Table 2.
Numbers, types, and clinical relevance of medication recommendations from pharmacists to GPs.
| Feedback in writing (% within category of clinical relevance) | Case conferences (% within category of clinical relevance) | ||||||
|---|---|---|---|---|---|---|---|
| Type of recommendation | Not clinically relevant | Potentially clinically relevant | Clinically relevant | Not clinically relevant | Potentially clinically relevant | Clinically relevant | Example of clinically relevant recommendation |
| Dose unsuitable for patients | 1 (4.8) | 51 (9.5) | 62 (42.2) | 0 | 73 (10.8) | 42 (26.9) | Use of more than 20 mg of temazepam daily |
| Medicines unsuitable for patients aged ≥75 years | 2 (9.5) | 18 (3.3) | 35 (23.8) | 0 | 14 (2.1) | 64 (41.0) | Use of glibenclamide, which can cause prolonged hypoglycaemia |
| Medicine not useful at al | 7 (33.3) | 27 (5.0) | 17 (11.6) | 4 (12.5) | 32 (4.7) | 15 (9.6) | Use of meprobamate, for which safer alternatives are available |
| Prescribing omissions | 4 (19.0) | 29 (5.4) | 16 (10.9) | 5 (15.6) | 43 (6.4) | 18 (11.5) | Omitting to prescribe osteoporosis prophylaxis for a patient using high doses of corticosteroids for a long period |
| Incorrect duration of therapy | 2 (9.5) | 10 (1.9) | 7 (4.8) | 0 | 6 (0.9) | 3 (1.9) | Prolonged use of hypnotics |
| Unnecessary therapeutic duplication | 0 | 39 (7.3) | 3 (2.0) | 1 (3.1) | 40 (5.9) | 5 (3.2) | Simultaneous use of different benzodiazepines |
| Form of medication unsuitable for older people | 0 | 12 (2.2) | 3 (2.0) | 2 (6.3) | 16 (2.4) | 0 | Use of immediate release nifedipine capsules |
| Suitable for the indication? | 0 | 53 (9.9) | 2 (1.4) | 0 | 111 (16.4) | 3 (1.9) | Patient uses an oestrogen preparation regularly used for complaints caused by menopause |
| Adherence (too much or too little use) | 1 (4.8) | 57 (10.6) | 1 (0.7) | 1 (3.1) | 74 (10.9) | 2 (1.3) | Patient uses more oxazepam than prescribed |
| Contraindication known | 2 (9.5) | 9 (1.7) | 1 (0.7) | 6 (18.8) | 12 (1.8) | 3 (1.9) | Use of amiodarone by patient suffering from hypothyreosis |
| Drug-drug interaction known | 1 (4.8) | 60 (11.2) | 0 | 0 | 60 (8.9) | 0 | – |
| Treatment of side effect of other medicine | 0 | 84 (15.6) | 0 | 2 (6.3) | 77 (11.4) | 0 | – |
| Others | 1 (4.8) | 88 (16.4) | 0 | 11 (34.4) | 118 (17.5) | 1 (0.6) | Use of a combination of amlodipine and losartan for a patient with oedema. Stop amlodipine and increase losartan dosage |
| Total | 21 (100) | 537 (100) | 147 (100) | 32 (100) | 676 (100) | 156 (100) | – |
| Number of records per patient | 0.06 | 1.53 | 0.42 | 0.08 | 1.75 | 0.40 | – |
| Total number | 705 | 864 | – | ||||
| Number of records per patient | 2.01 | 2.23 | P = 0.059, difference = 0.229, 95% CI = −0.467 to −0.009 | ||||