Drug-related problems and their determinants among stroke patients in suburban China: a PCNE-based analysis with targeted initiatives

Background: Stroke remains a major public health burden in China, and the complexity of long-term pharmacotherapy often places stroke survivors at high risk for drug-related problems (DRPs). This study aimed to identify determinants of DRPs among community-dwelling stroke patients in suburban Beijing and to propose targeted initiatives for improving rational drug use. Methods: A cross-sectional study was conducted from August 2022 to December 2024 among 481 stroke patients. Pharmacists performed face-to-face interviews to collect demographic, clinical, and drug-related information. DRPs were identified and categorized using the Pharmaceutical Care Network Europe (PCNE) Classification System (V9.1). Chi-square tests and multivariate logistic regression were used to determine factors associated with DRPs. Results: A total of 482 DRPs were identified, corresponding to 575 cause entries. The most common problems involved suboptimal treatment effectiveness and issues requiring further clarification. Patient-related causes were predominant, especially intentional underuse or non-use of drug and inappropriate timing or dosing intervals. Logistic regression showed that alcohol consumption (OR = 1.770), comorbid diabetes (OR = 1.818), depression/anxiety symptoms (OR = 1.733), and higher animal fat intake (OR = 1.711) significantly increased DRP risk. Lower income, polypharmacy, and poorer self-rated health were also associated with DRPs. Conclusion: DRPs were highly prevalent among community-dwelling stroke survivors, driven largely by modifiable behavioral and drug-use factors. Integrating PCNE-based DRP identification with pharmacist-led community interventions may help optimize drug management, enhance treatment safety and effectiveness, and support long-term secondary prevention.