Drug related problem
Under drug-related problems (short: ABP) is defined as complications that are associated with drug therapy by the drug caused the patient himself. Drug-related problems affect the success of the therapy. This is where the pharmaceutical care by before or during therapy intervened identified drug-related problems and timely: "Pharmaceutical care is the responsibility and integration of the pharmacist in the drug therapy of the patient to detect drug-related problems and to prevent, as well as the quality of life of the patient improve."
Occurrence
Drug-related problems arise, for example, from a lack of adherence to therapy (non- compliance : patients take the drug inadequately due to negligence or forgetfulness or not at all due to fear of side effects). Furthermore, drug-related problems can occur due to too high or too low a dosage, too short or too long therapy duration , side effects and interactions with other agents or application errors during administration. In addition, in the field of self- medication it can happen that symptoms do not allow self-medication but require a doctor's examination or a desired drug is not indicated or even contraindicated .
In Germany, the occurrence of drug-related problems was systematically examined for the first time in 2005 in a nationwide study initiated by the regional pharmacy chambers and the Center for Drug Information and Pharmaceutical Practice (ZAPP). In 2007, additional data was collected in two follow-up projects, which separately covered the areas of self-medication (OTC) and prescriptions.
In the area of self-medication, 70 percent of which related to the four indication areas pain , respiratory tract , gastrointestinal tract and skin , drug-related problems were found in almost every fifth patient. The most frequent problems were the unsuitability of self-medication (29.7 percent), followed by the desire for an unsuitable preparation (20.5 percent), too long an application period up to suspicion of abuse (17.1 percent) and incorrect dosage (6.8 percent) ).
The lack of therapy compliance (non-compliance) has a prominent position among the drug regulations. Its extent is estimated at 12 to 35 percent, depending on the clinical picture, and it is particularly high in many long-term treatments. This is where pharmaceutical care can begin, especially through patient education and motivation.
SOAP scheme
The procedure according to the SOAP scheme is used to identify and eliminate drug-related problems, especially in hospitals and clinical pharmacy:
- S - Collecting subjectively perceived complaints, for example through questioning. Example: patient complains of pain.
- O - collecting objective data (measurement data). Examples: renal clearance , blood pressure .
- A - Analysis: What is the drug-related problem? Examples: non-compliance, drug interaction.
- P - Drug-related Problem Solving Plan: How to Improve Compliance? How can one eliminate the drug interaction?
literature
- Ulrich Jaehde, Roland Radziwill, Stefan Mühlebach, Walter Schunack: Textbook of clinical pharmacy . 2nd Edition. Wissenschaftliche Verlagsgesellschaft mbH Stuttgart 2003. ISBN 3-8047-1939-2