Drug-Related Problems (DRPs) and Treatment Costs in Schizophrenia Patients at a Community Pharmacy in Yogyakarta

Abstract

Schizophrenia requires long-term antipsychotic therapy, which may increase the risk of drug-related problems (DRPs) and potentially contribute to a higher treatment cost burden. This study aimed to describe the profile of DRPs and treatment cost components among schizophrenia patients receiving medication services at a community pharmacy in Yogyakarta. A descriptive observational study with a cross-sectional design and retrospective data collection was conducted using patient medical records from January to December 2025. Medical records were selected using purposive sampling based on predefined inclusion and exclusion criteria. DRPs were identified using the Pharmaceutical Care Network Europe (PCNE) Classification Version 9.01, while treatment costs were analysed descriptively in Indonesian Rupiah (IDR). A total of 43 patient medical records met the study criteria. Most patients were male (60.47%), aged 26–35 years (41.86%), and diagnosed with paranoid schizophrenia (F20.0) (62.79%). Potential treatment safety problems or potential adverse drug reactions (P2.1) were identified in 27 patients (62.79%). The identified cause domains included therapeutic duplication (C1.4) in 8 patients (18.60%), treatment duration that was too short (C4.1) in 5 patients (11.63%), and insufficient dosing frequency (C3.3) in 3 patients (6.98%). The total recorded treatment cost was IDR 39,855,000, consisting of routine treatment costs of IDR 28,095,000, including primary antipsychotic therapy, additional medications, consultation, and therapy monitoring, as well as DRP-related costs of IDR 11,760,000, including the management of medication side effects, therapeutic duplication, insufficient dosing frequency, and short treatment duration. Potential treatment safety problems and medication-related causes were frequently identified among schizophrenia patients evaluated in this study. Systematic medication review, adverse effect monitoring, and evaluation of antipsychotic regimens by pharmacists may support safer and more efficient schizophrenia treatment. Further studies are required to evaluate direct and avoidable costs specifically attributable to DRPs using more comprehensive health economic analysis approaches.