5PSQ-005 Analysis of the adequacy of vitamin D prescriptions

• Published in: European journal of hospital pharmacy. Science and practice 2020-03, Vol.27 (Suppl 1), p.A151-A152
• Main Authors: Carrión Madroñal, IM, Martín Fernández, N, Arco Prados, Y, Grutzmancher Saiz, S, Santos Rubio, MD
• Format: Article
• Language: English
• Subjects: Computerized physician order entry; Medical errors; Prescriptions; Vitamin D; Vitamin deficiency
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2020-eahpconf.322

Background and importanceIn recent years, a considerable increase in vitamin D determinations and supplementation has been observed, although there is uncertainty about its clinical benefit in situations other than osteomalacia and rickets. In addition, according to the Spanish Agency for Medicines and Healthcare Products, serious cases of hypercalcaemia have been reported in children and adults associated with the use of cholecalciferol.Aim and objectivesTo analyse the adequacy of cholecalciferol prescriptions in inpatients to detect medication errors.Material and methodsA retrospective observational study was conducted from January 2018 to July 2019 in a second level hospital, which included patients who had prescriptions of cholecalciferol during their hospital admission.The following variables were recordedsex, age, pathology, indication, prescribed dose, vitamin D levels to define the degree of deficit, medication error (yes/no) and type of error, and prescribing service.Data were obtained from the electronic clinical records (Diraya) and electronic prescribing software (Prisma).ResultsForty-six patients (56.5% women) were included, with a median age of 71.5 years (range 23–87). The most frequent pathologies presented by the patients were: renal insufficiency (26%), digestive pathologies (19.6%), thyroid disorders (13%) and joint pathology (10.9%).Cholecalciferol was prescribed for vitamin D deficiency in 38 (82.6%) patients and as a prevention in 8 (17.4%). In 28 (60.9%) patients the dose of cholecalciferol was prescribed according to the summary of product characteristics, with a median of 400 IU. In 38 (82.6%) patients serum levels of vitamin D were available at hospital admission: 22 (57.9%) had a mild deficit, 11 (28.9%) had a severe deficit and 5 (13.2%) had levels within the range. Eighteen (39.1%) medication errors were detected, the most frequents were overdose (50%), non-indication (33.3%) and administration frequency (16.7%). The most prescribing services were endocrinology (26.10%), primary care physician (21.7%) and internal medicine (15.2%).Conclusion and relevanceThe causes of non-adequacy of prescriptions in our patients corresponded to cholecalciferol overdose and incorrect indication. An area of improvement in the prescription of cholecalciferol has been detected. We will carry out an interdisciplinary protocol for the use of cholecalciferol with the services involved. In addition, prescriptions with medication errors will be communi