Discrepancy analysis in the prescriptions of patients admitted to the Surgical Center of a Public Emergency Hospital

Authors

DOI:

https://doi.org/10.33448/rsd-v10i17.24205

Keywords:

Centro Cirúrgico Hospitalar; Polimedicação; Reconciliação de Medicamentos; Surgery department, hospital.

Abstract

Medication reconciliation has a strong impact on the prevention of adverse events and mistakes related to medications. The study aimed to observe the occurrence of divergences in the pharmacotherapy of surgical patients. Polymedicated patients were considered as those who used three or more medications. The sources used were the patient himself, his companion, the drugs taken at home taken to the hospital, and the consultation of the medical record. Discrepancies were considered as any unintentional change between the drugs used before admission and the drugs prescribed after the surgical intervention, which could be: omission of drugs, differentiation in doses, differences in frequency/time of administration, drug interaction, and therapeutic duplication. The collected data were tabulated and studied. During the work, 422 patients were admitted to post-surgical hospitalization. The main reason for admission was lower or upper limb amputation (41.3%); the average number of drugs used at home was 4.7. A total of 444 discrepancies were found and the average per patient was 5.5. The most relevant were interactions, equivalent to 53.4% ​​(n=237) of all identified discrepancies, then omission was 25.7% (n=114). Of the 106 interventions, only 15 were accepted. The discrepancies were found to indicate a high risk for the safety of these patients, requiring an effective process of recognition of home therapy when the individual is admitted to the hospital. Thus, measures to ensure patient safety at hospital admission and mitigate drug errors should be taken.

References

Documento de referência para o Programa Nacional de Segurança do Paciente / Ministério da Saúde; Fundação Oswaldo Cruz; Agência Nacional de Vigilância Sanitária. Ministério da Saúde, 2014

Drenth-van Maanen, A. C., Spee, J., van Hensbergen, L., Jansen, P. A., Egberts, T. C., & van Marum, R. J. (2011). A anamnese estruturada do uso de medicamentos revela dano iatrogênico devido a discrepâncias nos históricos de medicamentos em registros hospitalares e de farmácia. J Am Geriatr Soc, 59 (10), 1976-1977.

Flamme-Obry, F., Belaiche, S., Hazzan, M., Ramdan, N., Noël, C., Odou, P., & Décaudin, B. (2018). Impact du pharmacien clinicien sur la iatrogénie médicamenteuse chez le patient greffé rénal. Néphrologie & Thérapeutique, 14(2), 91-98.

Greenwald, J. L., Halasyamani, L., Greene, J., LaCivita, C., Stucky, E., Benjamin, B., & Williams, M. V. (2010). Making inpatient medication reconciliation patient centered, clinically relevant and implementable: a consensus statement on key principles and necessary first steps. Journal of Hospital Medicine, 5(8), 477-485.

Hellström, L. M., Bondesson, Å., Höglund, P., & Eriksson, T. (2012). Errors in medication history at hospital admission: prevalence and predicting factors. BMC clinical pharmacology, 12(1), 1-9.

Mc Comb, K. G., da Fonseca Meireles, S., & Pinheiro, F. G. Qual é a importância do enfermeiro auditor para a melhoria da qualidade de assistência à saúde? A pluralidade do conhecimento na saúde, na educação e na tecnologia, 88.

Lombardi, N. F., Mendes, A. E. M., Lucchetta, R. C., Reis, W. C. T., Fávero, M. L. D., & Correr, C. J. (2016). Análisis de las discrepancias encontradas durante la conciliación medicamentosa en la admisión de pacientes en unidades de cardiología: un estudio descriptivo. Revista Latino-Americana de Enfermagem, 24.

Markovic, M., Mathis, A. S., Ghin, H. L., Gardiner, M., & Fahim, G. (2017). A comparison of medication histories obtained by a pharmacy technician versus nurses in the emergency department. Pharmacy and Therapeutics, 42(1), 41.

