Assessment of drug-related problems identified in community pharmacy settings

Abstract

Background: DRPs are a major and increasingly important issue of outpatient and community healthcare environments, which lead to morbidity, hospitalization, and waste of healthcare resources. Community pharmacists have a unique position of being the first line healthcare providers who can be able to systematically identify, resolve and prevent DRPs before they translate into severe adverse events.

Purpose: The purpose of this research was to evaluate the prevalence, types, and clinical importance of DRPs detected in the process of ordinary community pharmacy work and to evaluate the outcomes of the pharmacist-led work aimed at the solution of these issues.

Methods: A cross-sectional prospective study was undertaken in twelve months in six community pharmacies in urban and semi-urban areas centrally located in India. Three hundred adult patients with at least one chronic illness and taking two or more medications simultaneously were recruited. The Pharmaceutical Care Network Europe (PCNE) v9.1 classification system was employed to identify DRPs with the help of structured medication reviews, interviews with the patients, and the analysis of prescriptions.

Findings: 822 DRPs were detected in 226 patients, prevalence 75.3%. Most common: drug-drug interactions (22.8%), dosing errors (19.7%), and non-adherence (18.0%). Frequencies were higher in elderly patients (>60 years) and polypharmacy (>5 drugs). Pharmacist interventions introduced in 86.8% DRPs; acceptance was 83.6%.

Conclusion: Drug-related issues in community pharmacy are very high, especially in elderly and multi-morbid patients. Medication reviews and DRP-resolution plans are acceptable. Clinical pharmacy services should be integrated into community practice.