Evaluating categorisation and clinical relevance of drug-related problems in medication reviews

被引:34
作者
Granas, Anne Gerd [1 ]
Berg, Christian [2 ]
Hjellvik, Vidar [2 ]
Haukereid, Cecilie [3 ]
Kronstad, Arvid [4 ]
Blix, Hege S. [2 ]
Kilhovd, Bente [5 ]
Viktil, Kirsten K. [6 ,7 ]
Horn, Anne Marie
机构
[1] Univ Bergen, Dept Publ Hlth & Primary Hlth Care, Ctr Pharm, N-5018 Bergen, Norway
[2] Norwegian Inst Publ Hlth, Oslo, Norway
[3] Frogner Apotek, Oslo, Norway
[4] Apotek1, Sandefjord, Norway
[5] Oslo Univ Hosp, Dept Endocrinol, Oslo, Norway
[6] Univ Oslo, Diakonhjemmet Hosp Pharm, Oslo, Norway
[7] Univ Oslo, Dept Pharmacotherapeut, Oslo, Norway
来源
PHARMACY WORLD & SCIENCE | 2010年 / 32卷 / 03期
关键词
Community pharmacy; Drug-related problems; Evaluation; Medication review; PCNE DRP classification; Type; 2; diabetes; DIABETES CARE; PHARMACISTS; INTERVENTIONS; MANAGEMENT; ADHERENCE; HOME;
D O I
10.1007/s11096-010-9385-x
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Objectives 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. Setting 23 Norwegian community pharmacies. Method 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.
引用
收藏
页码:394 / 403
页数:10
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