Modesto Ana Carolina Figueiredo, Ribeiro Allyne Marques, Pereira Jhonata Lima, Silva Lunara Teles, Provin Mércia Pandolfo, Ferreira Paula Sofia Lima Antonino Iglesias, Amaral Rita Goreti, Ferreira Tatyana Xavier Almeida Matteucci
Hospital of Clinics, Federal University of Goiás - UFG/EBSERH, First Avenue, East University District, Goiânia, Goiás, 74605-020, Brazil.
Multiprofessional Health Residence, Federal University of Goiás - UFG/EBSERH, Hospital, First Avenue, East University District, Goiânia, Goiás, 74605-020, Brazil.
Int J Clin Pharm. 2020 Feb;42(1):193-200. doi: 10.1007/s11096-019-00957-6. Epub 2019 Dec 21.
Background Prescription evaluation by pharmacists has potential to improve pharmacotherapy management. It requires the use of robust methods to identify drug-related problems (DRP), which are important issues in pharmacotherapy. Objective To evaluate the applicability and reliability of Grupo de Investigação em Cuidados Farmacêuticos (GIGUF) method for prescription analysis, identification and classification of drug-related problems in inpatients prescriptions. Setting Department of Medical Clinic of a tertiary and teaching Brazilian hospital. Method An observational and retrospective study of identification and classification of drug-related problems. GIGUF method was used to evaluate prescriptions of hematological patients hospitalized between August and October 2015. The problems were categorized using GICUF-method classification. Three pharmacists performed inter-rater agreement analysis of the method using Kappa. Differences in prevalence of DRP was calculated by age, sex, pharmacotherapy complexity, length of stay and number of drugs. Main outcome measure (a) frequency and characteristics and (b) inter-rater agreement in identification and classification of the drug-related problems. Results A total of 211 problems were identified and 'inadequate dosing' was the most common problem. There was an association between the occurence of a drug-reklated problem and complexity of pharmacotherapy (p = 0.001) and number of drugs used (p = 0.010). The overall inter-rater agreement was moderate (k = 0.44 IC 95% 0.34-0.55) and the problem 'not suitable drug' (k = 0.55 IC 95% 0.44-0.66) had greater inter-rater agreement. Conclusion The method "Evaluation Drug Use Process" was useful for prescription analysis since it made the identification and classification of DRPs possible. The method demonstrated a moderate inter-rater agreement, and can contribute to pharmacotherapy management by hospital pharmacists.
背景 药剂师进行处方评估有改善药物治疗管理的潜力。这需要运用可靠的方法来识别药物相关问题（DRP），而这些问题是药物治疗中的重要问题。目的 评估药物治疗护理研究小组（GIGUF）方法在住院患者处方药物相关问题分析、识别和分类中的适用性和可靠性。地点 巴西一家三级教学医院的内科门诊。方法 一项关于药物相关问题识别和分类的观察性回顾性研究。采用GIGUF方法评估2015年8月至10月住院血液科患者的处方。使用GICUF方法分类对问题进行归类。三名药剂师使用卡帕系数对该方法进行评分者间一致性分析。通过年龄、性别、药物治疗复杂性、住院时间和药物数量计算DRP患病率的差异。主要观察指标 （a）药物相关问题的频率和特征，以及（b）在药物相关问题识别和分类中的评分者间一致性。结果 共识别出211个问题，“剂量不足”是最常见的问题。药物相关问题的发生与药物治疗复杂性（p = 0.001）和所用药物数量（p = 0.010）之间存在关联。总体评分者间一致性为中等（k = 0.44，95%置信区间0.34 - 0.55），“药物不合适”问题（k = 0.55，95%置信区间0.44 - 0.66）的评分者间一致性更高。结论 “药物使用过程评估”方法对处方分析有用，因为它使DRP的识别和分类成为可能。该方法显示出中等程度的评分者间一致性，可为医院药剂师的药物治疗管理做出贡献。
