#L1 Drug Related Problems

Definition of Drug Related Problems

An actual or potential undesirable event related to drug therapy that interferes with achieving optimal outcomes.

3 Main Components of Drug Related Problems

1. Undesirable event

2. Drug therapy involved with the problem

3. Relationship that exist between undesirable patient event and drug therapy

Revised DRP Categories (7)

1. Unnecessary Drug Therapy

2. Requires Additional Drug Therapy

3. Ineffective Drug

4. Dosage Too Low

5. Adverse Drug Reaction

6. Dosage Too High

7. Nonadherence or Noncompliance

Revised DRP Categories

Requires additional drug therapy and unnecessary drug therapy falls into what category?

Indication

Revised DRP Categories

Requires different drug product and dosage too low falls into what category?

Effectiveness

Revised DRP Categories

Adverse drug reaction and dosage too high falls into what category?

Safety

Revised DRP Categories

Non-adherence falls into what category?

Adherence

Definition of ADE vs ADR

ADE is any harm (both preventable and unpreventable) cause by medication

ADR is unpreventable harm (side effects are not typically ADRs)

Average number of prescription drugs taken by adults

4

The average per capita spending in US in 2023 for retail prescription drugs is ?

$1500

Rx drugs are labeled with an —

Controlled substances are regulated by —

FDA label, DEA

Schedule I

High abuse, no accepted medical use

Schedule II

High abuse, accepted medical use

Schedule III

Moderate to low abuse

Schedule IV

Low abuse

Schedule V

Lowest abuse

Definition of investigational drugs?

Drugs that are not yet approved by FDA for general use, used in clinical trials (or under special special protocols)

Commonly prescribed therapeutic classes (4):

Analgesic, antihyperlipidemic, antihypertensive, antidepressant

How many percent of visits involve drug therapy?

76%

Number of drugs ordered after physician office visit?

4 billion

Over — OTC products available, across more than — drug classes

100,000, 80

About — retail trips made each year to buy OTCs

2.9 billion

In 2021, OTC sales exceeded

$37 billion

U.S. household spends approximately how much on OTCs per year?

$440

How many percent of adults use OTCs as their first choice for minor health issues?

81%

A serious adverse drug event can result in​

1. Life-threatening outcomes​

2. Death​

3. Hospitalization​

4. Disability​

5. Birth defect​

6. All of the above

6 (All of the above)

Morbidity = ?

Mortality = ?

sickness, death

5 Causes of Drug Related Morbidity and Mortality

• Inappropriate prescribing

• Inappropriate drug delivery

• Inappropriate patient behavior

  • Inappropriate monitoring

• Patient idiosyncrasy

Cost of drug related morbidity and mortality in the 2000 study?

$177 billion (very high cost)

Why is patient-centered care important for pharmacists?

• Pharmacists prevent drug-related harm, improves outcomes, and lower costs

• Pharmacy must shift to a rational, patient-focused drug use system

• Approaches include: Pharmaceutical Care, MTM, PCC, and Pharmacists’ Patient Care Process