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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 Sosa, Ma. de los Ángeles; Lopes, Natali; March Pujol, Marian
Universitat de Barcelona
Background: Drug 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. Methods: The 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. Results: The 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). Conclusion: A 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.
26-09-2013
Prescripció de medicaments
Atenció farmacèutica
Farmàcies
Insuficiència renal
Persones grans
Drug prescribing
Pharmacy practice
Drugstores
Renal insufficiency
Older people
cc-by (c) Via Sosa, Ma. de los Ángeles et al., 2013
http://creativecommons.org/licenses/by/3.0/es
Artículo
info:eu-repo/semantics/publishedVersion
BioMed Central
         

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Oliva, Mireia (Oliva Herrera); Bel Prieto, Elvira; Calpena Campmany, Ana Cristina; Colom Codina, Helena; Escribano Ferrer, Elvira; Esteva de Sagrera, Juan, 1948-; Fernández Campos, Francisco; Lauroba Viladrosa, Jacinto; March Pujol, Marian; Martín Barea, Pilar; Peraire i Guitart, Concepció; Pozo Carrascosa, Alfonso del; Bonet Clols, Francesc; Carbonell, M. Mercedes; Flo, Anna; Mallandrich Miret, Mireia; Via Sosa, Ma. de los Ángeles; Clares Naveros, Beatriz; Garduño Ramírez, M. L.; Giorgi Scalari, Sebastiano; Herrera Corominas, Júlia; Oliva Gimeno, José Ignacio
Oliva, Mireia (Oliva Herrera); Bel Prieto, Elvira; Calpena Campmany, Ana Cristina; Colom Codina, Helena; Escribano Ferrer, Elvira; Esteva de Sagrera, Juan, 1948-; Fernández Campos, Francisco; Lauroba Viladrosa, Jacinto; March Pujol, Marian; Martín Barea, Pilar; Peraire i Guitart, Concepció; Pozo Carrascosa, Alfonso del; Bonet Clols, Francesc; Carbonell, M. Mercedes; Flo, Anna; Mallandrich Miret, Mireia; Via Sosa, Ma. de los Ángeles; Clares Naveros, Beatriz; Garduño Ramírez, M. L.; Giorgi Scalari, Sebastiano; Herrera Corominas, Júlia; Oliva Gimeno, José Ignacio