title: [Medication adverse events: Impact of pharmaceutical consultations during the hospitalization of patients].
abstract: The medication iatrogenic events are responsible for nearly one iatrogenic event in five. The main purpose of this prospective multicenter study is to determine the effect of pharmaceutical consultations on the occurrence of medication adverse events during hospitalization (MAE). The other objectives are to study the impact of age, of the number of medications and pharmaceutical consultations on the risk of MAE. The pharmaceutical consultation is associated to a complete reassessment done by both a physician and a pharmacist for the home medication, the hospital treatment (3days after admission), the treatment during chemotherapy, and/or, the treatment when the patient goes back home. All MAE are subject to an advice for the patient, additional clinical-biological monitoring and/or prescription changes. Among the 318 patients, 217 (68%) had 1 or more clinically important MAE (89% drug-drug interaction, 8% dosing error, 2% indication error, 1% risk behavior). The patients have had 1121 pharmaceutical consultations (3.2±1.4/patient). Thus, the pharmaceutical consultations divided by 2.34 the risk of MAE (unadjusted incidence ratio, P≤0.05). Each consultation decreased by 24% the risk of MAE. Moreover, adding one medication increases from 14 to 30% as a risk of MAE on the population. Pharmaceutical consultations during the hospital stay could reduce significantly the number of medication adverse effects.
authors.affiliation: Service de pharmacie stérilisation, groupe hospitalier Saint-Vincent, clinique Sainte-Anne, rue Philippe-Thys, 67000 Strasbourg, France. Electronic address: r.santucci@ghsv.org.
authors.forename: R
authors.initials: R
authors.lastname: Santucci
authors.affiliation: Service de pharmacie-pharmacologie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France.
authors.forename: D
authors.initials: D
authors.lastname: Levêque
authors.affiliation: Service d'oncologie-hématologie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France.
authors.forename: R
authors.initials: R
authors.lastname: Herbrecht
authors.affiliation: Service de pédiatrie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France.
authors.forename: M
authors.initials: M
authors.lastname: Fischbach
authors.affiliation: Service de pharmacie-pharmacologie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France.
authors.forename: A C
authors.initials: AC
authors.lastname: Gérout
authors.affiliation: Service de pharmacie stérilisation, centre hospitalier de Haguenau, 64, avenue du Professeur-Leriche, 67500 Haguenau, France.
authors.forename: C
authors.initials: C
authors.lastname: Untereiner
authors.affiliation: Service des urgences, groupe hospitalier Saint-Vincent, clinique Sainte-Anne, rue Philippe-Thys, 67000 Strasbourg, France.
authors.forename: K
authors.initials: K
authors.lastname: Bouayad-Agha
authors.affiliation: Service de pharmacie stérilisation, groupe hospitalier Saint-Vincent, clinique Sainte-Anne, rue Philippe-Thys, 67000 Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Couturier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D005260:Female; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007223:Infant; D008297:Male; D054539:Medication Therapy Management; D008875:Middle Aged; D010361:Patients; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D010820:Physicians; D011446:Prospective Studies; D012017:Referral and Consultation; D012651:Self Medication; D055815:Young Adult
keywords: Consultation pharmaceutique; Iatrogenic; Iatrogénie; Medication adverse event; Medication error; Pharmaceutical care; Pharmaceutical consultation; Pharmacie clinique; Évitable; Évènement iatrogène médicamenteux