Characterization of drug-related problems identified by clinical pharmacy staff at Danish hospitals
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Background In 2010, a database of drug related problems (DRPs) was implemented to assist clinical pharmacy staff in documenting clinical pharmacy activities locally. A study of quality, reliability and generalisability showed that national analyses of the data could be conducted. Analyses at the national level may help identify and prevent DRPs by performing national interventions. Objective The aim of the study was to explore the DRP characteristics as documented by clinical pharmacy staff at hospital pharmacies in the Danish DRP-database during a 3-year period. Setting Danish hospital pharmacies. Method Data documented in the DRP-database during the initial 3 years after implementation were analyzed retrospectively. The DRP-database contains DRPs reported at hospitals by clinical pharmacy staff. The analyses focused on DRP categories, implementation rates and drugs associated with the DRPs. Main outcome measure Characteristics of DRPs. Results In total, 72,044 DRPs were documented in the DRP-database during the first 3 years of implementation, and the number of documented DRPs increased every year. An overall stable implementation rate of approximately 58 % was identified. The DRPs identified were multi-facetted, however evenly distributed for each of the 3 years. The most frequently identified DRP categories were: “Dose”, followed by “Nonadherence to guidelines” and “Supplement to treatment”. The highest implementation rates were found for the following DRP categories: “Non-adherence to guidelines” (79 %) followed by “Therapeutic duplication” (73 %) and “Dosing time and interval” (70 %). Even though the top 25 drugs were involved in 58 % of all DRPs, multiple drugs were associated with DRPs. The drugs most frequently involved in DRPs were paracetamol (4.6 % of all DRPs), simvastatin (3.0 %), lansoprazole (2.7 %), morphine (2.6 %) and alendronic acid (2.4 %). Conclusions The study found that a national database on DRPs contained multi-facetted DRPs, however evenly distributed for each of the 3 years. Even though the top 25 drugs were involved in 58 % of all DRPs, multiple drugs were associated with DRPs. The study emphasizes the importance of detecting and intervening for DRPs.
KeywordsClinical pharmacy Database Denmark DRP Drug-related problem Hospital Medication review
Conflicts of interest
The authors declare that they have no conflict of interest.
- 6.Kjeldsen et al. Manuscript submitted to IJCP for review.Google Scholar
- 7.WHO Collaborating Centre for Drug Statistics Methodology. The anatomical therapeutic chemical (ATC) classification system. http://www.whocc.no/atc/structure_and_principles/. Accessed 16 Dec 2013.
- 10.ASHP guidelines on a standardized method for pharmaceutical care. In: Deffenbaugh J, editor. Best practices for health-system pharmacy. Bethesda: American society of health-system pharmacists. 1996, pp. 109–11.Google Scholar
- 11.Pharmaceutical Care Network Europe. DRP-classification V6.2. http://pcne.org/sig/drp/documents/PCNE%20classification%20V6-2.pdf. Accessed 16 Dec 2013.
- 12.Grønkjær LS, Jensen ML, Madsen H, Hallas J. Successful implementation of pharmaceutical intervention at an acute medical admission unit. Ugeskr Laege. 2011;173(19):1353–5.Google Scholar
- 13.Kjeldsen LJ, Olesen C, Truelshøj T, Nielsen LB. Quality assurance of medical treatment—an approach by Danish clinical pharmacists. EJHP Pract. 2011;17:31–4.Google Scholar
- 16.Munk CL, Bendixen HK, Kjeldsen LJ. Medication review with a focus on fracture prophylaxis among patients suffering collum femoris fractures. EJHP Pract. 2011;17:26–30.Google Scholar
- 17.Nielsen TR, Andersen SE, Rasmussen M, Honoré PH. Clinical pharmacist service in the acute ward. Int J Clin Pharm. 2013;35(6):1137–51.Google Scholar