| Summary: | 碩士 === 國防醫學院 === 藥學研究所 === 103 === Backgrounds:
Drug therapy problem (DTP) may worsen patients’ health conditions, and could lead to unnecessary harm, causing great concerns both clinically and economically. Medication review aiming to identify, resolve and prevent DTPs related to physician prescribing during pharmacist dispensing process was encouraged. In Taiwan, pharmacists are not paid for routinely by providing medication review; as a result, pharmacists are not used to provide such a service. In 2014, Taiwan FDA provided research funding to encourage pharmacist to provide medication review while dispensing.
Purpose:
The aim of this study was to evaluate the value of providing medication review by pharmacists in Taiwan.
Methods:
A computerized documentation system was developed by the Taiwan Pharmacist Association to record every medication review provided. Community pharmacists were recruited and trained to provide medication review using AABBCC coding system to record DTPs identified (AA code), giving recommendation (Krska J, Jamieson D, Arris F et al.) and follow up the drug therapy changes by physician (CC). The pharmacists was paid NT$200 for every DTP identified and resolved.
Results:
263 pharmacists identified 1,487 DTPs while dispensing, most of the problems were "adverse drug reaction" (25.9%). Around 80% of the suggestions given to physicians were replied and 45.4% of them were accepted. In average, NT$ 66.3 drug expenditure was saved by providing one DTP identified and resolved.
Conclusions:
The cost benefit ratio of providing medication review is 1:0.31 (remuneration: drug expenditure saved), this may not be attractive, however, to protect drug safety and prevent potential adverse drug reaction may save more health care expenditure such as ER or inpatient care which did not capture in this study. To provide medication review while dispensing is worthwhile and valuable.
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