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Article ; Online: Evaluation of drug-related problems in older polypharmacy primary care patients.

Kovačević, Sandra Vezmar / Miljković, Branislava / Ćulafić, Milica / Kovačević, Milena / Golubović, Bojana / Jovanović, Marija / Vučićević, Katarina / de Gier, Johan J

Journal of evaluation in clinical practice

2017 Volume 23, Issue 4, Page(s) 860–865

Abstract: Aims and objectives: Targeting older patients with predictive factors for drug-related problems (DRPs) could make clinical medication reviews more cost-effective. The aim of this study was to identify the number, type, and potential predictive factors ... ...

Abstract	Aims and objectives: Targeting older patients with predictive factors for drug-related problems (DRPs) could make clinical medication reviews more cost-effective. The aim of this study was to identify the number, type, and potential predictive factors for DRPs in older polypharmacy patients. Methods: Community pharmacists performed clinical medication reviews and documented DRPs, types of interventions, and their implementation in older patients. Results: Three hundred eighty-eight medication reviews were analyzed, 964 DRPs (average 2.5 ± 1.9), and 1022 interventions (average 2.6 ± 2.0) were identified. The overall implementation rate of interventions was 70.1%, the highest was observed in interventions aiming to resolve the lack of therapy monitoring (86.8%). Patients with ≥12 medications had an increased risk of ≥5 DRPs (P < .001). Asthma was associated with lack of adherence (P = .002), lack of aspirin, statins, and proton pump inhibitors use with additional therapy needed (P = .002-.004). Predictive factors for drug interactions were antihypertensive medications and/or medications with narrow therapeutic index (P < .05). Lack of efficacy was associated with diabetes (P = .006). Nonsteroidal anti-inflammatory drugs were risk factors for inappropriate drug selection (P = .002). Lack of monitoring was associated with hypertension (P = .013), whereas benzodiazepines (P < .001) and aspirin (P = .021) were overused. Conclusion: Patients with asthma, hypertension, and diabetes and lack of statin, antithrombotic agent, and/or proton pump inhibitor use were associated with higher risks for DRPs.
Language	English
Publishing date	2017-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1327355-3
ISSN	1365-2753 ; 1356-1294
ISSN (online)	1365-2753
ISSN	1356-1294
DOI	10.1111/jep.12737
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Zs.A 4464: Show issues

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Article ; Online: Elderly polypharmacy patients' needs and concerns regarding medication assessed using the structured patient-pharmacist consultation model.

Kovačević, Sandra Vezmar / Miljković, Branislava / Vučićević, Katarina / Ćulafić, Milica / Kovačević, Milena / Golubović, Bojana / Jovanović, Marija / de Gier, Johan J

Patient education and counseling

2017 Volume 100, Issue 9, Page(s) 1714–1719

Abstract: Objective: To evaluate elderly polypharmacy patients' needs and concerns regarding medication through the Structured Patient-Pharmacist Consultation (SPPC).: Methods: Older patients on chronic treatment with ≥5 medications were asked to fill in the ... ...

Abstract	Objective: To evaluate elderly polypharmacy patients' needs and concerns regarding medication through the Structured Patient-Pharmacist Consultation (SPPC). Methods: Older patients on chronic treatment with ≥5 medications were asked to fill in the SPPC form at home. A consultation with the community pharmacist, structured according to patient's answers, followed within 2-4 weeks. Logistic regression associated patients' individual treatment with care issues and consultation outcomes. Results: Out of 440 patients, 39.5% experienced problems, and 46.1% had concerns about medication use. 122 patients reported reasons for discontinuing treatment. The main outcome of the consultation was a better understanding of medication use (75.5%). Side effects and/or non-adherence were identified in 50% of patients, and 26.6% were referred to the doctor. Atrial fibrillation, COPD, anticoagulants, benzodiazepines, and beta agonists/corticosteroids were associated with problems during medication use. Patients with diabetes improved their understanding of medication use significantly. Conclusion: Patients on benzodiazepines, anticoagulants, and beta agonists/corticosteroids, with atrial fibrillation and/or COPD, may have a higher potential for non-adherence. Counseling patients based on the SPPC model may be particularly useful for patients with diabetes. Practice implications: The SPPC model is a useful tool for counseling based on patient needs.
MeSH term(s)	Aged ; Community Pharmacy Services ; Counseling ; Female ; Humans ; Male ; Pharmacists ; Polypharmacy ; Professional-Patient Relations ; Referral and Consultation ; Serbia
Language	English
Publishing date	2017-09
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	605590-4
ISSN	1873-5134 ; 0738-3991
ISSN (online)	1873-5134
ISSN	0738-3991
DOI	10.1016/j.pec.2017.05.001
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Article: How Clinical Integration of Pharmacists in General Practice has Impact on Medication Therapy Management: A Theory-oriented Evaluation.

