This prese2.1 Introduction
Detecting and resolving as well as preventing patients’ drug-related problems is one of the essential activities of the pharmacist, aimed at ensuring a correct drug use to optimize the therapeutic effect and minimize the possible adverse effect of the patient’s medicat...
This prese2.1 Introduction
Detecting and resolving as well as preventing patients’ drug-related problems is one of the essential activities of the pharmacist, aimed at ensuring a correct drug use to optimize the therapeutic effect and minimize the possible adverse effect of the patient’s medications. Ever since the concept named pharmaceutical care was created and spread, it has been regarded the core of the concept.
2.2 Drug-Related Problems, What Is in the Name
The first definition of a drug-related problem read as follows: “An event or circumstance involving drug treatment that actually or potentially interferes with the patient’s experiencing an optimum outcome of medical care” [5] shortly followed by “an undesirable patient experience that involves drug therapy and that actually or potentially interferes with a desired patient outcome” [6]. A limitation of these definitions is however that a problem would require a negative experience in the patient to be recognized as a DRP. But there are DRPs, such as a less optimal effect of the drug treatment due to patient non-adherence, which may even make the patient feel better in the short run but may have bad consequences in the long run. Segal’s definition “a circumstance of drug therapy that may interfere with a desired therapeutic objective” [8] also includes DRPs that the patient may not experience or would not even be aware of and is hence more useful. Based on the previous definitions, the Pharmaceutical Care Network Europe (PCNE) defined a DRP as “An event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes” [9]. Other terms used to designate DRPs have been “drug-therapy problems” [7], “pharmaceutical care issues” [10], “pharmacotherapy failures” and “negative clinical outcomes” [11].
DRPs are primarily caused by the patient’s behavior in one way or another, while “medication errors” generally are due to faults committed by health professionals, although there is a gray area and a lack of a full consensus among practitioners and researchers.
Pharmacists are in a unique position to identify, correct and prevent the occurrence of patients’ drug therapy problems because of their pharmacotherapeutic training and regular contact with patients. In a patient-oriented role, they could, therefore, enhance drug therapy outcomes before they lead to morbidity and mortality. To further demonstrate the meaning of a DRP, the following examples are given:
Mrs Lorraine Johnson, 55, a regular at your pharmacy comes to get a first refill of her metoprolol depot tablets 200 mg for her hypertension, prescribed by the new, young doctor at her health care center. She thinks however that they are hard to swallow but tells you that she use to split them in half and then chew them carefully. Since years, Mrs Johnson also takes beclomethasone (Easyhaler) 200 mcg twice daily. As well as salmeterol (Diskus) 50 mcg, of which she wants another refill, a couple of we