Abstract
To investigate whether pharmacist interviews of hospitalised patients about their medication would result in identification of more drug-related problems (DRPs) than those found by usual care procedures and further to characterise the DRPs revealed at the interviews. Patients from five internal medicine and two rheumatology departments in four hospitals in Norway were prospectively included in the study. Clinical pharmacists assessed DRPs by reviewing medical records and by participating in multidisciplinary team discussions. Drugs used, medical history, laboratory data and clinical/pharmacological risk factors were recorded (usual care procedure). A proportion of patients were randomly selected for interview with pharmacists. A quality team assessed the clinical significance of the DRPs. Seven hundred and twenty seven patients were included. Significantly more DRPs were found in the interview group (96 patients), an average of 4.4 DRPs per patient as compared to 2.4 DRPs in the non-interview group (631 patients) (p < 0.01). Of a total of 431 DRPs recorded in the interview group, 168 DRPs (39.9%) were disclosed through interviews. 'Need for additional drug', 'medical chart error', 'patient adherence' and 'need for patient education' were significantly more often recorded in this group. The quality team assessed 63% of the DRPs revealed in the interviews to be of major clinical significance. Significantly more DRPs were identified among the patients who were interviewed compared to those patients having only usual care examination. A high proportion of the DRPs identified in the interviews were of major clinical significance. The clinical pharmacists, with their way of interviewing, seem to fill a gap, ensuring that significant DRPs do not escape detection.
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