Article Text
Abstract
Background and Importance Hospital pain protocol is a crucial element in improving patient’s quality of life, as effective pain management not only alleviates suffering but also promotes recovery.
The involvement of the pharmacist through pharmaceutical interventions (PIs) facilitates the implementation of the pain protocol.
Aim and Objectives To describe and analyse PIs associated with analgesic medications in accordance with the institutional pain protocol for patients admitted to a secondary level hospital.
Material and Methods An observational, descriptive and retrospective study that analyse PIs conducted with the Computerized Physician Order Entry (CPOE) Silicon® during the validation of prescriptions containing analgesics in hospitalised patients from January to December 2022.
Results 455 PIs were recorded with 64% of them involving surgical patients. The most common type of PIs were dose modification (272/455; 59,8%); drug suspension (138/455; 30,3%); drug changes (14/455; 3,1%); frequency adjustments (13/455; 2,9%); reconciliation upon admission (11/455; 2,4%); route of administration or pharmaceutical form modification (4/455; 0,9%) and incomplete medical order (3/455; 0,6%).
Medications most frequently involved in PIs were dexketoprofen (116/455; 25,5%), metamizole (113/455; 24,8%), tramadol (94/455; 20,7%) and acetaminophen (87/455; 19,1%).
Among dexketoprofen PIs, 39,7% (46/116) were attributed to contraindications. PIs related to excessive dosage were accounted for 57,5% (65/113) of all metamizole interventions, 72,3% (68/94) of tramadol interventions and 70,1% (61/87) of acetaminophen interventions. Furthermore, there were 34 IP detecting interactions of which metamizole was implicated in 79,4% (27/34) of the cases.
The level of acceptance among doctors was as follows: 61,8% overall with individual acceptance rates of 79,3% (69/87) for acetaminophen, 68,1% (77/113) for metamizole, 55,3% (52/94) for tramadol and 53,4% (62/116) for dexketoprofen.
Conclusion and Relevance Dose modification was the most frequent PIs, mainly due to excessive dosage.
The drugs that received the most PIs were dexketoprofen and metamizole.
The degree of acceptance of PIs was high, which supports the integration of the pharmacist in the multidisciplinary team and improves the safety of the patient’s analgesic treatment.
This study provides useful information to detect areas for improvement in the implementation of pain protocols and the importance of interdisciplinary collaboration.
Conflict of Interest No conflict of interest.