Hazen, Ankie C M / de Bont, Antoinette A / Leendertse, Anne J / Zwart, Dorien L M / de Wit, Niek J / de Gier, Johan J / Bouvy, Marcel L

International journal of integrated care

2019 Volume 19, Issue 1, Page(s) 1

Abstract: Background: Data on medication-related hospital admissions suggest that there is an opportunity for improved pharmaceutical care. Hence, concerns about medication-related hospital admissions is a driver to extend and integrate the role of community ... ...

Abstract	Background: Data on medication-related hospital admissions suggest that there is an opportunity for improved pharmaceutical care. Hence, concerns about medication-related hospital admissions is a driver to extend and integrate the role of community pharmacists in general practice. Aim: The aim of this paper is to give a systematic description of 1) what integrating a non-dispensing pharmacist (NDP) in general practice entails and 2) how this integrated care model is expected to contribute to patients' medication therapy management. Methods: Based on ethnographic data collected by NDPs in general practices in the Netherlands, we conducted a theory evaluation. Results: The impact of NDPs providing integrated care can be explained by 1) the specific expertise NDPs bring into general practice and the tailored solutions they offer for individual patients, including deviation from medical protocols when necessary, 2) the reconciliation of interprofessional tensions caused by overlapping tasks with practice nurses, which results in a distinct patient population, 3) the conduct of clinical medication reviews aligned to the work processes of the GP practice and 4) the integration of quality management work into clinical work. Conclusion: The success of integrated pharmaceutical care is dependent on how NDPs collaborate with GPs and practice nurses. NDPs need to mobilize clinical pharmaceutical expertise into general practice. Yet, integrating quality management into clinical work is key to integrate pharmaceutical care. Paradoxically, full integration requires from NDPs to develop a distinct role in general practice.
Language	English
Publishing date	2019-01-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2119289-3
ISSN	1568-4156
ISSN	1568-4156
DOI	10.5334/ijic.3291
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Article ; Online: Non-dispensing pharmacists' actions and solutions of drug therapy problems among elderly polypharmacy patients in primary care.

Hazen, Ankie C M / Zwart, Dorien L M / Poldervaart, Judith M / de Gier, Johan J / de Wit, Niek J / de Bont, Antoinette A / Bouvy, Marcel L

Family practice

2019 Volume 36, Issue 5, Page(s) 544–551

Abstract: Objective: To evaluate the process of clinical medication review for elderly patients with polypharmacy performed by non-dispensing pharmacists embedded in general practice. The aim was to identify the number and type of drug therapy problems and to ... ...

Abstract	Objective: To evaluate the process of clinical medication review for elderly patients with polypharmacy performed by non-dispensing pharmacists embedded in general practice. The aim was to identify the number and type of drug therapy problems and to assess how and to what extent drug therapy problems were actually solved. Method: An observational cross-sectional study, conducted in nine general practices in the Netherlands between June 2014 and June 2015. On three pre-set dates, the non-dispensing pharmacists completed an online data form about the last 10 patients who completed all stages of clinical medication review. Outcomes were the type and number of drug therapy problems, the extent to which recommendations were implemented and the percentage of drug therapy problems that were eventually solved. Interventions were divided as either preventive (aimed at following prophylactic guidelines) or corrective (aimed at active patient problems). Results: In total, 1292 drug therapy problems were identified among 270 patients, with a median of 5 (interquartile range 3) drug therapy problems per patient, mainly related to overtreatment (24%) and undertreatment (21%). The non-dispensing pharmacists most frequently recommended to stop medication (32%). Overall, 83% of the proposed recommendations were implemented; 57% were preventive, and 35% were corrective interventions (8% could not be assessed). Almost two-third (64%) of the corrective interventions actually solved the drug therapy problem. Conclusion: Non-dispensing pharmacists integrated in general practice identified a large number of drug therapy problems and successfully implemented a proportionally high number of recommendations that solved the majority of drug therapy problems.
MeSH term(s)	Aged ; Aged, 80 and over ; Community Pharmacy Services/statistics & numerical data ; Cross-Sectional Studies ; Drug-Related Side Effects and Adverse Reactions/diagnosis ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Female ; General Practice ; Humans ; Inappropriate Prescribing/statistics & numerical data ; Male ; Medication Therapy Management/statistics & numerical data ; Netherlands ; Polypharmacy ; Prevalence ; Risk Factors
Language	English
Publishing date	2019-02-17
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	605939-9
ISSN	1460-2229 ; 0263-2136
ISSN (online)	1460-2229
ISSN	0263-2136
DOI	10.1093/fampra/cmy114
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Article ; Online: Prevalence of medicinal drugs in suspected impaired drivers and a comparison with the use in the general Dutch population.

