Nirmatrelvir/ritonavir prescription: A chance for pharmaceutical care via telemedicine
Pharmacy Practice
Antonio Pérez-Landeiro1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Elena Yaiza Romero-Ventosa1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Susana Castro-Luaces1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Ana María Regueira-Arcay1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Mónica Gayoso-Rey1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Sonia González-Costas1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Adolfo Paradela-Carreiro1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Marisol Samartín-Ucha1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Miriam Álvarez-Payero1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Cecilia Arroyo Conde2Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.
Moises Couñago-Fernández2Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.
Debora Feijoo-Meléndez2Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.
Carmen Gallastegui1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Belén Leboreiro-Enríquez2Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.
Paula Prado Montes2Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.
David Robles-Torres1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Jose Pastor Vilasoa-Boo2Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.
Ana Rodríguez Vázquez3Department of Pharmacy, University Hospital Complex of Ourense, Ourense, Spain.
Nieves Valcarce Pardeiro4Department of Pharmacy, University Hospital Complex of Ferrol, Ferrol, Spain.
David Brandariz-Núñez5Department of Pharmacy, University Hospital Complex of A Coruña, A Coruña, Spain.
María Domínguez Guerra5Department of Pharmacy, University Hospital Complex of A Coruña, A Coruña, Spain.
Jaime Gulín-Dávila6Department of Pharmacy, University Hospital Lucus Augusti, Lugo, Spain.
Ana López-Vizcaíno Castro6Department of Pharmacy, University Hospital Lucus Augusti, Lugo, Spain.
Helena Esteban Cartelle7Department of Pharmacy, University Hospital Complex of Santiago, Santiago de Compostela, Spain.
María del Mar López-Gil Otero2Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain.
Noemí Martínez-López-de-Castro1Department of Pharmacy, University Hospital Complex of Vigo, Vigo, Spain; i-FARMA group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Vigo, Spain.
Background: Nirmatrelvir/ritonavir was authorised for the treatment of COVID-19 patients, despite limited evidence regarding its effectiveness, adverse events or interactions. Objectives: Main objective is to assess the impact of pharmaceutical care interventions delivered via telemedicine in patients who started treatment with nirmatrelvir/ritonavir. Secondary objectives are to describe its effectiveness, to analyse its adverse effects, to describe the potential interactions and to analyse patients' adherence. Method: A cohort, prospective and multicentre study was conducted from April to November 2022. Adult patients who initiated nirmatrelvir/ritonavir were included. A descriptive study of the pharmacist interventions, adverse effects, clinical outcomes, interactions and treatment adherence was carried out. Pharmaceutical care was provided through a telephone call. Results: 281 patients were included and 100% of them received telephone information. A total of 349 interventions of pharmaceutical care were carried out. Sixty-four interventions were related to dose reduction. A total of 285 potential interactions were detected. Sixty-five pharmacist interventions were related to potential severe interaction, that led to discontinuation of the concomitant medication in 56 cases (86,2%) All the pharmacist interventions were accepted by the prescribers. A total of 112 (39.9%) patients experienced some adverse effects. Seventeen patients were hospitalised (6.0%) and five deaths were recorded (1.7%). The 95.3% of the patients reported a total adherence. Conclusions: Telepharmacy is a powerful tool for the safe management of the nirmatrelvir/ritonavir. Hospital pharmacists were able to prevent severe potential interactions. The percentages of hospitalised patients, deceased and adverse effects were higher than those reported in pivotal trials. Most patients reported total adherence to the treatment.
