Pharmaceutical interventions on prescribed medicines in community pharmacies: focus on patient-reported problems

Abstract

Background While dispensing prescribed medicines, pharmacists frequently encounter technical and clinical problems that require a pharmaceutical intervention. Objective To describe the pharmaceutical interventions performed by community pharmacists while dispensing prescribed medicines and to investigate, in-depth, the patient-reported problems with the prescribed medicines that triggered pharmaceutical interventions. Method Twenty-one pharmacists each collected 30 prescriptions requiring a pharmaceutical intervention on five selected days within a five-week period. All pharmaceutical interventions were classified using the PharmDISC system. Results Of all 430 pharmaceutical interventions, 286 (66.5%) pharmaceutical interventions had a clinical cause and 144 (33.5%) pharmaceutical interventions a technical cause. Pharmacists mainly intervened to substitute a drug (n = 132, 30.7%), adjust a dose (n = 57, 13.3%), and clarify/complete information (n = 48, 11.2%). A total of 243 (56.5%) pharmaceutical interventions resulted in a change of the prescription. The implementation rate of pharmaceutical interventions reached 88.6%. Altogether, patient-reported problems triggered 99 (23.0%) pharmaceutical interventions. In 15 (15.2%) of these PIs, contact with the prescriber was necessary, whereas 61 (84.8%) PIs only involved the pharmacist. Conclusion While dispensing prescribed medicines, pharmacists performed individualised pharmaceutical interventions to solve or prevent drug-related problems. That almost a quarter of all pharmaceutical interventions triggered by patient-reported problems highlights the importance of direct patient-pharmacist interaction when dispensing prescribed medicines.

Keywords: Classification system; Community pharmacy practice; Drug-related problem; Pharmaceutical care; Pharmaceutical intervention; Switzerland.