title: Pharmacists' role in handling problems with prescriptions for antithrombotic medication in Belgian community pharmacies.
abstract: BACKGROUND
  Community pharmacists have an important task in the follow-up of patients treated with antithrombotics. When delivering these medicines, pharmacists can encounter drug-related problems (DRPs) with substantial clinical and economic impact.
  
  
  OBJECTIVE
  To investigate the amount and type of antithrombotic related DRPs as well as how community pharmacists handled these DRPs.
  
  
  METHODS
  Belgian community pharmacies.
  
  
  METHODS
  MSc pharmacy students of six Belgian universities collected data about all DRPs encountered by a pharmacist during ten half days of their pharmacy internship. Data were registered about DRPs detected at delivery and in an a posteriori setting, when consulting the medical history of the patient. Classification of the DRP, cause of the DRP, intervention and result of the intervention were registered.
  
  
  METHODS
  Amount and type of antotrombitocs related DRPs occurring in community pharmacies, as well as how community pharmacists handled these DRPs.
  
  
  RESULTS
  3.1 % of the 15,952 registered DRPs concerned antithrombotics. 79.3 % of these DRPs were detected at delivery and 20.7 % were detected a posteriori. Most antithrombotic-related DRPs concerned problems with the choice of the drug (mainly because of drug-drug interactions) or concerned logistic problems. Almost 80 % of the antithrombotic-related DRPs were followed by an intervention of the pharmacist, mainly at the patient's level, resulting in 90.1 % of these DRPs partially or totally solved.
  
  
  CONCLUSIONS
  Different DRPs with antithrombotic medication occurred in Belgian community pharmacies. About 20 % was detected in an a posteriori setting, showing the benefit of medication review. Many of the encountered DRPs were of technical nature (60.7 %). These DRPs were time-consuming for the pharmacist to resolve and should be prevented. Most of the DRPs could be solved, demonstrating the added value of the community pharmacist as first line healthcare provider.
authors.affiliation: Research Group Clinical Pharmacology and Clinical Pharmacy (KFAR), Centre for Pharmaceutical Research, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Desmaele
authors.forename: I
authors.initials: I
authors.lastname: De Wulf
authors.forename: A G
authors.initials: AG
authors.lastname: Dupont
authors.forename: S
authors.initials: S
authors.lastname: Steurbaut
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001530:Belgium; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D011307:Drug Prescriptions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D059065:Medication Reconciliation; D008875:Middle Aged; D010594:Pharmacies; D010595:Pharmacists; D024382:Professional Role; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents
references.citation: Chest. 2008 Jun;133(6 Suppl):546S-592S
references.pmid: 18574273
references.citation: Arq Bras Cardiol. 2013 Jun;100(6):e78-84
references.pmid: 23842881
references.citation: Int J Clin Pharm. 2013 Apr;35(2):202-9
references.pmid: 23187961
references.citation: Can J Cardiol. 2011 Jan-Feb;27(1):74-90
references.pmid: 21329865
references.citation: Europace. 2013 May;15(5):625-51
references.pmid: 23625942
references.citation: Br J Clin Pharmacol. 2004 Nov;58(5):503-11
references.pmid: 15521898
references.citation: Eur J Clin Pharmacol. 2002 Jul;58(4):285-91
references.pmid: 12136375
references.citation: Ir J Med Sci. 2015 Jun;184(2):441-7
references.pmid: 24899068
references.citation: Chest. 2012 Feb;141(2 Suppl):e326S-e350S
references.pmid: 22315266
references.citation: Eur Heart J. 2010 Oct;31(19):2369-429
references.pmid: 20802247
references.citation: Med J Aust. 1998 Apr 20;168(8):405-8
references.pmid: 9594953
references.citation: Curr Emerg Hosp Med Rep. 2013 Apr 21;1(2):83-97
references.pmid: 23687625
references.citation: Eur Heart J. 2012 Nov;33(21):2719-47
references.pmid: 22922413
references.citation: Pharmacoepidemiol Drug Saf. 2014 May;23(5):489-97
references.pmid: 24616171
references.citation: Circ J. 2010 Nov;74(11):2479-500
references.pmid: 20962419
references.citation: J Clin Pharm Ther. 2009 Jun;34(3):319-27
references.pmid: 19646078