TY  -  JOUR
AU  -  Volpi, Elisabetta
AU  -  Lo Surdo, Giuseppa
AU  -  Zizevskikh, Marina
AU  -  Salvadori, Stefano
AU  -  Toccafondi, Giulio
AU  -  Baroni, Monica
AU  -  Tonazzini, Sara
AU  -  Alduini, Stefania
AU  -  Gini, Rosa
AU  -  Bellandi, Tommaso
AU  -  Maffei, Stefano
AU  -  Biagini, Stefania
T1  -  Proton-pump inhibitor prescriptions in patients with cardiovascular disease: can the medication reconciliation process and the physician-hospital pharmacist teamwork improve adherence to international and national guidelines?
PY  -  2018
Y1  -  2018-07-01
DO  -  10.1721/2974.29813
JO  -  Giornale Italiano di Farmacia Clinica
JA  -  GIFAC
VL  -  32
IS  -  3
SP  -  126
EP  -  132
PB  -  Il Pensiero Scientifico Editore
SN  -  1120-3749
Y2  -  2026/04/18
UR  -  http://dx.doi.org/10.1721/2974.29813
N2  -  Summary. Background. International guidelines recommend prophylactic proton-pump inhibitors (PPIs) for patients receiving aspirin or nonsteroidal anti-inflammatory drugs. Moreover, PPIs are reimbursed at the point of dispensing by the Italian Healthcare System, if some criteria are satisfied and reported by the physician in the prescription. Gabriele Monasterio Foundation Heart Hospital created a pharmacist counseling service with the objective of improving prescribing at discharge. We aimed to evaluate the impact on PPI prescriptions of introducing the clinical pharmacist counseling, within a broader program for medication safety. Methods. All adult inpatients discharged at home from July 2015 to June 2017 were evaluated for PPI prescription. They were divided into two groups: before intervention (Group1) and after the intervention started (Group2), based on the pharmacist real-time monitoring of electronic prescription and structured verbal consultation with the doctor in charge to revise the medication scheme. Data on PPI prescriptions were collected and analyzed by comparison between the two time periods. Results. A total of 1471 patients were discharged at home during the selected period. Around 87.9% of patients (n=1293) had a prescription of PPI at discharge. In Group1 we observed that no prescription had the reimbursement note requested for PPI, even if many patients (48.5%, n=282) presented the criteria for having free PPI. In Group2 we observed that 40.5% (n=288) of PPI prescriptions had an appropriate reimbursement note and 50.5% (n=359) had a note for the family doctor to re-evaluate the continuation of PPI treatment. The hospital pharmacist intervention produced a remarkable reduction in PPI that not meet the reimbursement criteria (n=300 Group1 vs n=64 Group2, p<0.001) and a reduction in high-dose PPI prescriptions (n=449 Group1 vs n=365 Group2, p<0.001). Conclusions. The collaboration between physicians and clinical pharmacists decreased the number of incomplete or inappropriate prescriptions with an expected positive impact on the quality of prescriptions.
ER  -