Classifying pharmacists' interventions recorded in observational databases: Are they all necessary and appropriate?

Over the past 25 years in various countries, researchers have developed tools for recording pharmacist's interventions (PIs) and observational databases aimed at the exhaustive collection of these interventions. The large amount of published data contrasts strikingly with the fact that little attention has been paid to defining the different types of PIs from a theoretical point of view. Whatever the paper we read on this topic, each PI is presented as necessary and appropriate. We suggest this customary approach is biased and that the reality is somewhat more subtle. In order to better reflect the real world, we propose a new approach to the classification of PIs that is based on whether they are present or absent in observational databases, and we explain how to identify the absent ones. Present and absent PIs can be subdivided in two additional categories: appropriate and inappropriate ones. This additional classification should encourage pharmacists to critically examine and evaluate their practice and subsequently improve their ability to identify drug related problems in clinical practice.