Evaluación de un programa de intervención farmacéutica en pacientes con medicamentos de riesgo renal

Arroyo, L. Álvarez; Grana, Eduardo Climent; Ros, N. Bosacoma; Meroño, Susana Roca; Gil, M. Perdiguero; Baines, Juan Pablo Ordovás; Payá, José Sánchez

doi:10.1016/s1130-6343(09)71156-0

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Our study reveals similar results to other authors on the subject in distinct types of health care institutions. Alvarez Arroyo et al [12] in a hospital-based study with 185 patients (88 in the control group and 97 in the intervention group), found a frequency of dosing inadequacy of 22.5% in the control group and 18.7% in the intervention group. After the pharmaceutical intervention, the frequency of dosing inadequacy went down by 2.1% and this resulted in lower drug expenditure.…”

Section: Discussionmentioning

confidence: 99%

“…Despite this, similar designs have been used in other studies [12-14]. To improve outcome reliability, the unanswered physicians’ questionnaires were taken as negative responses to the pharmacists’ recommendations, the DRP was considered unresolved and was then included in the results pool.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of dosing inadequacy (DI) was calculated through the mathematical expression [12]: DI = (N° inadequately adjusted and/ or contra-indicated drugs / N° total adjustable drugs)*100…”

Section: Methodsmentioning

confidence: 99%

“…Assuming that the prevalence of dosing inadequacy in the elderly is 20%, as has been previously reported [12], and to obtain a precision of 3% with a 95% confidence interval, the sample size required was 683 drug products with restrictions in case of renal impairment.…”

Section: Methodsmentioning

confidence: 99%

“…Studies conducted in hospital settings and residential homes in which the pharmacist tried to prevent and treat DRPs in elderly, renally-impaired patients produced positive results in terms of patients’ health [12-15]. Recently, other studies [16,17] showed a reduction in medication errors and in inappropriately high doses of renally excreted medications in patients with CKD in ambulatory or primary care settings.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment — a comparative study

Via-Sosa¹,

Lopes²,

March³

2013

BMC Fam Pract

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BackgroundDrug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients’ safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacist’s intervention in improving dosing inadequacy in these patients when compared with usual care.MethodsThe study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient.ResultsThe mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists’ intervention was 0.73% [95% CI (−6.0) - 7.5] and after the pharmacists’ intervention it was 13.5% [95% CI 8.0 - 19.5] (p < 0.001) while the difference in the mean of drug-related problems per patient before the pharmacists’ intervention was 0.05 [95% CI( -0.2) - 0.3] and following the intervention it was 0.5 [95% CI 0.3 - 0.7] (p < 0.001).ConclusionA drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment — a comparative study

Via-Sosa¹,

Lopes²,

March³

2013

BMC Fam Pract

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Drug prescribing in patients with renal impairment optimized by a computer-based, semi-automated system

et al. 2013

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Before the intervention, the frequency of appropriate prescribing based on renal function was 65 %. After the intervention, this frequency was 86 % (p < 0.001). The interventions were more frequent in the emergency department (45 %). The program required 30-45 min of pharmacist time per day. The average number of patients reviewed daily was 28. This study found that a computer-based, semi-automated drug-dosage program for renal failure patients was able to reduce the number of inappropriate orders due to renal insufficiency.

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Effectiveness of pharmacist intervention in patients with chronic kidney disease

et al. 2014

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Evaluación de un programa de intervención farmacéutica en pacientes con medicamentos de riesgo renal

Abstract: The results of the study indicate that the application of a pharmaceutical care model based on the prospective validation of drugs with renal risk, very significantly improved the adaptation of dosing regimens in kidney disease.

Cited by 5 publications

References 15 publications

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment — a comparative study

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment — a comparative study

Drug prescribing in patients with renal impairment optimized by a computer-based, semi-automated system

Effectiveness of pharmacist intervention in patients with chronic kidney disease

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