International Journal of Clinical Pharmacy

, Volume 41, Issue 1, pp 13–17 | Cite as

Identify and categorize drug-related problems in hospitalized surgical patients in China

  • Can Qu
  • Long Meng
  • Ning Wang
  • Yong Chen
  • Xiao Yang
  • Jun Wang
  • Shusen SunEmail author
  • Feng QiuEmail author
Short Research Report


Background Data is lacking on types and severities of drug-related problems (DRPs) in hospitalized surgical patients in China. Objective To identify and categorize types and causes of DRPs, and to assess severities of these DRPs. Setting An academic teaching hospital in Chongqing, China. Method We retrospectively reviewed all medication orders for patients in six surgical departments during a six-month period. DRPs were classified using the Pharmaceutical Care Network Europe (PCNE) classification, and the severity ratings of these DRPs were based on the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) classification. Main outcome measure The number, types, causes and severities of the DRPs. Results A total of 291,944 medication orders in 10,643 patients were reviewed, and 3548 DRPs were identified. The average DRP number per patient was 0.3. The most common problem was treatment effectiveness (39.9%) and the major cause of the problems was dose selection (47.0%). Total 80.1% of the DRPs were rated at severity categories B to D (causing no or potential harm), whereas 19.9% were rated as categories E to H (causing actual harm). Conclusion DRPs are common in surgical patients, and prospective pharmacist medication order review services are needed to improve patients’ pharmaceutical care.


China Drug-related problems NCC-MERP classification PCNE classification Pharmacist Pharmacy service 



This work was funded by the Chongqing Health and Family Planning Commission Scientific Research Projects (No. 2018ZDXM014).

Conflict of interest

All authors declare that they have no conflict of interests.


  1. 1.
    Pharmaceutical Care Network Europe (PCNE). The PCNE classification V8.02. (2018). Accessed 16 Dec 2018.
  2. 2.
    World Health Organization. Medication Without Harm. Accessed 16 Dec 2018.
  3. 3.
    Lampert ML, Kraehenbuehl S, Hug BL. Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University Hospital. Pharm World Sci. 2008;30(6):768–76.CrossRefGoogle Scholar
  4. 4.
    Rashed AN, Wilton L, Lo CC, Kwong BY, Leung S, Wong IC. Epidemiology and potential risk factors of drug-related problems in Hong Kong pediatric wards. Br J Clin Pharmacol. 2014;77(5):873–9.CrossRefGoogle Scholar
  5. 5.
    National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Taxonomy of Medication Errors. Accessed 16 Dec 2018.
  6. 6.
    Schorr SG, Eickhoff C, Feldt S, Hohmann C, Schulz M. Exploring the potential impact of hospital ward-based pharmacy interns on drug safety. Pharmazie. 2014;69:316–20.Google Scholar
  7. 7.
    Hohmann C, Eickhoff C, Klotz JM, Schulz M, Radziwill R. Development of a classification system for drug-related problems in the hospital setting (APS-Doc) and assessment of the inter-rater reliability. J Clin Pharm Ther. 2012;37(3):276–81.CrossRefGoogle Scholar
  8. 8.
    Taeqtmeyer AB, Kullak-Ublick GA, Widmer N, Falk V, Jetter A. Clinical usefulness of electronic drug-drug interaction checking in the care of cardiovascular surgery inpatients. Cardiology. 2012;123(4):219–22.CrossRefGoogle Scholar
  9. 9.
    Basger BJ, Mole RJ. Application of drug-related problem (DRP) classification systems: a review of the literature. Eur J Clin Pharmacol. 2014;70:799–815.CrossRefGoogle Scholar
  10. 10.
    Mao W, Vu H, Xie Z, Chen W, Tang S. Systematic review on irrational use of medicines in China and Vietnam. PLoS ONE. 2015;10(3):e0117710.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PharmacyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
  2. 2.Department of Pharmacy Practice, College of Pharmacy and Health SciencesWestern New England UniversitySpringfieldUSA
  3. 3.Department of PharmacyXiangya Hospital Central South UniversityChangshaChina
  4. 4.Institute for Rational and Safe Medication PracticesNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South UniversityChangshaChina

Personalised recommendations