Table 3.

Drug Therapy Problems Identified During Pharmacist Intervention

Descriptiona	Drug therapy problems, N
There is no valid medical indication for the drug therapy at this time	4
Multiple drugs are being used for a condition that requires single-drug therapy	2
The medical condition is more appropriately treated with nondrug therapy	0
Drug therapy is being taken to treat an avoidable adverse reaction associated with another medication	1
Drug abuse, alcohol use, or smoking is causing the problem	0
A medical condition requires the initiation of drug therapy	7
Preventive drug therapy is required to reduce the risk for a new condition	3
A medical condition requires additional pharmacotherapy to attain synergistic or additive effects	0
The drug is not the most effective for the medical problem	1
The medical condition is refractory to the drug	0
The dosage form of the drug is inappropriate	2
The drug is not effective for the indication being treated	0
The dose is too low to produce the desired response	7
The dosage interval is too infrequent to produce the desired response	1
The drug interaction reduces the amount of active drug available	0
The duration of drug therapy is too short to produce the desired response	0
The drug causes an undesirable reaction that is not dose related	3
A safer drug is required because of risk factors	7
A drug interaction causes an undesirable reaction that is not dose related	0
The dosage regimen was administered or changed too rapidly	0
The drug causes an allergic reaction	0
The drug is contraindicated because of risk factors	1
Additional laboratory monitoring is recommended to prevent adverse drug reactionb	12
The drug's dose is too high	0
The dosing frequency is too short	0
The duration of drug therapy is too long	1
A drug interaction occurs, resulting in a toxic reaction to the drug	0
The dose of the drug was administered too rapidly	0
The patient does not understand the instructions	1
The patient prefers not to take the medication	0
The patient forgets to take the medication	1
The drug is too expensive for the patient	1
The patient cannot swallow or self-administer the drug appropriately	0
The drug is not available for the patient	0
Total drug therapy problems/total medications assessed among 13 patients	55/191 (28.8%)
Drug therapy problems unresolved at 30 days after discharge	24 (43.6%)

^aAdapted from Brown TR, ed. Handbook of Institutional Pharmacy Practice. 4th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2006.

^bDenotes addition to standard definitions of drug therapy problems.26