Ausgabe 3/2010

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Abstract

Objectives To explore and classify drug-related problems (DRPs) with new prescriptions detected in community pharmacies using a modified PCNE (Pharmaceutical Care Network Europe) classification system. Setting Sixty-four Swiss community pharmacies offering internships for pharmacy students. Main outcome measures Occurrence, nature and pharmacist’s management of DRPs. Methods Fifth-year pharmacy students collected consecutively hospital discharge and primary care prescriptions. After training, they documented clinical and technical DRPs, causes and interventions. Results Prescriptions of 616 patients (43.0% discharged from hospital) were analysed. The patients’ median age was 56 years and they received a median of 3 (range 2–19) different drugs. In 121 (19.6%) prescriptions 141 clinical DRPs were detected. The most frequent clinical DRPs were potential drug–drug interactions (DDIs) (37.6%), drug choice (24.8%) and drug use problems (15.6%). These clinical DRPs led to a total of 299 interventions. There were 222 prescriptions (36.0%) that showed 278 technical DRPs, resulting in a total of 417 interventions. Most frequent technical DRPs were missing or unclear package size or therapy duration (32.7%) and missing or unclear dosing/application instructions (30.9%). Most DRPs (75.4%) could be managed by the pharmacist alone. The number of prescribed drugs was the main factor with an influence on the frequency of clinical and technical DRPs. Conclusion Clinical and technical DRPs are frequently observed in primary care as well as in hospital discharge prescriptions. The modified PCNE classification system, especially the amendment with a technical DRP category, proved to be useful and allowed the classification of all DRPs. Neither the setting (hospital discharge vs. primary care) nor the quality of electronically printed prescriptions, but only the number of prescribed drugs influenced the occurrence of clinical or technical DRPs.
Literatur
1.
Zurück zum Zitat Westerlund LT, Almarsdottir AB, Melander A. Drug-related problems and pharmacy interventions in community practice. Int J Pharm Pract. 1999;7(11):40–50. Westerlund LT, Almarsdottir AB, Melander A. Drug-related problems and pharmacy interventions in community practice. Int J Pharm Pract. 1999;7(11):40–50.
2.
Zurück zum Zitat Ernst ME, Iyer SS, Doucette WR. Drug-related problems and quality of life in arthritis and low back pain sufferers. Value Health. 2003;6(1):51–8.CrossRefPubMed Ernst ME, Iyer SS, Doucette WR. Drug-related problems and quality of life in arthritis and low back pain sufferers. Value Health. 2003;6(1):51–8.CrossRefPubMed
3.
Zurück zum Zitat Triller DM, Clause SL, Briceland LL, Hamilton RA. Resolution of drug-related problems in home care patients through a pharmacy referral service. Am J Health Syst Pharm. 2003;60(9):905–10.PubMed Triller DM, Clause SL, Briceland LL, Hamilton RA. Resolution of drug-related problems in home care patients through a pharmacy referral service. Am J Health Syst Pharm. 2003;60(9):905–10.PubMed
4.
Zurück zum Zitat Paulino EI, Bouvy ML, Gastelurrutia MA, Guerreiro M, Buurma H. Drug related problems identified by European community pharmacists in patients discharged from hospital. Pharm World Sci. 2004;26(6):353–60.PubMed Paulino EI, Bouvy ML, Gastelurrutia MA, Guerreiro M, Buurma H. Drug related problems identified by European community pharmacists in patients discharged from hospital. Pharm World Sci. 2004;26(6):353–60.PubMed
5.
Zurück zum Zitat Hammerlein A, Griese N, Schulz M. Survey of drug-related problems identified by community pharmacies. Ann Pharmacother. 2007;41(11):1825–32.CrossRefPubMed Hammerlein A, Griese N, Schulz M. Survey of drug-related problems identified by community pharmacies. Ann Pharmacother. 2007;41(11):1825–32.CrossRefPubMed
6.
Zurück zum Zitat Krahenbuhl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krahenbuhl S. Drug-related problems in hospitals: a review of the recent literature. Drug Saf. 2007;30(5):379–407.CrossRefPubMed Krahenbuhl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krahenbuhl S. Drug-related problems in hospitals: a review of the recent literature. Drug Saf. 2007;30(5):379–407.CrossRefPubMed
7.
Zurück zum Zitat Howard R, Avery A, Bissell P. Causes of preventable drug-related hospital admissions: a qualitative study. Qual Saf Health Care. 2008;17(2):109–16.CrossRefPubMed Howard R, Avery A, Bissell P. Causes of preventable drug-related hospital admissions: a qualitative study. Qual Saf Health Care. 2008;17(2):109–16.CrossRefPubMed
8.
Zurück zum Zitat Krahenbuhl JM, Kremer B, Guignard B, Bugnon O. Practical evaluation of the drug-related problem management process in Swiss community pharmacies. Pharm World Sci. 2008;30(6):777–86.CrossRefPubMed Krahenbuhl JM, Kremer B, Guignard B, Bugnon O. Practical evaluation of the drug-related problem management process in Swiss community pharmacies. Pharm World Sci. 2008;30(6):777–86.CrossRefPubMed
9.
