4CPS-164 Pharmaceutical decision support system for salt acetaminophen use: raising awareness among cardiovascular patients

<h3>Background and Importance</h3> Each Effervescent Acetaminophen Formulation (EAF) (500 mg or 1,000 mg) contains high quantity of salt: 1 g. An EAF induced salt-regimen could reach 8 g of salt per day. But adults should consume less than 5 g of salt per day Recent studies suggest that EAFs lead to cardiovascular events. <h3>Aim and Objectives</h3> This study highlights the ability of a pharmaceutical decision support system (PDSS) to detect the prescription of EAF in cardiovascular patients. <h3>Material and Methods</h3> A prospective study was implemented from April 2020 to August 2022 at two facilities – 1,600 beds. Our PDSS operates on Pharmaclass (Keenturtle) using real-time patient data and modelled situations to generate alerts. The first version of the situation for identifying EAF prescriptions evolved into a second (May 2022), more sensitive in detecting various cardiovascular comorbidities through biological markers, patient‘s cardiac history and incorporating all EAF specialties. Data collected include analysed alerts, EAF consumption and patient‘s cardiovascular diseases. Data analysis is performed in Excel. <h3>Results</h3> With the first version, on 159 alerts, 101 Drug related problems (DRP) required a pharmacist’s intervention in 28 months of whom 49.5% were accepted by prescribers. Technical false positives were 13 (8.2%) and 39 situations do not correspond to a DRP (24.5%). EAFs on demand concerned 120 patients. With the second version, on 124 alerts, 35 DRP required a pharmacist’s intervention in 4 months of whom 57.1% were accepted. Technical false positives were 29 (23.4%) and 33 situations do not correspond to a DRP (26.6%). EAFs on demand concerned 46 patients. Only 10 alerts (8.1%) on 124 were detected by both of the two versions. At least one cardiovascular disease is present in 99 on 102 patients (general hospital) <i>versus</i> 146 on 156 (university hospital): 83 high blood pressure, 11 cardiac insufficiency and 61 ischaemic pathologies) <i>versus</i> respectively 142, 23 and 106. Before EAF interruption, the overall salt intake was 2,910 grams over 987 days of treatment at the general hospital and 624 grams over 361 days of treatment at the university hospital. <h3>Conclusion and Relevance</h3> Using a PDSS reveals the salt intake through EAF among cardiovascular patients. However, the increased sensitivity is accompanied by a rise in false positives, highlighting the importance of the modelling process. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest