International Journal of Clinical Pharmacy

, Volume 33, Issue 6, pp 1019–1027 | Cite as

Pharmaceutical interventions on prescription problems in a Danish pharmacy setting

  • Anton PottegårdEmail author
  • Jesper Hallas
  • Jens Søndergaard
Research Article


Background International studies regarding pharmacists’ interventions towards prescription problems produce highly variable results. The only peer-reviewed study in a Danish setting estimated an intervention rate of 2.3 per 1,000 prescriptions. With the introduction of a new tool for registration, we hypothesized that a better estimate could be obtained. Objective We aimed to produce an up-to-date estimate of the extent and type of pharmacists’ interventions towards prescription problems in a Danish pharmacy setting Setting The study was conducted at Copenhagen Sønderbro Pharmacy, a large urban 24-hour pharmacy. Method Data were collected prospectively through an electronic form. All interventions were primarily classified as either clinical or administrative in nature, and further classified in a number of pre-determined subcategories. Furthermore, information about age, sex, time of day, the wording of the prescription, the performed intervention, the person performing the intervention and the type of prescriber were recorded. All entries were manually validated by a study pharmacist. Main outcome measure The intervention rate, given as the number of interventions per 1,000 prescriptions. Results We found 599 validated interventions. Thirty-two percent of the interventions were clinical and 68% administrative by nature. Fifty-one percent of the administrative and 35% of the clinical interventions were regarding antibiotics. In the study period, a total of 55,522 prescriptions were filled out together with 3,069 dose-dispensing packages, giving a rate of 10.2 (9.4–11.1) interventions per 1,000 prescriptions. Conclusion We found an intervention rate substantially higher than reported in previous Danish studies.


Clinical pharmacy Denmark Pharmacy practice Primary care Problem prescriptions Pharmacists’ interventions 



The authors wish to acknowledge the staff at Sønderbro Pharmacy for the effort of performing the registrations. Furthermore, our thanks go to Mikkel Nørreslet and Charlotte Vermehren for valuable comments on the manuscript.

