Drug Utilization Reviews by Community Pharmacists in Japan: Identification of Potential Safety Concerns through the Brown Bag Program

Value Health Reg Issues. 2012 May;1(1):98-104. doi: 10.1016/j.vhri.2012.03.001. Epub 2012 May 25.


Objectives: Pharmacy-based drug utilization reviews were conducted through the Brown Bag program to understand drug-use patterns, identify potential safety concerns, and provide appropriate consultation for elderly individuals.

Methods: Community pharmacists in Hiroshima, Japan, participated in this review program from October to December 2009. Elderly individuals, 65 years or older, were recruited from community events or at pharmacies and were asked to bring all their prescription and nonprescription drugs including over-the-counter drugs and dietary supplements to the program. Pharmacists reviewed the medications and their usages and gave appropriate feedback if medications were used incorrectly, had potential interactions, or had safety concerns. The relationships among medication usage, participant responses, and potential safety concerns were analyzed by using logistic regression models. In addition, contraindications, duplicate medications, and potentially inappropriate medications were descriptively analyzed.

Results: Drug utilization reviews were conducted on 508 elderly participants at 177 community pharmacies. Of the 508 participants, 53% were 75 years old or older and 34% were men. Twenty-four percent of the elderly participants used prescription drugs only, and 73% used both prescription and nonprescription drugs. Pharmacists offered feedback to 250 participants (49%) concerning the risk of duplication/interaction, possible adverse drug reaction that can be averted, inappropriate/unnecessary medication, nonadherence, and overdose. Two cases of contraindicated drugs, 3 cases of duplicate medications, and 327 cases of potentially inappropriate medications were identified.

Conclusions: The drug-use patterns among elderly individuals were identified. This medication review program conducted at community pharmacies was a useful approach to reduce concerns among users and prevent safety problems.

Keywords: community pharmacist; drug utilization review; elderly; potentially inappropriate medication.