Zurück zum Zitat Lampert ML, Kraehenbuehl S, Hug BL. Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University Hospital. Pharm World Sci. 2008;30(6):768–76.CrossRefPubMed Lampert ML, Kraehenbuehl S, Hug BL. Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University Hospital. Pharm World Sci. 2008;30(6):768–76.CrossRefPubMed
10.
Zurück zum Zitat Patel P, Zed PJ. Drug-related visits to the emergency department: how big is the problem? Pharmacotherapy. 2002;22(7):915–23.CrossRefPubMed Patel P, Zed PJ. Drug-related visits to the emergency department: how big is the problem? Pharmacotherapy. 2002;22(7):915–23.CrossRefPubMed
11.
Zurück zum Zitat Becker ML, Kallewaard M, Caspers PW, Visser LE, Leufkens HG, Stricker BH. Hospitalisations and emergency department visits due to drug-drug interactions: a literature review. Pharmacoepidemiol Drug Saf. 2007;16(6):641–51.CrossRefPubMed Becker ML, Kallewaard M, Caspers PW, Visser LE, Leufkens HG, Stricker BH. Hospitalisations and emergency department visits due to drug-drug interactions: a literature review. Pharmacoepidemiol Drug Saf. 2007;16(6):641–51.CrossRefPubMed
12.
Zurück zum Zitat Rupp MT, DeYoung M, Schondelmeyer SW. Prescribing problems and pharmacist interventions in community practice. Med Care. 1992;30(10):926–40.CrossRefPubMed Rupp MT, DeYoung M, Schondelmeyer SW. Prescribing problems and pharmacist interventions in community practice. Med Care. 1992;30(10):926–40.CrossRefPubMed
13.
Zurück zum Zitat Smith CP, Christensen DB. Identification and clarification of drug therapy problems by Indian health service pharmacists. Ann Pharmacother. 1996;30(2):119–24.PubMed Smith CP, Christensen DB. Identification and clarification of drug therapy problems by Indian health service pharmacists. Ann Pharmacother. 1996;30(2):119–24.PubMed
14.
Zurück zum Zitat Blix HS, Viktil KK, Reikvam A, Moger TA, Hjemaas BJ, Pretsch P, et al. The majority of hospitalised patients have drug-related problems: results from a prospective study in general hospitals. Eur J Clin Pharmacol. 2004;60(9):651–8.CrossRefPubMed Blix HS, Viktil KK, Reikvam A, Moger TA, Hjemaas BJ, Pretsch P, et al. The majority of hospitalised patients have drug-related problems: results from a prospective study in general hospitals. Eur J Clin Pharmacol. 2004;60(9):651–8.CrossRefPubMed
15.
Zurück zum Zitat Viktil KK, Blix HS, Moger TA, Reikvam A. Interview of patients by pharmacists contributes significantly to the identification of drug-related problems (DRPs). Pharmacoepidemiol Drug Saf. 2006;15(9):667–74.CrossRefPubMed Viktil KK, Blix HS, Moger TA, Reikvam A. Interview of patients by pharmacists contributes significantly to the identification of drug-related problems (DRPs). Pharmacoepidemiol Drug Saf. 2006;15(9):667–74.CrossRefPubMed
16.
Zurück zum Zitat Shalansky S, Nakagawa R, Wee A. Drug-related problems identified and resolved using pharmaceutical care versus traditional clinical monitoring. Can J Hosp Pharm. 1996;49(6):7. Shalansky S, Nakagawa R, Wee A. Drug-related problems identified and resolved using pharmaceutical care versus traditional clinical monitoring. Can J Hosp Pharm. 1996;49(6):7.
17.
Zurück zum Zitat Hanlon JT, Lindblad CI, Gray SL. Can clinical pharmacy services have a positive impact on drug-related problems and health outcomes in community-based older adults? Am J Geriatr Pharmacother. 2004;2(1):3–13.CrossRefPubMed Hanlon JT, Lindblad CI, Gray SL. Can clinical pharmacy services have a positive impact on drug-related problems and health outcomes in community-based older adults? Am J Geriatr Pharmacother. 2004;2(1):3–13.CrossRefPubMed
18.
Zurück zum Zitat Barber N, Parsons J, Clifford S, Darracott R, Horne R. Patients’ problems with new medication for chronic conditions. Qual Saf Health Care. 2004;13(3):172–5.CrossRefPubMed Barber N, Parsons J, Clifford S, Darracott R, Horne R. Patients’ problems with new medication for chronic conditions. Qual Saf Health Care. 2004;13(3):172–5.CrossRefPubMed
20.
Zurück zum Zitat Hersberger K, Botomino A, Sarkar R, Tschudi P, Bucher H, Briel M. Prescribed medications and pharmacy interventions for acute respiratory tract infections in Swiss primary care. J Clin Pharm Ther. 2009;34(4):387–95.CrossRefPubMed Hersberger K, Botomino A, Sarkar R, Tschudi P, Bucher H, Briel M. Prescribed medications and pharmacy interventions for acute respiratory tract infections in Swiss primary care. J Clin Pharm Ther. 2009;34(4):387–95.CrossRefPubMed
21.
