RT Journal Article
SR Electronic
T1 Clinical evaluation of pharmacists’ interventions on multidisciplinary lung transplant outpatients’ management: results of a 7-year observational study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e041563
DO 10.1136/bmjopen-2020-041563
VO 10
IS 11
A1 Marion Duwez
A1 Sébastien Chanoine
A1 Marion Lepelley
A1 Thi Ha Vo
A1 Hélène Pluchart
A1 Roseline Mazet
A1 Benoit Allenet
A1 Christophe Pison
A1 Amandine Briault
A1 Christelle Saint-Raymond
A1 Boubou Camara
A1 Johanna Claustre
A1 Pierrick Bedouch
YR 2020
UL http://bmjopen.bmj.com/content/10/11/e041563.abstract
AB Objectives Lung transplant (LT) recipients require multidisciplinary care because of the complexity of therapeutic management. Pharmacists are able to detect drug-related problems and provide recommendations to physicians through pharmacists’ interventions (PIs). We aimed at assessing the clinical impact of PIs on therapeutic management in LT outpatients.Design Data were collected prospectively from an LT recipients cohort during 7 years. A multidisciplinary committee assessed retrospectively the clinical impact of accepted PIs.Setting French University Hospital.Participants LT outpatients followed from 2009 to 2015.Primary outcome measures Clinical impact of PIs performed by pharmacists using the CLEO tool and the Pareto chart.Results 1449 PIs led to a change in patient therapeutic management and were mainly related to wrong dosage (39.6%) and untreated indication (19.6%). The clinical impact of PIs was ‘avoids fatality’, ‘major’ and ‘moderate’, in 0.1%, 7.0% and 57.9%, respectively. Immunosuppressants, antimycotics for systemic use and antithrombotic agents had the greatest clinical impact according to the Pareto chart. PIs related to drug–drug interactions (10%) mainly had a moderate and major clinical impact (82.3%, p<0.0001).Conclusion Clinical pharmacists play a key role for detecting drug-related problems mostly leading to a change in therapeutic management among LT outpatients. Our study provides a new insight to analyse the clinical impact of PIs in order to target PIs which have most value and contribute to patient care through interdisciplinary approach.