Survey of drug-related problems identified by community pharmacies

BACKGROUND: A drug-related problem (DRP) is defined as an event or circumstance that actually or potentially interferes with desired health outcomes. DRPs can lead to ineffective pharmacotherapy and may cause drug-related morbidity and mortality. Most DRPs are avoidable and community pharmacies are assuming an active role in preventing and solving DRPs. OBJECTIVE: To identify the spectrum of DRPs encountered in community pharmacies. METHODS: In 2005, a nationwide survey in Germany was conducted in community pharmacies to record all identified DRPs. Participating community pharmacies were free to select one week within the designated study period (February-May) and were instructed to record basic statistics (eg, number of patient interactions, number of prescriptions filled/nonprescription [over-the-counter; OTC] drugs dispensed per week), as well as patient-, problem-, and intervention-related data (eg, patient age and sex, whether a prescription-only or OTC drug was involved in the DRP, the time needed for problem resolution). DRPs were categorized using a modified version of the PI-Doc (problem-intervention-documentation) classification system. RESULTS: Community pharmacies that participated in the study (N = 1146) documented 10,427 DRPs (9.1 DRP per pharmacy per week). A broad spectrum of DRPs was identified, with 9 of 10 cases involving prescribed medicines. DRPs arose on 3 primary levels: the prescription-, the patient-, and the delivery level. Overall, drug-drug interactions were the most frequently reported DFIP (8.6%) and, according to community pharmacies, more than 80% of identified DRPs could be resolved completely. The prescribing physician was contacted in 60.5% of all such cases. Median time needed for solving a DFIP was 5 minutes. CONCLUSIONS: Pharmacists in the community pharmacy setting are well suited to identify and resolve DRPs. Ensuring the proper use of both prescription and OTC drugs is one of the basic responsibilities of pharmacists. This specific role of pharmacists within the healthcare system needs to be more fully recognized.