Drug-related problems in patients with angina pectoris, type 2 diabetes and asthma – interviewing patients at home
Objective of the study
The objective of the overall study was to create a foundation for improving the quality of counselling practice in pharmacies. The research question addressed in this sub-study was to describe drug-related problems (DRPs) in terms of frequency as well as type in people with angina pectoris, type 2 diabetes and asthma, as the problems were identified through medication reviews and home interviews.
Setting and method
During their pharmacy internships, fourth-year pharmacy students collected data for the study in 1999, 2000 and 2001 by carrying out medication reviews, conducting home interviews and registering DRPs for 414 patients. Data were collected from the following patient groups in the years indicated: in 1999, 123 angina pectoris patients; in 2000, 192 type 2 diabetes patients, and in 2001, 99 asthma patients. The interviews dealt with the patient’s drug-related experiences, knowledge, perceptions, problems and actions. The DRPs were registered according to the so-called PI-Doc system.
A medication review was supplemented by qualitative interviews with the three patient groups, which revealed a relatively high number of DRPs compared to other studies. An average of 2.8 DRPs were identified per angina pectoris patient; 4.1 DRPs per type 2 diabetes patient and 4.0 DRPs per asthma patient. “Inappropriate use of medicines by the patient” and “Other problems” (such as limited knowledge of the illness, inappropriate lifestyle, fear of medication, lack of information, etc.) were the two most common DRP sub-categories identified in all three patient groups.
The study provided a profile of a pharmacy-based population of 414 patients visiting the pharmacy, all of whom are at high risk of experiencing drug-related problems. Pharmacy staff needs to take this high rate of DRPs in people with angina pectoris, asthma and type 2 diabetes into account when dispensing medicines to and advising patients from the three groups, especially when explaining how to use medicines appropriately.
KeywordsAngina pectoris Asthma Type 2 diabetes Drug-related problems Home interviews Medication review Patient perspective Diabetes DRP
- 2.Kane MP, Briceland LL, Hamilton RA. Solving drug-related problems in the professional experience program. Am J Pharm Edu 1993;57:347–51.Google Scholar
- 3.Gordon W, Malyuk D, Taki J. Use of Health-Record Abstracting to Document Pharmaceutical Care Activities. Can J Hosp Pharm 2000;53(3):199–205.Google Scholar
- 5.Britten N. Lay views of drugs and medicines: orthodox and unorthodox accounts. In: Williams SJ, Calnan M, editors. Modern medicine-lay perspectives and experiences. London: UCL Press; 1996:48–73, ISBN-number: 18-572-831-8X.Google Scholar
- 6.Calnan M. Health and illness – the lay perspective. London, New York: Tavistock Publications; 1987, ISBN-number: 04-2279-420-1.Google Scholar
- 7.Fallsberg M. Reflections on medicines and medication – a qualitative analysis among people on long-term drug regimens. Linköping Studies in Education. Dissertations, 1991;31, ISBN-number: 91-7870-799-4.Google Scholar
- 8.Hansen EH, Launsø L. Drugs and users – problems and new directions. Health Promot 1988;3(3):241–8Google Scholar
- 9.Timm HU. Patienten i centrum? Brugerundersøgelser, lægperspektiver og kvalitetsudvikling. [Is the focus on the patient? User study, user perspective and quality improvement. In Danish]. DSI • Danish Institute for Health Services Research and Development; 1997, Report, ISBN-number: 87-7488-335-6. Google Scholar
- 12.Hassell K, Noyce P, Rogers A, Harris J, Wilkinson J. Advice provided in British community pharmacies: what people want and what they get. J Health Ser Res Policy 1998;3(4):219–25.Google Scholar
- 16.Klasen H, Goodman R, Goodman R. Parents and GPs at cross-purposes over hyperactivity: a qualitative study of possible barriers to treatment. Brit J Gen Prac 2000;50:199–202.Google Scholar
- 19.Titley-Lake C, Barber N. Drug related problems in the elders of the British Virgin Islands. Int J Pharm Pract 2000;8:53–9.Google Scholar
- 21.Australian Government – Department of Health and Ageing. Home Medicines Review. Available from https://www.health.gov/au/internet/wcms/publishing/nsf/content/health-epc-ahmr.htm. Website viewed December 15th, 2005.Google Scholar
- 25.Gilbert AL, Roughead EE, Beilby J, Mott K, Barrarr JD. Collaborative medication management services: improving patient care. Med J Austr 2002;177:189–92.Google Scholar
- 27.Anon. Managing care of angina patients in the community: a model of good pharmacy practice. Int Pharm J 1998;12(Suppl IV):2–4.Google Scholar
- 28.Churton M. Theory and method. London: Macmillan Press Ltd; 2000, ISBN-number: 033368110X.Google Scholar
- 29.Fallsberg M, Herborg HH, Væggemose U. How asthma patients think and act. Internal report. Denmark: Pharmakon; 1998.Google Scholar
- 31.Antonovsky A. Unravelling the mystery of health. San Francisco: Jossey-Bass; 1987.Google Scholar
- 33.Pharmakon. Forebyggelse af lægemiddelrelaterede problemer gennem apotekets ældre service [Preventing drug-related problems through the pharmacy’s elder service project. In Danish]; 1997, Report.Google Scholar
- 34.Schaefer M. Basic principles for a coding system of drug-related problems: PI-Doc. Abstract at the International Working Conference on Outcome Measurements in Pharmaceutical Care; Pharmaceutical Care Network Europe January 26–29. Pharmakon, Danish College of Pharmacy Practice, Denmark; 1998.Google Scholar
- 36.Enger K. NSDstat For Windows 95/98NT. Norsk amfundsvidenskabelig data-tjeneste [The Norwegian social science data service]; 1999.Google Scholar
- 37.Kvale S. Interviews – an introduction to qualitative research interviewing. Hans Reitzels Forlag: Copenhagen; 1996, ISBN-number: 08-0395-819-6.Google Scholar
- 38.Westerlund T, Almarsdóttir AB. Drug-related problems and pharmacy interventions in community practice. Int J Pharm Pract 1999;7:40–50.Google Scholar
- 39.Granås AG, Bates I. The effect of pharmaceutical review of repeat prescriptions in general practice. Int J Pharm Pract 1999;7:264–75.Google Scholar
- 42.Nilsson JLG, Andersson Å, Kälvemark S, Lieberman-Ram H, Ulenius B, Wendel A, et al. Surveys of drug-related therapy problems of patients using medicines for allergy, asthma and pain. Int J Pharm Pract 2000;8:198–203.Google Scholar
- 45.Scwartzkoff J. Evaluation of the Home Medicines Review Program: pharmacy component. Canberra: Urbis Keys Young; 2005, ISBN.Google Scholar
- 47.Hepler CD, Strand LM. Oppontunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990;47(3): 533–43.Google Scholar