{
  "abstract": "Background and Importance High-risk medications are closely associated with patient safety incidents, as dosing or administration errors may cause serious adverse outcomes. Therefore, pharmaceutical validation should prioritise these treatments to minimise harm.Aim and Objectives To evaluate pharmaceutical interventions (PIs) related to high-risk medications in chronically ill patients and to determine their acceptance rate by prescribers.Material and Methods A prospective interventional study was conducted from July to October 2024.Hospitalised patients with prescriptions for high-risk drugs were included when prescribing errors were detected during routine pharmaceutical validation. Variables analysed were demographic (sex, age), clinical (inpatient services) and pharmacotherapeutic (high-risk drugs according to the Anatomical Therapeutic Chemical classification, ATC). Interventions were recorded via e-prescribing software and categorised as reconciliation PIs (dosage discrepancy, omission) or adequacy PIs (duplication, analytical monitoring, prescription errors, allergies). Data were obtained from Diraya and Athos Prisma digital records and processed using SPSS.Results Thirty-seven patients were selected from all patients reviewed in the hospital’s unit-dose system during the study period (56.8% male; 43.2% female). Median age: 69.1 years (IQR:63.0–78.5).Clinical services involved: Internal Medicine (29.7%), Traumatology (16.2%) and ICU (8.1%), followed by Urology, Cardiology, Vascular Surgery, Gastroenterology and Pneumology (each 5.4%), and other specialties including Anaesthesiology, Psychiatry, Medical Emergencies, General Surgery, Gynaecology, Oncology and Otorhinolaryngology (each 2.7%).According to the ATC classification, PI were mainly related to Anticoagulants (45.9%), Beta-blockers (13.5%), Analgesics (10.8%) and Diuretics (8.1%). Less frequent categories included Antiplatelet Agents, Immunosuppressants, Thyroid Hormones, Antiarrhythmics, Antipsychotics and Antiepileptics (each 2.7%).Most interventions (51.4%) involved drugs acting on the blood and haematopoietic system (n=19), primarily anticoagulants (n=17) and antiplatelet agents (n=2), followed by cardiovascular drugs (24.3%; beta-blockers [n=5], diuretics [n=3], antiarrhythmics [n=1]), nervous system drugs (16.2%; analgesics [n=4], antipsychotics [n=1], antiepileptics [n=1]) and thyroid therapy (2.7%).During hospitalisation, 94.6% PIs (n=35) were accepted. Of all interventions, 70.3% were adequacy-related (duplication [n=19], prescription errors [n=4], analytical monitoring [n=2], allergies [n=1]), while 29.7% were reconciliation-related (dosage discrepancies [n=6], omissions [n=5]).Conclusion and Relevance Pharmaceutical interventions in chronically ill hospitalised patients receiving high-risk drugs mainly targeted blood and cardiovascular agents, with a high acceptance rate. These findings suggest that routine pharmaceutical validation may contribute to safer and more effective medication use.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Juan Ramón Jiménez, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "A Ponce Gonzalez"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "MI Guzmán Ramos"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "E Rodríguez Molíns"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "I Corriente Gordón"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "MD Santos Rubio"
    }
  ],
  "title": "4CPS-310 Evaluation of pharmaceutical interventions in hospitalised patients receiving high-risk medications",
  "uid": "6534d306-d9f7-50b2-b4f2-335dd596022f"
}