Resumen de Safety impact of pharmaceutical alerts in the electronic prescription at the emergency services of patients with renal insuffiency

Almudena Ribed Sánchez, Paula Arrabal Durán, María Esther Durán García, Alvaro Giménez Manzorro, R. García Sánchez

• Objective: To evaluate a program implementing a dose adjustment alert system according to the patient's renal function.

  Method: A two-months prospective study where pharmaceutical interventions were carried out at a tertiary teaching hospital. Prescriptions of admitted patients from the emergency Service with Renal insufficiency (Ri) were reviewed. We detected whether appropriate dose adjustments were made by the physicians and a pharmaceutical intervention was performed in non-adequately prescribed drugs and analyzed its acceptance or rejection (cause and patient's clinical impact).

  Results: Renal function was reviewed in 2,691 patients. A total of 449 patients had renal impairment. A total of 147 renally cleared drugs were adequately prescribed, especially allopurinol and captopril; 159 required pharmaceutical intervention, mainly antibiotics, with an acceptance rate of 70%. The follow up of parameter of safety (in terms of renal toxicity) worsened in 17% of the overridden interventions.

  Conclusion: This study improves drug therapy safety, means drugs would be adjusted from the first day of hospitalisation and is an opportunity to involve the pharmacist in the patients care