Drug therapy must balance the potential to improve quality of life with the risk of adverse effects. In the context of ever-increasing treatment complexity, striking this balance is getting complicated.

Although avoiding drug-related problems (DRPs) reduces health care expenditures, saves lives, and enhances patients’ quality of life, one study identified 9.4 DRPs per hospitalized patient on average, while another study detected 4.1 DRPs per community pharmacy patient on average. More recently, a team of researchers estimated outpatient DRP incidence in a study published in the February 2016 issue of Therapeutics and Clinical Risk Management.

The researchers assessed DRP incidence at 5 hospital-run outpatient clinics. All 2898 patients enrolled in this study had at least 1 chronic cardiac, endocrine, or respiratory condition and received at least 2 medications.

Enrolled patients had an average of 11.2 DRPs, which was higher than the findings of comparable past studies in hospitalized and community pharmacy patients. The most common DRPs seen in the current study included the need for additional monitoring, adherence difficulties, and insufficient instruction or understanding.

Nonadherence to self-care activities was comparable in this study (13.45%) to a study in heart failure patients (14%). Insufficient instruction and understanding was also similar in magnitude to a previous study in patients who had diabetes.

Approximately 5% of study participants had gout, and these patients had more DRPs (12.2 per patient) than the population as a whole and those who did not have gout.

Patients with asthma and chronic obstructive pulmonary disease had fewer DRPs than other patients. The authors attributed this finding to campaigns targeting DRPs in asthma and COPD.

This study neither reported the patients’ average number of medications, nor employed pharmacist interventions to decrease DRPs or use interventions designed to decrease DRPs.

Nevertheless, the study authors noted that common DRPs can be prevented by incorporating pharmacists into outpatient clinics.