Respuesta de los profesionales de medicina de familia a la difusión de la posible interacción entre clopidogrel y los inhibidores de la bomba de protones

Abstract

Introduction

Recently, different studies with contradictory results have been published on the possible interaction between clopidogrel and proton pump inhibitors (PPI). This study aims to analyze the response of the family medicine professionals in regards to modification in the treatment of patients using both drugs simultaneously after an intervention that consisted in the diffusion of the informative note issued by the Agencia Española de Medicamentos y Productos Sanitarios, accompanied by pharmacotherapeutical recommendations and census of the affected patients.

Methods

Before and after quasiexperimental study was performed by the Health Care District of Granada. The study population included the patients who were being prescribed both medications in June 2009, identified through the computer program MicroStrategy. A total of 1499 patients were detected through sampling stratified by center and by gender. A sample of 360 clinical histories was obtained. The audit was done on 298. The outcome variable was the modification or not of treatment classified according to the therapeutic option chosen (elimination or substitution of any of the drugs administered simultaneously).

Results

In 42.6% (95% CI: 37–48) of the clinical histories, the physician modified treatment after diffusion of the note. In 19.68% of the patients, treatment with clopidogrel was discontinued or substituted with acetylsalicylic acid (ASA). In the remaining 102 patients, the PPI was substituted with another drug or was withdrawn. In patients from teaching sites, more modifications of the treatment were made then in the nonteaching sites.

Discussion

The number of patients with both drugs prescribed simultaneously decreased. Thus the intervention is shown to be a valid option to be incorporated into the usual practice in the work of primary care pharmacists.