Objetivo: Analisar a influência da complexidade da farmacoterapia (CFT) na adesão ao tratamento imunossupressor. Métodos: Trata-se de um estudo analítico, observacional e transversal, baseado nos registros do atendimento farmacêutico de pacientes transplantados renais de um hospital universitário (Fortaleza/Ceará). A CFT foi avaliada em consulta farmacêutica no período de janeiro a julho/2014, utilizando-se o Índice de Complexidade da Farmacoterapia (ICFT). A análise da adesão foi realizada através do nível sérico dos inibidores da calcineurina e imTor. Resultados: Analisou-se o acompanhamento de 36 pacientes: sendo 52,78% (n=19) homens; 27,80% (n=10) entre 41 e 50 anos; 41,70% (n=15) com ensino fundamental incompleto e 72,22% (n=26) possuíam cuidador. A média de medicamentos foi nove e de pontos no ICFT foi de 50,94. O ICFT máximo foi registrado na faixa de 31-60 dias pós-transplante. Analisando o nível sérico dos imunossupressores, observou-se prevalência de pacientes classificados como “não aderentes” maior no período menor de 60 dias pós-transplante. Conclusão: Concluiu-se que no pós-transplante renal a adesão dos pacientes ao tratamento imunossupressor aumenta com a diminuição da CFT, sendo necessária uma maior e melhor orientação dos pacientes no inicio do pós-transplante.

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Objective:The medication follow-up in infants with extremely low birth-weight in a neonatal intensive care unit is described, identifying drug-related problems (DRP), drug-related negative outcomes, and the relationship between the occurrence of DRP and birth-weight of newborns and their impact on pharmacotherapy and length of hospital stay.Methods:A descriptive and exploratory study was performed in which medication follow-up of a population of infants with extremely low birth-weight admitted to the neonatal intensive care unit of a government-run maternity hospital was carried out by clinical pharmacists. Monitoring comprised assessment of patients’ pharmacotherapy needs through visits to the neonatal unit, evaluation of prescriptions and information on medical records, identification of issues associated with pharmacotherapy and follow-up of the newborns’ clinical evolution to determine whether desired results were achieved.Results:The subjects were 33 infants characterized by extremely low weight at birth. Analysis of patients’ pharmacotherapy showed that 39.4% (n=13) of the neonates presented some type of DRP, totaling 37 DRPs and a mean of 2.8 problems/patient. Fourteen drugs were identified with the occurrence of DRP. Vancomycin and cefepime were the most prevalent, with 18.9% (n=7). Occurrence of DRPs and several clinical characteristics of newborns and their pharmacotherapy were compared. The most prevalent drug-related negative outcomes identified were “untreated health problem” (40%, n=10) and “quantitative ineffectiveness” (32%, n=8). Pharmaceutical interventions were performed for all problems associated with pharmacotherapy, with a prevalence of “treatment day count correction” and “dose correction”, both with 21.6% (n=8), and “correction of dosage” (16.2%, n=6).Conclusion:The research evidenced the role of the clinical pharmacist in the solution and prevention of drug-related problems, contributing with the multidisciplinary team to obtain a safe and effective pharmacotherapy. Further, current study confirmed that there is an association between the characteristics of the newborns under analysis (eg. birth-weight, pharmacotherapy) and the occurrence of drug-related problems.

Introduction: The transplanted patient has a complex pharmacotherapy, with the pharmacist having an important role in the multidisciplinary team. Objective: To analyze the pharmaceutical recommendations made during the hospitalization of the patients in kidney and liver transplant units. Methods: This was a cross-sectional study in which pharmaceutical recommendations from May 2017 to April 2018 were collected from the records contained in the database of the Clinical Pharmacy Unit of a University Hospital in Fortaleza, Brazil. The recommendations were categorized and analyzed based on the classification used in the institution. Results: There were 1241 pharmaceutical recommendations involving 325 patients and 1466 medications. The recommendations were more frequent during liver transplantation (54.2%, n = 672), with dose adjustments (18.2%, n = 122) and dilution / reconstitution (9.8%, n = 66) being the most predominant types. In kidney transplantation, recommendations for education about medication use (17.6%, n = 100) and treatment adherence strategies (17.6%, n = 100) were the most predominant. The most frequent therapeutic classes were systemic antibacterials (31.2%, n = 458) and immunosuppressants (25.1%, n = 368). The acceptance rate of recommendations for kidney and liver transplantation were 95.1% (n = 541) and 95.4% (n = 641), respectively. Conclusions: The present study showed a high frequency of pharmaceutical recommendations and these results demonstrate that the detection of drug-related problems generates pharmaceutical recommendations that can contribute to the reduction of negative drug-associated results and increase patient safety.