Bezemer, Karlijn D B / Smink, Beitske E / van Maanen, Rianne / Verschraagen, Miranda / de Gier, Johan J

Forensic science international

2014 Volume 241, Page(s) 203–211

Abstract: The aim of this study was to investigate the prevalence of psychotropic medicines in drivers suspected of driving under the influence of medicinal and illicit drugs in The Netherlands and to compare the prevalence of selected impairing medicines with the ...

Abstract	The aim of this study was to investigate the prevalence of psychotropic medicines in drivers suspected of driving under the influence of medicinal and illicit drugs in The Netherlands and to compare the prevalence of selected impairing medicines with the use of these medicines in the general Dutch population. In total, 3038 blood samples of suspected impaired drivers in The Netherlands have been analyzed for the presence of medicinal and illicit drugs between January 2009 and December 2012. In 94% (2842/3038) of the cases medicinal and/or illicit drugs were detected. Medicinal drugs were found in 33% of the blood samples, with the highest prevalence for anxiolytics. In 86% of the cases illicit drug-positive results were obtained, with the highest prevalence for cannabis. At least in 56% of the blood samples poly-drug use was determined, including medicinal and/or illicit drugs. The highest prevalence of poly-medicine use was found for combinations including anxiolytic and hypnotic drugs. In general, the prevalence of driving impairing medicines in suspected impaired drivers is higher than the use of these medicines in the general Dutch population, due to a positive selection bias in the first population. Differences between both populations may be explained by the used methodological approach (e.g., classification criteria of analytical findings, sample selection bias) and abuse of certain medicinal drugs (e.g., diazepam). Negative effects of medicinal drugs on driving performance determine largely the prevalence in the population of suspected impaired drivers. The degree of impairment depends on different factors, including pharmacokinetic properties of the drug and pharmacodynamic aspects. More research is needed to study the prevalence of all prescribed driving impairing medicines and to investigate if providing additional information to medicinal drug users on driving impairing medicines would lower the prevalence of medicinal drug positive drivers.
MeSH term(s)	Automobile Driving/legislation & jurisprudence ; Humans ; Netherlands/epidemiology ; Prescription Drugs/analysis ; Street Drugs/blood ; Substance Abuse Detection ; Substance-Related Disorders/epidemiology
Chemical Substances	Prescription Drugs ; Street Drugs
Language	English
Publishing date	2014-08
Publishing country	Ireland
Document type	Comparative Study ; Journal Article
ZDB-ID	424042-x
ISSN	1872-6283 ; 0379-0738
ISSN (online)	1872-6283
ISSN	0379-0738
DOI	10.1016/j.forsciint.2014.06.004
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Zs.B 1104: Show issues

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Article ; Online: A study comparing the effectiveness of three warning labels on the package of driving-impairing medicines.

Emich, Bas / van Dijk, Liset / Monteiro, Susana P / de Gier, Johan J

International journal of clinical pharmacy

2014 Volume 36, Issue 6, Page(s) 1152–1159

Abstract: Background: Several medicines are known to potentially impair patients' driving fitness. Appropriate communication towards patients about this risk can be supported by the use of package warning labels.: Objective: To compare the effectiveness of a ... ...

