[Causes of Patient Referral by Community Pharmacists in Madrid: An Analysis of the Conexión Futuro Study].

Introduction: The high prevalence of problems related to invalid or erroneous prescriptions causes numerous patient referrals from community pharmacy, as well as problems related to patients' adherence to their treatments and underscores the importance of effective review and validation systems in pharmacies.

Objective: To identify and quantify the causes of patient referral from community pharmacies to physicians.

Methods: Observational, cross-sectional, non-interventional and analytical study. The possible causes of patient referral from community pharmacies were defined and these causes were quantified by means of an online questionnaire.

Results: A total of 3530 referrals were recorded from 165 community pharmacists in 114 pharmacies. The most frequent cause of referral was lack of a valid prescription (57.7%). Health problems requiring a prescription (18.4%) and problems with the prescribed medication, such as shortages or incorrect dosage (17.2%) were also identified.The study highlights the importance of implementing Complementary Dispensing (CD) and Independent Dispensing (ID) to reduce referrals and improve adherence to treatment. Thirty-two percent of referrals could have been avoided through these professional pharmaceutical actions, reducing the pressure on primary care, specialized and emergency care centers, allowing pharmacists to adjust or advance prescriptions under consensus with physicians or to dispense certain drugs without prescription. The previously defined referrals were collected by means of a validated questionnaire.

Conclusion: Expanding the competencies of community pharmacists would improve the efficiency of the health care system, reducing referrals and improving adherence to treatment.