Pharmacist Interventions in Preventing Clinically Significant Drug–Drug Interactions in Hospitalized Patients
DOI:
https://doi.org/10.22399/ijcesen.4149Keywords:
Pharmacist interventions, drug-drug interactions, hospitalized patients, polypharmacy, medication managementAbstract
Pharmacist interventions play a crucial role in preventing clinically significant drug-drug interactions (DDIs) in hospitalized patients, where polypharmacy is common. Through active medication management, pharmacists assess patients' medication regimens upon admission and routinely during their hospital stay. They utilize their expertise in pharmacology and therapeutic guidelines to identify potential DDIs based on the patient’s medical history, current medications, and clinical condition. By collaborating with physicians and other healthcare professionals, pharmacists provide valuable insights and recommend alternative therapies or dosage adjustments to mitigate the risks associated with potentially harmful interactions, thus optimizing patient safety and medication efficacy. Furthermore, pharmacist-led interventions have been shown to reduce the incidence of adverse drug events related to DDIs, contributing to improved patient outcomes and shorter hospital stays. By implementing standardized protocols for screening and monitoring drug interactions, pharmacists not only educate patients and healthcare staff about the risks but also advocate for safe prescribing practices. Additionally, they can leverage electronic health record systems and drug interaction databases to enhance their surveillance capabilities. These proactive measures—coupled with ongoing clinical education and collaboration—underscore the pharmacist's vital role in the multidisciplinary healthcare team, reinforcing the importance of their interventions in minimizing the potential for adverse effects associated with drug-drug interactions.
References
1. Mongaret C, Quillet P, Vo TH, Aubert L, Fourgeaud M, Michelet-Huot E, et al. Predictive factors for clinically significant pharmacist interventions at hospital admission. Medicine. 2018;97(9):e9865.
2. Kucukarslan SN, Peters M, Mlynarek M, Nafziger DA. Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Archives of internal medicine. 2003;163(17):2014–2018.
3. Bertoli R, Bissig M, Caronzolo D, Odorico M, Pons M, Bernasconi E. Assessment of potential drug-drug interactions at hospital discharge. Swiss Med Wkly. 2010;140:w13043.
4. Ahmadizar F, Soleymani F, Abdollahi M. Study of drug-drug interactions in prescriptions of general practitioners and specialists in Iran 2007-2009. Iran J Pharm Res. 2011;10:921–31.
5. Mukker JK, Singh RS, Derendorf H. Developing Drug Products in an Aging Society. New York: Springer; 2016. Pharmacokinetic and pharmacodynamic considerations in elderly population; pp. 139–51.
6. WHO Collaborating Centre for Drug Statistics Methodology, Norwegian Institute of Public Health. ATC/DDD index. 2019. Available from: http://www.whocc.no/atc_ddd_index/. Accessed november 10, 2019.
7. Hôpitaux Universitaires de Genève, Université de Genève. PIM Check. [v1.2; 26.09.2016]. Available from: http://pimcheck.org/. Accessed July 20, 2018.
8. Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL. Clinical pharmacists and inpatient medical care: a systematic review. Archives of internal medicine. 2006;166(9):955–964.
9. Pazan F, Burkhardt H, Frohnhofen H, Weiss C, Throm C, Kuhn-Thiel A, et al. Changes in prescription patterns in older hospitalized patients: the impact of FORTA on disease-related over- and under-treatments. European journal of clinical pharmacology. 2018;74(3):339–347.
10. Blanc AL, Guignard B, Desnoyer A, Grosgurin O, Marti C, Samer C, et al. Prevention of potentially inappropriate medication in internal medicine patients: A prospective study using the electronic application PIM-Check. J Clin Pharm Ther. 2018 Dec;43(6):860–866.
11. Shafiekhani M, Karimi S, Ali Davarpanah M, Vazin A. Evaluating drug interactions, adverse drug reactions, and level of adherence to highly active antiretroviral therapy regimen amongst HIV-positive patients who referred to an AIDS healthcare center in fars, Southern Iran: The first multifaceted study from Iran. HIV AIDS Rev Int J HIV Relat Probl. 2017;16:24–31.
