ABSTRACT
Methods: The study was based on a retrospective analysis of pharmacist interventions for DRPs detected during the medication order review and documented into the French Act-IP© database over a 12-year period. DRPs and PIs were analyzed, and independent factors of physician acceptance were assessed via multiple logistic regression. Results: Out of the 620,620 PIs registered, 29,694 targeted a PPI (4.8%). PPI's DRPs were mostly related to the prescription of a "drug not available at the hospital" (26.1%) and a "drug use without indication" (18.3%); PIs were mostly "drug switch" (35.9%) and "drug discontinuation" (26.1%). In all, 18,919 PIs were accepted by physicians (63.7%). Acceptance was significantly associated with patient age: less accepted for the 18-75 years group (OR = 0.59, 95 CI [0.46-0.76]), and the >75 years group (OR = 0.57, 95 CI [0.44-0.73]) vs. <18 years group; for the type of DRP, "drug use without indication" was the less accepted (OR = 0.73, 95 CI [0.63-0.85]); for the type of PI, "dose adjustment" was the less accepted (OR = 0.32, 95 CI [0.23-0.45]). Conclusion: Pharmacists contribute to preventing DRPs associated with PPI prescriptions during the medication order review process. Moreover, they often detect PPIs used without indication and they propose drug discontinuation, which contributes to the PPI deprescribing process. PIs should be further developed in the future to reduce PPI overprescription.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , Pharmacy Service, Hospital , Adolescent , Adult , Aged , Hospitals , Humans , Medication Errors/prevention & control , Middle Aged , Pharmacists , Proton Pump Inhibitors/therapeutic use , Retrospective Studies , Young AdultABSTRACT
Since 2018, French community pharmacists are involved in pharmaceutical care program performing medication review (MR). Near graduated pharmacy students from two faculties of pharmacy were assigned to implement and perform 3 MR in order to identify enablers and barriers of the implementation of MR by community pharmacists. Among 179 MR performed by 117 pharmacists during 5 months, they reported 3 main barriers: the time spending to initiate and perform all steps in MR (lack of time), patients recruiting, and compensation by health care system. Communications initiatives to patients and health professionals in primary care could facilitate patient MR adhesion. Simplification of administrative approach and optimization of software will be welcome and useful in order to reinforced MR implementation and leading.
Subject(s)
Community Pharmacy Services , Pharmacies , France , Humans , Pharmacists , Professional Role , Prospective StudiesABSTRACT
WHAT IS KNOWN AND OBJECTIVE: The French Society of Clinical Pharmacy (SFPC) asked a group of experts to adapt the SFPC hospital pharmacists' interventions reporting tool for use in community pharmacy practice. This study aimed to develop and validate a tool for the routine reporting of pharmacists' interventions in French community settings. METHODS: Two groups of community pharmacists coded reports of 60 typical pharmacists' interventions. One group was "experts" (n = 4) who had participated in the development of the tool (internal validation) and the other were "external" community pharmacists (n = 6), naïve to the tool (external validation). The Kappa coefficient was used to assess the inter-reliability of classification between participants. A 4-level Likert scale was used to evaluate ease of use and acceptability. RESULTS AND DISCUSSION: The tool we developed for recording and classifying PIs has 19 items; 11 non-ordered categories describing drug-related problems; and 7 items describing interventions. Two tables of definitions were provided to help community pharmacists in the classification. The mean κ statistic was (i) 0.63 for experts and 0.73 for external community pharmacists in categorizing drug-related problems and (ii) 0.69 for experts and 0.75 for external community pharmacists in categorizing interventions. WHAT IS NEW AND CONCLUSION: A specific tool for the documentation of pharmacists' interventions in community pharmacies is now available in French. Besides being useful to describe pharmacists' interventions in studies in community settings, it can be used to document the pharmaceutical patient record and to support the traceability process.
