Pharmaceutical interventions and their clinical outcomes in an inpatient post-transplant unit
To contribute to the formation of knowledge in Brazil about the impact of the clinical pharmacist's role in the care of inpatient post-transplant by analyzing the results of the pharmaceutical interventions performed. A descriptive study was conducted from January to July/2014. Data were collected from the records of the Clinical Pharmacy Service (medication reconciliation, prescription analysis and pharmacotherapeutic follow-up), including all patients with drug-related problems and documented pharmaceutical interventions. Epidemiological variables and related to the clinical activities of the pharmacist were described. A total of 131 patients had drug-related problems, especially, during “Pharmacoterapeutic follow-up”. The most frequent categories were: “not prescribed required medicine” (125; 21.7%), “overdosing” (97; 16.8%) and “underdosing” (93; 16.1%). The main drugs involved were “ganciclovir” (81; 13.4%) and “tacrolimus” (33; 5.5%). The pharmaceutical interventions included “dose/adequacy” (193; 33.4%), “inclusion” (122; 21.1%) or “suspension” (122; 21.1%) of medication. The main clinical outcomes were “prevention” (481; 83.4%) or “improvement” (59; 10.2%) of health problems, such as “adverse effects” (170; 29.5%), “infection” (133; 23%) and “rejection” (41; 7.1%), being identified a significant relationship (p<0.05) between the acceptance of interventions and these outcomes, as well as between the non-acceptance and the occurrence of negative outcomes associated with medication. Our findings demonstrated that the pharmaceutical interventions, carried at all stages of care to inpatient post-transplant, integrated with the multidisciplinary team, were able to provide clinical outcomes in the prevention and improvement in health problems related to medication, such as adverse events, infection and rejection.
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