The status of the performance of medication reviews in German community pharmacies and assessment of the practical performance

Abstract

Background Pharmacist-led medication reviews have shown to prevent drug-related problems (DRPs). So far, data is rare about the implementation in routine care, the conditions for intensifying this service and the practical skills of community pharmacists to perform medication reviews. Objective To assess the current status of medication review implementation in German community pharmacies and the performance of identifying DRPs in a ficticious patient example. Setting German community pharmacies. Method An online survey was conducted from July to September 2015 including questions about medication reviews currently performed in routine care of community pharmacies and hidden DRPs in a ficticious patient example. Pharmacists were invited via newsletters from three local chambers of pharmacists. Main outcome measure (i) Frequency, conditions for implementation, and criteria of medication reviews currently being performed in routine care, (ii) requested further information to perform medication reviews, and (iii) proportion of pharmacists who identify DRPs in the patient example. Results A total of 143 community pharmacists completed the questionnaire. (i) One hundred and twenty-seven respondents (89 %) reported reviewing the medication regularly in routine care, whereas 56 (39 %) stated that they performed medication reviews between one and five times monthly. For 124 pharmacists (87 %), remuneration would be a necessary condition for performing medication reviews more frequently. When reviewing the medication, 112 (78 %) of the pharmacists considered the criterion 'drug-drug interactions' and 107 (75 %) reviewed the criterion 'correct dosage'. One of the least reviewed criteria was 'effectiveness of medication' [22 (16 %)]. (ii) According to the participants, laboratory values should be available in the community pharmacy, since 87/143 (61 %) would appreciate the GFR and the HbA1c level. Twenty-two of 54 respondents (41 %) would appreciate further administration instructions and 5 of 54 (15 %) think they would benefit from information about the recommended duration of drug use. (iii) Depending on the category, 4 (3 %) to 49 (34 %) of all 143 pharmacists identified the hidden DRP in the patient example. Conclusion German community pharmacists reported reviewing the medication of their patients regularly; however, most of the respondents review the medication very rarely in routine care. Consequently, their practical performance needs to be improved.

Prevalence and risk factors of drug-related problems identified in pharmacy-based medication reviews

“…Although pharmacy-based medication reviews provide a systematic means to identify and resolve DRPs, they are still rare in routine care in Germany [15]. During the dispensing process, DRP detection is restricted to drugs dispensed at that time [16][17][18][19].…”

Pharmacist-led medication reviews for geriatric residents in German long-term care facilities

“…The potential influence of the training may also explain the good results concerning the identification of PIM since it was one of the main topics during the pharmacists’ training in this study. Greissing et al found a lower agreement rate between DRPs identified by untrained German community pharmacists and predefined DRPs in a fictitious patient example [29]. In that study, 97% of 143 participating pharmacists did not identify PIM.…”

Evidence-based self-medication: development and evaluation of a professional newsletter concept for community pharmacies

“…In the survey period, 1975 persons subscribed to the professional newsletter. On the basis of response rates in other online surveys among community pharmacists in Germany [24,25], we aimed to reach a sample size of at least 8-10% of all subscribers.…”