Comparison between Detected and Prevented Adverse Events Identified Using MedDRA/J in Prescription Inquiries at a Community Pharmacy

Abstract

Although several pharmaceutical inquiries made by community pharmacists meet the PreAVOID criteria, the frequency of PreAVOID reports by community pharmacists is lower than that by hospital pharmacists. We aimed to clarify the characteristics of adverse events (AEs) in pharmaceutical inquiries to increase the number of PreAVOID reports and to improve their quality. We identified AEs using MedDRA/J and compared the types of AEs, information source, and drug efficacies between detected and prevented AEs. In this study, detected AEs were defined as AEs leading to pharmaceutical inquiries after the last visit; prevented AEs were defined as AEs leading to pharmaceutical inquiries before dispensing medicine based on patient interviews, medical records, and laboratory data. We evaluated prescriptions for adults against inquiries at a community pharmacy between April 2016 and March 2019. The chi-squared or Fisher’s exact test was used to compare the number of system organ classes (SOCs) between detected and prevented AEs. We identified 57 detected AEs and 121 prevented AEs from 5,545 prescription inquiries. Gastrointestinal disorders (30 AEs) and skin and subcutaneous tissue disorders (30 AEs) were the most common SOCs that showed a significantly higher number of detected than prevented AEs (P = 0.011 and P < 0.001, respectively). Renal disorder (22 AEs) was the second most common SOC that was associated with prevented AEs (P = 0.001). The results can be used to develop strategies to resolve clinical problems at community pharmacies. Our study contributes to an increase in PreAVOID reports through pharmaceutical inquiries.