Background and importance Medication treatment of cardiovascular disease (CVD) commonly consists of multiple drugs in long-term use, which efficiently reduces mortality and morbidity. Optimal treatment is often not achieved due to poor adherence and drug-related problems (DRPs). DRPs are defined as “an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes”. Medicine Start Service (MSS) is a government-funded pharmacy service, free of charge for all patients with a new CVD medication, that aims to improve patient safety. Patients are offered two consultations with a pharmacist, focusing on DRPs and beliefs and concerns about their new medication. Whether MSS is efficient to detect DRPs is unknown.
Aim and objectives To assess the number and nature of DRPs detected during MSS consultations, and to map out how pharmacists followed up those DRPs.
Material and methods A prospective, uncontrolled, multicentre, intervention study was conducted from September 2019 to February 2021 in three pharmacies based in different hospitals. Adult patients filling a first-time prescription for one or more CVD medications were offered a consultation with a pharmacist 1–2 and 3–5 weeks after initiating treatment. The consultation was conducted in the pharmacy or by telephone and followed the national MSS semi-structured interview guide. DRPs were registered and classified into seven different categories according to a modification of the system developed by Ruths et al.
Results A total of 67 patients completed consultation 1 and 2. Pharmacists detected 83 and 67 DRPs in consultation 1 and 2, respectively. DRPs related to adverse drug reactions (ADR) were most frequent (41.3%), followed by lack of knowledge about medication and disease (21.3%) and medicine use (12.0%). The pharmacists followed up 90.1% of the DRPs independently, most frequently by giving advice and counselling (60.1%), and conferred or referred to a doctor in 9.9% of cases.
Conclusion and relevance Pharmacists detected relevant DRPs in a majority of patients with newly started CVD medicines, including ADRs and problems related to medicine use. Early detection of such problems may be of importance for patient safety in the critical phase of transition from hospital to community.
References and/or acknowledgements 1. Ruths S, Viktil KK, Blix HS. Classification of drug-related problems. Tidsskr Nor Laegeforen 2007;127:3073–3076.
Conflict of interest No conflict of interest
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