Polypharmacy And Interactions - What Is A Pharmacist Role?

• Published in: Value in health Vol. 20; no. 9; p. A510
• Main Authors: Snopkova, M, Szmicsekova, K, Sukel, O
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.10.2017
• Subjects: Averages; Community pharmacists; Cooperation; Counseling; Drug therapy; Drugs; Health care expenditures; Health care management; Intervention; Patients; Pharmacists; Pharmacy; Polypharmacy; Prescription drugs; Quality of life
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.628

OBJECTIVES: Pharmacists have the potential to improve health system interventions, medicine therapy management and polypharmacy. There are many negative consequences associated with polypharmacy. The burden of taking multiple medications can be associated with greater health care costs and an increased clinical risk (adverse drug events, drug-interactions, drug duplicity and possibly medication non-adherence). In the healthcare system of Slovakia there is not yet defined the position of a clinical pharmacist (in a community pharmacy) as a control and counseling subject. METHODS: Data are from patient visits to pharmacy and outpatient. We examined patients and practitioners requirements between January and march 2017 and expose a "medicines report" requiring medical interventions. The medicines report contains: type, number and clinical evidence of interaction, recommendation regarding the presence of the interaction, recommendation for future (theoretical) therapy, consideration of patient's co-payment and drug duplication. RESULTS: Reviewing and monitoring the use of drugs by 29 patients it was identified a presence of interactions. The analysed patients were taking from 5 to 20 medicines (average 9.17; SD=4.61; median=7 drugs/patient). There were identified together 218 interactions C (monitor therapy), D (consider therapy modification) or X (avoid combination) type (average=7.52; SD=9.35; median=7).The most clinical relevant interactions were present in group C (85.32%; average=6.41; SD=7.89; median=4). In the next group D were 14.22% interactions (average=1.07; SD=2.23; median=0) and in the group X was 1 interaction (0.46%; average=0.03; SD=0.19; median=0). CONCLUSIONS: The medicine report provides amendments which aimed to improve the treatment of patients and contribute to their quality of life including decreasing patient's co-payment. Need to be developed the medicines report methodology and quantify the clinical and economic value of this intervention. The condition is cooperation between stakeholders, healthcare providers and patients.