Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University Hospital.
OBJECTIVE
To evaluate the Pharmaceutical Care Network Europe (PCNE) classification system as a tool for documenting the impact of a hospital clinical pharmacology service.


METHODS
Two medical wards comprising totally 85 beds in a university hospital.


METHODS
Number of events classified with the PCNE-system, their acceptance by the medical staff and cost implications.


METHODS
Clinical pharmacy review of pharmacotherapy on ward rounds and from case notes were documented, and identified drug-related problems (DRPs) were classified using the PCNE system version 5.00.


RESULTS
During 70 observation days 216 interventions were registered of which 213 (98.6%) could be classified: 128 (60.1%) were detected by reviewing the case notes, 33 (15.5%) on ward rounds, 32 (15.0%) by direct reporting to the clinical pharmacist (CP), and 20 (9.4%) on non-formulary prescriptions. Of 148 suggested interventions by the CP 123 (83.0%) were approved by the responsible physician, 12 ADR reports (8.1%) were submitted to the local pharmacovigilance centre and 31 (20.9%) specific information given without further need for action. An evaluation of the DRPs showed that direct drug costs of <euro>2,058 within the study period or <euro>10,731 per year could be avoided.


CONCLUSIONS
We consider the PCNE system to be a practical tool in the hospital setting, which demonstrates the values of a clinical pharmacy service in terms of identifying and reducing DRPs and also has the potential to reduce prescribing costs.
Lampert
Markus L
ML
Department of Pharmaceutical Sciences, Institute of Clinical Pharmacy, University of Basel, Basel, Switzerland.
Kraehenbuehl
Stephan
S
Hug
Balthasar L
BL
D016907:Adverse Drug Reaction Reporting Systems / Q000145:classification*; D001291:Attitude of Health Personnel; D003365:Costs and Cost Analysis; D016527:Drug Costs; D064420:Drug-Related Side Effects and Adverse Reactions; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D008508:Medication Errors / Q000145:classification* / Q000517:prevention & control; D004364:Pharmaceutical Preparations / Q000191:economics; D010595:Pharmacists / Q000458:organization & administration; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D024382:Professional Role; D011446:Prospective Studies; D013557:Switzerland
D004364:Pharmaceutical Preparations