Negative Clinical Outcomes Associated With Drug-Related Problems in Heart Failure (HF) Outpatients: Impact of a Pharmacist in a Multidisciplinary HF Clinic

Gastelurrutia, Paloma; Benrimoj, Shalom I.; Espejo, José Luis Martínez-Dueñas; Tuneu, Laura; Mangues, M. A.; Bayés‐Genís, Antoni

doi:10.1016/j.cardfail.2010.10.009

Cited by 77 publications

(110 citation statements)

References 25 publications

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“…Zaman and Fun (2013) found that 90% of diabetic patients in the hospital had DRP. Gastelurrutia et al (2011) observed DRP in 80% of patients suffering from heart failure seen in a medical clinic. These disparities may be attributed to the different populations studied and to the patient inclusion criteria, since in the present study patients were included regardless of specific criteria that required special pharmaceutical care.…”

Section: Discussionmentioning

confidence: 99%

“…The Dader method for pharmacotherapy follow-up defines DRP as situations that hinder pharmacotherapy aims and may or may not result in DNO, which are considered inadequate for patient health and associated with the use or lack of use of drugs (Committee of Consensus, 2007). This classification has been used in the literature by several authors (Zaman, Chai, 2013;Takahashi et al, 2011;Gastelurrutia et al, 2011;Amariles et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Unsatisfactory glycemic control in type 2 Diabetes mellitus patients: predictive factors and negative clinical outcomes with the use of antidiabetic drugs

Marczynski

Cortellazzi

Barberato‐Filho

et al. 2016

Braz. J. Pharm. Sci.

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Many factors can interfere with glycemic control in patients with type 2 diabetes mellitus and this patient group has an increased risk of experiencing drug-related negative outcomes (DNO). The aim of this study was to identify the predictive factors of unsatisfactory glycemic control and DNO in this group of patients. A cross-sectional study was conducted collecting data from prescriptions and interviews with 100 patients of the Endocrinology Clinic of the Hospital Complex of Sorocaba, São Paulo, Brazil. Variables associated with unsatisfactory glycemic control were determined and the DNO associated with antidiabetic drugs identified. Age (<65 years) (OR=4.09), family history of diabetes (OR=3.24), use of combined therapy to treat diabetes (2-4 antidiabetic drugs) (OR=5.13) and presence of DNO (OR=5.92) were found to be predictive factors for poor patient glycemic control. DNO were observed in 49% of the patients and were caused predominantly by ineffectiveness in patients with poor glycemic control (p<0.05). There was no significant difference between groups (satisfactory and unsatisfactory glycemic control) for DNO caused by safety issues (p>0.05). Characterization of the profile of patients with uncontrolled diabetes and of aspects associated with drug treatment can contribute to the planning of interventions to improve patient care.Uniterms: Type 2 Diabetes mellitus. Type 2 Diabetes mellitus/study/drugs use. Pharmaceutical care. Drug-related negative outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Unsatisfactory glycemic control in type 2 Diabetes mellitus patients: predictive factors and negative clinical outcomes with the use of antidiabetic drugs

Marczynski

Cortellazzi

Barberato‐Filho

et al. 2016

Braz. J. Pharm. Sci.

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“…Clonidine is mentioned in the Beers criteria as a drug that has a high risk of adverse effects, including those that affect the central nervous system, orthostatic hypotension and bradycardia. It is interesting to note that the mean age of our patients was 63 years, which is considered elderly in Brazil, and clonidine should not be routinely used for the treatment of hypertension in this population (Gastelurrutia et al, 2011). Therefore, the pharmacist recommended that the physician change the antihypertensive drug to a safer medication.…”

Section: Discussionmentioning

confidence: 99%

“…2 Calculated estimates considering the row totals in order to compare "with" and "without" polypharmacy. Adverse drug reactions can be associated with negative clinical outcomes in patients with chronic diseases, so interventions to solve this problem are very important (Gastelurrutia et al, 2011). A high occurrence of adverse drug reactions can lead to higher rates of treatment interruption (Vasconcelos et al, 2005;Firmo, Lima-Costa, Uchôa, 2004).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of medication therapy management services in primary health care

Mendonça

Melo

Pereira

et al. 2016

Braz. J. Pharm. Sci.

