Estructuración y validación del score de riesgo para evaluar el nivel de atención farmacéutica a pacientes ingresados en un hospital de Salvador

Autores/as

DOI:

https://doi.org/10.33448/rsd-v13i4.45471

Palabras clave:

Atención farmacéutica; Seguridad del paciente; Puntuación de riesgo.

Resumen

Objetivo: Así, el objetivo de este trabajo es desarrollar y validar un puntaje para identificar el nivel de atención farmacéutica que será brindado a los pacientes ingresados en un hospital terciario en Salvador, Bahía. Método: Este trabajo se llevó a cabo durante un período de un año (2022-2023) en el Hospital Universitario Profesor Edgard Santos. Se creó un formulario en línea que contenía varias variables recopiladas de la literatura, que luego fueron validadas mediante el Método Delphi. La evaluación de los expertos se produjo en dos etapas mediadas por la escala Likert hasta llegar a un consenso y finalizar la puntuación. Finalmente, se realizó una prueba piloto para evaluar la concordancia en la aplicabilidad de este puntaje, a partir de las respuestas de un grupo de farmacéuticos utilizando Kappa Cohen ponderado. Resultado: El puntaje de riesgo farmacéutico se desarrolló con base en decisiones de expertos con ocho variables como número de medicamentos, edad, comorbilidades y otras capaces de evaluar el nivel de atención que requieren los pacientes hospitalizados, siendo responsable de auxiliar la práctica clínica farmacéutica. El modelo presentó un Cohen Kappa ponderado de 0,67 (valor p <0,0001; IC 0,46-0,87) que demuestra una confiabilidad moderada y satisfactoria. De esta forma, la puntuación permite al farmacéutico ofrecer una atención proporcional a las necesidades del paciente, realizando sus actividades de forma más segura. Conclusión: Este estudio desarrolló un instrumento de evaluación de riesgos objetivo y claro desde una perspectiva farmacéutica, basado en la evidencia de la literatura.

Citas

Audurier, Y., Roubille, C., Manna, F., Zerkowski, L., Faucanie, M., Macioce, V., & Breuker, C. (2021). Development and validation of a score to assess risk of medication errors detected during medication reconciliation process at admission in internal medicine unit: SCOREM study. International Journal of Clinical Practice, 75(2), e13663.

Bakeman, R. (2023). KappaAcc: A program for assessing the adequacy of kappa. Behavior Research Methods, 55(2), 633-638.

Barbon, F. J., Wiethölter, P., & Flores, R. A. (2016). Alterações celulares no envelhecimento humano. Journal of oral investigations, 5(1), 61-65.

dos Santos Barreto, P. G., Barbosa Rezende, R., Dos Santos, A. L., de Oliveira Silva, F., Rodrigues Bezerra Góis, V., Corsino Freire, E., & Alvarenga Americano do Brasil, P. E. (2022). Fully independent validation and updating of a clinical pharmacy prioritizing risk score in an infectious disease hospital ward. British Journal of Clinical Pharmacology, 88(8), 3695-3708.

Benarrosh, E. M., & de Oliveira, C. A. B. (2022). Interaction between doctors and pharmacists in the diffusion of pharmaceutical compounding prescriptions in pediatrics. Brazilian Journal of Development, 8(7), 53826-53841.

Benchoufi, M., Matzner-Lober, E., Molinari, N., Jannot, A. S., & Soyer, P. (2020). Interobserver agreement issues in radiology. Diagnostic and interventional imaging, 101(10), 639-641.

Bohomol, E. (2014). Medication errors: a descriptive study of the classes of drugs and drugs of high surveillance. Anna Nery School, 18(2), 311-316.

Correa, A. R. L. et al. (2022). The transplanted patient and immunosuppression: the importance and effect of immunosuppressive drugs. Multidisciplinary Journal of the Northeast of Minas Gerais, 4(4).

Falconer, N., Barras, M., Abdel-Hafiz, A., Radburn, S., & Cottrell, N. (2022). Evaluation of two European risk models for predicting medication harm in an Australian patient cohort. European Journal of Clinical Pharmacology, 78(4), 679-686.

