Tina Roblek1, Andreja Deticek2, Bostjan Leskovar3, Stanislav Suskovic4, Matej Horvat5, Ales Belic5, Ales Mrhar2, Mitja Lainscak6. 1. Faculty of Pharmacy, University of Ljubljana, Askerceva cesta 7, Ljubljana, Slovenia; Lek d.d., Verovskova 57, Ljubljana, Slovenia. 2. Faculty of Pharmacy, University of Ljubljana, Askerceva cesta 7, Ljubljana, Slovenia. 3. Department of Internal Medicine, General Hospital Trbovlje, Rudarska 9, Trbovlje, Slovenia. 4. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. 5. Lek d.d., Verovskova 57, Ljubljana, Slovenia. 6. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Department of Cardiology, Department of Research and Education, General Hospital Celje, Celje, Slovenia. Electronic address: mitja.lainscak@guest.arnes.si.
Abstract
BACKGROUND: Incidence of drug-drug interactions (DDIs) increases with complexity of treatment and comorbidities, as in heart failure (HF). This randomized, double-blind study evaluated the intervention of the pharmacist on prevalence of clinically relevant DDIs (NCT01855165). METHODS:Patients admitted with HF were screened for clinically relevant DDIs, and randomized to control or intervention. All attending physicians received standard advice about pharmacological therapy; those in the intervention group also received alerts about clinically relevant DDIs. Primary endpoint was DDI at discharge and secondary were re-hospitalization or death during follow-up. RESULTS: Of 213 patients, 51 (mean age, 79 ± 6 years; male, 47%) showed 66 clinically relevant DDIs and were randomized. For intervention (n=26) versus control (n=25), the number of patients with and the number of DDIs were significantly lower at discharge: 8 vs. 18 and 10 vs. 31; p=0.003 and 0.0049, respectively. Over a 6 month follow-up period, 11 control and 9 intervention patients were re-hospitalized or died (p>0.2 for all). No significant differences were seen between control and intervention for patients with eGFR <60 mL/min/1.73 m(2) (78%) for re-hospitalization or death (10 vs. 7; p=0.74). CONCLUSIONS:Pharmacist intervention significantly reduces the number of patients with clinically relevant DDIs, but not clinical endpoints 6 months from discharge.
RCT Entities:
BACKGROUND: Incidence of drug-drug interactions (DDIs) increases with complexity of treatment and comorbidities, as in heart failure (HF). This randomized, double-blind study evaluated the intervention of the pharmacist on prevalence of clinically relevant DDIs (NCT01855165). METHODS:Patients admitted with HF were screened for clinically relevant DDIs, and randomized to control or intervention. All attending physicians received standard advice about pharmacological therapy; those in the intervention group also received alerts about clinically relevant DDIs. Primary endpoint was DDI at discharge and secondary were re-hospitalization or death during follow-up. RESULTS: Of 213 patients, 51 (mean age, 79 ± 6 years; male, 47%) showed 66 clinically relevant DDIs and were randomized. For intervention (n=26) versus control (n=25), the number of patients with and the number of DDIs were significantly lower at discharge: 8 vs. 18 and 10 vs. 31; p=0.003 and 0.0049, respectively. Over a 6 month follow-up period, 11 control and 9 intervention patients were re-hospitalized or died (p>0.2 for all). No significant differences were seen between control and intervention for patients with eGFR <60 mL/min/1.73 m(2) (78%) for re-hospitalization or death (10 vs. 7; p=0.74). CONCLUSIONS: Pharmacist intervention significantly reduces the number of patients with clinically relevant DDIs, but not clinical endpoints 6 months from discharge.
Authors: Abdulhakim A Alzahrani; Monira M Alwhaibi; Yousif A Asiri; Khalid M Kamal; Tariq M Alhawassi Journal: BMC Health Serv Res Date: 2021-05-06 Impact factor: 2.655
Authors: Mícheál de Barra; Claire L Scott; Neil W Scott; Marie Johnston; Marijn de Bruin; Nancy Nkansah; Christine M Bond; Catriona I Matheson; Pamela Rackow; A Jess Williams; Margaret C Watson Journal: Cochrane Database Syst Rev Date: 2018-09-04