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This study evaluates whether the integration of pharmacists into health-care teams through the delivery of pharmaceutical care-based medication therapy management (MTM) services can improve the clinical outcomes of patients with chronic health conditions in the primary health-care setting. A retrospective descriptive study of 92 outpatients assisted by MTM pharmacists in primary health-care units was carried out over 28 months (median follow-up: 05 months). Patients were followed up by MTM pharmacists, with a total of 359 encounters and a ratio of 3.9 encounters per patient. The prevalence of hypertension, diabetes mellitus and dyslipidaemia was 29.5%, 22.0% and 19.4%, respectively. There was a high prevalence of drug-related problems with a ratio of 3.4 per patient. Pharmacists performed a total of 307 interventions to prevent or resolve drug-related problems. With regard to control of the most prevalent chronic medical conditions, a high percentage of patients reached their therapy goals by the last encounter with the pharmacist: 90.0% for hypertension, 72.3% for diabetes mellitus and 90.3% for dyslipidaemia. MTM services provided by pharmacists resolved drug therapy problems and improved patients' clinical outcomes. This study provides evidence for health-care managers of the need to expand the clinical role of pharmacists within the Brazilian public health-care system. Uniterms: Pharmaceutical care/primary care. Medication therapy management. Chronic health/ conditions. Pharmacists/professional practice/Brazil

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“…13 Other research has indicated that between 69-78% of CVD patients have DRPs. 14,15 In 2011, a study reported that cardiovascular drugs were one of the major causes of all DRPs. 16 Identified risk factors for ADRs include age, gender, polypharmacy, drug administration with a narrow therapeutic index, decreased renal elimination and the use of oral anti-coagulants and diuretics.…”

mentioning

confidence: 99%

Evaluation of a Clinical Pharmacist Intervention on Clinical and Drug-Related Problems Among Coronary Heart Disease Inpatients: A pre-experimental prospective study at a general hospital in Indonesia

Sagita

Bahtiar

Andrajati

2018

Sultan Qaboos Univ Med J

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abstract:Objectives: This study aimed to evaluate the role of a clinical pharmacist intervention in decreasing subsequent clinical and drug-related problems (DRPs) among coronary heart disease (CHD) inpatients with at least one previous DRP. Methods: This pre-experimental study with a pre-post design was carried out from January to April 2017 among inpatients with at least one previous DRP at a general hospital in Tangerang District, Banten, Indonesia. Clinical and DRPs were documented prospectively by a clinical pharmacist, with DRPs classified using Version 6.2 of the DRP classification scheme of the Pharmaceutical Care Network Europe Foundation. The intervention consisted of a discussion of identified DRPs with physicians, patients, pharmaceutical logistics clerks, nurses and nutritionists. Following this, any subsequent clinical and DRPs were re-identified and further interventions were conducted as necessary. Results: A total of 75 inpatients were included in the study. Pre-intervention, there were 443 DRPs and 202 clinical problems. The most frequent DRPs were adverse drug reactions (52.6%), followed by drug effects (41.8%). Most DRPs were of moderate severity and would have resulted in moderate consequences had the pharmacist not intervened. The interventions resulted in a significant reduction in the number of DRPs, type of DRPs and number of clinical problems (P <0.05 each). Patients with complications were 26.047 times more likely to have no reduction or an increased number of clinical problems compared to patients without complications (P <0.05). Conclusion: Clinical pharmacist interventions were found to reduce subsequent DRPs and clinical problems among CHD patients with at least one previous DRP. Keywords

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Negative Clinical Outcomes Associated With Drug-Related Problems in Heart Failure (HF) Outpatients: Impact of a Pharmacist in a Multidisciplinary HF Clinic

Cited by 77 publications

References 25 publications

Unsatisfactory glycemic control in type 2 Diabetes mellitus patients: predictive factors and negative clinical outcomes with the use of antidiabetic drugs

Unsatisfactory glycemic control in type 2 Diabetes mellitus patients: predictive factors and negative clinical outcomes with the use of antidiabetic drugs

Clinical outcomes of medication therapy management services in primary health care

Evaluation of a Clinical Pharmacist Intervention on Clinical and Drug-Related Problems Among Coronary Heart Disease Inpatients: A pre-experimental prospective study at a general hospital in Indonesia

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