Endocrine Abstracts

JOINT1514

Introduction: The administration of drugs via a nasogastric tube or gastrostomy is a common practice in patients who are unable to take oral medications due to swallowing difficulties, neurological disorders, or other medical conditions. However, this route of administration presents several challenges, including the risk of tube obstruction, reduced drug efficacy, and potential drug-nutrient interactions. Some medications are not designed to be crushed or dissolved, which may alter their pharmacokinetics and pharmacodynamics, leading to suboptimal therapeutic effects or increased risk of adverse reactions. To address these issues, our hospital has implemented a structured, multidisciplinary evaluation process involving the Endocrinology/Nutrition and Pharmacy Departments. This collaboration aims to ensure that all medications administered via nasogastric tube or gastrostomy are appropriate, safe, and effective for each patient.

Objectives: This study evaluates the impact of a multidisciplinary team on medication reconciliation and adjustments for patients requiring drug administration via nasogastric tube or gastrostomy. It aims to identify common pharmaceutical interventions, determine frequently modified drug classes, and highlight the significance of interprofessional collaboration in patient care.

Material and Methods: We conducted a descriptive observational study from August 1, 2024, to December 15, 2024, documenting all interventions performed by the Endocrinology/Nutrition and Pharmacy team. The study included all hospitalized patients with a nasogastric tube or gastrostomy at discharge, as well as those attending nutrition consultations. The Pharmacy Department reviewed patient treatment plans with the patient or their caregivers, based on electronic prescription records. Necessary modifications were proposed to the Endocrinology team to ensure safe and effective drug administration. All changes were systematically recorded and analyzed.

Results: A total of 50 patients (52% men, 48% women) were included, with a mean age of 74 years. Medication modifications were required in 76% of cases, with a total of 66 changes recorded. The most frequent interventions included:.

• Modification of pharmaceutical form (31.3%).

• Adjustment of administration method (31.3%).

• Substitution with a therapeutic equivalent (16.4%).

• Discontinuation due to lack of evidence or incompatibility (13.4%).

• Prescribing separately (7.5%).

The most adjusted drug classes were proton pump inhibitors (12 patients), acetylsalicylic acid (9 patients), and levothyroxine (6 patients).

Conclusions: • Medication adjustments were necessary for 76% of patients with nasogastric tube or gastrostomy.

• Proton pump inhibitors and acetylsalicylic acid were the most frequently modified drug classes.

• This study underscores the importance of multidisciplinary collaboration in medication reconciliation to enhance patient safety and treatment efficacy.