Onderzoek naar prescriptie-interventies in een openbare apotheek

Objective: To describe the frequency, nature, determinants and clinical relevance of prescription modifications in a Dutch community pharmacy. Design: A descriptive, retrospective study of the documented prescription modifications during dispensing in 2007. Methods: The frequency and nature of prescription modifications and their patient, drug and prescriber related determinants were assessed. To examine the clinical value of pharmacists' interventions, each prescription modification was rated from A to D (A is clinically irrelevant, D is clinically relevant with possible fatal consequences for the patient). Results: In 2007, on average, one intervention was documented per workday. Almost 50% of all interventions concerned dose corrections. Prescriptions for incidental medications, children (0-20 year) and patients with less than four other medications, had a higher chance of modification. A higher chance of prescription modifications was found in anti-infective agents for systemic use, in treatments for the central nervous system and the sensory organs. Verification and attentiveness to the prescriptions of these risk groups can reduce (serious) clinical consequences. Of all prescription modifications 86% were clinically relevant (groups B, C and D) and every ten days at least one harmful clinical incident was prevented by prescription modifications. Conclusions: Modifications of prescriptions by pharmacists vary in nature from clinically irrelevant to potentially fatal. Analysis of documented interventions in one community pharmacy allows identification of patients who are at risk and need more attention from prescribing physicians. It also shows that pharmacists' interventions have a positive impact on patients' health