5PSQ-119 A new pharmaceutical care programme for COVID-19 patients treated with Paxlovid®: Implementation and safety outcomes reported

• Published in: European journal of hospital pharmacy. Science and practice Vol. 30; no. Suppl 1; pp. A151 - A152
• Main Authors: Ferris Villanueva, M, Chamorro de Vega, E, Gonzalez Rodriguez, CG, Torroba Sanz, B, Vicente Valor, J, Herranz Alonso, A, Sanjurjo Sáez, M
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 23.03.2023; BMJ Publishing Group LTD
• Subjects: Conflicts of interest; Coronaviruses; COVID-19; Drug stores; Patient education; Pharmacists; Section 5: Patient safety and quality assurance
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2023-eahp.316

Background and ImportanceThe COVID-19 pandemic has highlighted the important role that hospital pharmacists play in improving pharmacotherapy outcomes. Paxlovid® (Nirmatrelvir/ritonavir) was recently granted an Emergency Use Authorisation for the treatment of mild to moderate COVID-19. However, the use of Paxlovid® with certain other drugs in high-risk patients may result in potentially significant drug-drug interactions (DDI) and adverse drug events (ADE).Aim and ObjectivesTo assess the impact of a comprehensive pharmaceutical care program (CPCP) focusing on the prevention of DDI and ADE, initiated in a hospital pharmacy for patients with mild to moderate COVID-19 treated with Paxlovid®.Material and MethodsDesign: Quasi-experimental study performed between 1 May and 31 July 2022. Pharmacists were responsible for proposing COVID-19 local guidelines to physicians, monitoring adherence to guidelines, managing DDI and ADE, providing patient education, and evaluating health outcomes. A telephone consultation was carried out 10 days after the end of Paxlovid® treatment.Potential DDI were detected according to Lexi-Comp® and Liverpool COVID-19 databases. Paxlovid-related ADE reported were graded according to Common Terminology Criteria for Adverse Events, version 4.Results140 patients (60.7% outpatients) initiated Paxlovid® and were enrolled in the CPCP. Adherence to local guidelines for the use of Paxlovid® was 100%.Overall, 232 DDI were detected in 111 (79.3%) patients, 142 (61.2%) of which required specific management (34.5% discontinuation of the concomitant drug and 65.5% dose adjustment).Pharmacists made 267 interventions that led to the prevention of 177 ADE (1.3/patient), 96 (54.2%) of which were grade G-H (NCC MERP classification).At day 10, 96 ADEs were reported in 42 patients (26.1% of which were grade ≥3), being dysgeusia and diarrhoea the most common. Premature discontinuation of Paxlovid® due to ADEs was necessary in 4 (2.8%) patients.Conclusion and RelevanceThe implementation of a CPCP developed by hospital pharmacists for patients treated with Paxlovid® was an effective approach for monitoring adherence to guidelines, managing DDI, providing patient education, and evaluating safety outcomes. Paxlovid® showed an acceptable safety profile.References and/or AcknowledgementsConflict of InterestNo conflict of interest.