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Objective: To analyze the current drug-interaction management in Swiss community pharmacies, with a particular focus on electronic systems, and to compare the results with those expressed by German general practitioners in a recent survey., Methods: Data were collected with a postal questionnaire which was randomly sent to 500 out of 833 community pharmacies in the German part of Switzerland., Results: The response rate was 57.4%, and only 24.7% pharmacists reported that they were confronted less than daily with potential drug interactions. Use of computer software to identify potential drug interactions was widespread in community pharmacies (90.2%), and the software was the primary source of information (81.2 +/- 29.6%). The quality of the interaction software was judged sensitive (identifying all dangerous interactions) by 80.5 +/- 21.5%, but specific (identifying only relevant interactions) by only 38.3 +/- 32%. Pharmacists declared a low override rate (14%) of drug interaction alerts, although unjustified alerts were reported by 60.6 +/- 33.1%. In contrast to general practitioners, pharmacists opted less often for information on the mechanism of the interaction, and more frequently for details for dose adjustment. Both groups complained about deficient information on non-interacting alternatives., Conclusion: The information needs of community pharmacists differed considerably from general practitioners, and pharmacists were overwhelmed by inappropriate alerts because of a lack of specificity of their drug-interaction systems. Substantial improvement of drug-interaction software systems is thus required at least in two important aspects, the suppression of inappropriate alerts and the tailoring to the needs of the user.

The actual administration of pharmacotherapy is in most cases entirely up to the patient. Correct application can often be only achieved with application aids. They are already part of many preparations: printed blister packages, measures for dosing liquids, applicators for topical use, dosage sprays, and supports for eye drop containers. Special needs can be covered by additional application aids like dosage syringes for child medication, spacers for asthma sprays, devices for splitting or crunching tablets. Filling the medicines in containers better manageable by the patient, in week dispensers or week blisters, may also be crucial to guarantee correct dosing and regimen. Application aids often play a significant part in the success of a therapy. Needed are evidence based criteria for the selection of devices and instructions. Such criteria need to be developed because they are still largely lacking.