Analysis of interaction risks of patients with polypharmacy and the pharmacist interventions performed to solve them – a multicenter descriptive study according to medication reviews in Hungarian community pharmacies.

The study was a multicenter descriptive study carried out in Hungarian community pharmacies. The project was carried out between October 2017 and March 2018.The research was carried out in the framework of the training of specialist pharmacists at Semmelweis University.<br>The patients enrolled had to participate in pharmacist consultations monthly for 3 months, in which they took part in a medication review by the pharmacists participating in the study. During the consultations, pharmacists carried out medication reviews on the patients' entire drug list<i>.</i> If no problems were found, they dispensed the medications. In the event of a DRP detected by the pharmacist, a pharmacist intervention was carried out: the GP of the patient was informed, or the problem was solved independently, on the pharmacist’s authority. The DRPs detected were categorized by pharmacists and then recorded in an electronic data table prepared by the authors. At the same time, pharmacist intervention to solve the DRP was also recorded. The system used to classify the detected DRPs divides the problems into six groups. In addition to the six groups, the classification system also identifies the possible underlying causes of a particular drug-related problem. The first consultation was followed by at least two further face-to-face meetings monthly during the project.<br>From the data collected by pharmacists, the authors determined the amount of DRPs and interaction risks per capita and the percentage of each DRP category and underlying cause in proportion to the total DRP.During the medication review, in addition to the fact of interaction risks, pharmacists wrote down the active substances involved in the particular interactions and recorded the pharmacist intervention(s). We determined the incidence rate of each active substance. Interaction risks were grouped from two perspectives:1. Prescribing and dispensing category of the medicine, that is, which healthcare professional is competent to provide the necessary intervention and a complete solution.The clinical risk of the interaction based on the UpToDate Lexicomp® interaction database.Interventions to address the DRPs revealed during the medication review were recorded by pharmacists on the electronic data collection sheet. The pharmacist interventions described to address the identified interactions were grouped. More than one intervention may have been necessary to solve one DRP. During the project, pharmacists used a table summarizing the full medication of the patient, which could indicate the current problem (eg interaction and its severity, and related warning), in addition, pharmacists provided patients with written leaflets summarizing the general rules of medication and placed a counseling poster in pharmacies.<br>