ABSTRACT
Introduction: Pharmaceutical Intervention aims to optimize and rationalize the use, effectiveness, and safety of dispensed medications resolving drug-related problems (DRPs) and negative medicine outcomes (NMOs). Objectives: To evaluate Pharmaceutical Interventions in Benzodiazepines users during the COVID-19 pandemic from a Community Pharmacy. Method: Prospective observational, descriptive, and cross-sectional study (AEMPS code: DAA-CLO-2020-01) of Pharmaceutical Interventions offered by the community pharmacy between August 2020 and February 2021. Results: A total of 306 Pharmaceutical Interventions were conducted involving 127 patients. Health education and personalized medication information were the most common Pharmaceutical Interventions after detecting a high level of unfamiliarity with the Benzodiazepines among patients. Pharmaceutical Interventions leading to medical referrals accounted for 37.8% of the total, triggered by the detection of DRPs and/or NMOs or after identifying the patient as candidate for deprescription. These referrals included patients with a very high level of depression according to the Euroqol 5D-3L test. Pharmaceutical Interventions resulting in Medication Review with Follow-up Service were performed in 3.1% of patients. The patient acceptance rate of Pharmaceutical Interventions reached 98.4%. Conclusions: The high acceptance rate of Pharmaceutical Interventions reinforces the value of Community Pharmacy in optimizing and rationalizing Benzodiazepines usage, while strengthening the pharmacist-patient relationship. The COVID-19 pandemic posed challenges to pharmacist-physician collaboration despite of the availability of telecommunication protocols among healthcare professionals.
ABSTRACT
BACKGROUND: Tolerance and dependence stand out as the most relevant risks observed during benzodiazepine (BZD) treatments. OBJECTIVES: To evaluate the degree of dependence of patients on BZD treatments using the Tyrer test; to define a profile of patients at risk of developing BZD dependence; and to discuss the role of the pharmaceutical care offered by the community pharmacy during dispensing. METHODS: Prospective cross-sectional descriptive observational study (August 2020-February 2021) involving 127 patients using BZD. They voluntarily answered a questionnaire during the dispensing pharmaceutical care service. The study was evaluated and codified (code: DAA-CLO-2020-01) by the Spanish Agency for Drugs and Health Products (AEMPS), and statistical analysis was performed with SPSS 25.0. RESULTS: 19.05% of patients using BZD were suspected of suffering from BZD tolerance, and 77.88% of all patients were identified as being at a high risk of BZD dependence. The Tyrer test for dependence indicated a mean score of 5.59 out of 13 points. An 18-fold increased risk of developing dependence was detected in the case of coexistence of high anxiety or depression. CONCLUSIONS: The community pharmacy, through protocolized care practices and supported by tools such as the Tyrer test, can play a decisive role in the detection, prevention, and resolution of the risks associated with BZD treatments.
ABSTRACT
Users of benzodiazepines (BZDs) should have their quality of life monitored to minimize the risks associated with long-term treatments. The aim of this study is to use the EuroQol 5D-3L to analyze the quality of life of 127 patients under treatment with BZDs during the COVID-19 pandemic. The results show that lorazepam comprises 25.49% of all dispensing requests, and that the mean duration of BZDs treatments is four years (range: 0.3-25). When rating their general health status, BZDs users reported 59.29 points out of 100. Thirty-two percent of patients reported mobility problems; 16.5% reported having a lot of pain or discomfort despite being treated with BZDs, and 16.54% used a BZD together with an opioid analgesic. The EuroQol 5D-3L dimension "anxiety/depression" showed that, despite the use of BZDs, 48.2% of the patients reported being moderately anxious or depressed and 13.4% described themselves as very anxious or depressed. Nevertheless, 37.8% of BZDs users were identified as potential candidates to follow a BZD deprescription plan. In conclusion, BZDs users showed a low quality of life during the COVID-19 pandemic. Older patients and females have been identified as groups of patients that could benefit from integrating the use of the EuroQol 5D-3L instrument into the protocols of the pharmaceutical care follow up.