Category: Professional Posters
Purpose: Drug-related problems (DRPs) are events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes. While DRPs have been widely studied overseas and in hospital settings locally, there is no published data on the DRPs identified by community pharmacists in the three major private chains in Singapore. This study aimed to describe the nature and frequency of DRPs identified from prescriptions dispensed in private community pharmacies in Singapore and the interventions made by pharmacists. The study team also hoped to investigate the acceptance rate and perceived clinical significance of pharmacists’ interventions.
Methods: In this IRB-approved study, the top 30% pharmacy stores in terms of the number of prescriptions dispensed per month were selected and recruited from each of the three community pharmacy chains. Over the two-month study period, the study team collated from the pharmacies dispensed prescriptions with interventions. The DRPs detected and pharmacists’ recommendations were analysed and classified accordingly by the study team. An adapted version of the validated DOCUMENT DRP classification system was chosen for this study as the DOCUMENT DRP system also includes the classification of actions taken to resolve the DRPs. The acceptance rate and perceived clinical significance of interventions were also evaluated.
Results: A total of 17 259 prescriptions were dispensed, of which 550 were found to contain DRPs. Most of these prescriptions came from private general practitioner (GP) clinics (77.46%), and the median number of prescribed drugs was 1 (IQR: 1 – 2). A total of 627 DRPs were identified, of which incorrect strength was most common (n = 246, 39.23%), followed by incorrect dosing instructions (n = 184, 29.53%). The drug classes that were most commonly associated with DRPs were Dermatologicals (n= 119, 18.89%), Respiratory system products (n = 90, 14.35%) and Nervous system products (n = 86, 13.72%). Preparations with multiple strengths, available in several different dosage forms, or had a recent change in strength or formulation were most commonly implicated. Pharmacists often had to clarify the problem (n = 452, 72.09%) or recommend a change to patient’s therapy (n = 152, 24.24%). The recommendations made achieved a high acceptance rate of 86.79% from prescribers. Most of the interventions were perceived to be of low level of clinical significance (n = 469, 74.80%).
Conclusion: In this first nation-wide study, we saw a DRP occurrence rate of 3.63 DRPs per 100 prescriptions dispensed by community pharmacists in Singapore. This figure differs greatly from other similar studies done elsewhere due to the different classification systems used, different healthcare structures as well as methods of data collection. Nonetheless, through identifying and resolving DRPs, this study illustrates the important role of community pharmacists in ensuring that patients receive safe and effective therapy.