Pharmacotherapy evaluation of patients on anticoagulant therapy in the internal medicine department at Hospital Universidad del Norte through pharmaceutical care practice using the Dader method

Objective: To evaluate the pharmacotherapy of patients on anticoagulant therapy in the internal medicine department at Hospital Universidad del Norte through pharmaceutical care practice using the Dader method. Materials and methods: This study employed a quasi-experimental and ambispective descriptive methodology, which included a retrospective analysis of a study population called the reference group. This group consisted of 78 patients who were receiving anticoagulant therapy and were hospitalized for a period of three months in 2022. The patients in this group underwent a socio-demographic, clinical and pharmacological characterization, and analysis of medication-related problems (DRP) and negative results associated with medication (NOM), to determine the approach of the patient under pharmaceutical care practice who were hospitalized for a period of three months in the 2023, corresponding to the attended group with 66 patients. The activities were conducted in accordance with the Dader method, and the statistical analysis of the data was performed with the STATGRAPHICS Centurion XVI version 16.1.03 program, for both quantitative and qualitative data. Results: The DRP and NOMs most frequent reported in the attended group was drugdrug interactions, and quantitative insecurity respectively, while in the reference group was reported inadequate dose, regime and/or duration as DPR and followed by the NOM quantitative ineffectiveness. The drug associated with the occurrence of NOMs was Warfarin with 57.15% in the reference group, and a 62.5% in the attended group. Finally, through the application of statistical tests (chi-squared), it was demonstrated that patients with atrial fibrillation (AF) exhibited a 4.65 probability of presenting a DRP. Conclusion: The pharmacotherapeutic evaluation revealed potential opportunities for improvement in the management of anticoagulation in hospitalized patients. In particular, the use of warfarin was identified as a concern due to the variability in the international normalized ratio (INR), with 100% of the attended group falling outside the therapeutic window. Additionally, patients with atrial fibrillation were identified as a population that could benefit from pharmaceutical care service.