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Relationship between drug-related problems and health outcomes: a cross-sectional study among cardiovascular patients

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Abstract

Objective To describe drug-related problems (DRPs) and expense problems (EPs) identified by a standardised community pharmacist-based medication review (MR) program among Swiss cardiovascular outpatients (56–75 years old) and to evaluate the need for collaborative pharmacy practice to achieve economic, clinical and humanistic outcomes. Setting A pilot population of 85 cardiovascular outpatients who were customers of 14 community pharmacies (members of the pharmacieplus virtual chain) and insured with Groupe Mutuel health insurance. Method Cross-sectional study of a structured medication review program, conducted by 11 pharmacists in collaboration with 61 general practitioners (GPs), with patient interviews and access to medical data. Main outcome measure Numbers and types of DRPs and EPs within the study population and odds ratios between them, as well as economic, clinical and humanistic outcomes. Results Of the included patients, 91% had at least one DRP or EP. The odds ratios indicated that not being exposed to DRPs was associated with a higher chance of reaching the clinical target (OR: 3.4; IC95%:1.1–10.5; P = 0.01), of having a better physical quality of life than the median (OR: 2.5; IC95%:0.9–7.3; P = 0.05) and having lower total health care costs (OR: 3.2; IC95%:1.1–9.8; P = 0.02). Conclusions This cross-sectional study shows that the control of cardiovascular risk factors, quality of life and healthcare costs are statistically related to the presence of DRPs detected by a community pharmacist-based MR program.

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Notes

  1. Cardiotonic agents (C01A), antiarrhythmic agents (C01C), beta-blocking agents (C07), nitrates and nitrites (C01D), miscellaneous dilating agents (C01C), Ca-channel blockers (C08), antihypertensive agents (C02 + C09), diuretics (C03), antivitamin K agents (B01AA), platelet aggregation inhibitors (B01AC), lipid-lowering agents (C10).

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Acknowledgments

We are grateful to the voluntary participating community pharmacists and GPs; to Prof. Rob Horn for letting us use the MARS-5© and to J.-M. Krähenbühl and the virtual chain pharmacieplus for supporting this university research in community pharmacy practice.

Funding

This pilot study was funded by the virtual chain of independent pharmacists pharmacieplus.

Conflict of interests

None to declare.

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Authors and Affiliations

  1. School of pharmaceutical sciences, University of Geneva, University of Lausanne, Community Pharmacy, Pharmacie de la PMU, 44 Rue du Bugnon, 1011, Lausanne, Switzerland

    Anne Niquille & Olivier Bugnon

  2. Ambulatory Care and Community Medicine Department (PMU-Lausanne), Community Pharmacy Practice Unit, Pharmacie de la PMU, 44 Rue du Bugnon, 1011, Lausanne, Switzerland

    Olivier Bugnon

Authors
  1. Anne Niquille
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  2. Olivier Bugnon
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Correspondence to Anne Niquille or Olivier Bugnon.

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Niquille, A., Bugnon, O. Relationship between drug-related problems and health outcomes: a cross-sectional study among cardiovascular patients. Pharm World Sci 32, 512–519 (2010). https://doi.org/10.1007/s11096-010-9401-1

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  • DOI: https://doi.org/10.1007/s11096-010-9401-1

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