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Impact of the COVID-19 pandemic on drug-related problems and pharmacist interventions in geriatric acute care units - 19/08/22

Impact de la pandémie de la Covid-19 sur les problèmes médicamenteux et les interventions pharmaceutiques dans un service de médecine aiguë gériatrique

Doi : 10.1016/j.pharma.2021.12.006 
M. Chappe a, b, c, , M. Corvaisier a, b, d, A. Brangier b, C. Annweiler b, d, e, L. Spiesser-Robelet a, f
a Department of Pharmacy, Angers University Hospital, Angers, France 
b Department of Geriatric Medicine, Research Center on Autonomy and Longevity, Angers University Hospital, Angers, France 
c Department of Pharmacy, Haut Anjou Hospital, Chateau-Gontier, France 
d UPRES EA 4638, University of Angers, Angers, France 
e Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada 
f Health Education and Practices Laboratory-LEPS (EA 3412), Paris13-Sorbonne Paris Cité University, Bobigny, France 

Corresponding author. Department of Pharmacy, Haut Anjou Hospital, 53200 Chateau-Gontier, France.Department of Pharmacy, Haut Anjou HospitalChateau-Gontier53200France

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Highlights

During the COVID-19 pandemic a less typical form of medical care was expected for the infected patients.
Clinical pharmacists may help the geriatricians in drug management.
A greater amount of drug-related issues were detected during the first wave of the pandemic.
The pharmacists’ advice focused on drugs used for the management of COVID-19.

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Summary

Objectives

To assess and compare the pharmaceutical analysis on drug management in a geriatric acute care unit prior to and during the COVID-19 pandemic.

Methods

This was a single-centre, retrospective, and comparative cohort study. All Pharmacist Interventions (PIs) carried out in the unit between 27 January 2020 and 30 April 2020 were distinguished according to whether they were conducted prior to or during the first wave of COVID-19. The main outcome measure was the rate of PIs per patient and per prescription lines analysed. Other data collected were the drug class managed by the PI, the Drug Related Problems (DRP) identified, the nature of the advice given, and the acceptance rate by geriatricians.

Results

A total of 355 patients were analysed, with PIs generated for 21.7% of the patients prior to COVID-19, and for 53.4% of the patients during the first wave (p<0.001). Among the 4402 prescription lines analysed, 54 PIs were carried out for prescriptions prior to COVID-19, and 177 during the first wave (p=0.002). DRPs were mostly related to anti-infectious drugs during the pandemic (20.3%, p=0.038), and laxatives prior to the pandemic (13.0%, p=0.023). The clinical impact of the PIs was mainly moderate (43.7%). The acceptance rate was 59.3%.

Conclusions

A greater amount of DRPs were detected and more therapeutic advice was proposed during the first wave of COVID-19, with a focus on drugs used for the management of COVID-19 rather than geriatric routine treatments. The needs for clinical pharmacists were strengthened during the pandemic.

Il testo completo di questo articolo è disponibile in PDF.

Résumé

Objectifs

Évaluer et comparer l’analyse pharmaceutique sur la prise en charge médicamenteuse dans une unité aiguë de gériatrie avant et pendant la pandémie de Covid-19.

Méthodes

Il s’agissait d’une étude de cohorte monocentrique, rétrospective et comparative. Toutes les interventions pharmaceutiques (IP) réalisées entre le 27 janvier 2020 et le 30 avril 2020 ont été distinguées selon qu’elles aient été réalisées avant ou pendant la première vague. Le critère principal était le taux d’IP par patient et par ligne de traitement analysée. La classe thérapeutique concernée par l’IP, les problèmes médicamenteux (PM), la nature des conseils donnés et le taux d’acceptation par les gériatres furent recueillis.

Résultats

Au total, 355 patients ont été analysés, avec des IP pour 21,7 % des patients avant Covid-19 et pour 53,4 % des patients lors de la première vague (p<0,001). Parmi les 4402 lignes de prescriptions analysées, 54 IP ont été réalisées pour des prescriptions antérieures au Covid-19 et 177 lors de la première vague (p=0,002). Les IP étaient principalement sur les anti-infectieux pendant la pandémie (20,3 %, p=0,038), et les laxatifs avant (13,0 %, p=0,023). L’impact clinique des IP était principalement modéré (43,7 %). Le taux d’acceptation était de 59,3 %.

Conclusions

Un plus grand nombre de PM ont été détectés et davantage de conseils thérapeutiques ont été proposés au cours de la première vague de Covid-19, l’accent étant mis sur les médicaments utilisés pour la gestion de la COVID-19 plutôt que sur les traitements gériatriques de routine. Les besoins en pharmaciens cliniciens ont été renforcés pendant la pandémie.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Clinical Pharmacy, COVID-19, Older inpatients, Pharmacist interventions, Therapeutic optimisation

Mots clés : Pharmacie clinique, COVID-19, Patients âgés, Interventions pharmaceutiques, Optimisation thérapeutique


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Vol 80 - N° 5

P. 669-677 - Settembre 2022 Ritorno al numero
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