Doctors' acceptance of recommendations for patients with the opportunity for pharmacotherapy improvement.
OBJECTIVE
To identify and quantify the influence of different variables on the implementation of pharmacotherapy optimisation measures in hospitalised patients.


METHODS
Descriptive transversal study.


METHODS
2000-2007.


METHODS
public university general hospital (25,000 patients admitted/year). The Programme implemented to improve pharmacotherapy quality and patient safety covers 30% of all patients. Using records from the Atefarm(®) Farmis application, we analysed pharmacotherapy recommendations (PRs) made by pharmacists to doctors. The selected variables were the following: Risk of the medication for ADE (1-high, 0-low), ADE category, (0-indication, 1-effectiveness, 2-safety), potential severity (scale of 1 to 5), impact of the PR (0-effectiveness, 1-safety, 2-efficiency) and implementation of the PR (yes/no). We calculated the frequency (%) and 95% CI for the categorical variables and performed a multivariate logistical regression analysis to identify the variables' degree of influence on implementing the PRs.


RESULTS
We identified 7,920 ADEs in 4,680 patients. A PR was issued in 85% of the cases (6,762), and it was implemented in 83% (95% CI 74.2-89.8). Potential severity of the ADE ≥2 (OR 1.57; 95% CI 1.27-1.94), and ADE category for effectiveness and safety (OR 1.19; 95% CI 1.02-1.39) were shown to be determining factors for implementing the PR for the patient.


CONCLUSIONS
The probability that a PR will be implemented for a patient is related to the potential severity and the category of the identified ADE. Therefore, recommendations intended to improve effectiveness of pharmacotherapy or patient safety, and those with potential clinical consequences have a greater chance of being applied to a patient.
López-Montenegro Soria
M A
MA
Servicio de Farmacia, Hospital Universitario Doctor Peset, Valencia, España. lopez-montegro_ang@gva.es
Climente Martí
M
M
Jiménez Torres
N V
NV
D001291:Attitude of Health Personnel; D001519:Behavior; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D006769:Hospitals, General / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D059065:Medication Reconciliation; D010565:Persuasive Communication; D010607:Pharmacy Service, Hospital; D010820:Physicians / Q000523:psychology*; D058996:Quality Improvement; D012306:Risk; D012449:Safety; D012720:Severity of Illness Index