Mapping of drug-related problems involving the prescription of opioid drugs in a teaching hospital in Curitiba

Authors

DOI:

https://doi.org/10.30968/rbfhss.2023.142.0910

Abstract

Introduction: Drug-Related Problems (DRPs) are unwanted events presented in pharmacotherapy that negatively affect the treatment of a disease and the actions of Clinical Pharmacy in pharmacovigilance of prescriptions aims on the minimization of these problems. Considering that referral hospitals for trauma often use opioid drugs in trauma patients’ management, it is necessary to carry out an investigation into DRPs involving the prescription of opioids in these hospitals. Objective: To map the DRPs identified in the prescription of opioid drugs in the management of patients in the ward of a teaching hospital in Curitiba. Methods: The research was retrospective and observational. Prescription data was collected from February 2019 to April 2021. From the 14.014 prescriptions analyzed in the period, it was calculated through the DOT (Days of Therapy) that 6.996 of them contained opioids. Of the prescriptions evaluated, 9.075 had DRPs, 1.550 of which were related to opioids. Results: The main problem involving the prescription of opioids in the wards is cost-effectiveness (73,61%); the main cause of DRP is the prescription of the inappropriate drug form for the patient in question (73,23%). In 87,74% of the cases, an intervention was proposed to the prescriber; however, in only 35,61% of the cases the proposed intervention was accepted and fully implemented, so that the problem was fully resolved in only 36,6% of the cases. In 29,55% of the cases, the problem was not resolved due to lack of cooperation on the part of the prescribing physician. Also, a steady decrease in the incidence rate of DRPs was observed over time, as consequence of pharmacovigilance of prescriptions and prescribers. Conclusion: The research was not only fruitful in designing a complete mapping of opioidrelated DRPs in the hospital, but also highlighted the effectiveness of the educational action of pharmacists on prescribers.

Downloads

Download data is not yet available.

References

Marin N, Luiza VL, Osorio-de-Castro CGS et al. Assistência farmacêutica para gerentes municipais, 20ª edição. Rio de Janeiro: OPAS/PMS; 2003.

World Health Organization. The role of education in the rational use of medicines. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/205994/B0338.pdf;jsessionid=48F84D5198B7C55230B3E19717963A94?sequence=1. Acesso em: 17/01/2023.

Lewis PJ, Dornan T, Taylor D et al. Prevalence, incidence and nature of prescription errors in hospital inpatients: a systematic review. Drug Saf. 2009; 32(4):379-89. DOI: 10.2165/000020gr-200932050-00002

Franklin BD, McLeod M, Barber N. Comment on ‘prevalence, incidence and nature of prescription errors in hospital inpatients: a systematic review’. Drug Saf. 2010; 33(2):163-5. DOI: 10.2165/11319080-000000000-00000.

Tercer consenso de Granada sobre problemas relacionados con los medicamentos (PRM) y resultados negativos asociados a la medicación (RNM). Ars Pharm. 2007; 48(1):5-17.

Pharmaceutical Care Network Europe Foundation. The PCNE Classification V 8.02. Disponível em: https://www.pcne.org/upload/files/230_PCNE_classification_ V8-02.pdf. Acesso em: 17/01/2023.

Reis WCT, Scopel CT, Correr CJ et al. Análise das intervenções de farmacêuticos clínicos em um hospital de ensino terciário do Brasil. Einstein. 2013;11(2):190-6.

Cruz LT, Batista PN, Meurer IR. Análise do serviço de farmácia clinica em um hospital universitário. HU Rev. 2019;45(4):408-14. DOI: 10.34019/1982-8047.2019.v45.27553

Bórquez CAC. Programa de atención farmacéutica en pacientes dislipidémicos en farmacia comunitaria. [dissertação]. Facultad de Química y Farmacia, Universidad Austral de Chile, Valdivia, 2003.

Dader MJF, Romero FM. La atención farmacéutica en farmácia comunitaria: evolución de conceptos, necesidades de formación, modalidades y estrategias para su puesta en marcha. Pharm Care Esp. 1999;1:52-61.

