Article Text
Abstract
Background and Importance The purpose of the anti-Parkinsonian pharmacological treatment is to optimise dopamine levels and control of disease symptoms. Therefore, it is essential to implement a correct reconciliation procedure at hospitalisation to avoid adverse effects associated with the medication.1 2
Aim and Objectives To describe the interventions performed in hospitalised patients undergoing anti-Parkinsonian treatment, by hospital pharmacists in the area of pharmaceutical validation, and to evaluate their acceptance degree by clinicians.
Material and Methods This was a prospective, single-centre and interventional study, conducted from September 2022 to September 2023. The study included all the hospitalised patients showing a discordance between their domiciliary anti-Parkinsonian treatment and at hospitalisation. Demographic (sex, age), clinical [clinical judgements(CJ) and inpatient clinical service] and pharmacotherapeutic [number of chronic medicines and polymedication (≥6 drugs)] variables were collected. Interventions were reported to clinician via e-prescribing software. They were classified into: adequacy (detection of prescribing error/therapy reconciliation error), initiation (usual treatment not prescribed), posology modification (dosage increase/decrease, frequency/schedule modification), suspension (duplicity/unnecessary medication). Patient lists and data were collected through medical records and e-prescribing software, and processed using LibreOffice spreadsheet-7.5.1.2®.
Results The study included 34 patients (64.7% male; 35.3% female; median age 76 years; IQR=84–71). Most frequent CJ: urinary infection (11.8%), surgical intervention (11.8%) and deterioration of general condition (8.8%). Inpatient clinical services: Internal Medicine (47.1%), Gastroenterology (17.6%), Urology (5.9%), Cardiology (5.9%), Pneumology (5.9%) and Traumatology (5.9%). The median number of active medications was 11 (IQR=11–8). Polymedicated patients raised up to 85.3%. The number of interventions performed was 60 (n=12 ‘not accepted’ because of discharge/non-acceptance by the clinician). With regard to those accepted (n=48), 8.3% related to adequacy (4.2% detection of prescribing error, 4.2% therapy reconciliation error), 4.2% related to initiation (usual treatment not prescribed), 58.3% related to posology modification (27.1% dosage increase/decrease, 31.2% frequency/schedule modification) and 29.2% to suspension (2.1% duplicity and 27.1% prescription of unnecessary medication). Most interventions affected levodopa/carbidopa treatment but other medications represented a reduced percentage (10%) (safinamide, levodopa/benserazide or rasagiline).
Conclusion and Relevance The supervision of Parkinsonian patients at hospitalisation is a pharmaceutical daily work. This study showed that the reconciliation procedure has a high degree of acceptance, improving the quality and safety of the therapy.
References and/or Acknowledgements 1. https://neurologia.com/articulo/2022217/eng
2. https://pubmed.ncbi.nlm.nih.gov/24389262/
Conflict of Interest No conflict of interest.