4CPS-143 A description of pharmacists’ interventions to optimise the treatment of adults with orally available COVID-drug Paxlovid®

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Background and Importance Ritonavir is one of the main components of Paxlovid® an oral COVID-drug with numerous clinically significant interactions. This, results in increased numbers of adverse events, raising concerns for patient safety. Aim and Objectives The aim was to describe the frequency, type, and severity of detected drug-drug interactions in Paxlovid® recipients identified during pharmacy screening. This service was introduced since numerous instances of inappropriate prescribing, particularly with co-medications, were noted at the pharmacy despite prescriber consideration at the point of prescribing. Material and Methods A retrospective monocentric quantitative data analysis was performed after ethical approval in an Austrian clinic in Vienna. All patients prescribed Paxlovid® were included and data collected from the patients’ electronic records. A data collection tool was developed and piloted to ensure inter-rater reliability. Drug-drug interactions including prescribing recommendations were determined using the COVID-19 Drug Interactions checker developed by the University of Liverpool. Results 122 of 140 (87.1%) included patients required dose reduction, alternative COVID medication, or interventions to prevent interactions or overdosing. In 33 cases the necessary action was performed by the doctors at the point of prescribing. However, in 89 (63.6%) cases the required action was not identified at the point of prescribing but identified during the pharmaceutical medication analysis after Paxlovid® was ordered in the pharmacy. Since interventions were made prior to the patient receiving the supply, all patients in this group benefitted from the pharmaceutical service leading to enhancement of patient safety. Conclusion and Relevance This study demonstrated that many drug-drug interactions were identified through the pharmaceutical intervention. This shows that pharmacist involvement in prescribing highly interacting drugs such as Paxlovid® is beneficial to enhance patient safety and mitigate risks. References and/or Acknowledgements Conflict of Interest No conflict of interest.

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