title: Doctors' acceptance of recommendations for patients with the opportunity for pharmacotherapy improvement.
abstract: 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.
authors.affiliation: Servicio de Farmacia, Hospital Universitario Doctor Peset, Valencia, España. lopez-montegro_ang@gva.es
authors.forename: M A
authors.initials: MA
authors.lastname: López-Montenegro Soria
authors.forename: M
authors.initials: M
authors.lastname: Climente Martí
authors.forename: N V
authors.initials: NV
authors.lastname: Jiménez Torres
mesh_terms: 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