Coronary heart disease: Pharmaceutical care can make a big difference.

Ina Richling, a pharmaceutical consultant at St. Johann Hospital Dortmund, presented a compelling patient case at the current "pDL Campus live" webinar, using it as an example to provide practical tips for conducting a medication review. Professor Dr. Stephan Achenbach from the University Hospital of Erlangen provided a medical assessment of the recommendations.

Mr. M., 63, arrives with a new prescription. Pharmacy . He is visibly dissatisfied with another medication and agrees to a medication review. In addition to the prescribed medications (see box below), he is also taking [medication name] prescribed by his wife because of [reason not specified]. Pains now and then Diclofenac 25 mg. He completely removes the medication from its blister pack and stores it in a transparent plastic box. His BMI is 31 kg/ ^m² , and his blood pressure is elevated, as measured at the pharmacy during the examination. This results in pharmaceutical services . Adherence is not optimal.

Richling began by offering tips on conducting a structured medication review. Using available data from the patient file or medication list (electronic patient record, ePA), one can prepare for the patient consultation and, for example, perform an initial interaction check. Information about medications and dosage times that may have been omitted can also be looked up at leisure.

Nevertheless, the patient consultation remains the core of the service. This is where issues like the use of non-prescribed medications (such as diclofenac) or improper storage often come to light. For example, nitrendipine loses 10 percent of its effectiveness daily if it is not stored protected from light.

The consultation also addresses patient expectations and concerns regarding the therapy. Other services, such as standardized blood pressure measurement, can be offered directly. To assess adherence, Richling suggests acknowledging that one is not perfect ("I would certainly forget a dose myself – how about you?").