Table 3 Causes of the DRPs according to the PCNE classification V9.1
Code | Detailed classification a | Perioperative DRPs | Nonperioperative DRPs | ||
|---|---|---|---|---|---|
n = 144 | n = 124 | ||||
n (%) | Example (n) | n (%) | Example (n) | ||
C1 | Drug selection | 105 (72.9) | 57 (46.0) | ||
C1.1 | Inappropriate drug according to guidelines/formulary | 105 (72.9) | Taking ACEI/ARB increased the hypotension risk during the perioperative period (75) | 21 (16.9) | Irrational self-medication with herbal products (7) |
C1.2 | No indication for drug | - | - | 6 (4.8) | Taking aspirin as a supplement for health protection (4) |
C1.3 | Inappropriate combination of drugs, or drugs and herbal medications, or drugs and dietary supplements | - | - | 1 (0.8) | The combination of zopiclone and estazolam for insomnia in a 63-year-old patient (1) |
C1.5 | No or incomplete drug treatment in spite of existing indication | - | - | 29 (23.4) | The unknown presence of or incompletely treated diabetes before admission (14) |
C2 | Drug form | 28 (19.4) | - | ||
C2.1 | Inappropriate drug form/formulation (for this patient) | 28 (19.4) | Taking nifedipine controlled-release tablets that are unsuitable for nasogastric tube administration (18) | - | - |
C7 | Patient related | 11 (7.6) | 63 (50.8) | ||
C7.1 | Patient intentionally uses/takes less drug than prescribed or does not take the drug at all for whatever reason | 11 (7.6) | Self-discontinuation of chronic medications before admission for fear of affecting the surgery and preoperative examinations (11) | 25 (20.2) | Poor adherence due to forgetfulness or fear of adverse drug reactions (23) |
C7.5 | Patient takes food that interacts | - | - | 1 (0.8) | Drinking a lot of porridge every day which leads to poor glucose control (1) |
C7.6 | Patient stores drug inappropriately | - | - | 8 (6.5) | Keeping the in-use insulin pen along with the needle refrigerated (2 to 8 °C) (8) |
C7.7 | Inappropriate timing or dosing intervals | - | - | 18 (14.5) | Inappropriate time of taking diabetes medications (9) |
C7.8 | Patient unintentionally administers/uses the drug in a wrong way | - | - | 10 (8.1) | No resuspending before using the premixed insulin pen (1). |
C7.9 | Patient physically unable to use drug/form as directed | - | - | 1 (0.8) | Cannot split the small tablets of medications in half (1). |
C9 | Other | - | 4 (3.2) | ||
C9.1 | No or inappropriate outcome monitoring (incl. TDM) | - | - | 4 (3.2) | The self-monitoring of blood glucose not including a postprandial 2 h glucose (1) |