Survey of drug-related problems identified by community pharmacies.
BACKGROUND
A drug-related problem (DRP) is defined as an event or circumstance that actually or potentially interferes with desired health outcomes. DRPs can lead to ineffective pharmacotherapy and may cause drug-related morbidity and mortality. Most DRPs are avoidable and community pharmacies are assuming an active role in preventing and solving DRPs.


OBJECTIVE
To identify the spectrum of DRPs encountered in community pharmacies.


METHODS
In 2005, a nationwide survey in Germany was conducted in community pharmacies to record all identified DRPs. Participating community pharmacies were free to select one week within the designated study period (February-May) and were instructed to record basic statistics (eg, number of patient interactions, number of prescriptions filled/nonprescription [over-the-counter; OTC] drugs dispensed per week), as well as patient-, problem-, and intervention-related data (eg, patient age and sex, whether a prescription-only or OTC drug was involved in the DRP, the time needed for problem resolution). DRPs were categorized using a modified version of the PI-Doc (problem-intervention-documentation) classification system.


RESULTS
Community pharmacies that participated in the study (N = 1146) documented 10,427 DRPs (9.1 DRP per pharmacy per week). A broad spectrum of DRPs was identified, with 9 of 10 cases involving prescribed medicines. DRPs arose on 3 primary levels: the prescription-, the patient-, and the delivery level. Overall, drug-drug interactions were the most frequently reported DRP (8.6%) and, according to community pharmacies, more than 80% of identified DRPs could be resolved completely. The prescribing physician was contacted in 60.5% of all such cases. Median time needed for solving a DRP was 5 minutes.


CONCLUSIONS
Pharmacists in the community pharmacy setting are well suited to identify and resolve DRPs. Ensuring the proper use of both prescription and OTC drugs is one of the basic responsibilities of pharmacists. This specific role of pharmacists within the healthcare system needs to be more fully recognized.
Hämmerlein
Andrea
A
Center for Drug Information and Pharmacy Practice, ABDA-Federal Union of German Associations of Pharmacists, Berlin, Germany.
Griese
Nina
N
Schulz
Martin
M
D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D000075202:Contraindications; D003625:Data Collection; D004347:Drug Interactions; D011307:Drug Prescriptions; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000009:adverse effects; D010595:Pharmacists; D024382:Professional Role
D004366:Nonprescription Drugs