Conflicts of interest



  1. 1.
    Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–43.PubMedGoogle Scholar
  2. 2.
    Schommer JC, Pedersen CA, Worley MM, Brown LM, Hadsall RS, Ranelli PL, et al. Provision of risk management and risk assessment information: the role of the pharmacist. Res Social Adm Pharm. 2006;2(4):458–78.PubMedCrossRefGoogle Scholar
  3. 3.
    Carroll NV. Do community pharmacists influence prescribing? J Am Pharm Assoc. 2003;43(5):612–21.CrossRefGoogle Scholar
  4. 4.
    Indermitte J, Beutler M, Bruppacher R, Meier CR, Hersberger KE. Management of drug-interaction alerts in community pharmacies. J Clin Pharm Ther. 2007;32(2):133–42.PubMedCrossRefGoogle Scholar
  5. 5.
    Ekedahl A. Problem prescriptions in Sweden necessitating contact with the prescriber before dispensing. Res Social Adm Pharm. 2010;6(3):174–84.PubMedCrossRefGoogle Scholar
  6. 6.
    Mandt I, Horn AM, Granas AG. Communication about prescription interventions between pharmacists and general practitioners. Tidsskr Nor Laegeforen. 2009;129(18):1846–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Astrand B, Montelius E, Petersson G, Ekedahl A. Assessment of e-Prescription quality: an observational study at three mail-order pharmacies. BMC Med Inform Decis Mak. 2009;9:8.PubMedCrossRefGoogle Scholar
  8. 8.
    Warholak TL, Rupp MT. Analysis of community chain pharmacists’ interventions on electronic prescriptions. J Am Pharm Assoc. 2009;49(1):59–64.CrossRefGoogle Scholar
  9. 9.
    Knudsen P, Herborg H, Mortensen AR, Knudsen M, Hellebek A. Preventing medication errors in community pharmacy: frequency and seriousness of medication errors. Qual Saf Health Care. 2007;16(4):291–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Leemans L, Veroeveren L, Bulens J, Hendrickx C, Keyenberg W, Niesten F, et al. Frequency and trends of interventions of prescriptions in Flemish community pharmacies. Pharm World Sci. 2003;25(2):65–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Westein MP, Herings RM, Leufkens HG. Determinants of pharmacists’ interventions linked to prescription processing. Pharm World Sci. 2001;23(3):98–101.PubMedCrossRefGoogle Scholar
  12. 12.
    Hawksworth GM, Corlett AJ, Wright DJ, Chrystyn H. Clinical pharmacy interventions by community pharmacists during the dispensing process. Br J Clin Pharmacol. 1999;47(6):695–700.PubMedCrossRefGoogle Scholar
  13. 13.
    Hammerlein A, Griese N, Schulz M. Survey of drug-related problems identified by community pharmacies. Ann Pharmacother. 2007;41(11):1825–32.PubMedCrossRefGoogle Scholar
  14. 14.
    Vinks TH, de Koning FH, de Lange TM, Egberts TC. Identification of potential drug-related problems in the elderly: the role of the community pharmacist. Pharm World Sci. 2006;28(1):33–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Ross S, Bond C, Rothnie H, Thomas S, Macleod MJ. What is the scale of prescribing errors committed by junior doctors? A systematic review. Br J Clin Pharmacol. 2009;67(6):629–40.PubMedCrossRefGoogle Scholar
  16. 16.
    Dean FB, Vincent C, Schachter M, Barber N. The incidence of prescribing errors in hospital inpatients: an overview of the research methods. Drug Saf. 2005;28(10):891–900.CrossRefGoogle Scholar
  17. 17.
    Franklin BD, Birch S, Savage I, Wong I, Woloshynowych M, Jacklin A, et al. Methodological variability in detecting prescribing errors and consequences for the evaluation of interventions. Pharmacoepidemiol Drug Saf. 2009;18(11):992–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Haavik S, Horn AM, Mellbye KS, Kjonniksen I, Granas AG. Prescription errors—dimension and measures. Tidsskr Nor Laegeforen. 2006;126(3):296–8.PubMedGoogle Scholar
  19. 19.
    Knapp KK, Katzman H, Hambright JS, Albrant DH. Community pharmacist interventions in a capitated pharmacy benefit contract. Am J Health Syst Pharm. 1998;55(11):1141–5.PubMedGoogle Scholar
  20. 20.
    Buurma H, De Smet PA, van den Hoff OP, Egberts AC. Nature, frequency and determinants of prescription modifications in Dutch Community pharmacies. Br J Clin Pharmacol. 2001;52(1):85–91.PubMedCrossRefGoogle Scholar
  21. 21.
    Thomsen MH, Kristoffersen LB, Kjær-Hansen B, Hellebek T. Analyse af receptkorrektioner på apotek. Association of Danish Pharmacies; Published in 2008.Google Scholar
  22. 22.
    Hansen BK, Mortensen AR. Analyse på receptkorrektioner på apotek 2006 (in Danish). Association of Danish Pharmacies; Published in 2006.Google Scholar
  23. 23.
    WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment 2011. Oslo; 2010.Google Scholar
  24. 24.
    Receptbekendtgørelsen §27–28; [Last updated 2007]. Available from:
  25. 25.
    Gaist D, Sorensen HT, Hallas J. The Danish prescription registries. Dan Med Bull. 1997;44(4):445–8.PubMedGoogle Scholar
  26. 26.
    Pandey AA, Thakre SB, Bhatkule PR. Prescription analysis of pediatric outpatient practice in nagpur city. Indian J Commun Med. 2010;35(1):70–3.CrossRefGoogle Scholar
  27. 27.
    Knudsen P, Herborg H, Knudsen MS, Mortensen AR, Hellebek A. Apotekets forebyggelse af fejl [The prevention of errors by the pharmacy]. Association of Danish Pharmacies, Pharmakon and Danish Society for Patient Safety; Published in 2005. ISBN: 87-88873-83-8.Google Scholar
  28. 28.
    Danish Medicines Agency. Undersøgelse over apotekernes driftsforhold for 2009 [Examination of the pharmacies operational conditions for 2009]. Published in 2010. ISSN: 1602-4532. Available from:
  29. 29.
    Devine EB, Hansen RN, Wilson-Norton JL, Lawless NM, Fisk AW, Blough DK, et al. The impact of computerized provider order entry on medication errors in a multispecialty group practice. J Am Med Inform Assoc. 2010;17(1):78–84.PubMedCrossRefGoogle Scholar
  30. 30.
    Flynn EA, Barker KN, Carnahan BJ. National observational study of prescription dispensing accuracy and safety in 50 pharmacies. J Am Pharm Assoc (Wash). 2003;43(2):191–200.CrossRefGoogle Scholar
  31. 31.
    Buurma H, De Smet PA, Leufkens HG, Egberts AC. Evaluation of the clinical value of pharmacists’ modifications of prescription errors. Br J Clin Pharmacol. 2004;58(5):503–11.PubMedCrossRefGoogle Scholar
  32. 32.
    Rupp MT. Value of community pharmacists’ interventions to correct prescribing errors. Ann Pharmacother. 1992;26(12):1580–4.PubMedGoogle Scholar
  33. 33.
    Cherici C, Frazier J, Feldman M, Gordon B, Petrykiw C, Russel W, et al. White Paper: Navigating Drug Shortages in American Healthcare: a premier healthcare alliance analysis. Published in 2011. Available from:

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Anton Pottegård
    • 1
    • 2
    Email author
  • Jesper Hallas
    • 1
  • Jens Søndergaard
    • 2
  1. 1.Research Unit of Clinical PharmacologyUniversity of Southern DenmarkOdense CDenmark
  2. 2.Research Unit for General Practice, Institute of Public HealthUniversity of Southern DenmarkOdense CDenmark

Personalised recommendations