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Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University Hospital

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Aim To evaluate the Pharmaceutical Care Network Europe (PCNE) classification system as a tool for documenting the impact of a hospital clinical pharmacology service. Setting Two medical wards comprising totally 85 beds in a university hospital. Main outcome measure Number of events classified with the PCNE-system, their acceptance by the medical staff and cost implications. Methods Clinical pharmacy review of pharmacotherapy on ward rounds and from case notes were documented, and identified drug-related problems (DRPs) were classified using the PCNE system version 5.00. Results During 70 observation days 216 interventions were registered of which 213 (98.6%) could be classified: 128 (60.1%) were detected by reviewing the case notes, 33 (15.5%) on ward rounds, 32 (15.0%) by direct reporting to the clinical pharmacist (CP), and 20 (9.4%) on non-formulary prescriptions. Of 148 suggested interventions by the CP 123 (83.0%) were approved by the responsible physician, 12 ADR reports (8.1%) were submitted to the local pharmacovigilance centre and 31 (20.9%) specific information given without further need for action. An evaluation of the DRPs showed that direct drug costs of €2,058 within the study period or €10,731 per year could be avoided. Conclusion We consider the PCNE system to be a practical tool in the hospital setting, which demonstrates the values of a clinical pharmacy service in terms of identifying and reducing DRPs and also has the potential to reduce prescribing costs.

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  1. Krähenbühl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krähenbühl S. Drug related problems in hospitals—a review of the recent literature. Drug Saf. 2007;30:379–407.

    Article  PubMed  Google Scholar 

  2. Schlienger RG, Luescher TF, Schoenenberger RA, Haefeli WE. Academic detailing improves identification and reporting of adverse drug events. Pharm World Sci. 1999;3:110–5.

    Article  Google Scholar 

  3. Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003;138:161–7.

    PubMed  Google Scholar 

  4. Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL. Clinical pharmacists and inpatient medical care—a systematic review. Arch Intern Med. 2006;166:955–64.

    Article  PubMed  Google Scholar 

  5. Schumock GT, Butler MG, Meek PD, Vermeulen LC, Arondekar BV, Bauman JL. 2002 Task force on economic evaluation of clinical pharmacy services of the American College of Clinical Pharmacy. Pharmacotherapy. 2003;23:113–32.

    Article  PubMed  Google Scholar 

  6. Ferner RE, Aronson JK. Clarification of terminology in medication errors. Drug Saf. 2006;29:1011–22.

    Article  PubMed  Google Scholar 

  7. Pharmaceutical Care Network Europe. PCNE Classification for Drug-related Problems V5.00. 2005. (download 02–05–2005).

  8. Aronson JK. A prescription for better prescribing. Br J Clin Pharmacol. 2006;61:487–91.

    Article  PubMed  CAS  Google Scholar 

  9. Van Mil F, Westerlund T, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother. 2004;38:859–67.

    Article  PubMed  Google Scholar 

  10. Allenet B, Bedouch P, Rose FX, et al. Validation of an instrument for the documentation of clinical pharmacists’ interventions. Pharm World Sci. 2006;28:181–8.

    Article  PubMed  Google Scholar 

  11. AbuRuz SM, Bulatova NR, Yousef AM. Validation of a comprehensive classification tool for treatment related problems. Pharm Word Sci. 2006;28:222–32.

    Article  Google Scholar 

  12. Schaefer M. Discussing basic principles for a coding system of drug-related problems: the case of PI-Doc. Pharm World Sci. 2002;24:120–7.

    Article  PubMed  Google Scholar 

  13. Lagler M, editor. Arzneimittelkompendium der Schweiz. 2007. 28th ed. (ISBN 3–85640–313–2), Basel: Documed; 2006.

  14. Hatoum HT, Hutchinson RA, Elliott LR, Kendzierski DL. Physicians’ review of significant interventions by clinical pharmacists in inpatient care. Drug Intell Clin Pharm. 1988;22:980–2.

    PubMed  CAS  Google Scholar 

  15. Dooley MJ, Allen KM, Doecke CJ, et al. A prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals. Br J Clin Pharm. 2004;57:513–21.

    Article  Google Scholar 

  16. Overhage JM, Lukes A. Practical, reliable, comprehensive method for characterizing pharmacists’ clinical activities. Am J Health Syst Pharm. 1999;56:2444–50.

    PubMed  CAS  Google Scholar 

  17. Ganso M. Documentation and analysis of pharmaceutical interventions, 6. Konstanzer Apothekerkolloquium. 2006. (Oral Communication).

  18. Klopfer JD, Einarson TR. Acceptance of pharmacists’ suggestions by prescribers: a literature review. Hosp Pharm. 1990;25:830–6.

    PubMed  CAS  Google Scholar 

  19. Leape LL, Cullen DJ, Clapp MD et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999;282:267–70.

    Article  PubMed  CAS  Google Scholar 

  20. McMullin ST, Hennenfelt JA, Bailey TC, et al. A prospective, randomized trial to assess the cost of pharmacist-initiated interventions. Arch Int Med. 1999;159:2306–9.

    Article  CAS  Google Scholar 

  21. Croft Buck T, Brandstru L, Brandslund I, Kampmann JP. The effects of introducing a clinical pharmacist on orthopaedic wards in Denmark. Pharm World Sci. 2007;29:12–8.

    Article  Google Scholar 

  22. Ruettimann S, Keck B, Hartmeier C, Maetzel A, Bucher HC. Long-term antibiotic cost savings from a comprehensive intervention program in a medical department of a university-affiliated teaching hospital. Clin Infect Dis. 2004;38:348–56.

    Article  Google Scholar 

  23. Bajcar J, Chin T, Chui W, Wichman K. Development of a comprehensive clinical pharmacy workload documentation system. Can J Hosp Pharm. 1995;48:80–9.

    PubMed  CAS  Google Scholar 

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We would like to thank Monika Gisin, RN and Kristian Schneider, RN for their support and interest in setting up a clinical pharmacy service. We would also like to thank Peter Hockey, MD for his critical review of the text.


There was no financial support for his study.

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Correspondence to Balthasar L. Hug.

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Lampert, M.L., Kraehenbuehl, S. & Hug, B.L. Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University Hospital. Pharm World Sci 30, 768–776 (2008).

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