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Pharmacotherapeutic safety in patients with liver cirrhosis: a national multidisciplinary survey on resources and
Andrea Rodriguez Esquiroz1, Amaya Echeverría Gorriti1, Javier Garjón Parra1
1Servicio Navarro de Salud-Osasunbidea. Subdirección de Farmacia y Prestaciones, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España.
Objective:
To analyze, at a national and multidisciplinary level, the availability of resources, the level of knowledge, and the perceived needs of healthcare professionals in the management of patients with liver cirrhosis.
Patients And Methods:
A national, multicenter, descriptive, cross-sectional study was conducted using a questionnaire aimed at medicine, pharmacy, and nursing professionals in primary care, hospital care, and community pharmacy. Professional profiles, the use of clinical decision support tools, and self-perceived training were evaluated. Qualitative variables were expressed as frequencies and percentages. To assess national variability and differences by professional profiles, Pearson's ꭓ2test or Fisher's exact test was used, as appropriate.
Results:
A total of 275 responses were analyzed (94% national coverage). A marked polarization in healthcare delivery and a low availability of local protocols (12.7%) were detected, with significant gaps between hospital and primary care settings. Critical deficiencies were highlighted in training (only 5.1% perceived themselves as fully trained), lack of computerized safety alerts (30.5%), and absence of patient educational materials (77.8%). There is a majority demand (91.6%) for quick-reference clinical management guidelines.
Conclusions:
The pharmacotherapeutic management of liver cirrhosis is limited by a critical lack of specialized training and support tools. The almost unanimous demand for resources justifies the urgent need to implement clinical decision support systems to optimize patient safety.
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