Various classifications have been developed for classifying drug problems, based on different definitions of drug-related problems and with different structures and methods of use. To date, no universally accepted classification system has been adopted yet. In addition, there is also the question of the comparability of the developed classifications.
The goal of this master's thesis was to review and compare the characteristics of the classifications of drug-related problems and to map the content of these classifications.
We started the research with a literature review, accessed through specialized databases (PubMed, ResearchGate). We reviewed articles and collected data on classifications of drug-related problems. We were interested in data on authors, development, structure, purpose, and environment of use of drug-related classifications problems. Because we did not obtain all the desired data from the articles, we sent an online survey to the authors of the classifications. Authors who did not respond recieved an email with information about their classification and were asked to validate the data collected. After data collection was completed, we mapped the classifications.
We found 16 classifications of drug-related problems, of which 11 are hierarchical classifications (PCNE, APS-Doc, Cipolle et. al., DOCUMENT, iMAP, Horvat/Kos, Krska et. al., Mackie, NCC MERP, Pi-doc and Ruths) and 5 non-hierarchical (ASHP, Granada, Hanlon, Hepler/Strand, Westerlund). There are 5 classifications of drug-related problems (Cipolle et al., Hanlon, Horvat/33 gostoKos, NCC MERP, PCNE) with separate problems and causes. The PCNE classification (version V9.1) was chosen as the reference classification for the mapping process. The PCNE classification has a hierarchical structure and separates problems and causes. Not all other classifications have a hierarchical structure and do not have separate problems and causes. In mapping the classifications, we considered the primary and secondary levels of domains when mapping the classifications. For some categories of drug-related problems we needed more PCNE codes. In the mapping process, we found the most equivalents in the P2 Treatment Safety, C1 Drug Selection, C3 Dose Selection, and C7 Patient Related domains. Classifications of drug-related problems are used in various health care settings, most commonly in: outpatient pharmacies, dispensaries, nursing homes, drug utilization review services, hospitals, emergency rooms, intensive care, seamless care (discharge from a hospital).
|