Negative clinical outcomes associated with drug-related problems in heart failure (HF) outpatients: Impact of a pharmacist in a multidisciplinary HF clinic

Gastelurrutia, P; Benrimoj, SI; Espejo, J; Tuneu, L; Mangues, MA; Bayes-Genis, A

Negative clinical outcomes associated with drug-related problems in heart failure (HF) outpatients: Impact of a pharmacist in a multidisciplinary HF clinic

Gastelurrutia, P Benrimoj, SI

Espejo, J Tuneu, L Mangues, MA Bayes-Genis, A

Permalink

Publication Type:: Journal Article
Citation:: Journal of Cardiac Failure, 2011, 17 (3), pp. 217 - 223
Issue Date:: 2011-03-01

Closed Access

	Filename	Description	Size
	2011002344OK.pdf		147.62 kB	Adobe PDF	View/Open

Copyright Clearance Process

Recently Added
In Progress
Closed Access

This item is closed access and not available.

Full metadata record

Field	Value	Language
dc.contributor.author	Gastelurrutia, P	en_US
dc.contributor.author	Benrimoj, SI https://orcid.org/0000-0001-9768-7838	en_US
dc.contributor.author	Espejo, J	en_US
dc.contributor.author	Tuneu, L	en_US
dc.contributor.author	Mangues, MA	en_US
dc.contributor.author	Bayes-Genis, A	en_US
dc.date.available	2010-10-25	en_US
dc.date.issued	2011-03-01	en_US
dc.identifier.citation	Journal of Cardiac Failure, 2011, 17 (3), pp. 217 - 223	en_US
dc.identifier.issn	1071-9164	en_US
dc.identifier.uri	http://hdl.handle.net/10453/18667
dc.description.abstract	Background: Drug-related negative outcomes (DNOs) are health problems that patients experience due to drug use or nonuse. Heart failure (HF) patients are at high risk of experiencing DNOs owing to polypharmacy, comorbidities, and age. Methods and Results: Ninety-seven consecutive HF patients were enrolled and followed for 6 months. A pharmacist, integrated within a multidisciplinary HF team, reviewed the medication of each patient to detect, resolve, and/or prevent possible DNOs, risks of developing a DNO (rDNOs) and the drug-related problems (DRPs) that are associated with them. We detected 147 DNOs/rDNOs with a mean of 1.5 ± 1.4 per patient. Among DNOs, 45% were due to a lack of a pharmacologic treatment (need for a drug) and 24% were treatments with an insufficient drug dose (quantitative ineffectiveness). Among rDNOs, 33% were due to use of an unsafe drug (nonquantitative lack of safety) and 30% to quantitative ineffectiveness. Ninety-four percent of DNOs/rDNOs were preventable, and, importantly, 5.5% were classified as clinically serious. During follow-up, pharmacist interventions solved or prevented the health problem in 83% of cases. The most frequently identified DRPs were "insufficiently treated health problem" (31%), "inadequate dose, regimen, or duration of a drug" (22%), "probability of adverse effects" (16%), and "nonadherence" (14%). A significant relationship between the number of DNOs/rDNOs and the number of drugs was found (P < .013). Conclusions: Chronic HF outpatients have a high incidence of preventable DNOs. The inclusion of a pharmacist in multidisciplinary HF teams should be considered, because it is clinically beneficial for patients and it increases HF specialists' awareness of DNOs, especially those beyond HF. © 2011 Elsevier Inc. All rights reserved.	en_US
dc.relation.ispartof	Journal of Cardiac Failure	en_US
dc.relation.isbasedon	10.1016/j.cardfail.2010.10.009	en_US
dc.subject.classification	Cardiovascular System & Hematology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Drug Toxicity	en_US
dc.subject.mesh	Cardiovascular Agents	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Ambulatory Care	en_US
dc.subject.mesh	Interprofessional Relations	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Pharmacists	en_US
dc.subject.mesh	Ambulatory Care Facilities	en_US
dc.subject.mesh	Patient Care Team	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Heart Failure	en_US
dc.subject.mesh	Drug-Related Side Effects and Adverse Reactions	en_US
dc.title	Negative clinical outcomes associated with drug-related problems in heart failure (HF) outpatients: Impact of a pharmacist in a multidisciplinary HF clinic	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	17	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	17	en_US

Abstract:

Background: Drug-related negative outcomes (DNOs) are health problems that patients experience due to drug use or nonuse. Heart failure (HF) patients are at high risk of experiencing DNOs owing to polypharmacy, comorbidities, and age. Methods and Results: Ninety-seven consecutive HF patients were enrolled and followed for 6 months. A pharmacist, integrated within a multidisciplinary HF team, reviewed the medication of each patient to detect, resolve, and/or prevent possible DNOs, risks of developing a DNO (rDNOs) and the drug-related problems (DRPs) that are associated with them. We detected 147 DNOs/rDNOs with a mean of 1.5 ± 1.4 per patient. Among DNOs, 45% were due to a lack of a pharmacologic treatment (need for a drug) and 24% were treatments with an insufficient drug dose (quantitative ineffectiveness). Among rDNOs, 33% were due to use of an unsafe drug (nonquantitative lack of safety) and 30% to quantitative ineffectiveness. Ninety-four percent of DNOs/rDNOs were preventable, and, importantly, 5.5% were classified as clinically serious. During follow-up, pharmacist interventions solved or prevented the health problem in 83% of cases. The most frequently identified DRPs were "insufficiently treated health problem" (31%), "inadequate dose, regimen, or duration of a drug" (22%), "probability of adverse effects" (16%), and "nonadherence" (14%). A significant relationship between the number of DNOs/rDNOs and the number of drugs was found (P < .013). Conclusions: Chronic HF outpatients have a high incidence of preventable DNOs. The inclusion of a pharmacist in multidisciplinary HF teams should be considered, because it is clinically beneficial for patients and it increases HF specialists' awareness of DNOs, especially those beyond HF. © 2011 Elsevier Inc. All rights reserved.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/18667