International Journal of Clinical Pharmacy

, Volume 39, Issue 2, pp 354–363 | Cite as

Documentation of pharmaceutical care: development of an intervention oriented classification system

  • Karen A. MaesEmail author
  • Sophia Bruch
  • Kurt E. Hersberger
  • Markus L. Lampert
Research Article


Background A standardised classification system of pharmaceutical interventions (PI) is in use in several Swiss hospitals, whereas none exists for community pharmacies to date. To promote information exchange between both settings, a compatible structure of the classification system is needed. Objective To develop an intervention oriented classification system for community pharmacies named PharmDISC based on the hospital system; to test it on interrater reliability, appropriateness, interpretability, and face and content validity; to assess pharmacists’ opinions. Setting Seventy-seven Swiss community pharmacies. Method Based on previous studies, a modified classification system was developed. Fifth-year pharmacy students (n = 77) received a two-hour training and classified three model PIs with which Fleiss-Kappa coefficients K were calculated to determine interrater reliability. In the community pharmacies, each student consecutively collected ten prescriptions that required a PI. A focus group interview was conducted with pharmacists (n = 9). The anonymised transcript was analysed using thematic analysis. Main outcome measure Number of classified PIs, interrater reliability, pharmacists’ opinion/suggestions. Results The classification system includes 5 categories and 52 subcategories. Most of the 725 PIs (94.6%) were completely classified. The PharmDISC system reached an overall substantial user agreement (K = 0.61). Despite some points for optimisation, the pharmacists were satisfied with the PharmDISC system. They recognised the importance of PI documentation and believed that this may allow traceability, facilitate communication within the team and other healthcare professionals, and increase quality of care. Conclusion The PharmDISC system was valid and reached substantial interrater reliability. Refinement based on the pharmacists’ suggestions resulted in a final version to be tested in an observational study with community pharmacists.


Classification system Community pharmacy practice Drug-related problem Mixed method Pharmaceutical care Pharmaceutical intervention 



We thank the participating fifth-year pharmacy students and their community pharmacies offering internship for collecting prescriptions and documenting the cases. The authors thank the members of the focus group (Dr. Patrick Eichenberger, Dr. Patrick Imfeld, Andrea Studer, Dr. Fabienne Böni, Pascale Prétot, Renate Allemann, Eva Franz, Dr. Jérôme Berger, Sara Zehnder) who contributed to our findings. We thank Dr. Roland Preston for proof-reading.


No grants from any external funding body were received to conduct this study.

Conflicts of interest


Supplementary material

11096_2017_442_MOESM1_ESM.docx (197 kb)
Supplementary material 1 (DOCX 197 kb)


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Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Karen A. Maes
    • 1
    Email author
  • Sophia Bruch
    • 1
  • Kurt E. Hersberger
    • 1
  • Markus L. Lampert
    • 1
    • 2
  1. 1.Pharmaceutical Care Research Group, Department of Pharmaceutical SciencesUniversity of BaselBaselSwitzerland
  2. 2.Institute of Hospital PharmacySolothurner SpitälerOltenSwitzerland

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