Drug therapy problems represent the categorization and definition of clinical problems related to the use of medications or "drugs" in the field of pharmaceutical care. In the course of clinical practice, DTPs are often identified, prevented, and/or resolved by pharmacists in the course of medication therapy management, as experts on the safety and efficacy of medications, but other healthcare professionals may also manage DTPs. A drug-therapy problem can be defined as an event or circumstance involving drug treatment that interferes with the optimal provision of medical care. In 1990, L.M. Strand and her colleagues classified the DTPs into eight different categories. According to these categories, pharmacists generated a list of the DTPs for each patient. As a result, pharmacists had a cleaner picture of the patient's drug therapy and medical conditions. A second publication of R.J Cipolle with L.M Strand in 1998, change the eight categories into seven, grouped in four Pharmacotherapy needs: indication, effectiveness, safety and adherence.
Examples
Patients suffering from chronic pain that are prescribed opioid painkillers may build up a tolerance to the effect of the painkillers, requiring higher doses to achieve the same pain reducing effect. This risky practice of dose escalation can lead to drug overdoses.
According to page 73 in Introduction to Health Care Delivery: A Primer for Pharmacists, drug therapy problems originated from Strand et al. who defined eight problems that could result in poorer health outcomes in an attempt to categorize DTP. Helper and Strand later in 1990 stated the mission statement or raison d'etre of pharmacists should be to correct these drug therapy problems. The original eight problems have now been condensed into seven categories of problems. As given by Shargel, they are:
Unnecessary drug therapy. This could occur when the patient has been placed on too many medications for their condition and the drug is simply not needed.
Wrong drug. This could occur when a patient is given medication that does not treat the patient's condition. Ex. A heart medication to treat an infection.
Dose too low. This could occur when a patient is given medication that is not strong enough to get beneficial or therapeutic effects.
Dose too high. This could occur when a patient is given medication that is too strong and is causing detrimental effects or is simply not necessary.
