[Study protocol: evaluation of a pharmaceutical intervention for safe use of medications in patients with liver...

Liver cirrhosis is the final stage of chronic liver disease and can lead to deterioration of liver function. Because the liver is the main metabolizing organ, patients with liver cirrhosis experience changes that can affect drug effectiveness and safety. There are many drugs whose dosage must be adjusted or which are contraindicated. A lack of information in this field has been detected among health professionals who care for these patients, partly due to the lack of specific clinical guidelines on the management of drugs. The objective is to present the protocol of a study for the evaluation of a strategy to minimize risks related to the use of medications. This consisted of medication reviews of patients with liver cirrhosis carried out by primary care pharmacists and specific training for health professionals. The pharmacists made proposals (dose adjustment, substitution for safer alternatives, suspension or monitoring of adverse reactions) through the computerized clinical history, taking into account the stage of the disease (Child-Pugh) and other comorbidities, directed to the doctors responsible for the patient's pharmacotherapy (hepatologist, primary care doctor or other specialists), who will make the changes they deem appropriate. To evaluate this strategy, an analysis will be conducted to assess the degree of acceptance of these proposals. The results obtained will provide us with information on the impact of the pharmacist's review on reducing the risks associated with medications in these patients. This study will help us to design prescription support tools integrated into electronic prescribing to aid decision-making for all healthcare professionals involved in the patients' pharmacotherapy.