Janani Tharmalinga Sharma Jegath, Risla Rafaideen, Shanika Lelwala Guruge Thushani, Samaranayake Nithushi Rajitha
Department of Pharmacy and Pharmaceutical Sciences, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Sri Soratha Mawatha, Nugegoda, Sri Lanka.
Ministry of Health, Nutrition & Indigenous Medicine, Baddegama Wimalawansa Thero Mawatha, Colombo, Sri Lanka.
Explor Res Clin Soc Pharm. 2021 Aug 12;3:100061. doi: 10.1016/j.rcsop.2021.100061. eCollection 2021 Sep.
Appropriate medication use is necessary to ensure patient safety. Drug Related Problems (DRPs) could result in patient harm.
To assess the prevalence and types of DRPs in prescriptions, and the proportion of DRPs detected and resolved by community pharmacists during dispensation of prescriptions in a selected community pharmacy.
A prospective, cross-sectional study was conducted in a selected community pharmacy in Colombo, Sri Lanka, where one researcher reviewed for DRPs in systematically selected prescriptions ( = 400), and another directly observed the frequency of DRPs identified by community pharmacists in the same set of prescriptions. Actions taken by pharmacists on resolving DRPs were also documented. DRPs were classified according to a slightly modified version of Pharmaceutical Care Network Euro pe classification V8.01. Descriptive and comparative data analysis were performed using SPSS database V.21. < 0.05 was considered as significant.
Among 1986 medications, a total of 1211 DRPs were identified by researchers, of which only 441 DRPs were detected by community pharmacists who participated in the study ( = 24). DRPs identified by the researcher were related to medication selection ( = 15), medication form ( = 1), dose selection ( = 817), duration of treatment ( = 128), incomplete prescriptions ( = 128), and other (outdated prescriptions, missing unit of measurements, and ambiguous names of medications that could not be read by both community pharmacists and researcher) ( = 122) of which only one, one, 394, 13, five, and 27 were identified by pharmacists, respectively. Among 441 DRPs identified by pharmacists, 406 were resolved by them. Most DRPs were self-resolved by pharmacists themselves (367/406), while patients were also sent back to the prescriber (13/406), and some dispensation of medications to patients were refused (9/406).
Among the DRPs frequently observed in the sample of community prescriptions, the community pharmacists identified significantly fewer DRPs in relation to each type identified by the researcher, and pharmacists missed some, including incomplete prescriptions, that had potential to harm. Systematic and sustainable training of pharmacists on performing a preliminary prescription review and continuous education programs must be implemented to improve community pharmacist dispensing practices in this community.
合理用药对于确保患者安全至关重要。药物相关问题（DRPs）可能会对患者造成伤害。
评估处方中DRPs的发生率和类型，以及在选定社区药房调配处方期间社区药剂师检测和解决的DRPs比例。
在斯里兰卡科伦坡的一家选定社区药房进行了一项前瞻性横断面研究，一名研究人员对系统选择的处方（n = 400）进行DRPs审查，另一名研究人员直接观察社区药剂师在同一组处方中识别DRPs的频率。还记录了药剂师解决DRPs所采取的行动。DRPs根据欧洲药学保健网络分类V8.01的略微修改版本进行分类。使用SPSS数据库V.21进行描述性和比较性数据分析。P < 0.05被认为具有统计学意义。
在1986种药物中，研究人员共识别出1211个DRPs，而参与研究的社区药剂师仅检测到441个DRPs（n = 24）。研究人员识别出的DRPs与药物选择（n = 15）、药物剂型（n = 1）、剂量选择（n = 817）、治疗持续时间（n = 128）、处方不完整（n = 128）以及其他（过期处方、缺少测量单位以及社区药剂师和研究人员都无法读懂的药物名称不明确）（n = 122）有关，其中药剂师分别仅识别出1个、1个、394个、13个、5个和27个。在药剂师识别出的441个DRPs中，他们解决了406个。大多数DRPs由药剂师自行解决（367/406），同时也有患者被送回开处方者处（13/406），还有一些药物调配被拒绝给患者（9/406）。
在社区处方样本中经常观察到的DRPs中，社区药剂师识别出的每种DRP类型与研究人员识别出的相比明显更少，并且药剂师遗漏了一些可能有害的问题，包括处方不完整。必须实施关于进行初步处方审查的系统且可持续的药剂师培训以及持续教育计划，以改善该社区的社区药剂师调配实践。
