SpringerLink
Log in

Drug-related problems identified in medication reviews by Australian pharmacists

  • Research Article
  • Published:
Pharmacy World & Science Aims and scope Submit manuscript

Abstract

Objective In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study was to examine the number and nature of the drug-related problems identified and investigate differences between each type of review. Setting Australian patients living at home or in residential care-facilities. Method We collected a nation-wide sample of medication reviews conducted between 1998 and 2005. These reviews had been self-selected by pharmacists and submitted as part of the reaccreditation process to the primary body responsible for accrediting Australian pharmacists to perform medication reviews. The drug-related problems identified in each review were classified by type and drugs involved. Main outcome measure The number and nature of drug-related problems identified in pharmacist-conducted medication reviews. Results There were 1,038 drug-related problems identified in 234 medication reviews (mean 4.6 (±2.2) problems per review). The number of problems was higher (4.9 ± 2.0 vs. 3.9 ± 2.2; P < 0.001) in reviews for home-dwelling patients compared with care-facility residents. The number of clinically-significant problems was higher (2.1 ± 1.1 vs. 1.5 ± 0.7; P < 0.001) for home-dwelling patients. Oral hypoglycaemics and analgesics/antipyretics were significantly more likely to be associated with problems in home-dwelling patients than in residential care-facility patients. Conclusion These data illustrate the prevalence of drug-related problems and the ability of pharmacists to identify these problems in the Australian models of medication review. The nature and frequency of problems varied between reviews for home-dwelling and care-facility patients. Such information may be used to better focus the training of practitioners based on the most frequently encountered health problems and the nature of common drug-related problems in the two settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Population Projections: Australia 2004–2101 (Reissue). Australian Bureau of Statistics. http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/73D26920772F929ECA25718C001518FB/$File/32220_2004%20to%202101reissue.pdf. Accessed 2009 Jan 27.

  2. Farris KB, Ganther-Urmie JM, Fang G, Doucette WR, Brooks JM, Klepser DG, et al. Population-based medication reviews: a descriptive analysis of the medication issues identified in a Medicare not-for-profit prescription discount program. Ann Pharmacother. 2004;38(11):1823–9. doi:10.1345/aph.1E204.

    Article  PubMed  Google Scholar 

  3. Routledge PA, O’Mahony MS, Woodhouse KW. Adverse drug reactions in elderly patients. Br J Clin Pharmacol. 2004;57(2):121–6. doi:10.1046/j.1365-2125.2003.01875.x.

    Article  PubMed  CAS  Google Scholar 

  4. Simonson W, Feinberg JL. Medication-related problems in the elderly: defining the issues and identifying solutions. Drugs Aging. 2005;22(7):559–69. doi:10.2165/00002512-200522070-00002.

    Article  PubMed  Google Scholar 

  5. Roughead EE. The nature and extent of drug-related hospitalisations in Australia. J Qual Clin Pract. 1999;19(1):19–22. doi:10.1046/j.1440-1762.1999.00288.x.

    Article  PubMed  CAS  Google Scholar 

  6. Roughead EE, Barratt JD, Gilbert AL. Medication-related problems commonly occurring in an Australian community setting. Pharmacoepidemiol Drug Saf. 2004;13(2):83–7. doi:10.1002/pds.912.

    Article  PubMed  CAS  Google Scholar 

  7. Christensen D, Trygstad T, Sullivan R, Garmise J, Wegner SE. A pharmacy management intervention for optimizing drug therapy for nursing home patients. Am J Geriatr Pharmacother. 2004;2(4):248–56. doi:10.1016/j.amjopharm.2004.12.002.

    Article  PubMed  Google Scholar 

  8. Roberts MS, Stokes JA, King MA, Lynne TA, Purdie DM, Glasziou PP, et al. Outcomes of a randomized controlled trial of a clinical pharmacy intervention in 52 nursing homes. Br J Clin Pharmacol. 2001;51:257–65. doi:10.1046/j.1365-2125.2001.00347.x.

    Article  PubMed  CAS  Google Scholar 

  9. Sorensen L, Stokes JA, Purdie DM, Woodward M, Elliott R, Roberts MS. Medication reviews in the community: results of a randomised, controlled effectiveness trial. Br J Clin Pharmacol. 2004;58(6):648–64. doi:10.1111/j.1365-2125.2004.02220.x.

