In today’s health care system, pharmacy practice is evolving from a product oriented model (the prescription) to one that involves patient centered medication management.

In this new system, pharmacists are looking to optimize patient drug therapy by identifying and resolving medication related problems (MRP) leading to more positive health outcomes.

In beginning the discussion of this issue, let’s define what we mean by a medication related problem.

Medication related problems are unexpected events that result when taking medications.

A simple example is what is known as an adverse drug reaction, such as becoming drowsy when taking an antihistamine.

Medication Related Problems can be classified into 4 basic categories:

  • Indication
  • Safety
  • Efficacy
  • Adherence

 

Below you will find some common examples in each of these categories.

INDICATION:

  • Duplicate therapy: The patient is taking multiple medications to manage the same condition
  • Lack of therapy: The patient may have a medical condition for which no drug therapy is being taken.

 

SAFETY:

  • Dose used is too high: Is the medication dose appropriate fro the patient’s age, sex, condition, organ function and genetic profile?
  • Overdosage: Is the patient taking too much of the medication
  • Are there drug-drug or drug-food interactions and adverse drug events that can be prevented
  • High Risk Medications: Does the medication pose specific risks of adverse drug events in our elderly population

 

EFFICACY:

  • Dose too low: Is the dose not adequate to manage patient condition/symptoms
  • Drug selection: Is there a more effective drug that can be used to treat the patient condition/symptoms

 

ADHERENCE:

  • Failure to receive therapy: Is the patient taking/refilling their medication consistently and what might be obstacles to this
  • Over utilization: Is the patient using too much of the medication
  • Administration issues: Is the medication being given by the correct route
  • Cost: Can the patient afford their medication.

 

Many articles have been written about questions to ask your doctor and pharmacist when you receive a new prescription. Begin the discussions with these 4 areas in mind.

Your concerns be addressed quickly, preventable medication related problems will be reduced, your medication therapy benefits will be maximized, you will create stronger relationships with your healthcare providers and have better health outcomes.

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