Impact of Pharmaceutical Care interventions in the identification and resolution of drug-related problems and on quality of life in a group of elderly outpatients in Ribeirão Preto (SP), Brazil

Figures & data

Table 1 Quantitative distribution of the drug therapy interventions, Ribeirão Preto, 2004

Educational interventions	Frequency
Counseling about a new drug prescribed	30
Counseling about doubts related to drug administration	40
(dose, schedule, duration of drug therapy, route of administration)
Counseling about use of drug	14
Counseling about potential drug-drug interactions	36
Counseling about actual or potential adverse drug reactions	38
Counseling about drug home storage	45
Counseling about heath problem	41
Counseling about heath education	38
Counseling about lifestyle modifications	56
Referring to other health care providers	28
Other important educational counseling’s about drug therapy	10
TOTAL	376

Table 2 Quantitative distribution of the drug therapy interventions, Ribeirão Preto, 2004

Drug therapy interventions by the pharmacist (all accepted)	Frequency
Doctor advised to prescribed an additional drug therapy	8
Patient advised to stop taking unnecessary non-prescribed drug therapy	21
Doctor advised to withdraw unnecessary drug therapy	18
Doctor advised to change prescribed drug therapy	5
Doctor advised to increase frequency of a prescribed drug therapy	24
Doctor advised to increase dosage of a prescribed drug therapy	21
Helped patients re-schedule new drug regimen prescribed	32
Patient or doctor advised to switch/substitute the medication to generics	8
Pharmacist suspended drug therapy because of adverse drug reaction	50
Doctor advised to decrease frequency of a prescribed drug therapy	6
Doctor advised to r decrease dosage of a prescribed drug therapy	9
Adjusting schedule of taking medicines (preventative therapy)	12
TOTAL	214

Figure 1 Correlation between the number of diseases and quality of life.

Figure 2 Correlation between the number of medications used and quality of life.

Table 3 QoL scores before and after the intervention asassessed by the SF-36, Ribeirão Preto, 2004

Domain	Before (n = 30) Md (Q1, Q3)	After (n = 30) Md (Q1, Q3)	p-value
Functional capacity	87.5 (70; 95)	87.5 (66; 100)	0.796
Physical aspects	100 (25; 100)	100 (100; 100)	0.002*
Pain	61 (41; 75)	72 (61; 100)	0.006*
General health status	72 (55; 87)	79.5 (62; 91)	0.012*
Vitality	60 (39; 80)	75 (60; 90)	0.000*
Social aspects	81 (50; 100)	100 (87.5; 100)	0.001*
Emotional aspects	100 (67; 100)	100 (100; 100)	0.013*
Mental Health	68 (60; 93)	76 (66; 92)	0.182

n = 30, Md = mean, Q1 and Q3 = quartiles

* = statistically significant difference, p < 0.05.

Figure 3 Correlation between the number of drug-related problems (DRP) resolved or prevented and quality of life.

Table 4 Drug-related problems and QoL before and after the intervention per individual patient

Patient	Before (n = 30)		Number of Interventions	After (n = 30)		Improvement
	DRP identified	QoL		DRP Solved or Prevented	QoL	DRP (%)	QoL
1	6	55.6	28	6	85.1	100	29.5
2	2	73.0	31	2	92.9	100	19.9
3	3	85.5	29	3	91.0	100	5.5
4	1	59.5	15	0	90.0	0	30.5
5	4	54.3	6	3	62.9	75	8.6
6	2	63.3	30	2	72.1	100	8.8
7	5	91.6	9	1	95.9	80	4.3
8	4	34.1	30	4	50.0	100	15.9
9	4	53.4	9	3	81.3	75	27.8
10	2	41.8	32	2	92.1	100	50.3
11	6	70.1	10	1	75.1	83.3	5.0
12	1	51.9	8	0	64.9	0	13.0
13	2	77.8	13	2	85.0	100	7.3
14	7	33.9	16	5	47.1	71.4	13.2
15	3	44.3	13	2	73.8	66	29.5
16	5	75.9	13	4	81.4	80	5.5
17	1	84.5	32	1	91.8	100	7.3
18	3	43.1	29	3	83.3	100	40.2
19	5	85.6	12	2	95.4	40	9.8
20	2	91.8	11	1	99.5	50	7.8
21	1	83.9	28	1	88.9	100	5.0
22	2	94.1	31	2	96.9	100	2.8
23	2	66.9	28	2	80.9	100	14.0
24	3	45.8	12	2	74.3	60	28.5
25	2	85.8	27	2	91.6	100	5.9
26	2	83.9	24	1	89.5	50	5.6
27	3	81.1	13	2	82.8	66	1.6
28	1	86.0	11	0	80.3	0	−5.7
29	1	97.1	30	1	97.8	100	0.6
30	6	82.5	10	3	84.9	50	2.4

Classification of drug-related problems, according to the Consensus of Granada (2002)

Drug-related need	Drug-related problem type
Necessity needs	Type 1 – Patient does not use the drug he or she
	Type 2 – Patient uses a drug he or she does not need
Effectiveness	Type 3 – Patient does not respond to the drug
	Type 4 – Patient uses a dose, interval, or duration inferior to the one needed
Safety	Type 5 – Patient uses a drug that produces an adverse drug reaction
	Type 6 – Patient uses a dose, interval, or duration superior to the one needed