Abstract	Background: Several medicines are known to potentially impair patients' driving fitness. Appropriate communication towards patients about this risk can be supported by the use of package warning labels. Objective: To compare the effectiveness of a standing practice yellow/black label-with written warning-with a newly developed rating model in communicating risk on driving-impairing medicines (DIMs). Furthermore, the added value of a side-text in the rating model was determined. Setting: Community pharmacies in the Netherlands. Method: In a cross-sectional study, patients with a first dispensing of a DIM were asked by their community pharmacists (n = 38) to fill out a written questionnaire to compare each of the three warning labels. A 2 [yellow/black label vs. rating model (pair 1) and rating model with side-text vs. rating model without side-text (pair 2)] × 3 [category of driving-impairment: I = minor risk, II = moderate risk, III = severe risk] design was used. The category of driving-impairment varied per respondent, depending on the DIM the patient collected. Main outcome measure: (1) estimated level of driving risk valued by patients (2) intention to change driving behaviour after seeing the warning label. Results: An estimated number of 992 patients were approached. As 298 questionnaires were analysed, the net response rate was 30%. With the yellow/black label, respondents considered DIMs of all three categories of driving-impairment to equally impair driving fitness, while with the rating model the estimated risk was higher when the category referred to a higher level of driving-impairment. Addition of a side-text to the rating model resulted in a significantly higher estimated level of driving risk and a significant increase in intention to change driving behaviour. Only 8.0% of the patients using a category III DIM estimated the level of driving risk correctly when seeing the yellow/black label, while this was 26.7% for the rating model and 43.0% for the rating model with side-text. Conclusion: The yellow/black label, which is standing practice in the Netherlands, is less effective in terms of estimated risk and intention to change driving behaviour, compared to a newly developed rating model. This model is even more effective when a side-text is added. Implementation of the rating model in clinical practice should be considered.
MeSH term(s)	Adult ; Aged ; Automobile Driving/psychology ; Communication ; Cross-Sectional Studies ; Drug Labeling/methods ; Drug Packaging/methods ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Netherlands/epidemiology ; Patient Education as Topic/methods ; Risk Factors
Language	English
Publishing date	2014-09-10
Publishing country	Netherlands
Document type	Comparative Study ; Journal Article
ZDB-ID	2601204-2
ISSN	2210-7711 ; 2210-7703 ; 0928-1231
ISSN (online)	2210-7711
ISSN	2210-7703 ; 0928-1231
DOI	10.1007/s11096-014-0010-2
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Article ; Online: Implications of a clinical medication review and a pharmaceutical care plan of polypharmacy patients with a cardiovascular disorder.

Geurts, Marlies M E / Stewart, Roy E / Brouwers, Jacobus R B J / de Graeff, Pieter A / de Gier, Johan J

International journal of clinical pharmacy

2016 Volume 38, Issue 4, Page(s) 808–815

Abstract: Background A clinical medication review, including patient involvement, is expected to improve pharmaceutical care. Objective To determine whether a clinical medication review followed by a pharmaceutical care plan decreases the number of potential drug- ... ...

Abstract	Background A clinical medication review, including patient involvement, is expected to improve pharmaceutical care. Objective To determine whether a clinical medication review followed by a pharmaceutical care plan decreases the number of potential drug-related problems (DRPs) and pharmaceutical care issues (PCIs) and leads to a positive effect on relevant clinical and laboratory parameters for elderly cardiovascular patients with multiple drug use. Setting Randomized controlled trial in eight primary care settings in the Netherlands. Method Elderly polypharmacy patients with a cardiovascular disorder were randomized into two groups. Intervention patients received a clinical medication review, followed by a pharmaceutical care plan developed in cooperation between these patients' pharmacists and general practitioners (GPs), and agreed to by the patients. Control patients received care as usual. Patient data were collected at the start of the study (t = 0) and after 1-year follow-up (t = 1). Main outcome measure Decrease in potential DRPs and pharmaceutical PCIs, improvement of clinical and laboratory parameters. Results 512 patients were included. An average of 2.2 potential DRPs and pharmaceutical PCIs were defined per patient in the intervention group. After 1-year follow-up, 47.2 % of potential DRPs and PCIs were resolved. In total, 156 care interventions were proposed (0.9/patient), 108 of which were implemented after 1 year (69.2 %). For control-group patients, a total of 47 proposed care interventions were documented for 255 patients (0.2/patient); after 1 year, 43 had been implemented (91.5 %). The study intervention (p < 0.001) and the number of medicines used (p = 0.030) had a significant effect on the number of interventions proposed. Small biochemical changes in cardiovascular risk factors did occur, but the differences were small and not considered clinically relevant. Conclusion The integrated use of a clinical medication review with a pharmaceutical care plan in a primary care setting supports the detection of and decrease in DRPs and pharmaceutical PCIs in almost half of the patients. Its benefit in terms of control of cardiovascular risk factors and safety parameters was relatively low. Risk stratification might be necessary to decide which patients might benefit most from this type of intervention.
MeSH term(s)	Aged ; Cardiovascular Diseases/drug therapy ; Community Pharmacy Services/statistics & numerical data ; Drug Utilization Review/statistics & numerical data ; Drug-Related Side Effects and Adverse Reactions/prevention & control ; Female ; Humans ; Male ; Netherlands ; Pharmaceutical Services/statistics & numerical data ; Polypharmacy ; Primary Health Care/methods ; Treatment Outcome
Language	English
Publishing date	2016-04-06
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2601204-2
ISSN	2210-7711 ; 2210-7703 ; 0928-1231
ISSN (online)	2210-7711
ISSN	2210-7703 ; 0928-1231
DOI	10.1007/s11096-016-0281-x
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Article ; Online: Development of a web-based pharmaceutical care plan to facilitate collaboration between healthcare providers and patients.

