Classification of drug-related problems with new prescriptions using a modified PCNE classification system

Area of Science:

• Pharmaceutical care
• Clinical pharmacy
• Drug safety

Background:

• Drug-related problems (DRPs) are a significant concern in patient care.
• Community pharmacies play a crucial role in identifying and resolving DRPs.
• Accurate classification systems are essential for understanding and managing DRPs.

Purpose of the Study:

• To explore and classify DRPs in new prescriptions from community pharmacies.
• To evaluate the utility of a modified Pharmaceutical Care Network Europe (PCNE) classification system, including a technical DRP category.

Main Methods:

• A modified PCNE classification system was used.
• Fifth-year pharmacy students collected and analyzed hospital discharge and primary care prescriptions from 64 Swiss community pharmacies.
• Clinical and technical DRPs, their causes, and interventions were documented.

Main Results:

• 141 clinical DRPs and 278 technical DRPs were detected in 616 patient prescriptions.
• The most frequent clinical DRPs included potential drug-drug interactions (37.6%) and drug choice issues (24.8%).
• Missing package size/therapy duration (32.7%) and unclear dosing instructions (30.9%) were common technical DRPs. The number of prescribed drugs was the primary factor influencing DRP frequency.

Conclusions:

• DRPs are frequently observed in both primary care and hospital discharge prescriptions.
• The modified PCNE classification system, with its technical DRP category, effectively classified all identified DRPs.
• The number of prescribed drugs, not the setting or prescription quality, influenced DRP occurrence.