Drug-Related Problems (DRPs) pose a significant Public Health concern affecting patient safety in both urban and rural settings. Ensuring the Rational Use of Medicines is a central activity of Pharmaceutical Care (PC). This study aimed to evaluate the effectiveness of Pharmacist-led Intervention (PLI) in reducing DRPs and to analyze differences between rural and urban settings. The influence of sociodemographic variables in PLI acceptance was also estimated. A prospective quasi-experimental study was conducted with a pre-post PLI approach from August 2023 to June 2025 in Valencia (Spain). Patients whose medication was reviewed in community pharmacies were included and classified according to pharmacy location, categorized into rural (less than 5,000 inhabitants) and urban areas. This allowed a comparative analysis in each setting. Main variables included total number of DRPs, DRPs categorization, and sociodemographic factors in each location. PLI resulted in a notable reduction in general DRPs (p < 0.05) in both urban and rural settings. Significant differences were observed for precautions for use, contraindications, and START criteria (p < 0.05) between urban and rural settings. Furthermore, locations with more than 600 inhabitants evidenced a higher number of DRPs (p < 0.05). Additional analysis demonstrated that acceptance of PLI was significantly associated with region, urban/rural area, number of health centers, DRPs category, pharmacists’ recommendations, and category of medical intervention (p < 0.05). Further analysis indicated that a higher number of medications and living in areas with more than one health center (urban areas) were associated with an increased likelihood of intervention acceptance. This study confirms the positive impact of PLI on reducing drug-related problems. However, particular differences between rural and urban settings require adjustment of intervention strategies to optimize PC.
Gutiérrez-Igual et al. (Sat,) studied this question.