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Table 3 Causes of PCIs (using The PCNE Classification V 5.01)

From: Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension or hyperlipidaemia in primary care settings

Primary domain

Code V5.01

Cause

Frequency (%, n = 706)

1. Drug/Dose selection

C1.1

Inappropriate drug selection

7 (1.0)

 

C1.2

Inappropriate dosage selection

10 (1.4)

 

C1.3

More cost-effective drug available

2 (0.3)

 

C1.4

Pharmacokinetic problems, include ageing/deterioration in organ function and interactions

5 (0.7)

 

C1.5

Synergistic/preventive drug required and not given

11 (1.6)

 

C1.6

Deterioration/improvement of disease state

150 (21.2)

 

C1.7

New symptom or indication revealed/presented

75 (10.6)

 

C1.8

Manifest side effect, no other cause

93 (13.2)

  

Subtotal 1

353 (50.0)

2. Drug use process

C2.1

Inappropriate timing of administration and/or dosing intervals

44 (6.2)

 

C2.2

Drug underused/ under-administered

5 (0.7)

 

C2.3

Drug overused/ over-administered

9 (1.3)

 

C2.6

Patient unable to use drug/form as directed

2 (0.3)

 

C2.7

Too many medications*

6 (0.8)

 

C2.8

Inappropriate duration of use*

1 (0.1)

 

C2.9

New drug prescribed*

2 (0.3)

  

Subtotal 2

69 (9.8)

3. Information

C3.1

Instructions for use/taking not known

2 (0.3)

 

C3.2

Patient unaware of reason for drug treatment

16 (2.3)

 

C3.5

Lack of communication between HCPs

1 (0.1)

 

C3.6

Miscommunication between doctor and patient*

4 (0.6)

 

C3.7

Unclear label*

6 (0.8)

  

Subtotal 3

29 (4.1)

4. Patient/Psychological

C4.1

Patient forgets to use/take drug

34 (4.8)

 

C4.2

Patient has concerns with drugs

24 (3.4)

 

C4.3

Patient suspects side effects

37 (5.2)

 

C4.4

Patient unwilling to carry financial cost

6 (0.8)

 

C4.7

Patient unwilling to adapt life-style

3 (0.4)

 

C4.8

Burden of therapy

3 (0.4)

 

C4.9

Treatment not in line with health beliefs

6 (0.8)

 

C4.11

Religious belief*

6 (0.8)

 

C4.12

Patient unaware of possible complications*

8 (1.1)

 

C4.13

Patient unaware of drug name*

5 (0.7)

 

C4.14

Out of medication*

7 (1.0)

 

C4.15

Overseas or travelling*

9 (1.3)

 

C4.16

Patient smoking*

7 (1.0)

 

C4.17

Patient unaware of tablet strength*

1 (0.1)

 

C4.18

Patient does not trust HCPs*

1 (0.1)

 

C4.19

Patient on traditional medicine*

1 (0.1)

 

C4.20

Patient on too many supplements*

3 (0.4)

 

C4.21

Patient’s meal time is different*

1 (0.1)

 

C4.22

Patient shared medications

1 (0.1)

 

C4.23

Non-adherence to medications*

65 (9.2)

  

Subtotal 4

228 (32.3)

5. Logistics

C5.2

Prescribing error (only in case of slip of the pen)

1 (0.1)

 

C5.3

Dispensing error (wrong drug or dose dispensed)

1 (0.1)

  

Subtotal 5

2 (0.3)

6. Others

C6.11

Patient anxious about glucose level*

1 (0.1)

 

C6.12

Patient not sure of using glucose meter or other devices*

2 (0.3)

 

C6.13

Wrong frequency of glucose monitoring*

1(0.1)

 

C6.14

Drug stored in unsuitable condition*

2 (0.3)

 

C6.15

Patient not on medication in record*

3 (0.4)

 

C6.2

No obvious cause

16 (2.3)

  

Subtotal 6

25 (3.5)

  1. *Subclasses added, not in The PCNE Classification V 5.01.
  2. HCPs = Healthcare professionals.
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BMC Health Services Research

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