KALP YETERSİZLİĞİ HASTALARINDA ECZACI ODAKLI İLAÇ İNCELEME HİZMETİ: PROSPEKTİF BİR ÇALIŞMA

Öz

Amaç: Bu çalışma, klinik eczacılar tarafından sağlanan ilaç inceleme hizmeti aracılığıyla kalp yetersizliği (KY) hastalarında ilaçla ilişkili sorunları (İLİS) ve olası uygunsuz ilaçları tespit etmek ve önlemek ve kılavuza dayalı tıbbi tedaviye göre ilaç reçete oranlarını artırmak amacıyla yürütülmüştür. Gereç ve Yöntem: Gözlem ve müdahale dönemlerini içeren bu prospektif çalışmada, Eylül 2023 ile Mart 2024 tarihleri arasında KY hastalarına iki klinik eczacı tarafından ilaç inceleme hizmeti sunulmuştur. İLİS'ler Hepler-Strand'a göre sınıflandırılmış ve olası uygunsuz ilaçlar Beers kriterlerine® göre değerlendirilmiştir. Sonuç ve Tartışma: 90 hastada toplam 162 İLİS (hasta başına 1.8) tespit edildi. İLİS'lerin en sık nedeni tedavi edilmemiş endikasyondu (%66.05). Gözlem döneminde herhangi bir öneri sunulmamışken, müdahale döneminde kardiyologlara öneriler sunulmuş ve bunların %63.3'ü uygulanmıştır. Ancak müdahaleden sonra tespit edilen hasta başına düşen olası uygunsuz ilaç sayısında bir fark yoktu. İki klinik eczacının önerileriyle İLİS'ler önlendi ve azaltıldı (1.76'dan 0.64'e; p < 0.001). Sonuçlarımız, klinik eczacılar tarafından KY hastalarında ilaç kullanımının değerlendirilmesinin, tedavi yönetimini güncel kılavuzlarla uyumlu hale getirerek ve İLİS'leri azaltarak tedavi yönetimine önemli bir katkı sağladığına dair ikna edici kanıtlar sunmaktadır.

Anahtar Kelimeler

• İlaçla ilişkili sorunlar
• kalp yetersizliği
• klinik eczacı
• olası uygunsuz ilaçlar

PHARMACIST-DRIVEN MEDICATION REVIEW SERVICE IN PATIENTS WITH HEART FAILURE: A PROSPECTIVE STUDY

Öz

Objective: This study was conducted to detect and prevent drug-related problems (DRP) and potentially inappropriate medication (PIM) in patients with heart failure (HF) through a medication review service provided by clinical pharmacists and to increase drug prescription rates according to guideline-directed medical therapy (GDMT). Material and Method: In this prospective study, which included observation and intervention periods, medication review services were provided to patients with HF between September 2023 and March 2024 by two clinical pharmacists. DRPs were classified according to Hepler-Strand and PIMs were evaluated according to Beers criteria®. Result and Discussion: A total of 162 DRPs (1.8 per patient) were detected in 90 patients. The most common cause of DRPs was untreated indication (66.05%). In the observation period, no recommendations were offered, whereas in the intervention period, recommendations were offered to cardiologists, and 63.3% of them were implemented. DRPs were prevented and decreased by recommendations from two clinical pharmacists (from 1.76 to 0.64; p < 0.001). The prescription rates of sodium-glucose co-transporter 2 inhibitors and mineralocorticoid receptor antagonists increased (p<0.05). However, there was no difference in the number of PIMs per patient after the intervention (p>0.05). Our results provide compelling evidence that clinical pharmacists' assessment of medication use in patients with HF has made a crucial contribution to treatment management aligning treatment management with current guidelines and reducing DRPs.

Anahtar Kelimeler

• Clinical pharmacist
• drug-related problems
• heart failure
• potentially inappropriate medications

Destekleyen Kurum

There are no supporting institutions

Etik Beyan

The study with protocol code 09.2023.866 was approved by the Clinical Research Ethics Committee of Marmara University Faculty of Medicine. This study was conducted in accordance with the Declaration of Helsinki and the Clinical Research Ethics Committee. Written informed consent was obtained from all participants included in this study.

Teşekkür

We would like to thank the physicians and other health professionals in the cardiology service of the hospital where we conducted our study.

Kaynakça

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