Department of Medicine, Federal Union of German Associations of Pharmacists, Jaegerstrasse 49/50, 10117 Berlin, Germany.
Int J Clin Pharm. 2013 Jun;35(3):476-82. doi: 10.1007/s11096-013-9769-9. Epub 2013 Apr 20.
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.
German CPs in four different regions.
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.
Nature and frequency of DRPs.
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.
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.
药物相关问题（DRPs）可能对药物治疗的有效性和安全性产生重要影响。在德国，尚不清楚门诊患者处方药物中 DRPs 的发生频率。目的：定量社区药剂师（CPs）在发药时发现的处方药物中的 DRPs。
德国四个不同地区的 CPs。
我们邀请 CPs 使用标准化的记录表格记录一百名连续就诊的患者的处方。对于每位患者，记录人与药物相关以及已识别的 DRP 相关数据。数据通过电子方式转录，如果需要，进行编码，检查有效性并进行分析。
DRPs 的性质和频率。
共 143 名 CPs 记录了 14231 名患者的 24422 种处方药物，并在 2556 名患者（18.0%）中发现了 DRPs。分析结果为每位患者 0.23 个 DRPs 和每剂处方药物 0.13 个 DRPs。有四个 DRPs 导致了近 70%的所有 DRPs：潜在的药物-药物相互作用（22.9%）、患者不知道剂量（21.7%）、由于仿制药替代而使患者感到不安全（13.5%）以及患者对正确用药知识不足（10.9%）。如果患者的药物档案保存在药房中，会更频繁地发现特定类型的 DRPs，例如药物-药物相互作用（p < 0.001）。干预措施主要包括咨询、监测和改变药物或使用说明。在 28%的 DRPs 中联系了开处方医生，导致这些处方在 50%的情况下发生了变化。总体而言，根据药剂师的判断，超过 90%的发现的 DRPs 部分（10.4%）或完全（85.4%）得到解决。
我们在德国日常门诊实践中对处方药物中的 DRPs 进行了量化。在为患者配药时，近 20%的患者中发现了相关的 DRPs。根据药剂师的判断，大多数问题可以在药房就诊时得到部分或完全解决。保存包括患者特定数据的药物档案可以更方便地发现 DRPs，因此，应更频繁地向患者提供。
