SAFETY IMPACT OF PHARMACEUTICAL ALERTS IN THE ELECTRONIC PRESCRIPTION AT THE EMERGENCY SERVICES OF PATIENTS WITH RENAL INSUFFIENCY

Objective: To evaluate a program implementing a dose adjustment alert system according to the patient's renal function. Method: A two-months prospective study where pharmaceutical interventions were carried out at a tertiary teaching hospital. Prescriptions of admitted patients from the Emergency Service with Renal Insufficiency (RI) were reviewed. We detected whether appropriate dose adjustments were made by the physicians and a pharmaceutical intervention was performed in non-adequately prescribed drugs and analyzed its acceptance or rejection (cause and patient's clinical impact). Results: Renal function was reviewed in 2,691 patients. A total of 449 patients had renal impairment. A total of 147 renally cleared drugs were adequately prescribed, especially allopurinol and captopril; 159 required pharmaceutical intervention, mainly antibiotics, with an acceptance rate of 70%. The follow up of parameter of safety (in terms of renal toxicity) worsened in 17% of the overridden interventions. Conclusion: This study improves drug therapy safety, means drugs would be adjusted from the first day of hospitalisation and is an opportunity to involve the pharmacist in the patients care.