engleski

IMPACT OF PHARMACIST-LED MEDICATION MANAGEMENT ON ADVERSE DRUG REACTIONS REPORTED BY ELDERLY CARDIOVASCULAR PATIENTS AT A PRIMARY CARE LEVEL

Introduction Although adverse drug reaction (ADR) reporting is a legal obligation of all healthcare professionals, studies have shown that only around 6% of all ADRs are actually reported, hence contributing to a limited data on the epidemiology of ADRs. Therefore, the primary aim of this study was to determine the frequency and provide an in- depth analysis of ADRs reported by elderly cardiovascular patients receiving Comprehensive Medication Management (CMM) services at a primary care level. The secondary aim was to evaluate the impact of CMM services on the frequency of ADRs. Materials and methods A prospective, pre and post intervention study was conducted in the period from January 2018 to December 2020. Once identified, suspected ADRs were coded into the related Preferred Term using the MedDRA terminology and further analysed in respect to the baseline characteristics of patients, System Organ Class (SOC), occurrence mechanism, seriousness, expectedness and sequence number of consultations. Results Sixty-five patients who met the eligibility criteria completed the study. A total of 596 suspected ADR reports were found (9.2 ± 16.9 per patient). There was a strong, positive correlation between the number of drugs used and the rate of ADRs (r = 0.823 ; p < 0.001). According to SOC, the leading ADRs pertained to General disorders and administration site conditions (N = 103). Type A ADRs made the majority of the total number of ADRs (75%), while serious and unexpected ADRs represented a lower ratio of the total number of ADRs (12% and 19%, respectively). CMM services significantly reduced the rate of ADRs throughout the course of time, that is between the first and the last consultation (p < 0.001). Conclusions Through more careful selection and more frequent monitoring of patients' therapy, CMM services could serve as a solution to the evergrowing clinical, financial and humanistic burden of ADRs.

adverse drug reaction ; medication management ; elderly cardiovascular patients

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