Background Up to 80% of patients with chronic illness experience drug related problems (DRPs), which decreases their quality of life and is costly for society. To tackle DRPs, more insights into what they involve is needed. Besides insights measuring the effects of a controlled pharmacist intervention, or pertaining to poly-pharmacy, insights into how all types of patients experience DRPs in their daily life are also needed.

Purpose To holistically investigate the DRPs that patients are experiencing in a daily life context across therapeutic areas and existing DRP categories.

Method The data material in this study was part of a larger study evaluating a new education in patient-centered communication offered to pharmacy staff in Denmark. The extracted data consisted of short written descriptions of DRPs detected during counter conversations when dispensing medicines, as recorded by the pharmacy staff. The content of these stories were subjected to an inductive content analysis to understand the problems patients face with their medicines in daily life as they are happening.

Findings 297 short descriptions made by 28 pharmacy staff members from 11 different pharmacies were analyzed. Results showed that establishing and maintaining good medication treatment involves considerable efforts from both the patient and the prescriber. Three overall DRP themes were identified. Firstly, problems of actually receiving the medicines were observed. These pertained both to patients not picking up the medicine (for example due to the price or forgetfulness), a missing prescription or lack of prescription renewal, or problems with the medicine distribution system. Secondly, situations with lack of clarity about how to take the medicine were identified. This entailed patients not knowing why to take the medicine, how to administer the medicine or how to coordinate the intake with food/supplementary products. Thirdly, problems with getting satisfactory effects were registered. This included negative experiences with the medicine and concern of future side effect or lack of effect leading to strong worries and undertreatment.

Conclusion DRPs are widespread and impact patients’ daily lives practically, emotionally and health-wise. The DRP descriptions in this study clarified fundamental problems with the medicines, which have not been registered using other approaches: Before even considering whether the medicine has the desired effects, it’s necessary to ensure that basic conditions are in place, such as a continued supply of medicine and that the patient knows the treatment plan.