Community pharmacists' documentation of intervention on drug related problems of elderly patients

Few empirical investigations have documented pharmacists interventions with physicians and patients. This research describes community pharmacists' documentation of efforts to assess drug use of elderly patients who were on chronic drug therapies and to correct problems. Fifty-seven Florida community pharmacists trained to identify elderly patients 'at risk' for medication problems reported on each patient targeted for drug therapy assessment. Reports indicated the drug-related problems identified and the effectiveness of each intervention. The likelihood of identifying problems in targeted patients varied among the pharmacists, however, they reported considerable success in having recommendations accepted by physicians (accepted in 76% of the cases and rejected in 24%). In 631 reports on 487 different patients, 35% indicated no drug-related problem and 65% indicated that a problem was identified. On identified problems, 35% interventions were initiated with a prescribing physician. Four percent were interventions with the physician only - not the patient. Problems included noncomplicance (22% of all identified); drug side effects (17%); drug-drug interactions (13%); and misunderstanding regimens (8%). Logistic regression analysis revealed significant relationships between the likelihood of pharmacist interventions and specific pharmacist characteristics such as lower levels of job satisfaction, less perceived control over the amount of patient counseling done, greater confidence in patient communication skills, and more positive perception of having enough time to consult with physicians when drug-related problems are identified in patients. Pharmacists feeling more confident in their consulting skills and who seem more active in uncovering potential problems in patients may also be those who are more disillusioned about the constraints of their actual work environment.

Duke Scholars

Author Jane Frances Pendergast Biostatistics & Bioinformatics, Division of Biostatistics