Falconer, N., Barras, M., & Cottrell, N. (2018). Systematic review of predictive risk models for adverse drug events in hospitalized patients. British journal of clinical pharmacology, 84(5), 846-864.

Ferrández, O., Grau, S., Urbina, O., Mojal, S., Riu, M., & Salas, E. (2018). Validation of a score to identify inpatients at risk of a drug-related problem during a 4-year period. Saudi pharmaceutical journal, 26(5), 703-708.

Ferreira, C. E. F. (2021). Adverse drug events identified by clinical pharmacists in a high-complexity hospital. Thesis presented to the Faculty of Pharmacy of the Fluminense Federal University as a partial requirement to obtain the title of Doctor of Sciences. Niterói. SP, Brasil.

Gama, L. F. da. (2021). Proposal of a risk score for prioritization of pharmacotherapeutic follow-up in the medical clinic. Dissertation presented to the Graduate Program in Applied Sciences to Health Products, School of Pharmacy, Fluminense Federal University, Niterói, SP, Brasil.

Geeson, C., Wei, L., & Franklin, B. D. (2019). Development and performance evaluation of the Medicines Optimisation Assessment Tool (MOAT): a prognostic model to target hospital pharmacists’ input to prevent medication-related problems. BMJ Quality & Safety, 28(8), 645-656.

Gleason, K. M., McDaniel, M. R., Feinglass, J., Baker, D. W., Lindquist, L., Liss, D., & Noskin, G. A. (2010). Results of the Medications at Transitions and Clinical Handoffs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission. Journal of general internal medicine, 25, 441-447.

Gwynn, M. E., Poisson, M. O., Waller, J. L., & Newsome, A. S. (2019). Development and validation of a medication regimen complexity scoring tool for critically ill patients. American Journal of Health-System Pharmacy, 76(Supplement_2), S34-S40.

ISMP. Institute for Safe Practices in the Use of Medicines. (2015). Ismp Bulletin. Potentially Dangerous Drugs for Hospital and Outpatient Use - updated lists. 4(3). Available in: https://www.ismp-brasil.org/site/wp-content/uploads/2015/12/V4N3.pdf

Júnior, S. D. D. S., & Costa, F. J. (2014). Mensuração e escalas de verificação: uma análise comparativa das escalas de Likert e Phrase Completion. PMKT–Revista Brasileira de Pesquisas de Marketing, Opinião e Mídia, 15(1-16), 61.

Landis, J. R., & Koch, G. G. (1977). An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics, 363-374.

Leal, P. D. M., Amante, L. N., Girondi, J. B. R., Nascimento, E. R. P. D., & Magalhães, A. L. P. (2020). Building solutions for the safety of the patient with heart disease using warfarin: a qualitative study. Texto & Contexto-Enfermagem, 29, e20180002.

Le Couteur, D. G., Fraser, R., Kilmer, S., Rivory, L. P., & McLean, A. J. (2005). The hepatic sinusoid in aging and cirrhosis: effects on hepatic substrate disposition and drug clearance. Clinical pharmacokinetics, 44, 187-200.

Lima, S.I.V.C. (2021). Prediction of occurrence of adverse drug reaction in hospitalized patients. Thesis (PhD in Pharmaceutical Sciences) - Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brasil.

Lima, S. I. V. C., Martins, R. R., Saldanha, V., Silbiger, V. N., Dos Santos, I. C. C., Araújo, I. B. D., & Oliveira, A. G. (2020). Development and validation of a clinical instrument to predict risk of an adverse drug reactions in hospitalized patients. Plos one, 15(12), e0243714.

McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia medica, 22(3), 276-282.

