Drug therapy issues ( DTPs ) (or drug related issues, DRPs ) represent the categorization and definition of clinical problems associated with the use of drugs or "drugs" in the field of pharmaceutical care. In clinical practice, DTP is often identified, prevented, and/or solved by pharmacists in the course of drug therapy management, as an expert on drug safety and efficacy, but other health care professionals can also manage DTP.
The problem of drug therapy (related) can be defined as events or circumstances involving drug treatment (pharmacotherapy) that interfere with the provision of optimal medical care. In 1990, L.M. Strand and his colleagues (based on previous work R.L Mikeal and D.C Brodie, published respectively in 1975 and 1980) classify DTP into eight different categories. According to this category, the pharmacist generates a DTP list for each patient. As a result, pharmacists have a cleaner picture of drug therapy and the patient's medical condition. The second publication of R.J Cipolle with L.M Strand in 1998 changed eight categories into seven, grouped into four pharmacotherapy requirements: indications, effectiveness, safety and compliance.
Video Drug therapy problems
Example
- Patients suffering from chronic pain prescribed opioid painkillers (such as morphine) can build tolerance to the effects of painkillers, requiring higher doses to achieve the same pain reduction effect. The risk of escalating this dose may lead to an overdose of the drug.
- Some medications reduce the absorption of vital nutrients from food, which can cause nutritional deficiencies.
Maps Drug therapy problems
Eight original issues
According to page 73 in Introduction to Shipping Health Care: A Primer for Pharmacists , drug therapy problems (DTPs) originated from Strand et al. (1990) that define eight issues that could lead to worse health outcomes in an effort to categorize DTP. Helper and Strand later in 1990 declared a mission statement or pharmacist raison d'etre to fix the problem of this drug therapy.
The original eight issues have now been reduced to seven problem categories . As Shargel provides, they are:
- Unnecessary drug therapy. This can happen when the patient has been overuse of medication for their condition and the drug is not needed.
- The wrong medicine. This can happen when a patient is given a drug that does not treat the patient's condition. Ex. Cardiac drugs to treat infections.
- The dose is too low. This can happen when the patient is given a drug that is not strong enough to get a beneficial or therapeutic effect.
- The dose is too high. This can happen when the patient is given a drug that is too strong and causes adverse or unnecessary effects.
- Adverse drug reactions. This can happen when the patient has an allergic response to the drug.
- Objection is not appropriate. This can happen when the patient chooses not to or forgets to take medication.
- Requires additional drug therapy. This can happen when a patient needs more medication to treat their condition.
Further details of category
The DRP can be further broken down into the following categories:
Indication
Requires Additional Drug Therapy
- Untreated condition
- Prevention/prophylaxis
- Synergistic/potentiating
Unnecessary Drug Therapy
- There is no medical indication
- Duplicate therapy
- Non-drug therapy is indicated
- Treating ADRs that can be avoided
Effectiveness
Requires Different Drug Products
- More effective drugs are available
- Refractory conditions to drugs
- Inappropriate dosage form
- Not effective for conditions
Dose Too Low
- Incorrect dosage
- Inappropriate frequency
- Inappropriate duration
- Drug interactions
Security
Adverse drug reactions
- Unwanted effects
- The drug is not safe for patients
- Doses change too quickly
- Allergic reactions
- Contraindication presents
Dose Too High
- Incorrect dosage
- Inappropriate frequency
- Invalid administration
- Drug interactions
Obedience
Non-compliance
- Directions not understood
- Patients prefer not to take
- The patient forgot to fetch
- Overly expensive drug products
- Can not swallow/organize
- No drug products available
References
Source of the article : Wikipedia
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