Praktické lekárnictvo 1/2022

Biomedical Research Protocol „Optimization of pharmacotherapy of a patient with vascular disease on admission, discharge and post-discharge control (PHAROS)“

Pharmaceutical care is currently considered worldwide as a patient-centered approach, replacing the previous medicine-oriented care. Pharmacists actively cooperate not only with the patient but also with other healthcare professionals in health promotion, disease prevention, evaluation, monitoring, adjustment and initiation of drug use in order to ensure an effective and safe drug regimen, achieve positive clinical results and reduce the economic costs of care. At present, the hospital pharmacists are more frequently confronted with new challenges, following a model from abroad. The main focus of their expertise is changing dynamically. There is an increasing emphasis on their active participation in the process of optimizing the pharmacotherapy of hospitalized patients and outpatients, as well as on ensuring the effectiveness and safety of their therapy. A tool to ensure safe and effective pharmacotherapy for patients is the identification of drug related problems (DRP) by hospital pharmacists and the proposal of DRP solving their solution by hospital pharmacists to physicians. Biomedical research PHAROS aims to assess the impact of pharmaceutical care on the prevalence of DRP at hospital admission, discharge and at post-discharge check-up (4 - 8 weeks after patient‘s discharge from hospital) in patients with carotid artery disease hospitalized at the Department of Vascular Surgery in the National Institute of Cardiovascular Diseases. The Study Protocol is an implementation of the World Health Organization’s standard operating protocol and the Pharmaceutical Care Network Europe Association’s (PCNE) guidelines. The intervention by the time of patient’s admission, before discharge and at post-discharge check-up is performed by a trained pharmacist according to the research protocol in the following steps: medication reconciliation (MR), medication optimization at hospital admission, MR with medication optimization and patient education at discharge; MR with drug control at the first control after the patient‘s discharge after 4 - 8 weeks. The key area of this project is the identification of DRP, their occurrence and type. As a part of further research, the investigators tend to analyze the degree of acceptance of the proposed changes in pharmacotherapy by physicians, ATC groups of drugs with the highest incidence of DRP and identify patients at highest risk for DRP taking in consideration their personal and health information. Study population are adult (≥18 years of age) vascular surgery patients with carotid artery disease admitted for hospitalization at the study setting during the course of the study. Estimated patient population for this observational study is approximately 100 patients.

Keywords: pharmaceutical care, hospital pharmacist, drug related problem, medication reconciliation, medication optimization