CP-140 Analysis of distribution and acceptability of pharmaceutical interventions after implantation of the electronic assisted prescription

• Published in: European journal of hospital pharmacy. Science and practice 2017-03, Vol.24 (Suppl 1), p.A63-A63
• Main Authors: Gil-Sierra, MD, Diaz-Navarro, J, Camean-Castillo, M, Fenix-Caballero, S, GarciadeParedes-Esteban, JC, Blanco-Castaño, MA, Gandara-LadrondeGuevara, MJ, Martinez-Diaz, C, Borrero-Rubio, JM, Rey, EJ Alegre-Del
• Format: Article
• Language: English
• Subjects: Drug withdrawal; Internal medicine; Pharmaceuticals; Pharmacists; Prescriptions
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2017-000640.139

BackgroundPharmacist interventions are important to improve patient safety, avoid physicians prescriptions errors and reduce unnecessary expenses. Electronic assisted prescription is a differential factor to document pharmaceutical interventions, and to analyse their distribution and acceptability quickly and easily.PurposeTo assess clinical pharmacist interventions made using a computerised physician order entry system (CPOE) for hospital patients and physicians’ acceptance after electronic assisted prescription implementation.Material and methodsA retrospective study of pharmaceutical interventions was conducted over 9 months (January 2016 to September 2016) after implementation of electronic assisted prescriptions. Differences between original prescriptions and pharmaceutical recommendations were reported to the physicians using the Farmatools application from CPOE. Types of recommendations, medical departments, pharmacotherapeutic group of drug involved, degree of acceptance and type of accepted pharmaceutical interventions were recorded.ResultsThere were 863 pharmaceutical interventions. Withdrawal treatments proposals were 430 (49.8%): 378 (43.8%) for excessive treatment duration, 23 (2.7%) for therapeutic duplications, 22 (2.5%) according to an antibiogram, 5 (0.6%) for allergies and 2 (0.2%) for other reasons. There were 152 (17.6%) suggestions for therapy change: 83 (9.6%) according to an antibiogram, 41 (4.8%) for interactions, 21 (2.4%) according to therapeutic protocol change and 7 (0.8%) for others causes. Dose adjustment interventions were 133 (15.4%), due to 82 (9.5%) overdosing, 29 (3.4%) renal insufficiency and 22 (2.5%) under dosing. Proposals for modifying administration frequency were 117 (13.5%). Pharmaceutical interventions were detected in internal medicine (37.4%), surgery (10.3%) and pneumology (9.7%) departments, among others. Antimicrobials were the most frequent therapeutic group involved in recommendations (52.3%), followed by haematopoietic drugs (12%) and cardiovascular drugs (11.8%). There were 401 (46.5%) interventions accepted by physicians, 449 (52%) not accepted proposals and the rest were not evaluable. The most accepted suggestions were 158 (41.7%) treatment withdrawals for excessive duration, followed by 47 (57.3%) overdosage adjustment and 33 (39.7%) therapy change according to an antibiogram.ConclusionAlmost half of the pharmaceutical interventions were withdrawal treatment proposals. Excessive duration was the main