12. Blassmann U, Morath B, Fischer A, Knoth H, Hoppe-Tichy T. [Medication safety in hospitals: Integration of clinical pharmacists to reduce drug-related problems in the inpatient setting] Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. 2018;61(9):1103–1110.
13. Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte T. The rising tide of polypharmacy and drug-drug interactions: Population database analysis 1995-2010. BMC Med. 2015;13:74.
14. Bertsche T, Pfaff J, Schiller P, Kaltschmidt J, Pruszydlo MG, Stremmel W, et al. Prevention of adverse drug reactions in intensive care patients by personal intervention based on an electronic clinical decision support system. Intensive Care Med. 2010;36:665–72.
15. Hanlon JT, Weinberger M, Samsa GP, Schmader KE, Uttech KM, Lewis IK, et al. A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy. The American journal of medicine. 1996;100(4):428–437.
16. Nobili A, Licata G, Salerno F, Pasina L, Tettamanti M, Franchi C, et al. Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. Eur J Clin Pharmacol. 2011;67:507–19.
17. Hudhra K, Garcia-Caballos M, Casado-Fernandez E, Jucja B, Shabani D. Bueno-Cavanillas A. Polypharmacy and potentially inappropriate prescriptions identified by Beers and STOPP criteria in co-morbid older patients at hospital discharge. Journal of evaluation in clinical practice. 2016;22(2):189–193.
18. Haji Aghajani M, Sistanizad M, Abbasinazari M, Abiar Ghamsari M, Ayazkhoo L, Safi O, et al. Potential drug-drug interactions in post-CCU of a teaching hospital. Iran J Pharm Res. 2013;12:243–8.
19. Farhat A, Panchaud A, Al-Hajje A, Lang PO, Csajka C. Ability to detect Potentially Inappropriate Prescriptions in older patients: Comparative analysis between PIM-Check and STOPP/STARTv2. European journal of clinical pharmacology. 2021;77(11):1747–1756.
20. Farhat A, Al-Hajje A, Csajka C, Panchaud A. Clinical and economic impacts of explicit tools detecting prescribing errors: A systematic review. J Clin Pharm Ther. 2021;46(4):877–886.
21. Murtaza G, Khan MY, Azhar S, Khan SA, Khan TM. Assessment of potential drug-drug interactions and its associated factors in the hospitalized cardiac patients. Saudi Pharm J. 2016;24:220–5.
22. Dalleur O, Boland B, Losseau C, Henrard S, Wouters D, Speybroeck N, et al. Reduction of potentially inappropriate medications using the STOPP criteria in frail older inpatients: a randomised controlled study. Drugs & aging. 2014;31(4):291–298.
23. Mark SM, LJ Geller S., Weber RJ. In: Pharmacotherapy: a pathophysiologic approach. 8e. DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey M., editors. McGraw-Hill; New York: 2011. Principles and practices of medication safety.
24. Wastesson JW, Canudas-Romo V, Lindahl-Jacobsen R, Johnell K. Remaining life expectancy with and without polypharmacy: A register-based study of swedes aged 65 years and older. J Am Med Dir Assoc. 2016;17:31–5.
25. Di Giorgio C, Provenzani A, Polidori P. Potentially inappropriate drug prescribing in elderly hospitalized patients: an analysis and comparison of explicit criteria. International journal of clinical pharmacy. 2016;38(2):462–468.
26. Rafieii H, Arab M, Ranjbar H, Arab N, Sepehri G, Amiri M. The prevalence of potential drug interactions in intensive care units. J Crit Care Nurs. 2012;4:191–6.
27. Lang PO., Farhat A., Csajka C. [Optimizing one's prescriptions: Which approach, which tool to use?] Rev Geriatr. 2017;42(4):207–218.
28. Aparasu R, Baer R, Aparasu A. Clinically important potential drug-drug interactions in outpatient settings. Res Soc Adm Pharm. 2007;3:426–37.
