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Electronic monitoring of potential adverse drug events related to lopinavir/ritonavir and hydroxychloroquine during the first wave of COVID-19
  1. Christian Skalafouris1,2,
  2. Caroline Samer3,
  3. Jerome Stirnemann4,
  4. Olivier Grosgurin4,
  5. François Eggimann5,
  6. Damien Grauser5,
  7. Jean-Luc Reny4,
  8. Pascal Bonnabry1,2,
  9. Bertrand Guignard1
  1. 1 Pharmacy, Geneva University Hospitals, Geneva, Switzerland
  2. 2 Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), School of pharmaceutical sciences, University of Geneva, Geneva, Switzerland
  3. 3 Clinical Pharmacology and Toxicology Division, Geneva University Hospitals, Geneva, Switzerland
  4. 4 General Internal Medicine Division, Geneva University Hospitals, Geneve, Switzerland
  5. 5 Information Systems Department, Geneva University Hospitals, Geneva, Switzerland
  1. Correspondence to Christian Skalafouris, Pharmacy, Geneva University Hospitals, 1205 Geneva, Switzerland; christian.skalafouris{at}


During Switzerland’s first wave of COVID-19, clinical pharmacy activities during medical rounds in Geneva University Hospitals were replaced by targeted remote interventions. We describe using the electronic PharmaCheck system to screen high-risk situations of adverse drug events (ADEs), particularly targeting prescriptions of lopinavir/ritonavir (LPVr) and hydroxychloroquine (HCQ) in the presence of contraindications or prescriptions outside institutional guidelines. Of 416 patients receiving LPVr and/or HCQ, 182 alerts were triggered for 164 (39.4%) patients. The main associated risk factors of ADEs were drug–drug interactions, QTc interval prolongation, electrolyte disorder and inadequate LPVr dosage. Therapeutic optimisation recommended by a pharmacist or proposals for additional monitoring were accepted in 80% (n=36) of cases. Combined with pharmacist contextualisation to the clinical context, PharmaCheck made it possible to successfully adapt clinical pharmacist activities by switching from a global to a targeted analysis mode in an emergency context.

  • COVID-19
  • pharmacy service
  • hospital
  • automation
  • drug-related side effects and adverse reactions
  • medical informatics

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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