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Assessment of the clinical relevance of pharmacists' interventions performed during medication review in a rheumatology ward

  • Anne-Laure Yailian
    Correspondence
    Corresponding author.
    Affiliations
    Department of Pharmacy, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France

    Claude Bernard University Lyon 1, EA 4129 P2S Parcours Santé Systémique, 7-11 rue Guilllaume Paradin, 69008 Lyon, France
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  • Elsa Revel
    Affiliations
    Department of Pharmacy, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France
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  • Cléa Tardy
    Affiliations
    Department of Pharmacy, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France
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  • Aurélie Fontana
    Affiliations
    Department of Rheumatology, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France

    INSERM UMR 1033, Claude Bernard University Lyon 1, Laennec Faculty of Medicine, 7-11 rue Guillaume Paradin, 69008 Lyon, France
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  • Charline Estublier
    Affiliations
    Department of Rheumatology, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France

    INSERM UMR 1033, Claude Bernard University Lyon 1, Laennec Faculty of Medicine, 7-11 rue Guillaume Paradin, 69008 Lyon, France
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  • Evelyne Decullier
    Affiliations
    Department of Medical Information, Evaluation and Research, Clinical Research Unit, Hospices Civils de Lyon, 162 avenue Lacassagne, 69003 Lyon, France
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  • Claude Dussart
    Affiliations
    Claude Bernard University Lyon 1, EA 4129 P2S Parcours Santé Systémique, 7-11 rue Guilllaume Paradin, 69008 Lyon, France
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  • Roland Chapurlat
    Affiliations
    Department of Rheumatology, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France

    INSERM UMR 1033, Claude Bernard University Lyon 1, Laennec Faculty of Medicine, 7-11 rue Guillaume Paradin, 69008 Lyon, France
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  • Christine Pivot
    Affiliations
    Department of Pharmacy, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France
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  • Audrey Janoly-Dumenil
    Affiliations
    Department of Pharmacy, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 place d'Arsonval, 69003 Lyon, France

    Claude Bernard University Lyon 1, EA 4129 P2S Parcours Santé Systémique, 7-11 rue Guilllaume Paradin, 69008 Lyon, France

    Claude Bernard University Lyon 1, Faculty of Pharmacy, 8 avenue Rockefeller, 69008 Lyon, France
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Published:October 25, 2018DOI:https://doi.org/10.1016/j.ejim.2018.08.017

      Abstract

      Background

      Pharmacists contribute to reduce the number of medication errors during medication review. Nevertheless, few French studies report the potential clinical impact of pharmacists' interventions performed after detecting drug-related problems. The objective was to evaluate the clinical relevance of pharmacists' interventions in a rheumatology ward from medical and pharmaceutical perspectives.

      Method

      The analysis was conducted on pharmacists' interventions performed between January 1 and December 31, 2015 in a French teaching hospital. Similar pharmacists' interventions were grouped in one item and they were analysed according to 11 drug categories. The clinical significance of pharmacists' interventions was considered independently by a pharmacist and a rheumatologist using a validated French scale that categorises drug-related problems from minor to catastrophic. The agreement between the two professionals was analysed using the weighted kappa coefficient.

      Results

      Of 1313 prescriptions reviewed, 461 pharmacists' interventions (171 items) were formulated for drug-related problems with an acceptance rate of 67.2%. Of the 418 interventions selected for clinical significance analysis, 235 interventions (56.2%) for the physician and 400 interventions (95.7%) for the pharmacist were at least significant. The two professionals evaluated equally the clinical relevance of 90 items (50.6%). The categories with the most similarities were the analgesics/anti-inflammatory drugs (78.1%), the antidiabetics (75.0%) and the anticoagulants (71.4%). The agreement was estimated by a weighted kappa coefficient of 0.29.

      Conclusion

      This work highlights the positive clinical relevance of pharmacists' interventions in rheumatology and the importance of medico-pharmaceutical collaboration to prevent medication errors.

      Keywords

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