Medeiros, I.A.S. & Oliveira, F.S. (2020). Pediatric pharmacotherapy: the particularities of the use of drugs in pediatrics. Journal Health & Science Online, 9(3), 117-133. https://doi.org/10.35572/rsc.v9i3.468

Mongaret, C., Quillet, P., Vo, T. H., Aubert, L., Fourgeaud, M., Michelet-Huot, E., & Hettler, D. (2018). Predictive factors for clinically significant pharmacist interventions at hospital admission. Medicine, 97(9).

Oliveira, F. R. P., Magalhães, V. P., de Andrade Cavalcante, R. M., Martins, B. C. C., Guedes, M. M., de França Fonteles, M. M., & da Silva, L. J. (2019). Acompanhamento farmacoterapêutico em unidade de internação pós-transplante: descrição e análise. Revista Eletrônica de Farmácia, 16(E).

O’Mahony, D., O’Connor, M. N., Eustace, J., Byrne, S., Petrovic, M., & Gallagher, P. (2018). The adverse drug reaction risk in older persons (ADRROP) prediction scale: derivation and prospective validation of an ADR risk assessment tool in older multi-morbid patients. European Geriatric Medicine, 9, 191-199.

Pagnussat, L. R.; Hahn, S. R.; & Pasqualotti, A. (2021). Adverse reactions to antimicrobials in elderly people: what should be observed? Human Aging: Contemporary Challenges, 2(1), 299-309.

Parekh, N., Ali, K., Davies, J. G., Stevenson, J. M., Banya, W., Nyangoma, S., & Rajkumar, C. (2020). Medication-related harm in older adults following hospital discharge: development and validation of a prediction tool. BMJ Quality & Safety, 29(2), 142-153.

Pernassi, M. G. S. (2017). Development and validation of score (BRAPP) for prioritization of patients in the pharmacotherapeutic follow-up of the clinical pharmacist in pediatric ICU. Monograph presented to the Professional Improvement Program/CRH/SESSP, USP. Ribeirão Preto, SP, Brasil.

Perroca, M. G., & Gaidzinski, R. R. (2003). Assessing the interrater reliability of an instrument for classifying patients: kappa quotient. Revista da Escola de Enfermagem da USP, 37, 72-80.

Silva, A. C. B., Freitas, B. C. G., de Carvalho, B. F., da Conceição Rodrigues, E. L., de Oliveira, F. S., da Costa, I. V., & da Trindade, E. L. (2021). A polifarmácia entre pacientes hipertensos e diabéticos em uma unidade de saúde. Revista Eletrônica Acervo Saúde, 13(8), e8006-e8006.

Thangaratinam, S.; & Redman, C.W. E. (2005). The delphi technique. The obstetrician & gynaecologist, 7(2), 120-125.

Vieira, T. W., Sakamoto, V. T. M., Moraes, L. C. D., Blatt, C. R., & Caregnato, R. C. A. (2020). Validation methods of nursing protocols: an integrative review. Revista Brasileira de Enfermagem, 73.

Yokoo, B.A.C. (2021). Criteria for dose adjustment of antihypertensive and antihyperglycemic drugs in individuals with renal insufficiency. Final Paper presented to the Undergraduate Course in Pharmacy of Universidade Estadual Paulista Universidade Estadual Paulista. Araraquara, SP, Brasil.

Yusoff, M. S. B. (2019). ABC of content validation and content validity index calculation. Education in Medicine Journal, 11(2), 49-54.

Zanatta, A. B., & Lucca, S. R. D. (2015). Prevalence of Burnout syndrome in health professionals of an onco-hematological pediatric hospital. Revista da Escola de Enfermagem da USP, 49, 0253-0258.

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Publicado

11/04/2024

Cómo citar

SILVA, L. L. O. .; SILVA, L. S. S. .; NOBLAT, L. de A. C. B. . Estructuración y validación del score de riesgo para evaluar el nivel de atención farmacéutica a pacientes ingresados en un hospital de Salvador. Research, Society and Development, [S. l.], v. 13, n. 4, p. e2613445471, 2024. DOI: 10.33448/rsd-v13i4.45471. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/45471. Acesso em: 22 dic. 2024.

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Ciencias de la salud