ABSTRACT
Background and Importance Nirmatrelvir/ritonavir (PAXLOVID) is a recently approved drug to prevent progression in high-risk COVID-19-infected patients. Aim and Objectives To evaluate prescribing and dispensing of PAXLOVID and the proportion of patients with hospitalisation or death from any cause at 28 day. Material and Methods Descriptive, retrospective, observational study carried out between May and August 2022 in a secondlevel hospital. All patients with PAXLOVID prescription were selected. Sources of information were: electronic medical records and the prescription programme. The Variables analysed were: sex, age, risk factors, indications, interactions, dispensation (yes/no) and final treatment received. Risk factors were evaluated with our country's drug regulatory agency (DRA) recommendations to assesed the indication. Efficacy was assessed by the proportion of patients admitted to hospital and 28-day mortality. Results PAXLOVID was prescribed to 34 patients, 14 (41.2%) were women. The median age was 76.3 years old [RIQ 25.4]. Main indications for PAXLOVID were: to be undergoing treatment with myelotoxic chemotherapy (32.3%), corticosteroids or other immunosuppressants (29.4%);being over 80 years of age and presenting specific Risk factors (14.7%) and primary immunodeficiency (5.8%). 21 patients (61.8%) had some relevant interaction with their usual medication. The most frequent interactions were with statins (23.5%), analgesics (20.6%), oral anticoagulants (12%), antiarrhythmics (8.8%), antiplatelet drugs (5.8%), antidepressants (5.8%) and antidiarrhoeals (5.8%). After Validation by the Pharmacy Service, 11 patients (32.4%) did not receive PAXLOVID, 5 because they did not meet DRA criteria, 2 because their glomerular filtration rate was less than 30 ml/min and 4 because they had incompatible interactions. 4 patients finally received 3 days-remdesivir. Among patients who received PAXLOVID, 82.26% received full doses, with 4 patients (11.76%) requiring adjustment for renal impairment. 3 patients (13%) were hospitalised in the first month, none died. Conclusion and Relevance The main indications for which PAXLOVID was prescribed were patients undergoing chemotherapy and/or immunosuppressive treatments. Interactions with PAXLOVID were frequent and in some cases limited treatment. Validation by Pharmacy Service prevented a considerable number of patients from receiving PAXLOVID when it was no-indicated or when they had insurmountable interactions, also allowed patients to receive the dose adjusted for renal impairment. PAXLOVID was effective in avoiding hospital admission and mortality in the majority of patients.
ABSTRACT
Background and importance The pharmacy service (PS) is a cornerstone of the nutritional support of patients, especially those with special needs. For this reason, it is necessary to create individualised nutrition following recommendations from scientific organisations, such as the European Society for Clinical Nutrition and Metabolism (ESPEN). Aim and objectives To analyse prescriptions of parental nutrition (PN) during the pandemic and compare them with those from the same time period in 2019. Material and methods This was a retrospective descriptive observational analysis of data from a secondary care hospital during March and April, both in 2019 and 2020. Demographic (age and sex) and clinical (length of PN and diagnosis) data were collected from medical records. Results There were 157 patients with PN during the period of study in 2020, 106 (67.5%) men with a median age of 67 years (IQR 14.5 years). In 2019, 64 patients received PN, 38 (59.4%) were men with a median age of 70 years (IQR 17). In 2020, 48.8% of patients with PN were under the critical care service (CCS), 30.6% internal medicine service (IMS) and 18.5% surgical service (SS);108 (68.8%) were diagnosed with COVID-19. In 2019, 15.6% of patients were under CCS, 25% IMS and 56.4% SS. In 2020, 85 patients (54.1%) terminated PN due to health improvement and 60 (38.2%) died;in 2019, 54 (84.4%) improved and 9 (14.1%) died. In 2020, the median age of deceased patients was 67 years (IQR 12.5 years) and in 2019 it was 77 years (IQR 9.5 years). The total number of PN prescribed during the periods of the study was 2121 in 2020 and 876 in 2019. Conclusion and relevance In the context of the SARS-CoV-2 pandemic, nearly half of all PN were prepared for CCS patients. This increase in CCS patients in 2020 seems to explain the 10 year reduction in the median age of death and the increase in mortality. In 2020, the number of PN prepared by the PS nearly tripled in comparison with the same period in 2019. They were individually adapted to each patient's requirements, which led to a substantial increase in the care load and the preparation of the PN.
ABSTRACT
Background and importanceThe pharmacy service (PS) is a cornerstone of the nutritional support of patients, especially those with special needs. For this reason, it is necessary to create individualised nutrition following recommendations from scientific organisations, such as the European Society for Clinical Nutrition and Metabolism (ESPEN).Aim and objectivesTo analyse prescriptions of parental nutrition (PN) during the pandemic and compare them with those from the same time period in 2019.Material and methodsThis was a retrospective descriptive observational analysis of data from a secondary care hospital during March and April, both in 2019 and 2020. Demographic (age and sex) and clinical (length of PN and diagnosis) data were collected from medical records.ResultsThere were 157 patients with PN during the period of study in 2020, 106 (67.5%) men with a median age of 67 years (IQR 14.5 years). In 2019, 64 patients received PN, 38 (59.4%) were men with a median age of 70 years (IQR 17). In 2020, 48.8% of patients with PN were under the critical care service (CCS), 30.6% internal medicine service (IMS) and 18.5% surgical service (SS);108 (68.8%) were diagnosed with COVID-19. In 2019, 15.6% of patients were under CCS, 25% IMS and 56.4% SS. In 2020, 85 patients (54.1%) terminated PN due to health improvement and 60 (38.2%) died;in 2019, 54 (84.4%) improved and 9 (14.1%) died. In 2020, the median age of deceased patients was 67 years (IQR 12.5 years) and in 2019 it was 77 years (IQR 9.5 years). The total number of PN prescribed during the periods of the study was 2121 in 2020 and 876 in 2019.Conclusion and relevanceIn the context of the SARS-CoV-2 pandemic, nearly half of all PN were prepared for CCS patients. This increase in CCS patients in 2020 seems to explain the 10 year reduction in the median age of death and the increase in mortality. In 2020, the number of PN prepared by the PS nearly tripled in comparison with the same period in 2019. They were individually adapted to each patient’s requirements, which led to a substantial increase in the care load and the preparation of the PN.References and/or acknowledgementsConflict of interestNo conflict of interest