DOCUMENT: a system for classifying drug-related problems in community pharmacy
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Background Drug-related problems (DRPs) are a major burden on the Australian healthcare system. Community pharmacists are in an ideal position to detect, prevent, and resolve these DRPs. Objective To develop and validate an easy-to-use documentation system for pharmacists to classify and record DRPs, and to investigate the nature and frequency of clinical interventions undertaken by Australian community pharmacists to prevent or resolve them. Setting Australian community pharmacies. Method The DOCUMENT classification system was developed, validated and refined during two pilot studies. The system was then incorporated into software installed in 185 Australian pharmacies to record DRPs and clinical interventions undertaken by pharmacists during a 12-week trial. Main outcome measure The number and nature of DRPs detected within Australian community pharmacies. Results A total of 5,948 DRPs and clinical interventions were documented from 2,013,923 prescriptions dispensed during the trial (intervention frequency 0.3%). Interventions were commonly related to Drug selection problems (30.7%) or Educational issues (23.7%). Pharmacists made an average of 1.6 recommendations per intervention, commonly relating to A change in therapy (40.1%) and Provision of information (34.7%). Almost half of interventions (42.6%) were classified by recording pharmacists as being at a higher level of clinical significance. Conclusion The DOCUMENT system provided pharmacists with a useful and easy-to-use tool for recording DRPs and clinical interventions. Results from the trial have provided a better understanding of the frequency and nature of clinical interventions performed in Australian community pharmacies, and lead to a national implementation of the system.
KeywordsDocumentation system Australia Classification system Drug-related problems Clinical interventions Pharmacy interventions
The researchers would like to acknowledge the participating pharmacists and additional people who worked on the project (especially Josie Hughes, Colin Curtain, Dr Shane Jackson, Dr Luke Bereznicki, Lauren Ellerton, Traycee Di Virgilio, Les Vincent, and Peter Brownscombe).
The research was funded by the Australian Government Department of Health and Ageing as part of the Third and Fourth Community Pharmacy Agreement Research and Development Programs managed by the Pharmacy Guild of Australia.
Conflicts of interest
The authors declare there are no conflicts of interest that may involve the subject matter of the manuscript and compromise its integrity.
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