Analysis of clinical pharmacist interventions in a tertiary teaching hospital in Brazil

Einstein (São Paulo)

Wálleri Christini Torelli Reis¹  Vânia Mari Salvi Andrzejevski¹  Carolinne Thays Scopel¹  Cassyano Januário Correr¹ 

[1] Universidade Federal do Paraná;

关键词: serviço de farmácia hospitalar;    atenção farmacêutica;    prescrições de medicamentos;   

DOI  :  10.1590/S1679-45082013000200010

来源: DOAJ

【 摘 要 】

OBJECTIVE: To analyze the clinical pharmacist interventions performed during the review of prescription orders of the Adult Intensive Care, Cardiologic Intensive Care, and Clinical Cardiology Units of a large tertiary teaching hospital in Brazil. METHODS: The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. RESULTS: During the study, a total of 6,438 drug orders were assessed and 933 interventions were performed. The most prevalent drug therapy problems involved ranitidine (28.44%), enoxaparin (13.76%), and meropenem (8.26%). The acceptability of the interventions was 76.32%. The most common problem found was related to dose, representing 46.73% of the total. CONCLUSION: Our study showed that up to 14.6% of the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes in seven to ten of these prescriptions.

【 授权许可】

Unknown