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Doctoral Thesis
DOI
Document
Author
Full name
Andrea Fontoura
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Freitas, Osvaldo de (President)
Baldoni, André de Oliveira
Dach, Fabíola
Pazin Filho, Antonio
Pereira, Mariana Linhares
Varallo, Fabiana Rossi
Title in Portuguese
Importância do farmacêutico clínico na reconciliação medicamentosa em um hospital ensino
Keywords in Portuguese
Farmacoeconomia
Neurologia
Reconciliação medicamentosa
Serviço farmacêutico
Abstract in Portuguese
A reconciliação medicamentosa pode ser uma ferramenta utilizada pelo farmacêutico para minimizar os erros e/ou discrepâncias de medicamentos no ambiente hospitalar e principalmente na transição do cuidado. O presente estudo teve como objetivo identificar as discrepâncias nas prescrições de medicamentos dos pacientes internados na enfermaria da Neurologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, sugerir intervenções para solucioná-las, avaliar o grau de aceitabilidade e realizar uma análise farmacoeconômica. Trata-se de um estudo prospectivo, longitudinal de intervenção. Realizou-se a reconciliação medicamentosa, entre maio de 2016 a março de 2017, na admissão e alta hospitalar e também analisou-se diariamente as prescrições durante o período de internação do paciente. Todas as discrepâncias identificadas foram classificadas em intencionais e não intencionais e as intervenções sugeridas foram classificadas em aceitas ou não aceitas. As análises de custos diretos e custo-benefício foram realizadas. Neste estudo foram incluídos 96 pacientes, com média de idade de 53,5 (DP = 16,59) anos. Cerca de 92,0% dos pacientes apresentaram pelo menos uma discrepância e o total de discrepâncias encontradas foi de 399 (48,9% na admissão hospitalar), com média de 4,16 por paciente, sendo cerca de 78,0% não intencionais. O total de intervenções sugeridas foi de 318, das quais 79,2% foram aceitas. A análise farmacoeconômica mostrou que o custo marginal do serviço farmacêutico proporcionou uma economia de R$ 1.112,13, na perspectiva do hospital e na perspectiva do sistema de saúde o benefício líquido foi positivo. Conclui-se, desta forma, que o farmacêutico clínico contribui para a detecção de discrepâncias e problemas relacionados a medicamentos realizando a reconciliação medicamentosa na admissão e alta hospitalar, bem como, analisando diariamente as prescrições durante o período de internação do paciente, o que tem impacto positivo para a melhora da segurança do paciente e diminuição de custos para o sistema de saúde
Title in English
Importance of the clinical pharmacist in medication reconciliation at a teaching hospital.
Keywords in English
Economics
Medication Reconciliation
Neurology
Pharmaceutical
Pharmaceutical Services
Abstract in English
The medication reconciliation (MR) may be a tool used by the pharmacist to minimize medication errors and/or discrepancies in the hospital and especially in the health care transition. The present study aimed to identify discrepancies on the drug prescriptions for inpatients in Neurology ward of the General Hospital of Medical School of Ribeirão Preto, to suggest interventions to solve them, to evaluate the degree of acceptability and perform a pharmacoeconomic analysis. It is a prospective and longitudinal study of intervention. The MR was performed, between May 2016 and March 2017, at hospital admission and hospital discharge, and prescriptions were also analyzed daily during hospitalization. All discrepancies identified were classified as intentional and unintentional and the interventions were classified as accepted or not accepted. Direct healthcare costs analysis and cost-benefit analysis were performed. In this study, 96 patients were included, with a mean age of 53.5 (DP = 16,59) years. About 92.0% of the patients had at least one discrepancy and the total discrepancies were 399 (48,9% in hospital admission), mean of 4.16 per patient, of which 78.0% were unintentional. The total number of interventions suggested was 318, of which 79.2% were accepted. The pharmacoeconomics analysis showed that the marginal cost of the pharmaceutical service a savings R$ 1,112.13 from the perspective of the hospital, being positive from the perspective of the health system. Thus, it is concluded that the presence of the clinical pharmacist contributes to the detection of discrepancies and drug-related problems during MR performed in admission and discharge hospital and during hospitalization, which has a positive impact for the improvement of the patient safety and cost savings for the health system
 
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Release Date
2021-06-03
Publishing Date
2019-11-22
 
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