Incidence of Drug Related Problems in Outpatient Setting: A Review Article

  • Soheil Roshanzamiri Pharmacy Student, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  • Amir Farokhian Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Kaveh Eslami Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Keywords: Pharmaceutical Care, Outpatients, Ambulatory Care, Medication Therapy Management


Detection and resolution of Drug Related problems (DRPs) are one of the most important parts of Pharmaceutical care. As many as 4.6% of deaths in the United States may be the result of a DRPs, making DRP one of the top 5 leading causes of death. According The high prevalence of DRPs in an outpatient setting, lack of information about this setting rather than inpatient setting and the importance of detection and resolution of them, reviewing the articles in this regard is necessary. In this review article, PubMed, Scopus, and Google scholar databases were used for finding the relevant studies about the prevalence of DRPs in an outpatient setting and ambulatory care services. In the past 20 years the incidence of drug-related drug problems in the ambulatory care unit has increased and it's more important in the elderly patient due to pharmacokinetic changes and polypharmacy. patients with cardiovascular diseases or diabetes mellitus and patients who require chronic pain management are important target groups for DRP Screening. the lack of medication counseling in ambulatory care and in pharmacy settings are an important cause of DRPs in an outpatient setting. According the knowledge about physiology, pharmacology and toxicology, pharmacokinetics and Pharmacotherapy, the most qualified health care provider for detection and management of DRPs in the outpatient setting is pharmacist Quality improvement programs in the base of pharmaceutical care, such as medication therapy management service should target DRPs, especially for patient groups using cardiovascular drugs, analgesics, hypoglycemic agent’s and anti-Seizure agents.


Cipolle RJ, Strand L, Morley P. Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management, Third Edition: McGraw-Hill Education; 2012.

Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD. Drug-related problems: their structure and function. DICP: the annals of pharmacotherapy. 1990;24(11):1093-7.

Bourgeois FT, Shannon MW, Valim C, Mandl KD. Adverse drug events in the outpatient setting: an 11‐year national analysis. Pharmacoepidemiology and drug safety. 2010;19(9):901-10.

Center SE. Patterns of medication use in the United States, 2006: a report from the Slone Survey. Boston: Boston University. 2006;3.

Hing E, Cherry DK, Woodwell DA. National Ambulatory Medical Care Survey: 2004 summary. Advance data. 2006(374):1-33.

Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. Jama. 2006;296(15):1858-66.

Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. Jama. 1998;279(15):1200-5.

Thomsen LA, Winterstein AG, Søndergaard B, Haugbølle LS, Melander A. Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care. Annals of Pharmacotherapy. 2007;41(9):1411-26.

Hanlon JT, Schmader KE, Koronkowski MJ, Weinberger M, Landsman PB, Samsa GP, et al. Adverse drug events in high risk older outpatients. Journal of the American Geriatrics Society. 1997;45(8):945-8.

Gandhi TK, Burstin HR, Cook EF, Puopolo AL, Haas JS, Brennan TA, et al. Drug complications in outpatients. Journal of general internal medicine. 2000;15(3):149-54.

Gandhi TK, Weingart SN, Borus J, Seger AC, Peterson J, Burdick E, et al. Adverse drug events in ambulatory care. New England Journal of Medicine. 2003;348(16):1556-64.

Sarkar U, López A, Maselli JH, Gonzales R. Adverse drug events in US adult ambulatory medical care. Health services research. 2011;46(5):1517-33.

Taché SV, Sönnichsen A, Ashcroft DM. Prevalence of adverse drug events in ambulatory care: a systematic review. Annals of Pharmacotherapy. 2011;45(7-8):977-89.

Impicciatore P, Choonara I, Clarkson A, Provasi D, Pandolfini C, Bonati M. Incidence of adverse drug reactions in paediatric in/out‐patients: a systematic review and meta‐analysis of prospective studies. British journal of clinical pharmacology. 2001;52(1):77-83.

Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. Jama. 2003;289(9):1107-16.

How to Cite
Roshanzamiri S, Farokhian A, Eslami K. Incidence of Drug Related Problems in Outpatient Setting: A Review Article. J Pharm Care. 5(3-4):76-78.
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