Nature and frequency of drug-related problems in self-medication (over-the-counter drugs) in daily community pharmacy practice in Germany
Nature and frequency of drug-related problems in self-medication (over-the-counter drugs) in daily community pharmacy practice in Germany
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DOI：
10.1002/pds.2241
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发表时间：
2012-03-01
影响因子：
2.6
通讯作者：
Schulz, Martin
中科院分区：
文献类型：
--
作者：
Eickhoff, Christiane;Haemmerlein, Andrea;Schulz, Martin
目的量化德国社区药剂师(CP)在发放药物时发现的自我用药(非处方药)中的药物相关问题(DRP)。方法要求100名社区药剂师以标准化的文件形式记录100名连续出现症状或要求非处方药的客户。对于评估设定的目标，10000次相遇的次数似乎是合理的。对于每一次接触，诸如年龄、性别、第一次或重复请求以及药房中可获得的患者档案(包括服药史)等数据都被记录在案。此外，还记录了已确定的DRP、问题描述和解决方案。结果109个CPS共记录了12567次识别DRP的事件，占所有病例的17.6%。四种适应症占所有DRP的70%以上：疼痛、呼吸道、胃肠道和皮肤疾病。在所有已确定的DRP中，近75%由4个DRP负责：自我用药不当(29.7%)、请求产品不当(20.5%)、预期用药时间过长(包括滥用)(17.1%)和错误剂量(6.8%)。如果有服药史，错误剂量(p<；0.001)和药物-药物相互作用(p<；0.001)的病例明显更多。所有确诊的DRP患者都得到了相应的咨询。此外，最常见的干预措施是转诊到医生(39.5%)和改用更合适的药物(28.1%)。结论在近五次接触中，药剂师和患者关于自我用药的直接互动揭示了相关的DRP。访问患者档案，包括处方药和非处方药的数据，可能会增加患者的安全。版权所有(C)2011 John Wiley&Sons，Ltd.
Purpose To quantify drug-related problems (DRPs) in self-medication (over-the-counter [OTC] drug use) identified by community pharmacists (CPs) in Germany at the time the drug is dispensed.Methods One hundred CPs were asked to document 100 consecutive customers presenting symptoms or requesting OTC drugs using a standardized documentation form. The number of 10 000 encounters seemed reasonable to evaluate the set objective. For each encounter, data such as age, sex, and first or repeated request and the availability of a patient file in the pharmacy including drug history were documented. Furthermore, identified DRPs, problem descriptions, and solutions were documented. Data were transcribed electronically, coded, checked for validity, and analyzed.Results In total, 109 CPs documented 12 567 encounters identifying DRPs in 17.6% of all cases. Four indications comprised more than 70% of all DRPs: pain, respiratory, gastrointestinal, and skin disorders. Four DRPs were responsible for almost 75% of all DRPs identified: self-medication inappropriate (29.7%), requested product inappropriate (20.5%), intended duration of drug use too high including abuse (17.1%), and wrong dosage (6.8%). If a drug history was available, significantly more cases with wrong dosage (p< 0.05) and drug-drug interactions (p< 0.001) were detected.All patients with identified DRPs were counseled accordingly. Furthermore, the most frequent interventions were referral to a physician (39.5%) and switching to a more appropriate drug (28.1%).Conclusions In nearly one of five encounters, a direct pharmacist-patient interaction about self-medication revealed relevant DRPs. Having access to patient files including data on prescription and OTC drugs may increase patient safety. Copyright (C) 2011 John Wiley & Sons, Ltd.