Objetivo: Identificar eventos adversos a medicamentos (EAM) em pacientes adultos internados nas clínicas médica e cirúrgica em um hospital universitário, bem como caracterizar esses eventos.Materiais e Métodos: Foi realizado estudo retrospectivo em um hospital universitário. A amostra foi constituída pelos prontuários dos pacientes internados nas clínicas médica e cirúrgica entre outubro de 2010 e janeiro de 2011. Para identificação dos EAM aplicou-se um conjunto de rastreadores que são condições que podem indicar que um EAM ocorreu e tornam a revisão do prontuário mais objetiva e direcionada. Esses rastreadores podem ser um exame laboratorial alterado, o uso de um antídoto, ou uma condição clínica.Resultados: O grupo de estudo foi constituído de 263 pacientes, dos quais 58 (22,1%) tiveram ao menos um EAM durante a internação e 83 EAM foram identificados, resultando em uma taxa de 31,5 EAM por 100 pacientes. Os eventos mais frequentes foram náusea e vômito, erupções cutâneas e prurido e hipocalemia. Quanto aos medicamentos imputados o tramadol foi o mais frequentemente relacionado aos eventos. Os eventos foram mais presentes em pacientes com internação com caráter de urgência/emergência, que possuíam uma ou mais comorbidades. Ainda, pacientes com eventos apresentaram um tempo médio de internação mais prolongado. Conclusão: O uso de rastreadores para identificar EAM apresenta-se como estratégia útil, com a qual foi possível identificar que 22,1% dos pacientes apresentaram EAM durante a internação. Tal estratégia de identificação de eventos é passível de ser implementada pelos núcleos de segurança do paciente de instituições hospitalares.
The objective of this study is to validate the specific questionnaire for Hepatitis B HBQOL (Hepatitis B Quality of Life Instrument, version 1.0) for the Brazilian version, in addition to testing its applicability in patients with hepatitis B under treatment and comparing the quality of life between patients using first-line drugs (tenofovir and entecavir). For the validation, the back-translation technique was used in a sample of 47 patients. Factor analysis was performed between the items in each domain of the questionnaire and the internal consistency was calculated using Cronbach's α coefficient. In assessing the applicability of the validated questionnaire, interviews were carried out with 124 patients. Sociodemographic and treatment data were collected to characterize the sample and perform correlation analyzes. The results demonstrate that the Brazilian version of the questionnaire was successfully validated. In the analysis carried out among the 124 patients, the domains psychological well-being and stigma obtained the highest scores in quality of life and the lowest level of education conferred better results in these two domains. The comparison between tenofovir and entecavir showed no significant difference in patients' quality of life. The use of this validated instrument can make therapeutic decisions more rational.
The Parenteral Nutrition (PN) is a high-alert medication, with high-cost, indicated for patients in which oral or enteral nutrition is not possible, is insufficient or contraindicated. There are two PN systems currently available, the custom system, prepared in hospital pharmacies or outsourced to specialized clinics, and the standardized compartmentalized bag system. Currently, it is fundamental that the application of financial resources in health be performed efficiently, considering effectiveness, safety and economy. The aim of this study was to evaluate the effectiveness of industrialized NP in the supply of energy and to perform a pharmacoeconomic analysis of cost minimization comparing standardized and custom bags. For this, was determined the total energy expenditure of patient and then determined the adequacy of the prescriptions of PN. For cost analysis was used the values of the standardized bags used for the patient in relation with the hypothetical cost if the same formulation were custom manipulated. 28 patients and 296 PN prescriptions were identified in the study period. The rates of adequacy to the energy expenditure were 39.3% on the 1st day, 34.6% on the 2nd day, 44.65% on the remaining days of treatment, and 33.33% on the last day. As for the analysis cost, the cost of standardized bags was lower in relation to manipulated bags (p <0.05). It was therefore verified that this was a high level of the inadequacy of the prescriptions of industrialized PN bags and that the same is more cost effective for the hospital in question.
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