Article Text
Abstract
Background and Importance Benzodiazepines and derivatives (BZD) are anti-anxiety or hypnotic drugs. They are frequently prescribed over a long period of time and are rarely re-evaluated. However, they can cause side effects, especially among the elderly. It is then necessary to reassess the treatment. Through his activities, the pharmacist may participate at a re-evaluation of treatment (pharmaceutical validation, medication reconciliation process).
Aim and Objectives This study assesses the impact of the pharmacist in the re-evaluation of benzodiazepines treatments.
Material and Methods An extraction of prescriptions containing at least one BZD in a geriatric ward was conducted for 4 months. A pharmaceutical analysis of the prescription is carried out, then pharmaceutical interventions are made by message to the prescribers via our prescription software in order to propose substitutions, dosage reductions or stoppage of treatments by BZD.
At the patient’s discharge, a comparison of the exit prescription and the prescription during the hospitalisation allows us to know if the pharmaceutical interventions were accepted. Some patients have had a medication reconciliation process during which the same proposals are made to the doctor.
Results A total of 202 BZD were prescribed to the geriatric unit over 4 months, representing 169 patients. Of these, 34.2% were initiated during hospitalisation and 65.8% were home treatments.
A pharmaceutical intervention was performed in 71% of cases: a substitution was proposed in 40%, a dosage decrease in 13.3%, a re-evaluation of exit treatment in 15% and a discontinuation in 31.7%.
A total of 55% of pharmaceutical interventions were accepted at the discharge of patient.
Among the 169 patients, 12.4% received a medication reconciliation process during which pharmaceutical interventions were done: a substitution was proposed in 28.6% of cases, a dosage decrease in 19% and a discontinuation in 52.4%. In 100% of cases, they were accepted.
Conclusion and Relevance Through this study, we analyse that the pharmacist has a positive impact on the re-evaluation of treatments, especially during the medication reconciliation process where a review of BZD drug relevance is carried out with the geriatrician. It would be interesting to analyse if the presence of a pharmacist on the ward may improve the acceptance of pharmaceutical interventions and allow more medication reconciliation processing.
Conflict of Interest No conflict of interest.