Geurts, Marlies M E / Ivens, Martijn / van Gelder, Egbert / de Gier, Johan J

Informatics in primary care

2013 Volume 21, Issue 1, Page(s) 53–59

Abstract: Background: In medication therapy management there is a need for a tool to document medication reviews and pharmaceutical care plans (PCPs) as well as facilitate collaboration and sharing of patient data between different healthcare providers. Currently, ...

Abstract	Background: In medication therapy management there is a need for a tool to document medication reviews and pharmaceutical care plans (PCPs) as well as facilitate collaboration and sharing of patient data between different healthcare providers. Currently, pharmacists and general practitioners (GPs) have their own computer systems and patient files. To facilitate collaboration between different healthcare providers and to exchange patient data we developed a paper-based tool. As a result the structured collection of all relevant information for a clinical medication review was more protocol driven. The tool also enabled to plan interventions and follow-up activities: the PCP. The PCP was piloted among three GPs and six community pharmacists. Interviews with all healthcare providers concluded the PCP was found a very useful tool to collect and share patient data. A disadvantage was the time spent to collect all information. We therefore developed our PCP into a web-based tool: the web-based PCP (W-PCP). Objectives: Development of a W-PCP to (1) provide healthcare providers with information from pharmacist- and GP computer systems and (2) facilitate collaboration between healthcare providers and patients. Development and Application: W-PCP facilitates uploading and sharing of patient data among health care professionals and collaboration between professionals and patients on performing treatment plans. The W-PCP is a stand-alone application developed by cocreation using a generic software platform that provides developmental speed and flexibility. Method: The W-PCP was used in three research lines, two in primary care and one in a hospital setting. Outcomes measures were defined as satisfaction about efficiency and effectiveness during data sharing and documentation in providing care and conducting medication reviews using the W-PCP. First experiences concerning the use of W-PCP in a primary care setting were collected by a questionnaire and interviews with pharmacists and GPs using the W-PCP. Results: A questionnaire about first experiences with the W-PCP was sent to 38 healthcare providers. 17 healthcare providers returned the questionnaire (response 44.7%). The use of W-PCP resulted in positive experiences from participating healthcare providers. One of the needs expressed is to have the W-PCP application integrated in the current pharmacy and GP computer systems. All experiences, needs, and ideas for improvement of the current application were collected. On the basis of experiences and requirements collected, the application will be further developed. Conclusions: The W-PCP application can potentially support successful collaboration between different healthcare providers and patients, which is important for medication therapy management. With this application, a successful collaboration between different healthcare providers and patients could be achieved.
MeSH term(s)	Cooperative Behavior ; General Practitioners ; Humans ; Information Dissemination ; Internet ; Medication Therapy Management ; Netherlands ; Pharmacists ; Physician-Patient Relations ; Qualitative Research ; Surveys and Questionnaires
Language	English
Publishing date	2013
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2258410-9
ISSN	1475-9985 ; 1476-0320
ISSN (online)	1475-9985
ISSN	1476-0320
DOI	10.14236/jhi.v21i1.40
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Article ; Online: Learning Through Boundary Crossing: Professional Identity Formation of Pharmacists Transitioning to General Practice in the Netherlands.

Hazen, Ankie C M / de Groot, Esther / de Bont, Antoinette A / de Vocht, Simone / de Gier, Johan J / Bouvy, Marcel L / de Wit, Niek J / Zwart, Dorien L M

Academic medicine : journal of the Association of American Medical Colleges

2018 Volume 93, Issue 10, Page(s) 1531–1538

Abstract: Purpose: To unravel boundary crossing as it relates to professional identity formation in pharmacists transitioning from a community pharmacy to working as nondispensing clinical pharmacists in general practice, with the aim of optimizing their ... ...

