title: The process of identifying, solving and preventing drug related problems in the LIMM-study.
abstract: OBJECTIVE
  To avoid negative effects of drug treatment and need for additional medical care, drug treatment must be individualised. Our research group has developed a model for clinical pharmacy which improves several aspects of the patient's drug treatment. This study describes the process behind these improvements, i.e. drug related problems identified by pharmacists within a clinical pharmacy service.
  
  
  METHODS
  Three wards at a department of internal medicine.
  
  
  METHODS
  Pharmacists performed systematic interventions during the patient's hospital stay, aiming to identify, solve and prevent drug related problems in the elderly. Identified drug related problems were put forward to the health care team and discussed. Information on identified problems, and their outcomes was collected and analysed. A questionnaire was used to evaluate the health care personnel's attitudes towards the process.
  
  
  METHODS
  The number of drug related problems identified by the clinical pharmacists, the proportion of problems discussed with the physicians, the proportion of problems adjusted by the physicians and whether pharmacists and physicians prioritised any subgroup of drug related problems when choosing which problems to address. Finally, we wanted to evaluate the health care personnel's attitudes towards the model.
  
  
  RESULTS
  In total, 1,227 problem were identified in 190 patients. The pharmacists discussed 685 (55.8%) of the identified problems with the physicians who accepted 438 (63.9%) of the suggestions. There was no significant difference in which subgroup to put forward and which to adjust. There was a high response rate (84%) to the questionnaire, and the health care personnel estimated the benefits to be very high, both for the patients and for themselves.
  
  
  CONCLUSIONS
  The process for identifying, solving and preventing drug related problems was good and the different types of problems were considered equally important. The addition of a clinical pharmacy service was considered very useful. This suggests that the addition of our clinical pharmacy service to the hospital setting add skills of great importance.
authors.affiliation: Apoteket Farmaci, Hospital Pharmacy, Skåne University Hospital, Malmö, Sweden. anna.bergkvist@med.lu.se
authors.forename: Anna
authors.initials: A
authors.lastname: Bergkvist Christensen
authors.forename: Linda
authors.initials: L
authors.lastname: Holmbjer
authors.forename: Patrik
authors.initials: P
authors.lastname: Midlöv
authors.forename: Peter
authors.initials: P
authors.lastname: Höglund
authors.forename: Lisa
authors.initials: L
authors.lastname: Larsson
authors.forename: Åsa
authors.initials: Å
authors.lastname: Bondesson
authors.forename: Tommy
authors.initials: T
authors.lastname: Eriksson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D017146:Models, Organizational; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D010595:Pharmacists / Q000458:organization & administration*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D010820:Physicians / Q000706:statistics & numerical data; D057285:Precision Medicine; D024382:Professional Role; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D004364:Pharmaceutical Preparations
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