2021, Number 1
Rev Biomed 2021; 32 (1)
Pilot study: Impact of the pharmacist on identification and evaluation of potential drug-drug interactions in Internal Medicine inpatient prescriptions
Vázquez-Alvarez AO, Pedroza-Gómez C, Uribe-Sánchez A, Huerta-Olvera SG
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ABSTRACTIntroduction. Potential drug interactions can contribute to therapeutic failures and/or possible iatrogenesis when prescribed with two or more drugs that may interact. In Mexico, there are few studies that allow establishing the current panorama and their importance in the validation of the prescription by the pharmacist.
Objective. To evaluate the impact of the pharmacist in the identification and evaluation of potential drug-drug interactions in prescriptions of hospitalized patients of Internal Medicine
Material and methods. Observational, cross-sectional, retrospective, continuous inclusion study. Complete prescription sheets, indistinct diagnosis, and ≥2 prescribed drugs were evaluated. Interactions were detected through the micromedex 2.0 software. They were grouped by frequency, severity and pharmacological group. Secondarily, potential laboratory parameter drug interactions were recorded.
Results. In 94 patients, 743 different medications, an average of 8±3 medications/patient, with analgesics being the most prescribed. 141 potential drug-drug interactions (IPFF) were found. 47.9 % of the patients presented some interaction, of which 38.3 % were severe; percentage that decreased to 11.4 % after pharmacist evaluation as clinically relevant. Potential laboratory parameter drug interactions were identified, 8.3 % were severe. An index of 1.5 IPFF/patient was observed, which was reduced to 0.20 IPFF/patient after their evaluation by the pharmacist.
Conclusions. 47.9 % presented IPFF, which, regardless of its severity, constitutes an unrecognized problem during hospital care. Identifying those potential interactions, validating their clinical relevance by the clinical pharmacist, showed a reduction of 88.7 % of the observed interactions; allowing for more targeted surveillance.