Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos

Detalhes bibliográficos
Ano de defesa: 2015
Autor(a) principal: Martins, Bruna Cristina Cardoso
Orientador(a): Fonteles, Marta Maria de França
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/13598
Resumo: Renal transplanted patients have a c omplex pharmacotherapy, being possible for pharmacists to contribute with the pharmacotherapy and its benefits management by integrating the multiprofessional team. This work aimed to assess the pharmacotherapeutic follow - up of renal transplanted patients considering the clinic outcome after the interventions performed by the pharmacist. It is a descriptive study with quantitative, exploratory and retrospective approach carried out in the Renal Transplant Service Ambulatory from a University Hospital (Fortaleza/Ceará), during the period from January to December 2013. Were included registers from patients who had at least two appointments in the Pharmaceutical Care Service during the stu dy period. The Drug Related Problems (DRP), Pharmaceutical Interventions (PI) and Clinic Outcomes were categorized through a classification used by the Clinical Pharmacy Service of the institution. The Negative Outcomes associated with Medication (NOM) wer e classified accordingly to the Third Granada Consensus. The impact and significance evaluation of the PI was made using the Farré Riba method. The Pharmacotherapy Complexity Index (PCI) assessed the pharmaceutical form, intake frequency and additional ins tructions. During the period 237 patients were attended by the pharmacist, with 109 from them attending the inclusion criteria of this study. Their profile was: 1.4% (n = 56) men; 35% (n = 38) Basic disease of unknown etiology; mean age of 44.9 years (± 10 .8) and most with education level "elementary school". The average number of drugs prescribed was 8.5 (± 2.6) in the 1st consultation and 8.0 (± 2.4) at the last. The average total points of PCI was 46 (± 13.7) in the 1st query and 43.7 (± 12.3) in the las t one (p <0.05), the minimum score of 19 was associated with the use of 3 medicines and the maximum of 83.5 points to 16 medicines. It was observed that patients with up to 180 days after transplantation showed higher scores on PCI (p <0.05) with predomina nce of the capsule / tablet formulation in the pharmacotherapy, 1 per day and 12/12 hours dosage and ̳take as directed‘, ̳take on specific times‘ and ̳interaction with food‘ additional instructions. 113 NOM were identified with the most frequent being "unt reated health problem" (61.9%; n = 70). 467 PI were held, with predominance of the one referring to "educate about the use of the drug" (77.5%; n = 362). With the completion of the IF, 86% (n = 97) of risk to or worsening of the health problems related to the drug were prevented and 8.8% (n = 10) had clinical improvement (p <0.05) with the latter classified as "extremely significant" because they generated a very significant increase in the effectiveness of therapy (p <0.05). The findings of the study show that renal transplanted patients under pharmacotherapeutic follow - up, despite the complexity of pharmacotherapy identified, have had negative outcomes avoided and minimized as well as improvement of health problems associated with the pharmacotherapy of tr ansplantation after completion of the pharmaceutical interventions
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spelling Martins, Bruna Cristina CardosoFonteles, Marta Maria de França2015-10-19T13:51:05Z2015-10-19T13:51:05Z2015MARTINS, B. C. C. Acompanhamento farmacoterapêutico de pacientes transplantados renais: da descrição aos desfechos clínicos. 2015. 93 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2015.http://www.repositorio.ufc.br/handle/riufc/13598Renal transplanted patients have a c omplex pharmacotherapy, being possible for pharmacists to contribute with the pharmacotherapy and its benefits management by integrating the multiprofessional team. This work aimed to assess the pharmacotherapeutic follow - up of renal transplanted patients considering the clinic outcome after the interventions performed by the pharmacist. It is a descriptive study with quantitative, exploratory and retrospective approach carried out in the Renal Transplant Service Ambulatory from a University Hospital (Fortaleza/Ceará), during the period from January to December 2013. Were included registers from patients who had at least two appointments in the Pharmaceutical Care Service during the stu dy period. The Drug Related Problems (DRP), Pharmaceutical Interventions (PI) and Clinic Outcomes were categorized through a classification used by the Clinical Pharmacy Service of the institution. The Negative Outcomes associated with Medication (NOM) wer e classified accordingly to the Third Granada Consensus. The impact and significance evaluation of the PI was made using the Farré Riba method. The Pharmacotherapy Complexity Index (PCI) assessed the pharmaceutical form, intake frequency and additional ins tructions. During the period 237 patients were attended by the pharmacist, with 109 from them attending the inclusion criteria of this study. Their profile was: 1.4% (n = 56) men; 35% (n = 38) Basic disease of unknown etiology; mean age of 44.9 years (± 10 .8) and most with education level "elementary school". The average number of drugs prescribed was 8.5 (± 2.6) in the 1st consultation and 8.0 (± 2.4) at the last. The average total points of PCI was 46 (± 13.7) in the 1st query and 43.7 (± 12.3) in the las t one (p <0.05), the minimum score of 19 was associated with the use of 3 medicines and the maximum of 83.5 points to 16 medicines. It was observed that patients with up to 180 days after transplantation showed higher scores on PCI (p <0.05) with predomina nce of the capsule / tablet formulation in the pharmacotherapy, 1 per day and 12/12 hours dosage and ̳take as directed‘, ̳take on specific times‘ and ̳interaction with food‘ additional instructions. 