Optimising the pharmacotherapy of vascular surgery patients at hospital admission and at discharge (PHAROS): study protocol for quasi-experimental clinical uncontrolled trial (Preprint)

BACKGROUND Patient safety is the absence of preventable harm to a patient during the process of providing health care and reduction of the risk of unnecessary harm associated with health care to an acceptable minimum. It is coming in the forefront of interest worldwide in healthcare delivery. OBJECTIVE The aims of this protocol are to assess the impact of pharmaceutical care in collaboration with physicians on the prevalence of drug-related problems at hospital admission and discharge in vascular surgery patients. METHODS The study is conducted in the Vascular Surgery Department at the National Institute of Cardiovascular Diseases in Bratislava, Slovakia during 1-year period, included adult patients with carotid artery disease or lower extremity artery disease, taking ≥3 medications. The estimated population for this clinical uncontrolled trial is approximately 100. Medication reconciliation and medication reviews will be performed by hospital pharmacists at both admission and discharge. Pharmacist-proposed interventions will be documented and communicated to the physician, patients will be educated about their medications upon discharge. RESULTS The key focus area of this project will be the identification of drug-related problems, their occurrence and type. As a part of further research, analysis will be performed to describe the degree of acceptance of the proposed changes in pharmacotherapy by physicians, groups of drugs based on the Anatomical Therapeutic Chemical classification system with the highest incidence of drug-related problems and identify patients at highest risk for drug-related problems taking in consideration their personal and health information. CONCLUSIONS This study should demonstrate that pharmacist-led interventions in collaboration with physicians could reducing the risks of pharmacotherapy and optimising medicines management and control systems for patient safety. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT04930302