Rev. OFIL 2017, 27;3:272-278
Fecha de recepción: 28/07/2016 – Fecha de aceptación: 30/12/2016
Briegas Morera D, Rangel Mayoral JF, García Lobato E
Servicio de Farmacia Hospitalaria. Complejo Hospitalario Universitario de Badajoz. Hospital Infanta Cristina.
Badajoz (España)
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Correspondencia:
Daniel Briegas Morera
Complejo Hospitalario Universitario de Badajoz
Hospital Infanta Cristina
(Servicio de Farmacia Hospitalaria)
Avda. de Elvas, s/n
06006 Badajoz
Correo electrónico: danielbriegas@outlook.com
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SUMMARY
In our hospital, the expenses on vitamin K are 65% above the national average of same level hospitals, a fact that suggests it is probably being overprescribed. With this article, we aim to gather and assess the clinical evidence behind every phytomenadione indication of use; estimating the extent to which this drug is being overused, the consequences of this phenomena and the effect pharmacist’s counselling has on prescription habits. We examined the clinical indication behind every vitamin K prescription done during July 2015, and also the dispensations associated to each one. Gathered data was registered on a Filemaker® database designed for this purpose. Excel®2016 and SPSS®22 were used to perform the statistical analysis. Sixty-six patients (47 male, average age 65.1±17.2 years) received vitamin K during this period. The lowest expense (385 mg) and better compliance to clinical evidence (54.0% of the doses unnecessary) were observed for the hypoprothrombinemia due to oral anticoagulation, its main indication. Management of hypoprothrombinemia due to malabsorption or liver disease, poorly supported by current knowledge, consumed 2,350 mg (78% of the doses unnecessary). Perioperative hypoprothrombinemia, an indication where vitamin K can be useful under certain conditions, consumed 1,380 mg (93.5% of the doses unnecessary). For unsupported indications 2,290 mg were consumed. Pharmacists gave advice about eighteen treatments, having influenced on prescriptions in most cases (fifteen). These results point to an excessive use of vitamin K, which leads to significant clinical (overmedication, discomfort) and economic consequences (about 2,360€ per year). Pharmaceutical care would have positive results on both areas.
Key Words: Phytomenadione, vitamin K 1, drug use studies, rational use of medicines.
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