113 NOM were identified with the most frequent being "unt reated health problem" (61.9%; n = 70). 467 PI were held, with predominance of the one referring to "educate about the use of the drug" (77.5%; n = 362). With the completion of the IF, 86% (n = 97) of risk to or worsening of the health problems related to the drug were prevented and 8.8% (n = 10) had clinical improvement (p <0.05) with the latter classified as "extremely significant" because they generated a very significant increase in the effectiveness of therapy (p <0.05). The findings of the study show that renal transplanted patients under pharmacotherapeutic follow - up, despite the complexity of pharmacotherapy identified, have had negative outcomes avoided and minimized as well as improvement of health problems associated with the pharmacotherapy of tr ansplantation after completion of the pharmaceutical interventionsO crescente aumento do número de agentes imunossupressores e outros medicamentos disponíveis para o transplante renal resultou em farmacoterapias complexos, com maior potencial para interações medicamentosas e ocorrência de eventos adversos. O farmacêutico pode integrar a equipe multiprofissional, através das funções clínicas desenvolvidas no contexto da Farmácia Clínica e da Atenção Farmacêutica, contribuindo para o manejo da farmacoterapia e seus benefícios. O presente trabalho objetivou analisar acompanhamento farmacoterapêutico de pacientes transplantados renais considerando o desfecho clínico após as intervenções realizadas pelo farmacêutico. Trata-se de um estudo descritivo com abordagem quantitativa, exploratório e retrospectivo (modelo follow-up) realizado no Ambulatório do Serviço de Transplante Renal de um Hospital Universitário no período de janeiro a dezembro/2013. Foram incluídos os pacientes que tiveram pelo menos dois atendimentos no período avaliado. Os Problemas Relacionados aos Medicamentos (PRM), Intervenções Farmacêuticas (IF) e Desfechos Clínicos foram categorizados através da classificação utilizada pelo Serviço de Farmácia Clínica da instituição do estudo. Os Resultados Negativos associados aos Medicamentos (RNM) forma classificados conforme o Terceiro Consenso de Granada. A avaliação do impacto e significância das IF foi realizada segundo o método de Farré Riba e colaboradores. Os resultados foram analisados através do programa Statistic Package for Social Sciences, sendo os testes de qui-quadrado e teste t utilizados, respectivamente, para as variáveis categóricas e numéricas, com valor de significância de p<0,05. Um total de 109 pacientes foram avaliados, sendo 51,4% (n=56) homens, com 35% (n=38) doença de base de causa indeterminada, com média de idade 44,9 anos (Desvio padrão: ±10,8; Mínimo: 14 anos; Máximo: 77 anos). A média de tempo pós-transplante foi maior que um ano e 40,4% (n=44) dos pacientes tinha no máximo o ensino fundamental. O esquema imunossupressor predominante foi à associação: tacrolimo, micofenolato de sódio e prednisona. Houve diferença estatística entre o número de pacientes dentro do valor de creatinina preconizado (<1,2mg/dl) no início e na última consulta. Foram identificados 113 PRM, onde o mais frequente foi “a quantidade de medicamento insuficiente para o tratamento” (36,3%; n=41), sendo realizadas 467 IF com predominância daquela referente a “educar sobre o uso do medicamento” (77,5%; n=362). Com a realização das IF, cerca de 86% (n=97) tiveram o risco ou piora do problema de saúde relacionado ao medicamento prevenidos. As IF relacionadas ao desfecho clínico “melhora do problema de saúde” foram consideradas, segundo a classificação de Farré, como “extremamente significantes”. A pontuação total obtida na análise do índice de complexidade da farmacoterapia foi maior que a encontrada na literatura, sendo a principal contribuição para essa complexidade relacionada ás “instruções adicionais”, que não mostrou diferença estatisticamente significante no início e final do período avaliado. Os achados no estudo demonstram que os pacientes transplantados renais sob acompanhamento farmacoterapêutico, apesar da complexidade da farmacoterapia identificada, tiveram riscos relacionados aos medicamentos prevenidos devido à realização de intervenções farmacêuticas.Transplante de RimAtenção FarmacêuticaAcompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessORIGINAL2015_dis_bccmartins.pdf2015_dis_bccmartins.pdfapplication/pdf1866887http://repositorio.ufc.br/bitstream/riufc/13598/1/2015_dis_bccmartins.pdf148caf3028967e73676b96d5fcc233feMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81786http://repositorio.ufc.br/bitstream/riufc/13598/2/license.txt8c4401d3d14722a7ca2d07c782a1aab3MD52riufc/135982018-12-27 10:56:39.332oai:repositorio.ufc.br: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Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2018-12-27T13:56:39Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
title Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
spellingShingle Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
Martins, Bruna Cristina Cardoso
Transplante de Rim
Atenção Farmacêutica
title_short Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
title_full Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
title_fullStr Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
title_full_unstemmed Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
title_sort Acompanhamento farmacoterapêutico de pacientes transplantados renais : da descrição aos desfechos clínicos
author Martins, Bruna Cristina Cardoso
author_facet Martins, Bruna Cristina Cardoso
author_role author
dc.contributor.author.fl_str_mv Martins, Bruna Cristina Cardoso
dc.contributor.advisor1.fl_str_mv Fonteles, Marta Maria de França
contributor_str_mv Fonteles, Marta Maria de França
dc.subject.por.fl_str_mv Transplante de Rim
Atenção Farmacêutica
topic Transplante de Rim
Atenção Farmacêutica
description Renal transplanted patients have a c omplex pharmacotherapy, being possible for pharmacists to contribute with the pharmacotherapy and its benefits management by integrating the multiprofessional team. This work aimed to assess the pharmacotherapeutic follow - up of renal transplanted patients considering the clinic outcome after the interventions performed by the pharmacist. It is a descriptive study with quantitative, exploratory and retrospective approach carried out in the Renal Transplant Service Ambulatory from a University Hospital (Fortaleza/Ceará), during the period from January to December 2013. Were included registers from patients who had at least two appointments in the Pharmaceutical Care Service during the stu dy period. The Drug Related Problems (DRP), Pharmaceutical Interventions (PI) and Clinic Outcomes were categorized through a classification used by the Clinical Pharmacy Service of the institution. The Negative Outcomes associated with Medication (NOM) wer e classified accordingly to the Third Granada Consensus. The impact and significance evaluation of the PI was made using the Farré Riba method. The Pharmacotherapy Complexity Index (PCI) assessed the pharmaceutical form, intake frequency and additional ins tructions. During the period 237 patients were attended by the pharmacist, with 109 from them attending the inclusion criteria of this study. Their profile was: 1.4% (n = 56) men; 35% (n = 38) Basic disease of unknown etiology; mean age of 44.9 years (± 10 .8) and most with education level "elementary school". The average number of drugs prescribed was 8.5 (± 2.6) in the 1st consultation and 8.0 (± 2.4) at the last. The average total points of PCI was 46 (± 13.7) in the 1st query and 43.7 (± 12.3) in the las t one (p <0.05), the minimum score of 19 was associated with the use of 3 medicines and the maximum of 83.5 points to 16 medicines. It was observed that patients with up to 180 days after transplantation showed higher scores on PCI (p <0.05) with predomina nce of the capsule / tablet formulation in the pharmacotherapy, 1 per day and 12/12 hours dosage and ̳take as directed‘, ̳take on specific times‘ and ̳interaction with food‘ additional instructions. 113 NOM were identified with the most frequent being "unt reated health problem" (61.9%; n = 70). 467 PI were held, with predominance of the one referring to "educate about the use of the drug" (77.5%; n = 362). With the completion of the IF, 86% (n = 97) of risk to or worsening of the health problems related to the drug were prevented and 8.8% (n = 10) had clinical improvement (p <0.05) with the latter classified as "extremely significant" because they generated a very significant increase in the effectiveness of therapy (p <0.05). The findings of the study show that renal transplanted patients under pharmacotherapeutic follow - up, despite the complexity of pharmacotherapy identified, have had negative outcomes avoided and minimized as well as improvement of health problems associated with the pharmacotherapy of tr ansplantation after completion of the pharmaceutical interventions
publishDate 2015
dc.date.accessioned.fl_str_mv 2015-10-19T13:51:05Z
dc.date.available.fl_str_mv 2015-10-19T13:51:05Z
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dc.identifier.citation.fl_str_mv MARTINS, B. C. C. Acompanhamento farmacoterapêutico de pacientes transplantados renais: da descrição aos desfechos clínicos. 2015. 93 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2015.
dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/13598
identifier_str_mv MARTINS, B. C. C. Acompanhamento farmacoterapêutico de pacientes transplantados renais: da descrição aos desfechos clínicos. 2015. 93 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2015.
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