Nirmatrelvir/ritonavir prescription: a chance for pharmaceutical care via telemedicine.
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Keywords
nirmatrelvir/ritonavir, covid19, pharmaceutical care, adverse effects, interactions
Abstract
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.
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