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The process of identifying, solving and preventing drug related problems in the LIMM-study

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Abstract

Objective To avoid negative effects of drug treatment and need for additional medical care, drug treatment must be individualised. Our research group has developed a model for clinical pharmacy which improves several aspects of the patient’s drug treatment. This study describes the process behind these improvements, i.e. drug related problems identified by pharmacists within a clinical pharmacy service. Setting Three wards at a department of internal medicine. Method Pharmacists performed systematic interventions during the patient’s hospital stay, aiming to identify, solve and prevent drug related problems in the elderly. Identified drug related problems were put forward to the health care team and discussed. Information on identified problems, and their outcomes was collected and analysed. A questionnaire was used to evaluate the health care personnel’s attitudes towards the process. Main outcome measure The number of drug related problems identified by the clinical pharmacists, the proportion of problems discussed with the physicians, the proportion of problems adjusted by the physicians and whether pharmacists and physicians prioritised any subgroup of drug related problems when choosing which problems to address. Finally, we wanted to evaluate the health care personnel’s attitudes towards the model. Results In total, 1,227 problem were identified in 190 patients. The pharmacists discussed 685 (55.8%) of the identified problems with the physicians who accepted 438 (63.9%) of the suggestions. There was no significant difference in which subgroup to put forward and which to adjust. There was a high response rate (84%) to the questionnaire, and the health care personnel estimated the benefits to be very high, both for the patients and for themselves. Conclusion The process for identifying, solving and preventing drug related problems was good and the different types of problems were considered equally important. The addition of a clinical pharmacy service was considered very useful. This suggests that the addition of our clinical pharmacy service to the hospital setting add skills of great importance.

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Acknowledgments

We would like to thank the staff at the department of internal medicine at Landskrona Hospital, especially Dr Per Löfdahl, and the clinical pharmacists Sofia Jönsson and Emma Olsson for excellent cooperation and work.

Funding

We are grateful to the National Board of Health and Welfare, the Swedish Academy of Pharmaceutical Sciences, the County of Skåne and Apoteket Farmaci AB for funding the study.

Conflicts of interests

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Apoteket Farmaci, Hospital Pharmacy, Skåne University Hospital, Malmö, Sweden

    Anna Bergkvist Christensen

  2. Apoteket Farmaci, Hospital Pharmacy, Skåne University Hospital, Lund, Sweden

    Linda Holmbjer, Lisa Larsson, Åsa Bondesson & Tommy Eriksson

  3. Department of Clinical Pharmacology, Lund University, Lund, Sweden

    Anna Bergkvist Christensen, Peter Höglund, Åsa Bondesson & Tommy Eriksson

  4. Skvadronsgatan 9C, 217 52, Malmö, Sweden

    Anna Bergkvist Christensen

  5. Department of Clinical Sciences in Malmö—General Practice/Family Medicine, Lund University, Lund, Sweden

    Patrik Midlöv

  6. Centre for Primary Health Care Research, Lund University, Lund, Sweden

    Patrik Midlöv

Authors
  1. Anna Bergkvist Christensen
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  2. Linda Holmbjer
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  3. Patrik Midlöv
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  4. Peter Höglund
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  5. Lisa Larsson
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  6. Åsa Bondesson
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  7. Tommy Eriksson
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Corresponding author

Correspondence to Anna Bergkvist Christensen.

Appendix

Appendix

  The questionnaire sent out to all health care personnel, evaluating the attitudes towards the clinical pharmacy service
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Bergkvist Christensen, A., Holmbjer, L., Midlöv, P. et al. The process of identifying, solving and preventing drug related problems in the LIMM-study. Int J Clin Pharm 33, 1010–1018 (2011). https://doi.org/10.1007/s11096-011-9575-1

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  • DOI: https://doi.org/10.1007/s11096-011-9575-1

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