title: Evaluating categorisation and clinical relevance of drug-related problems in medication reviews.
abstract: OBJECTIVE
  We aimed to evaluate the categorisation and clinical relevance of DRPs identified by community pharmacists, and further, to assess the quality of interventions with the patients and the physicians as documented by the pharmacists.
  
  
  METHODS
  23 Norwegian community pharmacies.
  
  
  METHODS
  Patients with type 2 diabetes were recruited by 24 community pharmacists who performed structured medication reviews based on the patients' drug profiles and patient interviews. The DRPs identified were subsequently categorised. An evaluation group (EG) retrospectively evaluated the reviews. Clinical/practical relevance of each DRP and quality of community pharmacists' intervention with patients and physician were scored. Average agreement between the EG and the community pharmacists was calculated. Internal agreement in the EG was calculated using a modified version of Fleiss' Kappa coefficient.
  
  
  RESULTS
  A total of 73 patients were included (mean age 62 years, 52% female, on average prescribed 8.7 drugs). The pharmacists identified 88 DRPs in 43 of the patients. The most common DRPs were adverse drug reactions (22%) and wrong drug or dose used by patient (14%). Anti-diabetic drugs and lipid modifying drugs were associated with the most DRPs. The EG agreed with detection and categorisation of DRPs in more than 80% of the cases. The clinical/practical relevance of the detected DRPs was scored by the EG to be high or medium in 87% of the cases. The quality of the follow-up with patients and physicians was scored to be good or satisfactory in 93 and 98% of the cases, respectively.
  
  
  CONCLUSIONS
  Pre-defined categories of DRPs supported by structured forms were reliable and valid tools for identifying DRPs. The evaluation demonstrated that community pharmacists were able to identify DRPs of high to medium clinical/practical relevance, and to perform follow-ups of the DRPs with the patients and the physicians with a good or satisfactory quality.
authors.affiliation: Department of Public Health and Primary Health Care, Centre for Pharmacy, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway. anne.granas@isf.uib.no
authors.forename: Anne Gerd
authors.initials: AG
authors.lastname: Granas
authors.forename: Christian
authors.initials: C
authors.lastname: Berg
authors.forename: Vidar
authors.initials: V
authors.lastname: Hjellvik
authors.forename: Cecilie
authors.initials: C
authors.lastname: Haukereid
authors.forename: Arvid
authors.initials: A
authors.lastname: Kronstad
authors.forename: Hege S
authors.initials: HS
authors.lastname: Blix
authors.forename: Bente
authors.initials: B
authors.lastname: Kilhovd
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Viktil
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Horn
mesh_terms: D000368:Aged; D003157:Community Pharmacy Services / Q000592:standards; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology; D017723:Drug Utilization Review / Q000145:classification* / Q000592:standards*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000592:standards*
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