Vinciguerra Valeria, Fantozzi Roberto, Cena Clara, Fruttero Roberta, Rolle Carla
Hospital Pharmacy, Humanitas Gradenigo Hospital, Turin, Italy.
Department of Science and Technology, University of Turin, Turin, Italy.
Eur J Hosp Pharm. 2018 Nov;25(6):301-309. doi: 10.1136/ejhpharm-2017-001253. Epub 2017 Aug 1.
(1) To evaluate drug-drug interactions (DDIs) in general practitioners' (GPs) prescriptions; (2) to implement a cooperation project between pharmacists and GPs to improve DDI management and patient care.
In 2013, pharmacists from the Community Drug Assistance ASL TO1 launched a cooperation project involving 48 GPs. As a first step, GPs were asked to select, from a list, drug associations for which they recommended analysis of occurrence in their prescriptions. The pharmacists (1) analysed GPs' prescriptions dated 2012-2014, according to the list of DDIs selected (n= 9); (2) evaluated solutions for DDI management, using the DDI checker database and literature analysis; they then (3) disseminated DDI-related information to GPs through training meetings and (4) assessed the efficacy of these actions through a questionnaire submitted to the GPs in 2013.
(1) : a reduction in the number of DDIs was observed (-14% in 2013 vs 2012, -9% in 2014 vs 2012); in some cases these reductions were statistically significant (calcium carbonate + proton pump inhibitors (PPIs) -50%, p<0.0041, amoxicillin+lansoprazole -42%, p<0.0088). (2) : this was completed by 75% of GPs. The literature analysis was considered interesting by 94% of GPs; solutions were adopted by 89% of GPs and 34% of GPs affirmed that clinical improvements after application of the measures were observed in their patients, even if they could not provide quantitative data for this outcome.
The cooperation project between pharmacists and GPs was effective because it established a professional exchange between the two health professionals. The pharmacist gave support to GPs, which benefited the patients, who gained clinical improvements and improved satisfaction with their medical care, as declared by the GPs in answers to the questionnaire.
(1)评估全科医生(GPs)处方中的药物相互作用(DDIs);(2)开展药剂师与全科医生之间的合作项目,以改善药物相互作用管理和患者护理。
2013年,阿斯利康社区药物援助中心TO1的药剂师发起了一个涉及48名全科医生的合作项目。第一步,要求全科医生从一份清单中选择他们建议分析其处方中出现情况的药物组合。药剂师(1)根据所选的药物相互作用清单(n = 9)分析了全科医生2012 - 2014年的处方;(2)使用药物相互作用检查数据库和文献分析评估药物相互作用管理的解决方案;然后他们(3)通过培训会议向全科医生传播与药物相互作用相关的信息,并且(4)通过2013年向全科医生提交的问卷评估这些行动的效果。
(1)观察到药物相互作用数量减少(2013年相较于2012年减少14%,2014年相较于2012年减少9%);在某些情况下,这些减少具有统计学意义(碳酸钙 + 质子泵抑制剂(PPIs)减少50%,p < 0.0041,阿莫西林 + 兰索拉唑减少42%,p < 0.0088)。(2)75%的全科医生完成了此项工作。94%的全科医生认为文献分析很有趣;89%的全科医生采用了相关解决方案,34%的全科医生确认在应用这些措施后观察到其患者的临床改善,尽管他们无法提供该结果的定量数据。
药剂师与全科医生之间的合作项目是有效的,因为它在这两个医疗专业人员之间建立了专业交流。药剂师为全科医生提供了支持,这使患者受益,如全科医生在问卷回复中所宣称的,患者获得了临床改善并提高了对医疗护理的满意度。