Drug-related problems, adverse drug reactions, and drug–drug interactions as a result of a pandemic that took us by surprise: COVID-19 in Mexico

Objectives The health emergency caused by the COVID-19 pandemic led to the off-label use of drugs in an improvised manner in the early years, increasing the risk of drug-related problems (DRPs), adverse drug reactions (ADRs), and drug interactions (DDIs) in hospitalized patients. The aim of this study was to evaluate the frequency and characteristics of DRPs, ADRs, and DDIs in patients hospitalized for COVID-19 in a private hospital in Mexico. Methods An observational, descriptive, and cross-sectional study was conducted using data from 280 patients hospitalized with COVID-19 at the Star Médica Tlalnepantla Hospital in 2021. DRPs, ADRs, and DDIs were identified and analysed by reviewing clinical records and the hospital’s Pharmacy Department databases. Key findings We observed 45.36% of patients presented at least one DRP, among which prescription errors were the most frequent. A total of 17 ADRs were identified, mainly associated with dexamethasone and levofloxacin. Nearly 87% of patients presented at least one DDI, in which glucocorticoids were the most frequently involved group of drugs. Age and the number of comorbidities were significantly associated with the occurrence of DRPs and DDIs. Conclusions The pharmacotherapeutic decisions taken during the COVID-19 pandemic contributed to the occurrence of DRPs and DDIs. However, it is important to recognize the complexity of the early stages of the pandemic, when there was high pressure on the health system and limited clinical evidence. Strengthening the role of clinical pharmacology, drug safety, and emergency plans could reduce the risk of preventable medication-related harm in future health crises.