Impact of a community pharmacist-led medication review on medicines use in patients on polypharmacy - a prospective randomised controlled trial

Table 3 Drug-related problems addressed during PMC at T-0 in intervention group (N = 258)

	N	%
Drug-related problems
Potential	149	58
Manifest	109	42
Urgency rated by the study pharmacist
High	36	14
Medium	113	43
Low	109	43
Recommendation accepted by patient
Yes	219	85
No	25	10
Unclear	14	5
Causes of pharmacists’ interventions
Insufficient adherence	69	26.7
Patient needs information about safe and effective use of his medicines	50	19.4
Patient needs information about potential medicines’ adverse drug reaction	19	7.4
Inappropriate timing or frequency of administration	18	7.0
Under-dosed therapy	15	5.8
Drug-drug/drug-food interaction	14	5.4
Adverse effect	12	4.7
Inappropriate therapy duration	10	3.9
Inappropriate drug administration	9	3.5
Patient needs information about lifestyle, nutrition or empowerment	8	3.1
Not received treatment	7	2.7
More cost-effective therapy available	5	1.9
No concordance with guidelines or contraindication	4	1.6
No dose adjustment because of pathological changes (renal/liver failure)	4	1.6
Not indicated drug or duplication	3	1.2
Incomplete patient documentation	3	1.2
Over-dosed therapy	3	1.2
Prescribed drug not available	2	0.8
Inappropriate monitoring	1	0.4
Not classifiable	2	0.8
Description of pharmacist's interventions
Counseling of patient, training	152	58.9
Optimisation of administration	40	15.5
Information to other caregivers	24	9.3
Dose adjustment	12	4.7
Substitution of a therapy	10	3.9
Therapy started/restarted	7	2.7
Therapy stopped	7	2.7
Therapy monitoring	3	1.2
Clarification in the patient history	2	0.8
Not classifiable	1	0.4

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