Comparison of Drug-Related Problems Identified During a Pharmaceutical Care Model and Physician Consultations in the Geriatric Department

Abstract

Background/Purpose: The study aimed to identify common drug-related problems (DRP), their causes and pharmacists' interventions during the pharmaceutical care (PC) model and physician consultations, and to explore the gap between physicians and pharmacists to achieve a better understanding and to provide better cooperation. Methods: We conducted a single-center prospective study at the geriatric department of a tertiary academic hospital. A PC model was implemented and defined a list of pharmacy services, high-risk patients and medications. Data were collected during pharmacist's medication reviews according to the PC model and physician consultations. DRPs, causes and interventions frequency during PC model and physician consultations were compared. Results: Pharmacists identified 197 DRPs during the PC model with primarily adverse drug events (possibly) occurring, followed by untreated indication and unnecessary drug treatment. In line with that, more than half of pharmacists’ interventions were initiation or discontinuation of the drugs, followed by dosage changes. During 107 physician consultations, the most reported DRP was treatement efficacy, which demanded drug or dosage changes. Antibiotics were the top medicines related to DRPs during the PC model and physician consultations. The level of acceptance of pharmacists’ interventions was higher for physician consultations (98.1%) compared to the PC model (68.5%). Conclusion: Physicians consulted pharmacists more on questions related to treatment effectiveness, while pharmacists paid attention to medication safety. The presented results might help physicians better understand the principles of pharmacy care services and guide pharmacists during their daily practice, achieve better cooperation in multidisciplinary teams, and improve the quality of patient care