Home health care: drug-related problems detected by consultant pharmacist participation

Consultant pharmacists conducted a drug history and regimen review on one-fourth of the patient population served by a community hospital-based home health department. About one-third of study patients had inappropriately stopped taking their medications; over one-fourth of the study patients had changed their schedule or dose without health professional consultation. Fifteen percent of all medications were duplications, and only 8% of prescription medications were correctly identified by name. Consultant pharmacist activities that could reduce drug-related problems were identified as drug therapy consultation with patients and staff, drug regimen review, drug information, and patient medication education.