Pharmaceutical Care of Nirmatrelvir Tablets/Ritonavir Tablets in a Medical Alliance
Objective To promote the rational use of small-molecule drugs against Corona Virus Disease 2019(COVID-19)in clinical practice.Methods A medical alliance was set up by the Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,community health service centers of Kangjian Street,Lingyun Street and Tianlin Street in Xuhui District,Shanghai.The pharmaceutical care mode for small-molecule drugs against COVID-19 was constructed,including the links such as community pharmacist training,carring out pharmaceutical care,providing guidance and evaluation by pharmacists in tertiary hospitals.The data of outpatients with COVID-19 using Nirmatrelvir Tablets/Ritonavir Tablets(NMV/RTV)from January to February 2023 in above three community health service centers were collected,the medication information and occurrence of drug-related problem(DRP)was analyzed.Results A total of 79 patients were included,of which 78(98.73%)were or over 60 years.Each patient had(3.04±1.71)types of comorbidities on average,mainly cardiovascular diseases(64 case times,81.01%),diabetes mellitus(35 case times,44.30%),hyperlipidemia(16 case times,20.25%).Each patient used(6.00±3.66)kinds of drugs on average,and 36 patients(45.57%)used Chinese patent medicines.A total of 150 follow-up visits were conducted by community pharmacists,and 87 cases of DRPs were identified and intervened,among which 77 were involved in NMV/RTV,mainly DDIs(70 cases),and the top three drugs involved were calcium channel blockers(31 cases,44.29%),antianxiety drugs(12 cases,17.14%),hydroxy methylglutaryl coenzyme A reductase inhibitor(11 cases,15.71%).Based on the current DRPs,pharmacists in medical alliance proposed medication recommendations such as decreasing dosage,suspending medication and closely monitoring relevant indicators(such as efficacy,adverse drug reactions,blood pressure and thrombotic risk).Conclusion The proportion of elderly patients with COVID-19 in the community is high,the medication is complex,and there are more DRPs when using NMV/RTV.The pharmaceutical care mode for small-molecule drugs against COVID-19 based on medical alliance can help community pharmacists carry out pharmaceutical care work normatively,timely discover and intervene DRPs,which is conducive to promoting the homogenization of pharmaceutical care in the medical alliance,and can provide a basis for the subsequent management of small-molecule drugs against COVID-19.
Corona Virus Disease 2019small-molecule drugNirmatrelvir Tablets/Ritonavir Tabletsmedical alliancepharmaceutical caretertiary hospitalcommunity health service center
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