Implementation of vertical clinical pharmacist service on venous thromboembolism prophylaxis in hospitalized medical patients

Abstract

Objective:To describe the vertical clinical pharmacist service's interventions in prevention of venous thromboembolism.Methods:This prospective study was done at a private hospital. From January to May 2012, the clinical pharmacist evaluated medical patients without prophylaxis for thromboembolism. If the patient fulfilled criteria for thromboembolism and did not have contraindications, the clinical pharmacist suggested inclusion of pharmacologic agents and/or mechanical methods for venous thromboembolism prevention. In addition, the appropriate dose, route of administration, duplicity and replacement of the drug were suggested.Results:We evaluated 9,000 hospitalized medical patients and carried out 77 pharmaceutical interventions. A total of 71 cases (92.21%) adhered to treatment so that non-adherence occurred in 6 cases (7.79%). In 25 cases pharmacologic agents were included and in 20 cases mechanical prophylaxis. Dose adjustments, route, frequency, duplicity and replacement made up 32 cases.Conclusion:The vertical clinical pharmacist service included the prophylaxis for venous thromboembolism and promotion of appropriate use of medicines in the hospital.

Desenvolvimento e validação de um instrumento para avaliação dos conhecimentos e atitudes educacionais de farmacêuticos docentes frente aos serviços clínicos realizados por farmacêuticos

“…Entre estas ações estão as capacitações para a implantação dos serviços no Sistema Único de Saúde (SUS), promovidas pelo Ministério da Saúde, no ano de 2014, e as ações educacionais promovidas pelo CFF (BRASIL, 2014;SOUZA et al, 2015;CONSELHO FEDERAL DE FARMÁCIA, 2016b). Estudos sobre a implantação dos serviços clínicos providos por farmacêuticos no sistema de saúde relatam a boa aceitação da equipe de saúde, frente às intervenções propostas por farmacêuticos e os seus impactos positivos na saúde do paciente (AGUIAR et al, 2018;HAGA et al, 2014). Entretanto, é descrito na literatura a existência de barreiras para a implantação desses serviços, relacionadas à formação do profissional farmacêutico desarticulada, gerando a falta de conhecimentos clínicos e a baixa aquisição de habilidades em comunicação (ALCÂNTARA et al, 2018;FREITAS, G. R. M. et al, 2016).…”

Pharmaceutical intervention in the rational use of intravenous omeprazole

“…(17) It is known that the presence of the pharmacist is a safety strategy, (15) since it contributes to promoting the correct use of medications in the hospital setting. (18) Although the presence of the pharmacist is, in fact, a strongly recommended and accepted safety strategy in other countries, this is not true for a large part of Brazil. The pharmacist faces difficulties both in support by managers, and in acceptance on the part of their own multiprofessional team.…”

Developing an economic case of clinical pharmacists' interventions on venous thromboembolism prophylaxis through service evaluation

“…[ 24 ] Second, this study aimed to assess the clinical and economic impact of CPIs on VTEP. Many of the studies[ 1 3 7 8 9 12 13 18 21 25 26 ] evaluated the clinical impact of CPIs but only few studies[ 8 9 ] extended their study objectives to the economic impact of CPIs. Even these two studies did not use precise method for economic analysis.…”

“…[ 11 14 15 ] To determine the probability of VTE (0.1 for the medical patients, 0.4 for the surgical patients) and bleeding (0.01) as ADEs caused by inappropriate VTEP was also based on previous studies and published reports. [ 1 3 9 16 17 18 ]…”