Jourdan JP, Muzard A, Goyer I et al. Impact of pharmacist interventions on clinical outcome and cost avoidance in a university teaching hospital. Int J Clin Pharm. 2018;40(6):1474-81. DOI: 10.1007/s11096-018-0733-6.

Benson H, Lucas C, Kmet W et al. Pharmacists in general practice: a focus on drug-related problems. Int J Clin Pharm. 2018;40(3):566-72. DOI: 10.1007/s11096-018-0617-9

Choi I, Lee SM, Flynn L at al. Incidence and treatment costs attributable to medication errors in hospitalized patients. Res Social Adm Pharm. 2016;12(3)428-37. DOI: 10.1016/j.sapharm.2015.08.006.

Rang HP, Ritter JM, Flower RJ et al. Rang & Dale Farmacologia, 7ª edição. Rio de Janeiro: Elsevier; 2016.

Lehmann KA. Le tramadol dans les douleurs aiguës. Drugs. 1997;53:25-33. DOI: 10.2165/00003495-199700532-00007

Lopes MCBT, Santana NS, Costa KAL et al. Analgesia em pacientes de trauma no serviço de emergência. Rev Enferm UFSM. 2019;9(26):1-14. DOI: 10.5902/2179769234502

Pimenta CAM, Carvalho MB, Fogaça V. Dor e analgesia no atendimento pré-hospitalar às vítimas de acidente de causa externa. Âmbito Hosp. 2003;14(160):8-13.

Baird J, Faul M, Green TC et al. A retrospective review of unintentional opioid overdose risk and mitigating factors among acutely injured trauma patients. Drug and alcohol dependence. 2017;178;130-5. DOI: 10.1016/j.drugalcdep.2017.04.030.

Neuman MD, Bateman BT, Wunsch H. Inappropriate opioid prescription after surgery. Lancet. 2019;393(1):1547-57. DOI: 10.1016/S0140-6736(19)30428-3

Agência Nacional De Vigilância Sanitária. Diretriz Nacional para Elaboração de Programa de Gerenciamento do Uso de Antimicrobianos em Serviços de Saúde. Brasília, 2017. Disponível em: https://www.ccih.med.br/wp-content/uploads/2018/01/Diretriz-Nacional-para-Elaboração-de-Programa-de-Gerenciamento-do-Uso-de-Antimicrobianos-em--Serviços-de-Saúde.pdf. Acesso em: 17/01/2023.

Morris AM, Brener S, Dresser L et al. Use of a Structured Panel Process to Define Quality Metrics for Antimicrobial Stewardship Programs. Infection Control & Hospital Epidemiology. 2012;33(5)500-6. DOI: 10.1086/665324

Araújo APV, Melo DO. Substituição da via de administração de medicamentos: atuação do residente farmacêutico e economia de recursos. J Assist Farmac Farmacoecon. 2018;3(2):14-24. DOI: 10.22563/2525-7323.2018.

Silva MM, Filho JRSB, Nunes MS. Erros de prescrição de medicamentos no âmbito hospitalar dos analgésicos opioides: revisão sistêmica. Brazilian Journal of Health Review. 2018;5(3):8472-87. DOI: 10.34119/bjhrv5n3-037.

Locatelli DL, Blatt CR, Werlang MC. Conversion of intravenous to oral antibiotic therapy in an adult intensive care unit. Rev Bras Farm Hosp Serv Saude. 2020;11(3):0444. DOI: 10.30968/rbfhss.2020.113.0444.

Hospital Universitário Cajuru. Gerência médica. Protocolo de Switch Oral (EV para VO). Data de publicação: 14 jun. 2018, rev: 16 out. 2018.

Published

2023-06-27

How to Cite

1.
GUERRA E, FUCHS EN, AMARAL PE, SALES FC, ZEQUINÃO T. Mapping of drug-related problems involving the prescription of opioid drugs in a teaching hospital in Curitiba. Rev Bras Farm Hosp Serv Saude [Internet]. 2023Jun.27 [cited 2024Dec.22];14(2):910. Available from: https://rbfhss.org.br/sbrafh/article/view/910

Issue

Section

ORIGINAL ARTICLES