    Article  PubMed  Google Scholar 

  10. Rao D, Gilbert A, Strand LM, Cipolle RJ. Drug therapy problems found in ambulatory patient populations in Minnesota and South Australia. Pharm World Sci. 2007;29(6):647–54. doi:10.1007/s11096-007-9123-1.

    Article  PubMed  Google Scholar 

  11. Framework Document for Domiciliary Medication Management Reviews. Medication Management Implementation Steering Group. http://www.psa.org.au/site.php?id=856. Accessed 2009 Jan 27.

  12. Guidelines and Standards for the Collaborative and Pharmacist Residential Medication Management Review (RMMR) Program and Quality Use of Medicines (QUM) Services. Pharmaceutical Society of Australia. http://www.psa.org.au/site.php?id=1122. Accessed 2009 Jan 27.

  13. Burkiewicz JS, Sweeney BL. Medication reviews in senior community housing centers. Consul Pharm. 2006;21(9):715–8.

    Google Scholar 

  14. Lau DT, Kasper JD, Potter DE, Lyles A, Bennett RG. Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents. Arch Intern Med. 2005;165(1):68–74. doi:10.1001/archinte.165.1.68.

    Article  PubMed  Google Scholar 

  15. Ruths S, Straand J, Nygaard HA. Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) study. Qual Saf Health Care. 2003;12(3):176–80. doi:10.1136/qhc.12.3.176.

    Article  PubMed  CAS  Google Scholar 

  16. Home Medicines Review (HMR). Medicare Australia. http://www.medicareaustralia.gov.au/provider/pbs/fourth-agreement/hmr.jsp. Accessed Jan 27 2009.

  17. Peterson GM, Tenni PC. Identifying, prioritising and documenting drug-related problems. Aust Pharm. 2004;23(10):706–9.

    Google Scholar 

  18. van Mil JW, Westerlund LO, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother. 2004;38(5):859–67. doi:10.1345/aph.1D182.

    Article  PubMed  Google Scholar 

  19. Krska J, Cromarty JA, Arris F, Jamieson D, Hansford D, Duffus PR, et al. Pharmacist-led medication review in patients over 65: a randomised, controlled trial in primary care. Age Ageing. 2001;30(3):205–11. doi:10.1093/ageing/30.3.205.

    Article  PubMed  CAS  Google Scholar 

  20. Haugbolle LS, Sorensen EW. Drug-related problems in patients with angina pectoris, type 2 diabetes and asthma—interviewing patients at home. Pharm World Sci. 2006;28(4):239–47. doi:10.1007/s11096-006-9023-9.

    Article  PubMed  Google Scholar 

  21. Finkers F, Maring JG, Boersma F, Taxis K. A study of medication reviews to identify drug-related problems of polypharmacy patients in the Dutch nursing home setting. J Clin Pharm Ther. 2007;32(5):469–76. doi:10.1111/j.1365-2710.2007.00849.x.

    Article  PubMed  CAS  Google Scholar 

  22. Elliott RA. Problems with medication use in the elderly: an Australian perspective. J Pharm Pract Res. 2006;36(1):58–66.

    Google Scholar 

  23. Becker ML, Kallewaard M, Caspers PW, Visser LE, Leufkens HG, Stricker BH. Hospitalisations and emergency department visits due to drug–drug interactions: a literature review. Pharmacoepidemiol Drug Saf. 2007;16(6):641–51. doi:10.1002/pds.1351.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The assistance with data collection provided by Mr. Bill Kelly, Chief Executive Officer of the Australian Association of Consultant Pharmacists, is acknowledged with gratitude.

Funding

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Private Bag 26, Hobart, TAS, 7001, Australia

    Andrew C. Stafford, Peter C. Tenni, Gregory M. Peterson & Shane L. Jackson

  2. The Faculty of Pharmaceutical Sciences, Department of Pharmacology and Pharmacotherapy, University of Copenhagen, Helsingør, Denmark

    Anne Hejlesen, Christine Villesen & Mette Rasmussen

Authors
  1. Andrew C. Stafford
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter C. Tenni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gregory M. Peterson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shane L. Jackson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anne Hejlesen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christine Villesen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mette Rasmussen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew C. Stafford.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stafford, A.C., Tenni, P.C., Peterson, G.M. et al. Drug-related problems identified in medication reviews by Australian pharmacists. Pharm World Sci 31, 216–223 (2009). https://doi.org/10.1007/s11096-009-9287-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-009-9287-y

Keywords

Search

Navigation