Pharmaceutical Care Network Europe (PCNE) drug-related problem classification version 9.00: German translation and validation.

Background The drug-related problem classification system of the Pharmaceutical Care Network Europe (PCNE) is well established and continuously updated. A translated version of the drug-related problem classification system can facilitate research and implementation of clinical pharmacy services in the corresponding countries. Aim This study aimed to translate and validate the current version 9.00 into German language. Method The forward-backward translation method was used to translate the English version 9.00 into German language. Validation was done with 20 patient cases. Consistency was calculated in percentage and compared to international results. Results Translation of the classification system yielded in a German version. Validation was done with 32 pharmacists and 20 patient cases. In the five primary domains, average consistencies of 77.3% (problem), 57.8% (cause), 57.4% (intervention), 74.5% (acceptance) and 74.9% (status) were achieved. Ambiguities were found in some patient cases, as raters came to differing but plausible codes. Conclusions This study provides a German translation of the PCNE classification for drug related problems of approximately similar consistency as the international version. It hence can be considered to classify drug-related problems in German speaking countries. Patient cases need to be more specific in future validations, feasibility and layout of the classification system need to improve.

Medication Review by Community Pharmacists for Type 2 Diabetes Patients in Routine Care: Results of the DIATHEM-Study.

Most elderly patients with type 2 diabetes take multiple drugs. Earlier studies in other countries suggested that interdisciplinary medication reviews are beneficial for these patients regarding medication safety and therapy optimization. In Germany, medication reviews by community pharmacies are rarely performed, although it is a service stipulated in the "Apothekenbetriebsordnung" (rules governing the operation of pharmacies in Germany) since 2012. Therefore, the aim of the DIATHEM study (type 2 DIAbetes: optimizing THErapy by Medication review in community pharmacies) was to evaluate the impact of medication reviews from German community pharmacies under real-life conditions. Primary outcomes were: identification of drug related problems (DRPs) and to evaluate to what extent they could be solved by the medication review. Secondary outcomes were: evaluation of changes in the number of drugs and the interdisciplinary cooperation between pharmacists and physicians. In a single arm interventional study, 121 patients aged 65 or older with type 2 diabetes, taking at least five drugs for long-term treatment were provided with one medication review between February 2016 and April 2017. Physicians were not pre-informed about the review and neither patients nor physicians nor the 13 participating community pharmacies were reimbursed for their contributions to the study. For 121 patients, 586 DPRs were identified (4.84 DRPs per patient) of which 31.6% were related to the antidiabetics. Due to the medication review, 46.9% of these DRPs could be completely resolved, indicating a statistically significant decline from 4.84 DRPs to 2.57 DRPs per patient (p < 0.001). The average number of drugs was significantly reduced from 9.5 drugs (standard deviation, SD = 2.9) to 9.3 drugs (SD = 2.8) per patient (p < 0.001). The pharmacists received feedback for 76.7% of the intervention proposals sent to the physicians. In total 59.5% of the intervention proposals were accepted, of which 643 (85.3%) were accepted and fully implemented. In conclusion, the study shows that medication reviews performed by community pharmacists under routine care conditions reduced the frequency and number of DRPs, even though the pharmacies had to face obstacles such as lack of cooperation by the prescriber or lack of reimbursement.