Article Text
Abstract
Background and Importance Opioid analgesics are considered high risk medications. Their growing use in patients with non-oncological chronic pain has increased in recent years, making it important to review the appropriateness of the prescriptions in order to minimise the risk of adverse events.
Aim and Objectives The objective of the study was to analyse pharmaceutical interventions carried out in hospitalised trauma patients already receiving chronic treatment with opioids at the time of admission.
Material and Methods Prospective, observational study, carried out between April and July 2023. Pharmacists daily reviewed the chronic therapies that included opioids prescribed to patients admitted to the trauma unit, and recorded the pharmaceutical interventions that were carried out. The following variables were considered: age, sex, diagnosis, indication of chronic therapy with opioids, opioids prescribed, adverse events, type of interventions carried out, and degree of acceptance of the interventions by the clinics. Information was obtained from electronic clinical records for primary care and specialised care, and from the hospital electronic prescription program.
Results During the time of the study, prescriptions were validated for 596 patients and pharmacists intervened in 34 patients (73.5% women) with a mean age [range] of 73.5 [62.5–81.5] years. A total of 45 interventions were carried out, with a degree of acceptance by clinics of 76%. Most interventions (52%) involved patients being treated with fentanyl patches, followed by tapentadol tablets (25%).
The interventions were focused to warn professionals about reconciliation errors with chronic opioid therapy at admission (53.3%), inappropriate prescription of two or more opioids (20%), dosage errors (17.8%) and risk of respiratory depression due to comorbidity and/or concomitant medications (8.9%).
The percentage of patients with adverse events was 21%, and consisted of withdrawal symptoms, dizziness, hypotension, disorientation, and constipation.
Conclusion and Relevance Prescription review by pharmacists allowed us to detect and avoid numerous errors in treating trauma patients who receive chronic opioids to treat non-oncologic pain, leading to safer use of these medications.
Conflict of Interest No conflict of interest.