Use of medication profiles to detect potential therapeutic problems in ambulatory patients

Abstract

The effect of using a patient medication profile on the pharmacist's ability to detect potential therapeutic problems in ambulatory patients was studied. Phase I of the study consisted of obtaining and recording patient information on medication profile cards. Data were collected on 23,657 prescriptions representing 14,069 patients. During Phase I, the pharmacist did not utilize the medication profile cards to detect potential therapeutic problems. Phase II consisted of the detection (using the medication profile cards) and recording of potential therapeutic problems for 25,197 prescriptions representing 14,975 patients. Phase I data were compared with Phase II results. In Phase II, 1,497 potential therapeutic problems were identified, compared to only 13 potential therapeutic problems in Phase I. The incidence of detection of potential problems was 5.8% in Phase II and 0.1% in Phase I (a statistically significant difference). Over 65% of the total therapeutic problems in Phase n resulted from potential patient over-utilization of medications while 22% resulted from potential patient under-utilization. Data are presented to show the relationship between (1) potential therapeutic problems detected in new and refill prescriptions, (2) the method of financing prescription payment and patient utilization of drugs, (3) therapeutic drug classification and patient utilization of drugs, and (4) potential therapeutic problems and various patient age groupings. Patient medication profiles, when properly utilized by the pharmacist, demonstrated their effectiveness in aiding in the detection of potential therapeutic problems.