Zurück zum Zitat AbuRuz SM, Bulatova NR, Yousef AM. Validation of a comprehensive classification tool for treatment-related problems. Pharm World Sci. 2006;28(4):222–32.CrossRefPubMed AbuRuz SM, Bulatova NR, Yousef AM. Validation of a comprehensive classification tool for treatment-related problems. Pharm World Sci. 2006;28(4):222–32.CrossRefPubMed
22.
Zurück zum Zitat Westerlund LT, Marklund BR, Handl WH, Thunberg ME, Allebeck P. Nonprescription drug-related problems and pharmacy interventions. Ann Pharmacother. 2001;35(11):1343–9.CrossRefPubMed Westerlund LT, Marklund BR, Handl WH, Thunberg ME, Allebeck P. Nonprescription drug-related problems and pharmacy interventions. Ann Pharmacother. 2001;35(11):1343–9.CrossRefPubMed
23.
Zurück zum Zitat Eccles M, Grimshaw J, Campbell M, Ramsay C. Research designs for studies evaluating the effectiveness of change and improvement strategies. Qual Saf Health Care. 2003;12(1):47–52.CrossRefPubMed Eccles M, Grimshaw J, Campbell M, Ramsay C. Research designs for studies evaluating the effectiveness of change and improvement strategies. Qual Saf Health Care. 2003;12(1):47–52.CrossRefPubMed
24.
Zurück zum Zitat Allenet B, Bedouch P, Rose FX, Escofier L, Roubille R, Charpiat B, et al. Validation of an instrument for the documentation of clinical pharmacists’ interventions. Pharm World Sci. 2006;28(4):181–8.CrossRefPubMed Allenet B, Bedouch P, Rose FX, Escofier L, Roubille R, Charpiat B, et al. Validation of an instrument for the documentation of clinical pharmacists’ interventions. Pharm World Sci. 2006;28(4):181–8.CrossRefPubMed
25.
Zurück zum Zitat Knapp KK, Katzman H, Hambright JS, Albrant DH. Community pharmacist interventions in a capitated pharmacy benefit contract. Am J Health Syst Pharm. 1998;55(11):1141–5.PubMed Knapp KK, Katzman H, Hambright JS, Albrant DH. Community pharmacist interventions in a capitated pharmacy benefit contract. Am J Health Syst Pharm. 1998;55(11):1141–5.PubMed
26.
Zurück zum Zitat Leemans L, Veroeveren L, Bulens J, Hendrickx C, Keyenberg W, Niesten F, et al. Frequency and trends of interventions of prescriptions in Flemish community pharmacies. Pharm World Sci. 2003;25(2):65–9.CrossRefPubMed Leemans L, Veroeveren L, Bulens J, Hendrickx C, Keyenberg W, Niesten F, et al. Frequency and trends of interventions of prescriptions in Flemish community pharmacies. Pharm World Sci. 2003;25(2):65–9.CrossRefPubMed
27.
Zurück zum Zitat Schaefer M. Discussing basic principles for a coding system of drug-related problems: the case of PI-Doc. Pharm World Sci. 2002;24(4):120–7.CrossRefPubMed Schaefer M. Discussing basic principles for a coding system of drug-related problems: the case of PI-Doc. Pharm World Sci. 2002;24(4):120–7.CrossRefPubMed
28.
Zurück zum Zitat Benrimoj SI, Langford JH, Berry G, Collins D, Lauchlan R, Stewart K, et al. Economic impact of increased clinical intervention rates in community pharmacy. A randomised trial of the effect of education and a professional allowance. Pharmacoeconomics. 2000;18(5):459–68.CrossRefPubMed Benrimoj SI, Langford JH, Berry G, Collins D, Lauchlan R, Stewart K, et al. Economic impact of increased clinical intervention rates in community pharmacy. A randomised trial of the effect of education and a professional allowance. Pharmacoeconomics. 2000;18(5):459–68.CrossRefPubMed
29.
Zurück zum Zitat Currie JD, Chrischilles EA, Kuehl AK, Buser RA. Effect of a training program on community pharmacists’ detection of and intervention in drug-related problems. J Am Pharm Assoc (Wash). 1997;NS37(2):182–91. Currie JD, Chrischilles EA, Kuehl AK, Buser RA. Effect of a training program on community pharmacists’ detection of and intervention in drug-related problems. J Am Pharm Assoc (Wash). 1997;NS37(2):182–91.
Metadaten
Titel
Classification of drug-related problems with new prescriptions using a modified PCNE classification system
verfasst von
Patrick M. Eichenberger
Markus L. Lampert
Irene Vogel Kahmann
J. W. Foppe van Mil
Kurt E. Hersberger
Publikationsdatum
01.06.2010
Verlag
Springer Netherlands
Erschienen in
International Journal of Clinical Pharmacy / Ausgabe 3/2010
Print ISSN: 2210-7703
Elektronische ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-010-9377-x

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