Characterization of drug-related problems and associated factors in ambulatory patients in China.

Abstract

This study aimed to investigate the prevalence and the type of drug-related problems (DRPs) in ambulatory patients and identify factors that may be associated with risk of DRPs. Consecutive patients were enrolled from pharmacist outpatient clinics between January 2018 and June 2019. The pharmacists performed a comprehensive assessment of the patient's drug therapy. The DRPs and recommendations were evaluated using the DOCUMENT classification system. The study population consisted of 248 patients with a mean age of 72.55±6.29. The patients had a mean of 7.55±4.72 ongoing medications during patients' routine clinic visits. A total of 1188 DRPs were identified during the study period. An average of 4.79 DRPs per patient was detected. Sixty-two different traditional Chinese patent medicines (TCPMs) contributed to 102 DRPs. Drug selection (24.9%) was the most common DRP followed by under treated (24.2%) and monitoring needed (24.2%). The number of medications taken was the significant factor for DRPs. Pharmacists made 1092 recommendations to address the DRPs (an average 0.92 recommendations per DRP). A change in therapy was the most common recommendation (43.6%), followed by the category 'monitoring' (28.6%). The overall acceptance rate of clinical pharmacist recommendations was 88.7%. More than a half (51.6%) of all interventions were assigned a moderate level of clinical significance. Drug-related problems were commonly observed among ambulatory Chinese patients. Clinical pharmacists had a valuable role to play in identifying and solving the DRPs.