Background In July 2013, the Spanish Medicines Agency published an informative note (IN) limiting the use of metoclopramide to prevent and treat nausea and vomiting caused by chemotherapy, radiotherapy or surgery and suggesting a maximum duration of treatment of 5 days.
Purpose To evaluate the impact of the metoclopramide IN on a general hospital.
Materials and methods Prospective quasi-experimental study in different Clinical Units (CU) using the Unitary Dose Drug Dispensing System (UDDDS): Digestive/General Surgery (DGS), Vascular Surgery, Digestive, Obstetrics/Gynaecology, Haematology, Internal Medicine (IM), Nephrology, Neurology, Traumatology and Urology. During August 2013, following the IN guidance, hospital pharmacists directed a pharmaceutical intervention (PI) at physicians prescribing metoclopramide. An alarm system was created in the UDDDS module of Farmatools-Dominion to detect metoclopramide treatments in excess of 5 days. Daily, every metoclopramide prescription was reviewed by a pharmacist and physicians were alerted in accordance with the IN.
Data collection: age, gender, CU, PI (reason for PI and degree of acceptance).
Results 553 patients were hospitalised during the study: 96 treated with metoclopramide, mainly in DGS (59) and IM (17). 41 PIs were made. The majority of patients were female (63%) and the mean age was 64 years. 34 of the 41 PIs were made because metoclopramide was not recommended for use, while 7 were due to excessive length of treatment (surgery patients). The degree of acceptance of the PIs was 61% (19 drug interruptions and 6 changes from daily administration to only when presenting nausea or vomiting). Obstetrics/Gynaecology and Neurology were the CU with the highest degree of acceptance (100%), while IM (41%) and Surgery (20%) represented the highest number of PIs.
Conclusions The degree of acceptance confirms both the importance of the involvement of pharmacists in the patient’s pharmacotherapy, as well as the importance of cooperation with physicians to optimise pharmaceutical care. Furthermore, PIs were successful and considered useful to improve the use of metoclopramide, not only improving safety but also efficacy.
No conflict of interest.
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