Background and Importance KCl-inj is a risky drug, its administration error is a Never Events. Limiting its use to justified situations contributes to its security. Medication Review (MR) contributes to this limitation. Despite awareness campaigns, non-compliant prescriptions persist. During the MR, the Pharmaceutical Intervention (PI) includes a Prescription Proposal (PP): for KCl-inj the clinical context has a strong impact and complicates the MR.
Aim and Objectives Creation and validation of a support tool for the MR of KCl-inj prescriptions allowing taking into account the entire clinical context of the patient.
Material and Methods Bibliographic research associated with brainstorming on the various clinical and biological criteria of the patient and their consequences allowed setting up of a flowchart.
For validation: experimentation of the tool in a prescriptions prospective study (for each prescription the problem related to therapeutics, the proposed PP and its acceptance are collated in an Excel file); then discussion and validation of the results in Medicines and Sterile Medical Devices Commission (MSMDC), in particular for the not accepted PIs.
Results The flowchart criteria are kalemia, oral intake, KCl-inj concentration, KCl-inj in prevention during high-dose hypokalemic treatments, initiation of treatment. Each of the situations identified is linked to a PI or the absence of PI. 6 axes of PP have been identified including oral co-prescription, switch by electrolyte solution, and adaptation of the volume of solvent.
The study over one month gives 172 lines with a MR according to our tool. 85 prescriptions were compliant. 87 PI formulated including 6 without PP. The PI acceptance rate is 43.2%, with a maximum of 52% for the oral relay and a minimum of 0% for adaptation of the volume of solvent or electrolyte solution switch. At the end of the MSMDC, our tool is validated after an agreement on the importance of promoting the use of electrolyte solution.
Conclusion and Relevance The acceptance rate and the conclusions of the MSMDC allow us to validate the flowchart. Its use improves the relevance of PIs, their acceptance and reduces the use of KCl-inj. To facilitate the use of the tool, an Excel file that identifies the PPs according to the criteria is being developed.
Conflict of Interest No conflict of interest
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