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Drug-related problems in patients admitted for SARS-CoV-2 infection during the COVID-19 pandemic

Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Barceló-Vidal, J.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Echeverría-Esnal, D.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Carballo, N.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
De Antonio-Cuscó, M.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Fernández-Sala, X.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Navarrete-Rouco, M. E.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Colominas-González, E.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Luque, S.;
Affiliation
Faculty of Medicine ,Universitat Pompeu Fabra (UPF) ,Barcelona ,Spain
Fuster-Esteva, M.;
Affiliation
Institut Hospital del Mar d’Investigacions Mèdiques (IMIM) ,Barcelona ,Spain
Domingo, L.;
Affiliation
Institut Hospital del Mar d’Investigacions Mèdiques (IMIM) ,Barcelona ,Spain
Sala, M.;
Affiliation
Statistics Deparment ,Institut Hospital del Mar D'Investigacions Mèdiques (IMIM) ,Barcelona ,Spain
Duran, X.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Grau, S.;
Affiliation
Pharmacy Department ,Hospital del Mar ,Parc de Salut Mar ,Barcelona ,Spain
Ferrández, O.

Introduction: Drug-related problems (DRP) are events or circumstances in which drug therapy does or could interfere with desired health outcomes. In December 2019, a new coronavirus, SARS-CoV-2, appeared. Little knowledge about this type of infection resulted in the administration of various drugs with limited use in other pathologies. Evidence about DRP in patients with COVID-19 is lacking. Objective: The aim of the present study is to describe identified cases of DRP and those drugs involved in the first wave of patients with COVID-19, and evaluate associated risk factors. Material and methods: Observational, retrospective study performed in a tertiary university hospital between 14th March 2020 and 31 May 2020 (corresponding to the first COVID-19 wave). We recruited patients admitted during the study period. Exclusion criteria included age < 18 years; admission to critically ill units; and care received either in the emergency room, at-home hospitalization or a healthcare center. Results: A total of 817 patients were included. The mean age was 62.5 years (SD 16.4) (range 18–97), and 453 (55.4%) were male. A total of 516 DRP were detected. Among the patients, 271 (33.2%) presented at least one DRP. The mean DRP per patient with an identified case was 1.9. The prevailing DRPs among those observed were: incorrect dosage (over or underdosage) in 145 patients (28.2%); wrong drug combination in 131 (25.5%); prescriptions not in adherence to the then COVID-19 treatment protocol in 73 (14.1%); prescription errors due to the wrong use of the computerized physician order entry in 47 (9.2%); and incorrect dosage due to renal function in 36 (7%). The logistic regression analysis showed that patients who received only prescriptions of antibacterials for systemic use (J01 ATC group) faced a higher likelihood of experiencing a DRP (OR 2.408 (1.071–5.411), p = 0.033). Conclusion: We identified several factors associated with an increased risk of DRPs, similar to those reported in other pre-pandemic studies, including a prolonged length of stay, higher number of prescribed drugs and antimicrobial administration. The relevance of pharmacists and tools like pharmacy warning systems can help prevent, identify and resolve DRP efficiently.

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License Holder: Copyright © 2022 Barceló-Vidal, Echeverría-Esnal, Carballo, De Antonio-Cuscó, Fernández-Sala, Navarrete-Rouco, Colominas-González, Luque, Fuster-Esteva, Domingo, Sala, Duran, Grau and Ferrández.

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