Assessment of the Incidence of DRP/NOM in Patients Treated with Oral Anticoagulants and Evaluation of Pharmaceutical Intervention in Community Pharmacy
Abstract In recent years, consumption of oral anticoagulants has increased due to the high incidence of cardiovascular diseases and the development of new drugs. These drugs are associated with a high rate of DRP/NOM related health problems. An observational and cross-sectional study was carried out in an urban community pharmacy in Valladolid to evaluate the safety of DOACs compared to VKAs based on the identification of DRP/NOM in outpatients. The number of DRP/NOM per patient in the sample was 10.15, which implied 5.45 potential interventions. The patients treated with DOACs presented 2.3 DRP/NMO more than those treated with VKA, which leads to 1.3 more potential interventions. However, when we take into account only the DRP/NOM only derived from anticoagulant therapy, VKAs produce 3.0 DRP/NOM compared to 1.4 DRP/NOM derived from the consumption of DOACs. In addition, patients treated with VKAs have 1.20 moderate or severe DRP/NOM more than patients treated with DOACs. These data demonstrate that this type of patient should be a proactive target in pharmaceutical care programs.
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Williams M, Peterson GM, Tenni PC, Bindoff IK, Curtain C, Hughes J et al. Drug-related problems detected in Australian Community Pharmacies: The PROMISe Trial. Ann Pharmacother. 2011; 45(9):1067-1076.
Agencia Española de Medicamentos y Productos Sanitarios (Web). Enero 2021 Utilización de antitrombóticos en España. Ref. v.130319.
Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al. Dabigatran versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2009 Sep 17; 361(12):1139-1151.
Escobar Cervantes C, Martí-Almor J, Cabeza AIP, Bowrin K, Llorac Moix A, Genís Gironès M et al. Real-world cost-effectiveness analysis of NOACs versus VKA for stroke prevention in Spain. PLoS One. 2022; 17(4):e0266658.
Foro de Atención Farmacéutica-Farmacia Comunitaria (Foro AF-FC). Guía práctica para los Servicios Profesionales Farmacéuticos Asistenciales en la Farmacia Comunitaria. Madrid: Consejo General de Colegios Oficiales de Farmacéuticos; 2019.
Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL et al. Edoxaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2013 Nov 28; 369(22):2093-2104.
Gómez MA, Villafaina A, Hernández J, Salgado RM, González MA, Rodríguez J et al. Promoting appropriate drug use through the application of the Spanish drug-related problem classification system in the primary care setting. Ann Pharmacother. 2009; 43(2):339-346.
Granger CB, Alexander JH, McMurray JJV, Lopes RD, Hylek EM, Hanna M et al. Apixaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2011 Sep 15; 365(11):981-992.
Hämmerlein A, Griese N, Schulz M. Survey of drug-related problems identified by community pharmacies. Ann Pharmacother. 2007; 41(11):1825-1832.
López-López JA, Sterne JAC, Thom HHZ, Higgins JPT, Hingorani AD, Okoli GN et al. Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis. BMJ. 2017; 359:j5058.
Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W et al. Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation. N Engl J Med. 2011 Sep 8; 365(10):883-891.
Paulino EI, Bouvy ML, Gastelurrutia MA, Guerreiro M, Buurma H, ESCP-SIR Rejkjavik Community Pharmacy Research Group. Drug related problems identified by European community pharmacists in patients discharged from hospital. Pharm World Sci [Internet]. 2004 [citado el 1 de febrero de 2023]; 26(6):353-360.
Schulman S, Kearon C, Kakkar AK, Schellong S, Eriksson H, Baanstra D et al. Extended Use of Dabigatran, Warfarin, or Placebo in Venous Thromboembolism. N Engl J Med. 2013 Feb 21; 368(8):709-718.
Treceño C, Jiménez MI. Manual de farmacología básica para ciencias de la salud. Valladolid: Servicio de publicaciones de la UEMC; 2019.
Williams M, Peterson GM, Tenni PC, Bindoff IK, Curtain C, Hughes J et al. Drug-related problems detected in Australian Community Pharmacies: The PROMISe Trial. Ann Pharmacother. 2011; 45(9):1067-1076.
Martínez de Morentin de Benito, L. M., Treceño Lobato, C., & Valles Martín, E. (2023). Assessment of the Incidence of DRP/NOM in Patients Treated with Oral Anticoagulants and Evaluation of Pharmaceutical Intervention in Community Pharmacy. FarmaJournal, 8(1), 33–47. https://doi.org/10.14201/fj2023813347
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