Relationship between drug-related problems and health outcomes: a cross-sectional study among cardiovascular patients

Abstract

Objective: To describe drug-related problems (DRPs) and expense problems (EPs) identified by a standardised community pharmacist-based medication review (MR) program among Swiss cardiovascular outpatients (56-75 years old) and to evaluate the need for collaborative pharmacy practice to achieve economic, clinical and humanistic outcomes.

Setting: A pilot population of 85 cardiovascular outpatients who were customers of 14 community pharmacies (members of the pharmacieplus virtual chain) and insured with Groupe Mutuel health insurance.

Method: Cross-sectional study of a structured medication review program, conducted by 11 pharmacists in collaboration with 61 general practitioners (GPs), with patient interviews and access to medical data.

Main outcome measure: Numbers and types of DRPs and EPs within the study population and odds ratios between them, as well as economic, clinical and humanistic outcomes.

Results: Of the included patients, 91% had at least one DRP or EP. The odds ratios indicated that not being exposed to DRPs was associated with a higher chance of reaching the clinical target (OR: 3.4; IC95%:1.1-10.5; P = 0.01), of having a better physical quality of life than the median (OR: 2.5; IC95%: 0.9-7.3; P = 0.05) and having lower total health care costs (OR: 3.2; IC95%:1.1-9.8; P = 0.02).

Conclusions: This cross-sectional study shows that the control of cardiovascular risk factors, quality of life and healthcare costs are statistically related to the presence of DRPs detected by a community pharmacist-based MR program.