RESEARCH ARTICLE: An educational intervention to improve the ability of community pharmacists in Sri Lanka to detect drug related problems
DOI:
https://doi.org/10.46542/pe.2020.201.357364Keywords:
Educational workshop, community pharmacists, drug related problems, medication safety, prescriptions.Abstract
Background: Drug related problems (DRPs) in prescriptions could result in patient harm. Objective: To assess the effectiveness of an educational workshop on detecting DRPs in prescriptions by a cohort of community pharmacists.
Methods: Pharmacists working in a large community pharmacy chain in Sri Lanka were invited for an educational workshop on detecting DRPs in prescriptions. Participants were asked to review three mock prescriptions containing hypothetical DRPs before the workshop. After an interactive teaching session, pharmacists were asked to review the same three prescriptions again.
Results: All pharmacists who attended the workshop (N=58) participated. The mean score for detecting DRPs per pharmacist at pre-assessment was 5.3±2.1 which increased to 8.5±1.7 at post-assessment (p<0.001).
Conclusion: An educational intervention improved the community pharmacists’ ability to detect DRPs related to completeness and legality of prescriptions but failed to make a significant impact on detecting serious pharmacological issues like medicine duplications and interactions.
References
Amaka, E.Y., Sunday, N.O., Chukwuanugo, O.N., John, U.O., Emmanuel, I.E., & Mathew O.J. (2015). Drug related problem (DRP) identification and resolution among healthcare professionals working in the emergency and intensive care units of a Nigerian teaching hospital. World Journal of Pharmacy and Pharmaceutical Sciences, 4(5), 47-60
Blenkinsopp, A., Bond, C., & Raynor, D.K. (2012). Medication reviews. British Journal of Clinical Pharmacology, 74(4), 573-580. https://doi.org/10.1111/j.1365-2125.2012.04331.x
Cunningham, G., Dodd, T.R., Grant, D.J., McMurdo, M.E., Michael, R., & Richards, E. (1997). Drug-related problems in elderly patients admitted to Tayside hospitals, methods for prevention and subsequent reassessment. Age and Ageing, 26(5), 375-382. https://doi.org/10.1093/ageing/26.5.375
Currie, J.D., Chrischilles, E.A., Kuehl, A.K., & Buser, R.A. (1997). Effect of a training program on community pharmacists' detection of and intervention in drug-related problems. Journal of the American Pharmaceutical Association, 37(2), 182-191. https://doi.org/10.1016/S1086-5802(16)30203-0
Gandhi, T.K., Weingart, S.N., Borus, J., Seger, A.C., Peterson, J., Burdick, E., Seger, D.L., Shu, K., Federico, F., Leape, L.L., & Bates, D.W. (2003). Adverse drug events in ambulatory care. New England Journal of Medicine, 348(16), 1556-1564. https://doi.org/10.1056/NEJMsa020703
Hammerlein, A., Griese, N., & Schulz, M. (2007). Survey of drug related problems identified by community pharmacies. Annals of Pharmacotherapy, 41(11), 1825-1832. https://doi.org/10.1345/aph.1K207
Jamal, I., Amin, F., Jamal, A., & Saeed, A. (2015). Pharmacist's interventions in reducing the incidences of drug related problems in any practice setting. International Current Pharmaceutical Journal, 4(2), 347-352. https://doi.org/10.3329/icpj.v4i2.21483
Kimberlin, C.L., Berardo, D.H., Pendergast, J.F., & McKenzie, L.C. (1993). Effects of an education program for community
pharmacists on detecting drug-related problems in elderly patients. Medical Care, 451-468. https://doi.org/10.1097/00005650-199305000-00007
Kjeldsen, L.J., Nielsen, T.R.H., & Olesen, C. (2017). Investigating the relative significance of drug-related problem categories. Pharmacy, 5(2), 31. https://doi.org/10.3390/pharmacy5020031
Kohn, M.A., & Senyak, J. (2018). Sample Size Calculators. UCSF CTSI. 19 August 2020. Available at: https://www.sample-size.net/
Kováčová, B., & Ďurišová, A. (2016). Drug-related problems identified by pharmacist-led medication review in Slovak hospitalised patients. Die Pharmazie, 71(9), 548-551
