Background
Methods
Design and setting
Participants and data collection
Analysis
Results
General data and clinical pharmacists recommendations
Proposed interventions | Total |
---|---|
Number of proposed interventions by clinical pharmacists | 625 |
Number of interventions accepted by general practitioners | 304 |
Median of the proposed interventions | 7 |
Median accepted interventions | 3 |
Maximum number of proposed interventions by clinical pharmacists | 15 |
Maximum number of accepted interventions by general practitioners | 8 |
Potential and clinically important drug-drug interactions and potentially inappropriate medications in the elderly
pXDDIs | N prior | N after | pXDDIs | N prior | N after |
Amiodarone-torsemide | 1 | 0 |
ipratropium / fenoterol-tiotropium
|
3
|
2
|
Amiodarone-clozapine | 1 | 0 |
quetiapine-amiodarone
|
1
|
0
|
Amiodarone-warfarin | 1 | 0 |
quetiapine -domperidone
|
2
|
1
|
Etoricoxib-meloxicam | 1 | 0 |
quetiapine -escitalopram
|
7
|
3
|
Haloperidol-sulpiride | 2 | 1 |
quetiapine-metoclopramide
|
3
|
2
|
Haloperidol-metoclopramide | 1 | 0 |
quetiapine-sulpiride
|
2
|
1
|
Cholecalciferol-calcitriol | 3 | 0 |
metoclopramide-trimetazidine
|
2
|
1
|
Ipratropium/fenoterol-Olanzapine | 2 | 1 |
sulpiride-risperidone
|
1
|
0
|
Not accepted pXDDIs | N prior | N after | pXDDIs | N prior | N after |
Amisulpride-sulpiride | 1 | 1 |
quetiapine-budenoside / formoterol
|
1
|
1
|
Desloratadine-mirtazapine | 1 | 1 |
quetiapine-domperidone
|
2
|
1
|
Escitalopram-sotalol | 1 | 1 |
quetiapine-escitalopram
|
7
|
3
|
Haloperidol-sulpiride | 2 | 1 |
quetiapine-haloperidol
|
3
|
3
|
Haloperidol- ipratropium/phenoterol | 1 | 1 |
quetiapine-metoclopramide
|
3
|
2
|
Haloperidol ipratropium/phenoterol- | 1 | 1 |
quetiapine-sulpiride
|
2
|
1
|
Olanzapine- ipratropium/phenoterol | 2 | 1 |
quetiapine-trazodone
|
1
|
1
|
Quetiapine-tiotropium | 1 | 1 |
quetiapine-tiotropium
|
1
|
1
|
Carbamazepine-clozapine | 3 | 2 |
metoclopramide-trimetazidine
|
2
|
1
|
Carvedilol- budenoside/formoterol | 2 | 2 |
olanzapine-thyrotropium
|
1
|
1
|
Quetiapine- ipratropium/phenoterol | 1 | 1 |
sulpiride-trimetazidine
|
1
|
1
|
Linear regression model results for the occurrence of potential X DDIs
Independent variable | β value | P value |
---|---|---|
Clinical pharmacist acceptance | −1.955 | 0.003 |
Age | 0.024 | 0.546 |
Total number of medicines | −0.442 | < 0.001 |
Gender | 0.253 | 0.686 |
Adherence to heart failure treatment guidelines
Case number | Treatment guidelines issue | Clinical pharmacist recommendations | GPs acceptance (YES/NO) |
---|---|---|---|
1.
|
Methyldigoxin treatment
|
Methyldigoxin discontinuation and perindopril initiation
|
YES
|
2. | Methyldigoxin treatment | Methyldigoxin discontinuation and enalapril initiation | NO |
3.
|
Methyldigoxin treatment + β-blocker +ACE inhibitor
|
Methyldigoxin treatment discontinuation
|
YES
|
4.
|
Methyldigoxin treatment +ACE inhibitor
|
Methyldigoxin treatment discontinuation + β-blocker initiation
|
YES
|
5. | Methyldigoxin treatment | β-blocker initiation and ACE inhibitor initiation | NO |
6, 7, 8, 9, 10.
|
Methyldigoxin treatment + β-blocker
|
Methyldigoxin treatment discontinuation
|
YES, NO, YES, NO, YES
|
11. | Methyldigoxin treatment +ACE inhibitor | Methyldigoxin treatment discontinuation + β-blocker initiation | NO |
12.
|
1.25 mg bisoprolol daily
|
Drug adjustment (2,5 mg daily)
|
YES
|
13, 14, 15. | ACE inhibitor treatment | β-blocker adding | NO, NO, NO |
16, 17, 18. | ACE inhibitor treatment with verapamil | Verapamil discontinuation and selective β-blocker initiation | NO, NO, NO |
19. | Inappropriate dosing of ACE inhibitor and β-blocker | Reduce the ACE inhibitor dose and increase the dose of the β-blocker | NO |
20.
|
Nonselective β-blocker
|
Switching to bisoprolol
|
NO, YES
|
21.
|
Amlodipine treatment
|
Amlodipine discontinuation and β-blocker (bisoprolol) initiation
|
YES
|