Resumen de Interactions of hepatitis C antivirals in a pharmacy ambulatory care setting
M. Florit-Sureda, Nuria Rudi Solá, Estefanell Anna, Belén López García, Roser Vives Vilagut
Introduction: In the pharmacy ambulatory care setting in our hospital, potential interactions (PI) between direct action antiviral (DAA) and any concomitant medications (CM) are routinely screened and registered with the aim of improving the pharmacological prescription in patients with chronic hepatitis C (CHC). The objective of the present work was to describe our experience since the introduction of DAA in 2014, in terms of prevalence, characteristics and clinical relevance of PI detected in patients treated with DAA. The main objective of the study was to quantify the PI detected among DAA for treatment of CHC and CM for the treatment of comorbidities. The secondary objectives were to describe the pharmacological groups associated with greater number of clinically relevant PI as well as recommendations made and their acceptance by the medical team. Method: We performed an observational retrospective study. Data from all patients with CHC, who started antiviral treatment with interferon free regimens during the period from September 2014 to December 2015, were retrieved from the electronic clinical records and the database of patients used in our pharmacy ambulatory care unit. Results: During the period studied, 479 patients were prescribed treatment with DAA in our hospital. In total, 1,481 checks for PI were registered and in 463 occasions a PI was detected. Of the PI detected, 416 were classified as moderate and only 47 were considered relevant. The pharmacological groups most frequently involved with PI were antihypertensive drugs (16.6%), anxiolytic drugs (10.4%), gastric protectors (9.5%), antiarrhythmic agents (9.3%), lipid-lowering agents (7.3%) and antidepressants (6.5%). 38.3% of relevant PI were related to lipid-lowering agents. In 203 PI detected (46.8%) actions advised were related to changes of CM (178, 38.4%) and changes in the DAA (25, 5.4%). Nearly all (98.5%) actions proposed by the pharmacist were accepted by the medical team. Conclusions: This study shows the importance of the role of the pharmacist in a multidisciplinary team to detect PI between DAA and any CM with the purpose of improving the pharmacological prescription and avoiding medication related problems in patients with CHC.