29. McHugh ML. Interrater reliability: the kappa statistic. Biochemia medica. 2012;22(3):276–282.
30. Shah S, Naqvi BS, Ale-Zehra AZ, Ali D, Saeed R, Naqvi GR. Quantitative analysis of drug-drug interactions of OTC drugs with other prescribed drugs collected from different hospitals and clinics of Karachi, Pakistan. Jordan J Pharm Sci. 2011;4:1–24.
31. Blanc AL, Spasojevic S, Leszek A, Théodoloz M, Bonnabry P, Fumeaux T, et al. A comparison of two tools to screen potentially inappropriate medication in internal medicine patients. J Clin Pharm Ther. 2018 Apr;43(2):232–239.
32. Reimche L, Forster AJ, van Walraven C. Incidence and contributors to potential drug-drug interactions in hospitalized patients. J Clin Pharmacol. 2011;51:1043–50.
33. Klopotowska JE, Kuiper R, van Kan HJ, de Pont AC, Dijkgraaf MG, Lie-A-Huen L, et al. On-ward participation of a hospital pharmacist in a dutch intensive care unit reduces prescribing errors and related patient harm: An intervention study. Crit Care. 2010;14:R174.
34. Appelman Y, van Rijn BB, Ten Haaf ME, Boersma E, Peters SA. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015;241:211–8.
35. Patel VK, Acharya LD, Rajakannan T, Surulivelrajan M, Guddattu V, Padmakumar R. Potential drug interactions in patients admitted to cardiology wards of a South Indian teaching hospital. Australas Med J. 2011;4:9–14.
36. Allenet B, Bedouch P, Rose FX, Escofier L, Roubille R, Charpiat B, et al. Validation of an instrument for the documentation of clinical pharmacists' interventions. Pharmacy world & science: PWS. 2006;28(4):181–188.
37. Hannou S, Voirol P, Pannatier A, Weibel ML, Sadeghipour F, von Gunten A, et al. Pharmacist intervention acceptance for the reduction of potentially inappropriate drug prescribing in acute psychiatry. International journal of clinical pharmacy. 2017;39(6):1228–1236.
38. Bond CA, Raehl CL. Clinical pharmacy services, pharmacy staffing, and hospital mortality rates. Pharmacotherapy. 2007;27:481–93.
39. Farhat A, Al-Hajje A, Rachidi S, Zein S, Zeid MB, Salameh P, Bawab W, Awada S. Risk factors and quality of life of dyslipidemic patients in Lebanon: A cross-sectional study. J Epidemiol Glob Health. 2016 Dec;6(4):315–323.
40. Makiani MJ, Nasiripour S, Hosseini M, Mahbubi A. Drug-drug interactions: The importance of medication reconciliation. J Res Pharm Pract. 2017;6:61–2.
41. Nabovati E, Vakili-Arki H, Taherzadeh Z, Hasibian MR, Abu-Hanna A, Eslami S. Drug-drug interactions in inpatient and outpatient settings in Iran: A systematic review of the literature. Daru. 2014;22:52.
42. Maes KA, Tremp RM, Hersberger KE, Lampert ML. Demonstrating the clinical pharmacist's activity: validation of an intervention oriented classification system. International journal of clinical pharmacy. 2015;37(6):1162–1171.
43. Bright JM, Tenni PC. The clinical services documentation (CSD) system for documenting clinical pharmacists’ services. Aust J Hosp Pharm. 2000;30:10–15.
44. Armahizer MJ, Kane-Gill SL, Smithburger PL, Anthes AM, Seybert AL. Comparing drug-drug interaction severity ratings between bedside clinicians and proprietary databases. ISRN Crit Care. 2012;2013:1–6.
45. Dunn SP, Holmes DR, Jr, Moliterno DJ. Drug-drug interactions in cardiovascular catheterizations and interventions. JACC Cardiovasc Interv. 2012;5:1195–208.
46. Magro L, Moretti U, Leone R. Epidemiology and characteristics of adverse drug reactions caused by drug-drug interactions. Expert Opin Drug Saf. 2012;11:83–94.
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