Assessment of Pharmacist-Initiated Intervention in Drug Therapy Management in Community Settings

Abstract

Aims: Pharmacists often focus more on dispensing medications in community pharmacies rather than offering extended pharmaceutical services such as patient counseling, prescription screening and health monitoring. This enables their role in addressing drug-related problems (DRPs), which can lead to adverse outcomes in patient care. Pharmacist-led interventions have shown potential in enhancing therapeutic outcomes through early identification and resolution of DRPs. Study Design: Prospective interventional study Place and Duration of Study: The study was conducted in a selected community pharmacy located in Mysuru city over a period of nine months August 2018 to May 2019. Methodology:  Patients aged 18 and above who visited the pharmacy were included in the study. Data were collected through patient interviews and prescription reviews. Drug-related problems were identified using Charles D. Hepler and Linda Strand’s classification system and analyzed using Medscape and Micromedex mobile applications. Data about drug-related problems were subjected to analysis of various parameters such as type of DRP, incidence, disease conditions, class and individual drugs implicated in DRPs, which was analyzed using descriptive statistics. Results: Out of 500 prescriptions reviewed, 100 drug-related problems were identified. Drug-drug interactions (6%) and adverse drug reactions (5%) were the most common DRPs. Among 32 identified DDIs, 94% were of minor severity and primarily pharmacokinetic in nature. Risk factors significantly associated with DRPs included advanced age, presence of comorbid conditions, polypharmacy and increased dosing frequency (p < 0.05). Conclusion: The overall incidence of DRPs was high in the community setting. Patients with advanced age, comorbid conditions, and use of multiple medication were at greater risk of developing drug related problems. Community pharmacists' role in identifying DRPs early and implementing targeted interventions to improve medication safety. Continuous involvement in routine patient counselling and medication review can significantly reduce preventable drug-related issues.