Impact of a pharmaceutical algorithm on patients with upper-gastrointestinal symptoms: A pre-post intervention study

Abstract

Objective: To evaluate the algorithm impact on the upper gastrointestinal patients' symptoms (PROMs) and satisfaction with pharmaceutical care received (PREMs).

Methods: The algorithm was previously developed by clinicians and pharmacists, through a pre-post intervention study in Spain (June-October 2022). We included 1221 patients who were seeking advice and/or medication for symptoms at 134 community pharmacies. Patients' sociodemographic and clinical variables were assessed at baseline and were classified in accordance with the Gastroesophageal Reflux Disease Impact Scale (GIS) into patients with either epigastric, retrosternal or overlapping symptoms. Interventions included medical referral; education on healthy habits; prescription of an OTC treatment or a non-pharmacologic prescription. Fourteen days later, patients were assessed through: a) the change on the GIS score, and b) patients' satisfaction with pharmaceutical care received.

Results: Most patients reported overlapping symptoms (660, 54.0%), 171 (14.0%) reported epigastric symptoms and 390 (32.0%) retrosternal symptoms. Patients with epigastric symptoms did not show a difference in the GIS score after the intervention while those with retrosternal symptoms and those with overlapping symptoms did (mean 1.09 (4.28 SD), p < 0.001 and mean 3.18 (6.01 SD), p < 0.001, respectively). Patients who received education on healthy habits and those with a prescription of a pharmacological treatment (antiacids in monotherapy and alginates-antiacids) showed an increase in the GIS score. Patients' satisfaction with pharmaceutical care received was over 99.2% of sample.

Conclusion: Implementation of the upper-gastrointestinal symptoms algorithm in Community pharmacies had a positive impact on patients' symptoms, quality of life, and satisfaction with pharmaceutical care received.

Keywords: Community pharmacy(1); Epigastric symptoms(5); Functional dyspepsia(3); Gastroesophageal reflux(2); Pharmaceutical professional Service(7); Retrosternal symptoms(6); Upper-gastrointestinal symptoms(4).