Clinical evaluation of pharmacists' interventions on multidisciplinary lung transplant outpatients' management : results of a 7-year observational study
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
BMJ open - 10(2020), 11 vom: 27. Nov., Seite e041563 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Duwez, Marion [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 06.04.2021 Date Revised 06.04.2021 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/bmjopen-2020-041563 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318134977 |
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| 100 | 1 | |a Duwez, Marion |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical evaluation of pharmacists' interventions on multidisciplinary lung transplant outpatients' management |b results of a 7-year observational study |
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| 520 | |a © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a 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 | ||
| 520 | |a DESIGN: Data were collected prospectively from an LT recipients cohort during 7 years. A multidisciplinary committee assessed retrospectively the clinical impact of accepted PIs | ||
| 520 | |a SETTING: French University Hospital | ||
| 520 | |a PARTICIPANTS: LT outpatients followed from 2009 to 2015 | ||
| 520 | |a PRIMARY OUTCOME MEASURES: Clinical impact of PIs performed by pharmacists using the CLEO tool and the Pareto chart | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a respiratory medicine (see thoracic medicine) | |
| 650 | 4 | |a therapeutics | |
| 650 | 4 | |a transplant medicine | |
| 700 | 1 | |a Chanoine, Sébastien |e verfasserin |4 aut | |
| 700 | 1 | |a Lepelley, Marion |e verfasserin |4 aut | |
| 700 | 1 | |a Vo, Thi Ha |e verfasserin |4 aut | |
| 700 | 1 | |a Pluchart, Hélène |e verfasserin |4 aut | |
| 700 | 1 | |a Mazet, Roseline |e verfasserin |4 aut | |
| 700 | 1 | |a Allenet, Benoit |e verfasserin |4 aut | |
| 700 | 1 | |a Pison, Christophe |e verfasserin |4 aut | |
| 700 | 1 | |a Briault, Amandine |e verfasserin |4 aut | |
| 700 | 1 | |a Saint-Raymond, Christelle |e verfasserin |4 aut | |
| 700 | 1 | |a Camara, Boubou |e verfasserin |4 aut | |
| 700 | 1 | |a Claustre, Johanna |e verfasserin |4 aut | |
| 700 | 1 | |a Bedouch, Pierrick |e verfasserin |4 aut | |
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