Drug-related problems observed in a pharmaceutical care service, Belo Horizonte, Brazil

Abstract

This present observational, longitudinal, and non-concurrent study was developed with the purposes of evaluate the profile of patients attended by a pharmacotherapeutic follow-up service and describe the Drug-Related Problems (DRPs) found over there; determine the proportion of DRPs between the health problems presented by the studied population, classifying them and identifying the situations related with their appearance. The study was developed at the School Pharmacy of Newton Paiva University Center, Belo Horizonte, MG, during the period from 2001 November up to 2003 November. Ninety seven patients have been evaluated, the majority of female sex (66.0%), with up to 8 years of scholarship (45.4%), mean age of 56.7 ± 13.0 years; mean of 4 ± 2 diagnosed diseases; 7 ± 6 complaints and 4 ± 2 medications per patient. Nine hundred and twelve health problems have been identified: 56.5% uncontrolled. From the uncontrolled problems, 380 (73.6%) were DRPs and between these, 81 (21.3%) were risks for DRP. From the 97 followed-up patients, 89 (91.7%) have presented at least one DRP during the follow-up. The more frequent DRPs were related to effectiveness (53.2%), to necessity (25.2%) and to safety (21.6%). A great number of uncontrolled problems was observed, as well as the possibility to resolve them by means of pharmaceutical care, indicating so the resolutive potential of this practice. Uniterms: Pharmaceutical care. Pharmacotherapeutic follow-up. Drug Related Problem (DRP).O presente estudo observacional, longitudinal, não concorrente teve por objetivos avaliar o perfil dos pacientes atendidos por um serviço de acompanhamento farmacoterapêutico e descrever os 'problemas relacionados com medicamento' (PRM) encontrados; determinar a proporção de PRM dentre os problemas de saúde apresentados pela população estudada, classificá-los e identificar situações relacionadas com seu surgimento. O estudo foi realizado na Farmácia Escola do Centro Universitário Newton Paiva, em Belo Horizonte, MG, durante o período de novembro de 2001 a novembro de 2003. Foram avaliados 97 pacientes, maioria mulheres (66,0%), com até 8 anos de escolaridade (45,4%), média de idade de 56,7 ± 13,0 anos; média de 4 ± 2 doenças com diagnóstico; 7 ± 6 queixas e 4 ± 2 medicamentos por paciente. Foram identificados 912 problemas de saúde: 56,5% não controlados. Dos problemas não controlados, 380 (73,6%) eram PRM e desses 81 (21,3%) eram riscos de PRM. Dos 97 pacientes acompanhados 89 (91,7%) apresentaram pelo menos um PRM durante o acompanhamento. Os PRMs mais freqüentes foram relacionados à efetividade (53,2%), à necessidade (25,2%) e à segurança (21,6%). Observou-se grande número de problemas não controlados e a possibilidade de resolvê-los por meio da atenção farmacêutica, demonstrando o potencial resolutivo dessa prática.

Evaluation of drug therapy problems among renal patients receiving care in some tertiary hospitals in Nigeria

“…This result is consistent with a number of studies [25,[29][30][31][32][33] on DTPs in which dosing and/or drug selection problems and drug interaction were identified among the major forms of DTPs encountered.…”

“…Although Ramalho de Oliveira et al [28] identified 38,631 DTPs over a period of 10 years, ð The denominator was 234 (total DTPs encountered); RI = renal impairment, DTP = Drug-Therapy problem, DI = Dosing inadequacy, Drugs with restrictions (dose adjustment needed in case of renal impairment (RI)) per patient, SD = Standard deviation. [29] in a period of two years, and Root et al [30] identified 88 DTPs from 40 patients. The difference in the number of DTPs encountered is probably due to differences in research design in terms of patients type, hospital types, duration of the studies and nature of data collected.Our study showed that mean drug per patient was almost 3.0 which is moderate, despite the involvement of older population of patients in this study.…”

“…Appreciable number of DTPs identified were totally resolved. Just like in many studies where pharmaceutical care interventions were instituded [28][29][30], DTPs were resolved, patients' conditions were improved and consequently the rate of encoutered DTPs in that setting was reduced. This is predicated in high acceptance of the intervention by the doctors.…”

Capacitação e intervenções de técnicos de farmácia na dispensação de medicamentos em Atenção Primária à Saúde

“…The inadequate use of medications and difficulty understanding the prescribed posology were among the most frequently identified problems by the pharmacy technicians, which is similar to data reported in previous studies conducted in Brazil [13][14][15][16][17] . Similarities in the packaging of different medications, reduced vision among elderly individuals, illiteracy, an inability to understand the writing of the prescribing physician or the abbreviations employed and complex therapeutic protocols involving different administration times are among the factors that contribute to confusion with regard to the use of medications 18 .…”

A contribuição do farmacêutico para a promoção do acesso e uso racional de medicamentos essenciais no SUS

“…Brazilian studies have already described the difficulty of many patients in understanding the prescribed regimen [28][29][30][31][32] . The understanding of prescription varied in studies conducted in other cities, and according to the methodology, ranging from 34% to 70% 25,26,31 .…”