Gutiérrez-Igual Salvador, Lucas-Domínguez Rut, Sendra-Lillo José, Martí-Rodrigo Alberto, Crespo Isabel Romero, Montesinos M Carmen
Muy Ilustre Colegio Oficial de Farmacéuticos de Valencia (MICOF), Valencia, Spain.
Chair for the Rational Use of Medicines, MICOF-University of Valencia, Valencia, Spain.
Explor Res Clin Soc Pharm. 2024 Oct 24;16:100536. doi: 10.1016/j.rcsop.2024.100536. eCollection 2024 Dec.
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.
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.
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.
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 ( < 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 %.
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.
药物相关问题是一个主要问题，由于就诊次数增加、再次住院或急诊就诊，可能导致发病率、死亡率上升以及医疗费用增加。在农村地区，临床药学服务的新工具，如药物重整，可能会减少这一问题。
分析农村药房中新的药物重整软件（Revisem®）识别出的临床相关药物相关问题（DRP）和潜在不适当处方（PIP）的患病率。还评估了在接受药师主导干预（PLI）的患者中解决DRP和PIP的有效性。
在西班牙巴伦西亚地区的17家农村药房进行了一项为期6个月的前瞻性、多中心观察性试点研究。开发并实施了1型药物重整软件Revisem®，以检测和解决药物相关问题（DRP和PIP）。记录了135名使用多种药物患者的临床病史，以及在发现问题后进行的PLI。分析并比较了PLI前后DRP和PIP的平均数量。
在135名患者（86名女性）中总共检测到1545个药物相关问题。其中1166个是DRP，379个是PIP。药物相互作用是最常见的问题（43.7%），呋塞米和奥美拉唑是发生显著相互作用次数最多的药物。在干预前后的研究中，Revisem®检测到的每位患者的平均问题数在PLI后从9.7±6.9降至8.8±6.9（P<0.05）。书面报告是药师与医生之间最常用的沟通方式（45.0%）。药师建议的接受率为45.2%。
药师主导的干预措施对农村药房产生了影响，能够发现大量药物相关问题，并显著减少DRP和PIP的数量，预防不良健康后果。
