Clinical evaluation of pharmacists' interventions on multidisciplinary lung transplant outpatients' management: results of a 7-year observational study. Issue 11 (27th November 2020)

• Record Type: Journal Article
• Authors: Duwez, Marion; Chanoine, Sébastien; Lepelley, Marion; Vo, Thi Ha; Pluchart, Hélène; Mazet, Roseline; Allenet, Benoit; Pison, Christophe; Briault, Amandine; Saint-Raymond, Christelle; Camara, Boubou; Claustre, Johanna; Bedouch, Pierrick
• Is Part Of: BMJ open. Volume 10:Issue 11(2020)
• Publication Date: 2020-11-27
• Subjects: respiratory medicine (see thoracic medicine) -- therapeutics -- transplant medicine; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-041563
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: Lung transplant (LT) recipients require multidisciplinary care because of the complexity of therapeutic management. Pharmacists are able to detect drug-related problems and provide recommendations to physicians through pharmacists' interventions (PIs). We aimed at assessing the clinical impact of PIs on therapeutic management in LT outpatients. Design: Data were collected prospectively from an LT recipients cohort during 7 years. A multidisciplinary committee assessed retrospectively the clinical impact of accepted PIs. Setting: French University Hospital. Participants: LT outpatients followed from 2009 to 2015. Primary outcome measures: Clinical impact of PIs performed by pharmacists using the CLEO tool and the Pareto chart. Results: 1449 PIs led to a change in patient therapeutic management and were mainly related to wrong dosage (39.6%) and untreated indication (19.6%). The clinical impact of PIs was 'avoids fatality', 'major' and 'moderate', in 0.1%, 7.0% and 57.9%, respectively. Immunosuppressants, antimycotics for systemic use and antithrombotic agents had the greatest clinical impact according to the Pareto chart. PIs related to drug–drug interactions (10%) mainly had a moderate and major clinical impact (82.3%, p<0.0001). Conclusion: Clinical pharmacists play a key role for detecting drug-related problems mostly leading to a change in therapeutic management among LT outpatients. Our study provides a new insight to analyse the clinical impact of PIs in order to target PIs which have most value and contribute to patient care through interdisciplinary approach.