Published in:
01-06-2022 | Valsartan | Original Research Article
Impact of clinical pharmacy guidance on valsartan recall management: a retrospective review
Published in: Drugs & Therapy Perspectives | Issue 6/2022
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Purpose
Given the prevalent use of valsartan, the extensive manufacturer recalls in 2018–2019 often required clinicians to change a patient’s therapy to an alternative medication. The purpose of this study was to determine the effect of the guidance from the Clinical Pharmacy Department at Atrius Health on prescribing appropriate comparative doses of alternative angiotensin receptor blockers (ARBs) in response to the recalls of valsartan-containing products (VCPs) at a multi-site ambulatory care organization in Massachusetts.
Methods
This study was a retrospective review of 201 patient charts and the changes made to antihypertensive therapy, if any, in response to the manufacturer recalls of VCPs. The primary outcome measured the percentage of patients who were switched from valsartan-containing therapy to an alternative ARB at an approximate comparative dose. The secondary outcome measured cardiac-related acute care visits between patients who switched to alternative ARBs at comparative doses versus non-comparative doses.
Results
Of the 131 patients who were switched to an alternative ARB in response to valsartan recalls, 88 (67.18%) were switched to an approximate comparative dose and 43 (32.82%) were switched to a non-comparative dose. The secondary outcome of cardiac-related acute care visits was similar between the two ARB cohorts. The percentage of patients with uncontrolled blood pressure (i.e., blood pressure > 140/90 mmHg) in the non-comparative dose ARB cohort increased from 32.56% pre-intervention to 48.84% post-intervention, with a greater incidence of uncontrolled blood pressure in the non-comparative dose ARB cohort compared to the comparative dose ARB cohort.
Conclusion
Following the extensive recalls of valsartan-containing products, guidance for prescribers may have contributed to a statistically significant number of patients who switched to an alternative ARB at a comparative dose without worsening of blood pressure (BP) control, whereas worsening of blood pressure occurred in patients who switched to an alternative ARB at a non-comparative dose.