title: Drug-related problems in prescribed medicines in Germany at the time of dispensing.
abstract: BACKGROUND
  Drug-related problems (DRPs) can have an important impact on the effectiveness and safety of pharmacotherapy. In Germany, the frequency of DRPs in prescribed medicines in ambulatory care is not yet known. Objective To quantify DRPs in prescribed medicines identified by community pharmacists (CPs) at the time the medicine is dispensed.
  
  
  METHODS
  German CPs in four different regions.
  
  
  METHODS
  We invited CPs to document one hundred consecutive patients presenting prescriptions using a standardized documentation form. For each patient, person- and medication-related as well as identified DRP-related data were documented. Data were transcribed electronically, coded if necessary, checked for validity, and analyzed.
  
  
  METHODS
  Nature and frequency of DRPs.
  
  
  RESULTS
  In total, 143 CPs documented 14,231 patients with 24,422 prescribed drugs and identified DRPs in 2,556 patients (18.0%). Analyses resulted in 0.23 DRPs per patient and 0.13 DRPs per prescribed medicine. Four DRPs were responsible for almost 70% of all DRPs: Potential drug-drug interaction (22.9%), dose not known to patient (21.7%), patient insecure due to generic substitution (13.5%), and insufficient patient knowledge of correct drug use (10.9%). If a patient's drug file was kept in the pharmacy, specific types of DRPs were detected more frequently e.g., drug-drug interactions (p < 0.001). Interventions primarily comprised counselling, monitoring, and changing drug or instructions for use. The prescribing physician was contacted in 28% of DRPs resulting in a change of these prescriptions in 50% of the cases. Overall and according to the pharmacists, more than 90% of the DRPs detected were partially (10.4%) or completely (85.4%) solved.
  
  
  CONCLUSIONS
  We quantified DRPs in prescribed medicines in daily ambulatory care practice in Germany. When filling a prescription, in nearly 20% of the patients relevant DRPs were revealed. According to the pharmacists, the majority could be partially or completely solved during the encounter at the pharmacy. Keeping a patient's drug file including patient specific data may facilitate the detection of DRPs and shall, therefore, be offered to patients more often.
authors.affiliation: Department of Medicine, Federal Union of German Associations of Pharmacists, Jaegerstrasse 49/50, 10117 Berlin, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nicolas
authors.forename: Christiane
authors.initials: C
authors.lastname: Eickhoff
authors.forename: Nina
authors.initials: N
authors.lastname: Griese
authors.forename: Martin
authors.initials: M
authors.lastname: Schulz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D003157:Community Pharmacy Services / Q000458:organization & administration; D004347:Drug Interactions; D057915:Drug Substitution / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010595:Pharmacists / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D055553:Prescription Drugs