Krähenbühl-Melcher, A., Schlienger, R., Lampert, M., Haschke, M.,Drewe, J., & Krähenbühl, S. (2007). Drug related problems in hospitals. a review of the recent literature. Drug Safety, 30(5), 379-407. https://doi.org/10.2165/00002018-200730050-00003
Mamunuwa, G.N., & Dorabawila, B.M. (2014). The need for clinical pharmacy services in Sri Lanka; a study based on the prevalence of drug related problems in two hospitals. International Journal of Scientific and Research Publications, 4(9), 2250-3153
Mamunuwa, N., Jayamanne, S., Coombes, J., De Silva, A., Lynch, C., & Wickramasinghe, D. (2016). . Drug related problems among patients with diabetes; a descriptive analysis of data from an urban hospital in Sri Lanka. Paper presented at the 17th International Postgraduate Research Conference, Colombo, Sri Lanka, December 8-9, 2016
Nicolas, A., Eickhoff, C.,Griese-Mammen, N., & Schulz, M. (2013). Drug related problems in prescribed medicines in Germany at the time of dispensing. International Journal of Clinical Pharmacy, 35(3), 476-482. https://doi.org/10.1007/s11096-013-9769-9
Paulino, E.I., Bouvy, M.L., Gastelurrutia, M.A., Guerreiro, M., & Buurma, H. (2004). Drug related problems identified by European community pharmacists in patients discharged from hospital. Pharmacy World and Science, 26(6), 353-360
PCNE [Pharmaceutical Care Network Europe]. (201). Classification for Drug Related Problems. The PCNE Classification V8. 01. Available at: https://www.pcne.org/upload/files/215_PCNE_classification_V8-01.pdf
Perera, D.M.P., Coombes, J.A., Shanika, L.G.T., Dawson, A., Lynch, C., Mohamed, F., et al. (2017). Opportunities for pharmacists to optimise quality use of medicines in a Sri Lankan hospital: An observational, prospective, cohort study. Journal of Pharmacy Practice and Research, 47(2), 121-130. https://doi.org/10.1002/jppr.1302
Rathish, D., Bahini, S., Sivakumar, T., Thiranagama, T., Abarajithan, T., Wijerathne, B., et al. (2016). Drug utilization, prescription errors and potential drug-drug interactions: an experience in rural Sri Lanka. BMC Pharmacology and Toxicology, 17(1), 27. https://doi. org/10.1186/s40360-016-0071-z
Sakeena, M.H.F., Bennett, A.A., & McLachlan, A.J. (2019). The Need to Strengthen the Role of the Pharmacist in Sri Lanka: Perspectives. Pharmacy, 7(2), 54. https://doi.org/10.3390/pharmacy7020054
Shanika, L.G.T., Jayamanne, S., Coombes, J., Coombes, I., & Wijekoon, C.N. (2016). Adverse Drug reactions and associated factors in a cohort of Sri Lankan patients with non-communicable chronic diseases. Pharmaceutical Journal of Sri Lanka, 6, 2-8. https://doi.org/10.4038/pjsl.v6i0.9
Shanika, L.G.T., Jayamanne, S., Wijekoon, C.N., Coombes, J., Perera, D., Mohamed, F. et al. (2018). Ward-based clinical pharmacists and hospital readmission: a non-randomized controlled trial in Sri Lanka. Bulletin of the World Health Organisation, 96(3), 155-164. https://doi.org/10.2471/BLT.17.198366
Thirumagal, M., Ahamedbari, M.A.R., Samaranayake, N.R., & Wanigatunge, C.A. (2017). Pattern of medication errors among inpatients in a resource-limited hospital setting. Postgraduate Medical journal, 93(1105), 686-690. https://doi.org/10.1136/postgradmedj-2017-134848
Westerlund, T., Almarsdóttir, A.B., & Melander, A. (1999). Drug- related problems and pharmacy interventions in community practice. International Journal of Pharmacy Practice, 7(1), 40-50. https://doi.org/10.1111/j.2042-7174.1999.tb00947.x
WHO [World Health Organisation]. (2011). Joint FIP/WHO guidelines on good pharmacy practice: standards for quality of pharmacy services. WHO Technical Report Series, No.961. Available at: https://gmpua.com/GPP/GPPen.pdf
Zekan, L., Mestrovic, A., Perisin, A. S., Bukic, J., Leskur, D., Rusic, D. et al. (2020). Improving community pharmacists' clinical knowledge to detect and resolve drug-related problems in Croatia: a before/after survey study investigating the efficacy of an educational intervention. BMJ Open, 10(6), e034674. https://doi.org/10.1136/bmjopen-2019-034674