Eur J Hosp Pharm 20:A22 doi:10.1136/ejhpharm-2013-000276.060
  • General and risk management, patient safety

GRP-060 Evaluation of a Pharmaceutical Care Program to Patients with Impaired Renal Function

  1. J Bilbao Aguirregomezcorta
  1. Hospital San Eloy, Farmacia, Bilbao, Spain


Background According to EPIRCE study results (Epidemiology of Chronic Kidney Disease in Spain), approximately 11% of the adult Spanish population suffers from some degree of Cronic Kidney Disease (CKD).

Purpose Evaluate a Pharmaceutical Care Program to hospitalised patients with impaired renal function and determine the degree of acceptance.

Materials and Methods Prospective intervention study of 9 months (January–September 2012) at a regional 110 beds hospital. Patients with creatinine clearance (CRCL) < 50 ml/min/1.73 m2 and a prescribed medication where is needed a CKD adjustment were selected. CRCL was estimated using the Cockroft-Gault equation (60 kg for women and 70 kg for males).

The patients identification was performed using the electronic prescription programme (eOsabide) and the laboratory INFOMEGA application. The data collected in the study were: age, sex, serum creatinine, pharmacotherapy and clinical service profile. The crossing data has been made in Access 2003.

The dose adjustment report’s was made in writing in the patient’s medical record (Osabide global). At 24–48 hours, the acceptance was evaluated.

Results A total of 618 hospitalised patients were included in the study (16 had a CRCL < 10 ml/min, 342 a CRCL between 10 and 30 ml/min and 309 a CRCL between 30 and 50 ml/min).

899 (14%) of 6.248 prescriptions were considered non-adjusted and were informed (27 were advices and 113 not evaluated because patient’s discharge).

Fifty one per cent of the interventions were accepted.

Antibiotics were 26% of the interventions, anticoagulants in 39%, benzodiazepines in 18%, antiemetics in 6% and digitalis in 5%.

Conclusions Pharmaceutical care plays an important role in the drug treatment of patients in renal failure.

The implementation of the project has been well received among clinicians.

No conflict of interest.

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