Hospital Medication Review: risk and network analysis
DOI:
https://doi.org/10.30968/rbfhss.2023.144.0995Abstract
Objective: To assess the relationship between Drug Related Problems (DRP) and its respective drugs identified from a hospital medication review (MR). Method: This is a retrospective, cross-sectional observational study based in STROBE Statement. DRP records from study period (2019-2020) were collected from a hospital MR database and classified by Pharmaceutical Care Network Europe (PCNE) standards. Through an online form, a panel of experts (pharmacists and physicians) analyzed the clinical significance of DRP included, using the Hazard Scoring Matrix (HSM). Using Gephi software, two networks were built to visualize the relationship between DRPs and drugs from the following perspectives: (i) the hospital’s pharmacists; and (ii) the panel of experts. Results: 1250 DRP related to 177 different drugs were included and compiled in 202 “DRP-drug” different combinations. According to the PCNE, 41.6% of DRP were classified as class C1 (drug selection), 20.3% as C5 (dispensing) and 13.8% as class C3 (dose selection). According to the expert panel, the “dose selection- antibiotic” combination was the one with the highest risk by HSM in the global and pharmacist analysis. To physicians, the combination “monitoring- vitamin K antagonist anticoagulants” was presented with the highest HSM. On the other hand, the “drug selection- antiulcer” combination, which was the most found in the database, was classified by the specialists with a low risk (HSM 6). Conclusion: The profile of “DRP- drug” combinations were different when compared results pre and post risk analysis. Thus, it was demonstrated that HSM can be a useful tool to improve DRP evaluation and to standardize MR services, guiding pharmacists to situations of greater clinical significance and increasing their effectiveness in improving health outcomes.
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