Avaliação de protocolo de reconciliação medicamentosa farmacêutica na admissão de paciente internado

Abstract

The aim of this study was to evaluate the effects of an institutional protocol, entitled Pharmaceutical Prescription Protocol – Drug Reconciliation Process in a hospital in Curitiba, Paraná. The protocol was implemented in November 2017 and had the objective of improving the Medication Reconciliation (MR) process that already existed in that hospital and was carried out on admission, on transfer between care levels and on patient discharge; there was the participation of the nurse who collects the first information on continuous use of medications, the physician who took into account the information collected by the nurse for the preparation of the medical prescription, the pharmacist who analyzed the list of continuous use medications with the prescription physician and validated the medicines brought to the hospital and the patient or family member who informed the medicines that the patient was using before hospitalization and whether they had brought these medicines to the hospital. The protocol allowed the pharmacist to adjust the medication prescription. When the pharmacist found discrepancies in the analysis of the list with the medical prescription, he made the pharmaceutical intervention with the physician; he discussed with the doctor the need or not to continue the medications on the list during hospitalization. When the physician agreed with the pharmacist’s intervention and was no longer in the hospital, the physician authorized the pharmacist to adjust the medication prescription. This adjustment was called Pharmaceutical Prescription (PF). To analyze the effectiveness of the protocol, the following data from the admission MRI were analyzed: number of pharmaceutical interventions and numbers of Adherence (prescription adjustment) and Non-Adherence (when prescription adjustment did not occur). These data were collected from June 2017 to June 2018. It was observed that before the implementation of the protocol, the average for Adhesion was 25.8% and for Non-Adherence of 74.2%. After implementation of the protocol, the average for Adhesion was 69.3% and for Non-Adherence, 30.7%. The results found demonstrate an increase in the correction of prescriptions in the MRI process, which would make drug therapy for hospitalized patients safer.