Background Patients with Multiple Sclerosis (MS) can present a wide range of symptomatic problems associated with disease progression.
Purpose To review the treatments MS patients take at home to manage their comorbidities and to check for possible drug interactions.
Materials and methods On 30 September 2013 all patients with MS treated with immunomodulatory drugs were identified with the hospital pharmacy dispensing software Farmatools. The domiciliary drugs prescribed and dispensed in the ambulatory pharmacy were identified with the primary care electronic medical record. Additionally, their indications were identified by means of the primary care and the hospital electronic medical record. A descriptive analysis of drugs and indications was performed. The appropriateness of the comorbidities treatment was assessed by comparing prescriptions with registered indications. The possible interactions between the domiciliary and the immunomodulatory treatments were checked using “Stockley’s Drug Interactions” and the Micromedex database.
Results 68 patients were selected with a mean age of 40.5 ± 8.8 years, 19 men (27.9%) and 49 women (72.1%). 66 with relapsing remitting MS (97.1%) and 2 with secondary progressive MS (2.9%). 32 patients were being treated with interferon beta-1a, 10 with interferon beta-1b, 13 with glatiramer acetate and 13 with fingolimod. 48 domiciliary drugs in 74 prescriptions were identified. Amantadine (7 prescriptions), levothyroxine (5), lorazepam (4), amitriptyline (3), citalopram (3), clonazepam (3), clorazepate dipotassium (3), fluoxetine (2), budesonide (2), omeprazole (2) and alprazolam (2) amounted to approximately half of the prescriptions. The indications of depression, fatigue, spasticity, anxiety, pain and asthma accounted for more than half of cases. All patients received appropriate prescriptions compared to registered indications. There was no interaction between the immunomodulatory and the domiciliary treatments.
Conclusions Patients with advanced MS need several medicines to manage the comorbidities associated with the evolution of the disease. The review of possible drug interactions contributed to safer and more effective drug treatment.
No conflict of interest.
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