Abstract	Purpose: To unravel boundary crossing as it relates to professional identity formation in pharmacists transitioning from a community pharmacy to working as nondispensing clinical pharmacists in general practice, with the aim of optimizing their education. Method: This was a multiple-case study, including two-stage interviews, peer feedback, and individual reflection, that collected data in 2014-2016 from eight clinical pharmacists working in general practice in the Netherlands. These pharmacists acted-without a workplace role model-as pharmaceutical care providers in general practices during a 15-month training program. In within-case and cross-case analysis, data were collected regarding pharmacists' role development in practice and perceptions of learning processes, and examined through the lens of professional identity formation and boundary crossing. Results: Analysis of data collected during and after the training program demonstrated that the clinical pharmacists who applied the learning mechanisms of reflection and transformation developed a patient-care-oriented professional identity. Some clinical pharmacists, who learned mainly through the mechanism of identification, did not integrate the new patient-care-oriented role into their professional identity. They felt that their workplace provided limited opportunities for reflection and transformation. Learning with peers on formal training days was seen as highly valuable for professional identity formation; it counterbalanced the lack of a role model in the workplace. Conclusions: Professional identity formation in the transition from community pharmacist to clinical pharmacist in general practice benefited from reflective, on-the-job training. This permitted transformative, boundary-crossing learning with peers and supported professional identity formation oriented to providing practice-based pharmaceutical care.
MeSH term(s)	Education, Pharmacy, Continuing ; General Practice/organization & administration ; Humans ; Netherlands ; Patient-Centered Care ; Perception ; Pharmacists/psychology ; Professional Role ; Role Playing
Language	English
Publishing date	2018-03-24
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	96192-9
ISSN	1938-808X ; 1040-2446
ISSN (online)	1938-808X
ISSN	1040-2446
DOI	10.1097/ACM.0000000000002180
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Article ; Online: Expectations, concerns, and needs of patients who start drugs for chronic conditions. A prospective observational study among community pharmacies in Serbia.

Vučićević, Katarina M / Miljković, Branislava R / Golubović, Bojana C / Jovanović, Marija N / Vezmar Kovačević, Sandra D / Ćulafić, Milica D / Kovačević, Milena M / de Gier, Johan J

The European journal of general practice

2018 Volume 24, Issue 1, Page(s) 19–25

Abstract: Background: During the initiation of treatment of a chronic disease, patients may have varying interests, expectations, concerns, and reasons to stop treatment, influencing compliance with prescribed treatment. Thus, healthcare professionals are ... ...

Abstract	Background: During the initiation of treatment of a chronic disease, patients may have varying interests, expectations, concerns, and reasons to stop treatment, influencing compliance with prescribed treatment. Thus, healthcare professionals are expected to integrate these needs into medicines management. Objectives: To determine what information is important to patients; assess predictors of patients' interests, expectations, concerns, reasons to stop therapy; evaluate drug-related problems following initiation of therapy and summarize how pharmacists resolve them during patient-pharmacist counselling. Methods: In 2014, a four-month study was performed in Serbian community pharmacies, as part of the Pharmaceutical Care Quality Indicators Project led by the European Directorate for the Quality of Medicines & Healthcare. Seventy community pharmacists were asked to participate in the study. Pharmacists recruited adult patients who consented to participate in the study and who initiated treatment, lasting at least six months. Patients completed an open-ended questions form. After two-to-four weeks, a patient-pharmacist consultation was performed. Results: Forty-four community pharmacists (response rate 62.9%) sent back the completed forms from 391 patients (response rate 67.1%). The total number of dispensed drugs was 403. In terms of drug safety, 29.4% of patients sought information, 32.5% expressed concerns, and 28.1% of patients cited it as a reason to discontinue treatment. During the first weeks of therapy, 18% of patients experienced practical problems, while 27.3% reported adverse drug reactions. Conclusion: Safety issues are a major focus of patients' prescribed new medicines for long-term treatment.
MeSH term(s)	Adult ; Chronic Disease ; Community Pharmacy Services/organization & administration ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Drug-Related Side Effects and Adverse Reactions/prevention & control ; Health Services Needs and Demand ; Humans ; Medication Adherence ; Needs Assessment/organization & administration ; Pharmacists/organization & administration ; Prescription Drugs/administration & dosage ; Prescription Drugs/adverse effects ; Prospective Studies ; Serbia
Chemical Substances	Prescription Drugs
Language	English
Publishing date	2018-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1281338-2
ISSN	1751-1402 ; 1381-4788
ISSN (online)	1751-1402
ISSN	1381-4788
DOI	10.1080/13814788.2017.1388778
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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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