Review of computerised patient medication records to determine potential clinical interventions in community pharmacy

摘要

The potential intervention rate for cardiovascular drugs dispensed in community pharmacy was investigated by a retrospective study of 300 patient medication records (PMRs) collected from 10 community pharmacies in Sydney, Australia. A medication review protocol and operational definitions were developed for 17 types of clinical intervention and three levels of clinical significance. Spearman's correlation coefficient (rs) was used to examine the relationship between total number of potential interventions and predictor variables. From 5,271 medications dispensed, 1,509 (28.6 per cent) potential interventions were identified. The most frequent types of potential intervention were precautions (27.6 per cent), overutilisation (17 per cent) and dose discrepancy (16.3 per cent). Of the interventions classified as being of major clinical significance, 61.3 per cent were precautions, 19.7 per cent drug interactions and 19 per cent contraindications. The cardiovascular drug classes with the highest potential intervention rate were inotropics (93.2 per cent) and anticoagulants (89.5 per cent). There was a statistically significant correlation between the number of potential interventions per patient and the total number of medications dispensed per patient (rs=0.68,P<0.001), the total number of cardiovascular drugs dispensed per patient (rs=0.67,P<0.001) and the number of different prescribing doctors per patient (rs=0.29,P<0.001). This study demonstrates the potential for community pharmacists to review computerised PMRs and intervene in patients' drug therapy, thereby reducing iatrogenic problems and improving health outcomes for patients.