Background One of the activities of the primary care (PC) pharmacy service is to detect prescriptions of incorrect drugs and communicate them to each doctor to decide if they are required or not.
Purpose To beef-up the active participation of hospital pharmacy residents by a PC pharmacy service, through training activities that improve patient safety.
Material and methods In March 2017, a strategy for the detection and analysis of therapeutic duplicities or not recommended drug combinations in a health area was initiated as part of a training activity of the HPR during the PC stage. A Pharmaceutical Consumption Information System provides information on which patients are affected by any of the following incidences:
Combination of ACE inhibitors/ARA II/aliskiren,
Combination of alpha1–blockers or
Use of non–selective beta–blockers in asthma/COPD or diabetes.
For each incidence, a safety note with safer recommendations and alternatives was sent to doctors. That note included the list of affected patients, age and sex for review.
Results A total of 627 patients were reported (mean age: 76.2±9.4 years, 54.3% females). Three hundred and sixty-eight (58.7%) had prescribed a combination of drugs acting on the renin-angiotensin system, increasing the risk of hyperkalaemia, hypotension and renal failure. Sixty-three (10%) patients received at least two alpha1-blockers with the consequent risk of postural hypotension, dizziness, syncope, headache or priapism. One hundred and fifty-three (24.4%) patients with asthma or COPD and 43 (6.9%) with diabetes received treatment with a non-selective beta-blocker, which may increase airway resistance or worsen glycaemic control and/or mask hypoglycaemic symptoms, respectively.
Conclusion The collaboration of HPR in strategies that improve safety in the prescription of medicines is an activity included in their formative programme in PC, and also allows the detection of combinations of drugs with risk of iatrogenia effects on patients.
No conflict of interest
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