Silva Ana Carolina de Souza E, Sousa Domingos Sávio de Carvalho, Perraud Eunice Bobô de Carvalho, Oliveira Fátima Rosane de Almeida, Martins Bruna Cristina Cardoso
Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
Universidade Federal do Ceará, Fortaleza, CE, Brazil.
Einstein (Sao Paulo). 2018 Jun 21;16(2):eAO4112. doi: 10.1590/S1679-45082018AO4112.
To describe and evaluate the pharmacotherapeutic follow-up by a clinical pharmacist in an intensive care unit.
A descriptive and cross-sectional study carried out from August to October 2016. The data were collected through a form, and pharmacotherapeutic follow-up conducted by a clinical pharmacist at the respiratory intensive care unit of a tertiary hospital. The problems recorded in the prescriptions were quantified, classified and evaluated according to severity; the recommendations made by the pharmacist were analyzed considering the impact on pharmacotherapy. The medications involved in the problems were classified according to the Anatomical Therapeutic Chemical Classification System.
Forty-six patients were followed up and 192 pharmacotherapy-related problems were registered. The most prevalent problems were missing information on the prescription (33.16%), and those with minor severity (37.5%). Of the recommendations made to optimize pharmacotherapy, 92.7% were accepted, particularly those on inclusion of infusion time (16.67%), and dose appropriateness (13.02%), with greater impact on toxicity (53.6%). Antimicrobials, in general, for systemic use were drug class most often related to problems in pharmacotherapy (53%).
Pharmacotherapeutic follow-up conducted by a pharmacist in a respiratory intensive care unit was able to detect problems in drug therapy and to make clinically relevant recommendations.
描述并评估临床药师在重症监护病房开展的药物治疗随访工作。
于2016年8月至10月进行一项描述性横断面研究。通过一份表格收集数据，由一名临床药师在一家三级医院的呼吸重症监护病房开展药物治疗随访。对处方中记录的问题按照严重程度进行量化、分类和评估；分析药师提出的建议对药物治疗的影响。根据解剖学治疗学化学分类系统对涉及问题的药物进行分类。
对46例患者进行了随访，共记录了192个与药物治疗相关的问题。最常见的问题是处方信息缺失（33.16%），以及严重程度较轻的问题（37.5%）。在为优化药物治疗而提出的建议中，92.7%被采纳，尤其是关于加入输注时间的建议（16.67%）和剂量适宜性的建议（13.02%），对毒性的影响更大（53.6%）。一般而言，全身用抗菌药物是最常与药物治疗问题相关的药物类别（53%）。
临床药师在呼吸重症监护病房开展的药物治疗随访能够发现药物治疗中的问题并提出具有临床相关性的建议。