Mekonnen, A. B., McLachlan, A. J., & Brien, J. A. (2016). Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis. BMJ open, 6(2), e010003.

Mendes, A. E., Lombardi, N. F., Andrzejevski, V. S., Frandoloso, G., Correr, C. J., & Carvalho, M. (2016). Medication reconciliation at patient admission: a randomized controlled trial. Pharmacy Practice (Granada), 14(1), 0-0.

Miranda, T. M. M., Petriccione, S., Ferracini, F. T., & Borges Filho, W. M. (2012). Interventions performed by the clinical pharmacist in the emergency department. Einstein (São Paulo), 10, 74-78.

Nuez, C. R., Navarro, M. G., Valdivieso, J. G., Barrera, M. F., Sumalla, A. B., Rubí, J. S., & Eroles, X. G. (2012). Efectividad de un programa de conciliación perioperatoria de la medicación crónica en pacientes de cirugía programada. Medicina Clínica, 139(15), 662-667.

Oliveira, S. T. de, Farias, P. de O., Drummond, B. M., Rodrigues, L. B., Reis, P. G. dos, Souza, L. de O., Oliveira, L. R. de, & Miranda, V. F. de. (2018). Taxas de erro de prescrição e dispensação de um hospital público especializado em urgência e trauma. Rev Med Minas Gerais, 5, 61–68.

Pimenta, P. A., Santos, K. F. S., Silva, C. M. L., da Silva Passos, I., da Cunha Barros, I. M., & de Carvalho Brito, G. (2020). Conciliação de medicamentos em um hospital de ensino de Sergipe: lições aprendidas na implementação de um serviço. Scientia Plena, 16(8).

Peixoto, A. M., Zimpel, S. A., Oliveira, A. C. A. D., Monteiro, R. L. S., & Carneiro, T. K. G. (2017). Prevalência de amputações de membros superiores e inferiores no estado de Alagoas atendidos pelo SUS entre 2008 e 2015. Fisioterapia e Pesquisa, 24, 378-384.

Quélennec, B., Beretz, L., Paya, D., Blicklé, J. F., Gourieux, B., Andrès, E., & Michel, B. (2013). Potential clinical impact of medication discrepancies at hospital admission. European journal of internal medicine, 24(6), 530-535.

Salanitro, A. H., Kripalani, S., Resnic, J., Mueller, S. K., Wetterneck, T. B., Haynes, K. T., & Schnipper, J. L. (2013). Rationale and design of the multicenter medication reconciliation quality improvement study (MARQUIS). BMC health services research, 13(1), 1-12.

Santos, K. P. B. D., Luz, S. C. T. D., Mochizuki, L., & d'Orsi, E. (2018). Carga da doença para as amputações de membros inferiores atribuíveis ao diabetes mellitus no Estado de Santa Catarina, Brasil, 2008-2013. Cadernos de Saúde Pública, 34.

Stolldorf, D. P., Mixon, A. S.., Auerbach, A. D., Aylor, A. R., Shabbir, H., Schnipper, J., & Kripalani, S. (2020). Implementação e sustentabilidade de um kit de ferramentas de reconciliação de medicamentos: uma avaliação de métodos mistos. Jornal americano de farmácia do sistema de saúde: AJHP: jornal oficial da Sociedade Americana de Farmacêuticos do Sistema de Saúde, 77 (14), 1135–1143.

Published

22/12/2021

How to Cite

BEZERRA, C. S. L. F. .; ALMEIDA, F. H. O. de; SANTOS, A. N. dos .; SOUSA, D. S. de .; SANTOS, I. V. .; SANTOS, A. R. .; SILVA, W. B. da .; SILVA, F. A. da. Discrepancy analysis in the prescriptions of patients admitted to the Surgical Center of a Public Emergency Hospital. Research, Society and Development, [S. l.], v. 10, n. 17, p. e146101724205, 2021. DOI: 10.33448/rsd-v10i17.24205. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/24205. Acesso em: 23 nov. 2024.

Issue

Section

Health Sciences