International Journal of Clinical Pharmacy

, Volume 35, Issue 3, pp 476–482 | Cite as

Drug-related problems in prescribed medicines in Germany at the time of dispensing

  • Andrea Nicolas
  • Christiane Eickhoff
  • Nina GrieseEmail author
  • Martin Schulz
Research Article


Background Drug-related problems (DRPs) can have an important impact on the effectiveness and safety of pharmacotherapy. In Germany, the frequency of DRPs in prescribed medicines in ambulatory care is not yet known. Objective To quantify DRPs in prescribed medicines identified by community pharmacists (CPs) at the time the medicine is dispensed. Setting German CPs in four different regions. Method We invited CPs to document one hundred consecutive patients presenting prescriptions using a standardized documentation form. For each patient, person- and medication-related as well as identified DRP-related data were documented. Data were transcribed electronically, coded if necessary, checked for validity, and analyzed. Main outcome measure Nature and frequency of DRPs. Results In total, 143 CPs documented 14,231 patients with 24,422 prescribed drugs and identified DRPs in 2,556 patients (18.0 %). Analyses resulted in 0.23 DRPs per patient and 0.13 DRPs per prescribed medicine. Four DRPs were responsible for almost 70 % of all DRPs: Potential drug–drug interaction (22.9 %), dose not known to patient (21.7 %), patient insecure due to generic substitution (13.5 %), and insufficient patient knowledge of correct drug use (10.9 %). If a patient’s drug file was kept in the pharmacy, specific types of DRPs were detected more frequently e.g., drug–drug interactions (p < 0.001). Interventions primarily comprised counselling, monitoring, and changing drug or instructions for use. The prescribing physician was contacted in 28 % of DRPs resulting in a change of these prescriptions in 50 % of the cases. Overall and according to the pharmacists, more than 90 % of the DRPs detected were partially (10.4 %) or completely (85.4 %) solved. Conclusion We quantified DRPs in prescribed medicines in daily ambulatory care practice in Germany. When filling a prescription, in nearly 20 % of the patients relevant DRPs were revealed. According to the pharmacists, the majority could be partially or completely solved during the encounter at the pharmacy. Keeping a patient’s drug file including patient specific data may facilitate the detection of DRPs and shall, therefore, be offered to patients more often.


Community pharmacy Drug-related problems Drug safety Germany Pharmacy 



We thank all participating community pharmacists for making this piece of research possible, Christiane Sauerwein for generating the database and data analyses, and Susanne vom Scheidt, both from the Department of Medicine at ABDA, Berlin, for supporting study organization and critical reading of the manuscript.


This study was funded by ABDA—Federal Union of German Associations of Pharmacists, Berlin, Germany.

Conflicts of interest

None declared.

Supplementary material

11096_2013_9769_MOESM1_ESM.doc (61 kb)
Supplementary material 1 (DOC 61 kb)
11096_2013_9769_MOESM2_ESM.doc (70 kb)
Supplementary material 1 (DOC 70 kb)


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Andrea Nicolas
    • 1
  • Christiane Eickhoff
    • 1
  • Nina Griese
    • 1
    Email author
  • Martin Schulz
    • 1
    • 2
  1. 1.Department of MedicineABDA—Federal Union of German Associations of PharmacistsBerlinGermany
  2. 2.Department of PharmacologyGoethe-University Frankfurt am MainFrankfurt am MainGermany

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