Impact of pharmacist-led interventions in identifying and resolving drug related problems and potentially inappropriate prescriptions among rural patients: A pilot study

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy Pub Date : 2024-10-24 DOI:10.1016/j.rcsop.2024.100536

Salvador Gutiérrez-Igual , Rut Lucas-Domínguez , José Sendra-Lillo , Alberto Martí-Rodrigo , Isabel Romero Crespo , M. Carmen Montesinos

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Abstract

Background

Drug-related problems are a major problem that can lead to increased morbidity, mortality, and healthcare costs due to heightened medical visits, hospital readmissions, or emergency room visits. In rural areas, new tools for clinical pharmacy services, such as medication review, could decrease this problem.

Objective

To analyze the prevalence of clinically relevant drug-related problems (DRPs) and potentially inappropriate prescriptions (PIPs) identified by new medication review software (Revisem®) in rural pharmacies. The effectiveness of resolving DRPs and PIPs in patients who received pharmacist-led intervention (PLI) was also evaluated.

Methods

A prospective, multicenter, observational pilot study in 17 rural pharmacies from the Valencian region (Spain) was conducted over a period of 6 months. Revisem®, a type 1 medication review software, was developed and implemented to detect and resolve drug-related issues (DRPs and PIPs). The clinical history of 135 polymedicated patients was recorded, as well as the PLI conducted after the identification of incidences. The mean number of DRPs and PIPs before and after PLI were analyzed and compared.

Findings

A total of 1545 drug-related issues were detected in 135 patients (86 women). 1166 were DRPs and 379 were PIPs. Interactions were the most common incidence (43.7 %), with furosemide and omeprazole being the drugs with the highest number of significant interactions. In the before-after intervention study, the mean number of incidents detected per patient by Revisem® decreased from 9.7 ± 6.9 to 8.8 ± 6.9 (p < 0.05) after PLI. Written reports were the most frequent means of communication between pharmacists and physicians (45.0 %). The acceptance rate of pharmacists' suggestions was 45.2 %.

Conclusion

The impact of pharmacist-led interventions in rural pharmacies allowed the detection of a high number of drug-related issues and significantly reduced the number of DRPs and PIPs, preventing negative health outcomes.

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以药剂师为主导的干预措施在识别和解决农村患者药物相关问题及潜在不当处方方面的影响：试点研究

背景药物相关问题是一个重大问题，可导致发病率、死亡率和医疗费用增加，原因是就诊人数、再次入院人数或急诊就诊人数增加。目的分析农村药房使用新型药物审查软件 (Revisem®) 发现的临床相关药物问题 (DRP) 和潜在不当处方 (PIP) 的发生率。方法在巴伦西亚地区（西班牙）的 17 家农村药房开展了一项为期 6 个月的前瞻性、多中心、观察性试点研究。Revisem® 是一款 1 类药物审查软件，用于检测和解决与药物相关的问题（DRP 和 PIP）。记录了 135 名多药患者的临床病史，以及发现问题后进行的 PLI。对 PLI 前后的 DRP 和 PIP 平均数量进行了分析和比较。其中 1166 例为 DRP，379 例为 PIP。相互作用是最常见的情况（43.7%），其中呋塞米和奥美拉唑是发生重大相互作用次数最多的药物。在干预前后的研究中，PLI 后，Revisem® 检测到的每位患者的平均事件数从 9.7 ± 6.9 降至 8.8 ± 6.9（p <0.05）。书面报告是药剂师和医生之间最常见的沟通方式（45.0%）。药剂师建议的接受率为 45.2%。结论药剂师主导的干预措施对农村药房的影响是发现了大量与药物相关的问题，显著减少了 DRP 和 PIP 的数量，避免了负面的健康后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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