Reconciliação de medicamentos e revisão da farmacoterapia a pacientes pediátricos hospitalizados.

Abstract

Introduction: Pediatric patients have pharmacokinetic and pharmacodynamic particularities that alter the responses to the use of medications, in addition to the scarcity in the development of medications suitable for their use. These factors can contribute to the occurrence of preventable medication errors, and that is why actions are needed to promote the safety of this patient. Ensuring that the use of medicines is safe and appropriate, aiming at the rational use of medicines is the premise of clinical pharmacy and its implementation occurs through pharmaceutical services directed to the care of the individual, contemplating the reconciliation of medicines and the review of pharmacotherapy. Objective: To describe the review of pharmacotherapy for pediatric hospitalized patients from the medication reconciliation service. Method: This is an observational study, carried out from April to August 2019, in the pediatric inpatient units of a university hospital linked to the Unified Health System (SUS) in Belo Horizonte, Minas Gerais. This hospital has 89 beds for pediatrics. The included patients were aged 28 days to 12 years and were approached within 48 hours of admission to the institution. From the reconciliation of drugs, intentional and unintended drug discrepancies were assessed during all care transitions (admission, internal transfers and hospital discharge) and, afterwards, the advanced type pharmacotherapy review service was carried out (3) , according to the methodology recommended by the Pharmaceutical Care Network Europe Association (PCNE). Results: 69 patients were included in the study and during medication reconciliation, 399 discrepancies were identified, 306 (76.7%) intentional discrepancies and 93 (23.3%) unintentional discrepancies. The omission of a medication previously used by the patient was the most frequent unintentional discrepancy, 53 (57.0%), in all care transition units. The drug classes most involved in discrepancies were vitamins 17 (18.2%) and antimicrobials 10 (10.7%). From the review of pharmacotherapy, 185 Drug-Related Problems were identified, 130 (65.3%) of which were related to safety; 33 (16.6%) to efficacy and 22 (11.1%) to unnecessary medications. Conclusion: With the performance of the clinical pharmacist with the health team, the review of pharmacotherapy and the reconciliation of medications can be useful to identify PRM and medication discrepancies, and can prevent medication errors, contributing to the rational use of medications and for better results pharmacotherapeutic.