uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Comparing 4 classification systems for drug-related problems: Processes and functions
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
2008 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, Vol. 4, no 4, 320-31 p.Article in journal (Refereed) Published
Abstract [en]


Counseling patients on drug-related problems (DRPs) is a new enterprise for pharmacists. Accordingly, a variety of classification systems have been created to document DRPs. This aroused our interest in finding out how classification systems differ.


The objective is to explore and describe the characteristics of 4 classification systems for DRPs to understand their similarities and differences with regard to processes and functions.


Four established classification systems were selected; they were Strand, Granada-II, Pharmaceutical Care Network Europe v5.0, and Apoteket. To gain experience of the use of the systems, an existing database containing documented problems that were identified during patient counseling at community pharmacies was used. The entries in the database were classified using the 4 selected classification systems, one at a time. In the following analysis, focus was set on what issues were classified and how they were classified in each system. Based on similarities and differences, 8 themes were identified and characteristics of the 4 systems were listed according to these themes. Characteristics of each system were thoroughly scrutinized and interpreted.


The processes of selecting classification categories were different in all 4 systems, and as a result the contents of categories in systems were different. The systems had different characteristics and a decisive characteristic was whether the patients were involved in the classification of problems or not. Because of the different characteristics the systems had different functions.


To understand the usefulness of a classification system, both structure of categories and work process must be considered. The studied systems had different functions that revealed different aims embedded in the systems. To develop the counseling role of pharmacists, a limited number of classification systems would be beneficial. To get there, common aims and common systems must be developed.

Keywords: Pharmaceutical care; Drug-related problems; Classification systems

Place, publisher, year, edition, pages
2008. Vol. 4, no 4, 320-31 p.
URN: urn:nbn:se:uu:diva-95182DOI: 10.1016/j.sapharm.2007.10.006OAI: oai:DiVA.org:uu-95182DiVA: diva2:169299
Available from: 2006-11-21 Created: 2006-11-21 Last updated: 2010-05-26Bibliographically approved
In thesis
1. Towards Improved Medication Use: Increasing Understanding of Professional Efforts
Open this publication in new window or tab >>Towards Improved Medication Use: Increasing Understanding of Professional Efforts
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Professionals and researchers have developed a number of strategies aimed at improving the quality and safety of medication use. However, studies continue to demonstrate persistent problems. For instance, the first paper in this thesis reveals the prevalence of potentially harmful drug combinations among elderly people in Europe. The following four papers focus on two professional groups and how they have approached safety and quality issues related to medication use: 1) the Swedish drug and therapeutics committees (DTCs) and 2) pharmacist involved in pharmaceutical care, an international movement. Qualitative research approaches were applied.

Papers II and III focus on the DTCs: analyses indicate a development of the perception of the DTC role over time. The focus of the activities was broadened – from targeting prescribing physicians to incorporating decision-makers and patients. However, a clear patient-centered perspective was generally lacking. Moreover, the findings indicate a shift in focus from cost aspects of medication use to an increased focus on quality and safety aspects.

In the studies addressing pharmaceutical care (Papers IV and V), the findings propose that different classification systems for drug-related problems had different characteristics which reflected differences in goals in the pharmaceutical care process. It was also found that the concept of pharmaceutical care was understood in different ways and that the perceptions were based on at least two different understandings of health and illness. First, a patient-centered perspective characterized by a holistic understanding of health and illness, and, second, an “EBM perspective” primarily based on a biomedical understanding of health and illness.

This thesis has disclosed new aspects of how two groups of professionals perceive their work towards improved quality and safety of medication use. A patient-centered perspective among healthcare collectives is not obvious; therefore, efforts and comprehensive strategies supporting change are necessary. Strategies should focus on challenging the traditional thought patterns and care approaches among professionals and students.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 85 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 206
Health services research, drug quality problems, drug and therapeutics committees, pharmaceutical care, perceptions, patient centeredness, Hälso- och sjukvårdsforskning
urn:nbn:se:uu:diva-7343 (URN)91-554-6731-8 (ISBN)
Public defence
2006-12-12, Robergsalen, Akademiska sjukhuset ing 40, 4 tr, Uppsala, 13:15
Available from: 2006-11-21 Created: 2006-11-21Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Björkman, IngeborgSanner, MargaretaBernsten, Cecilia
By organisation
Health Services Research

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 255 hits
ReferencesLink to record
Permanent link

Direct link