Identification and Classification of Drug-Related Problems Associated with Analgesic Therapy Using the Pharmaceutical Care Network Europe (PCNE) Classification System: A Narrative Review

Author

Kushi Sanjay,Preetham Gowda Chujjalakyathanahalli Manjunath, Amulya Swamy Gowda, Shama Ramesh, Sheba Baby John, Bettaswamy Huraliganaganahalli Vykuntappa,Hanumantachar Joshi K

Abstract

 Background: Analgesic therapy is essential for pain management but frequently carries risks of complex drug-related problems (DRPs). Standardized frameworks like the Pharmaceutical Care Network Europe (PCNE) classification system are crucial for systematically identifying, documenting, and mitigating these issues. Objectives: This review aims to systematically identify and classify analgesic-associated DRPs using the PCNE framework, evaluate their prevalence and causes, and assess the impact of pharmacist-led interventions, multidisciplinary stewardship, and audit loops on patient safety. Methods: A narrative review was conducted by searching electronic databases (PubMed, Scopus, Google Scholar, Cochrane Library) for peer-reviewed literature published between 2020 and 2025 focusing on DRP classification and opioid stewardship in acute and chronic pain settings. Result: DRP prevalence often exceeds 75% in high-risk populations, with opioids, NSAIDs, and acetaminophen being the most frequently implicated drug classes. The primary PCNE problem domains identified were treatment effectiveness and treatment safety, heavily driven by prescribing errors, incorrect dosing, and prolonged treatment durations. Hospital-based DRPs typically stem from complex protocols and communication gaps, whereas community-based DRPs relate to polypharmacy and self-medication. Pharmacist-led interventions resulted in an 11% reduction in mean daily opioid doses and a 24.6% decrease in high-risk co-prescribing. Conclusion: Analgesic therapy is highly prone to DRPs, but structured PCNE classification enables data-driven quality improvement. Formal integration of clinical pharmacists into multidisciplinary stewardship programs significantly reduces medication-related harm and optimizes patient pain outcomes.

Keywords

Analgesics; Drug-Related Problems; PCNE Classification; Opioid Stewardship; Clinical Pharmacist.

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References

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