The possibilities to perform a retrospective medication review are largely dependent on the setting, the available expertise and the available information. It seems that especially the available information controls the depth of the review. Therefore PCNE proposes following three categories:
I. The simple medication review
The simple medication review is based on the medication history in the pharmacy. When doing a review based on medication history only, one can detect drug-drug interactions, some side-effects, unusual dosages and some adherence issues?
II. The Intermediate medication review
The intermediate review is based on medication history and 'life' patient information. Under such cicumstances, the professional could find drug-drug interactions, some side-effects, unusual dosages adherence issues, drug-food interactions, effectiveness issues, side effects, and possible problems with OTC medications.
III. The advanced medication review
An advanced medication review is based on medication history, patient information and clinical information. One can identify the wides array of potential and real drug-related problems, such as drug-drug interactions, some side-effects, unusual dosages adherence issues, drug-food interactions, effectiveness issues, side effects,possible problems with OTC medications plus indications related problems such as indication without a drug and drugs without indication. There would also be a possibly to identify also dosage issues based on laboratory data, antibiotic appropriateness, adherence to clinical guidelines & formularies etc..
More on this categorisation can be found at the website of the 2009 PCNE working symposium at
http://pcne.vanmilconsult.nl/wc2009/.
