Implementação de um serviço de gerenciamento da terapia medicamentosa em um serviço de medicina nuclear em hospital referência em oncologia no município do Rio de Janeiro.

Abstract

Thyroid cancer has elevated incident in Brazil, and differentiated thyroid carcinoma (DTC) is the most frequent type. The treatment of choice for DTC is surgery, which is usually combined with radioiodine therapy (RIT), which ensures a good prognosis, low mortality, and high survival rate. Therefore, expanding the focus on DTC survivors undergoing RIT within the pharmacotherapeutic complexity is especially relevant within the oncology area. In this context, the Comprehensive Medication Management (CMM) service is a strategic clinical pharmaceutical service, with a holistic approach, and that supports people who use medications to achieve positive outcomes. The objective of the present study was to describe the implementation of the CMM service offered to people with DTC and undergoing RIT in a reference oncology hospital in Rio de Janeiro/RJ. To this end, a descriptive implementation study was developed, outlined in accordance with the StaRI (Standards for Reporting Implementation Studies) statement, referring to the period from 03/2020 to 12/2022. Data were collected from the CMM service´s records and the institution's electronic medical record. Service indicators were analyzed using descriptive statistics. A total of 100 patients were followed, 82.0% of whom were women, with a mean age of 47.9 years and a mean number of health problems of 4.76. Papillary DTC was frequent (89.0%), with stage I (65.0%), and with an intermediate risk of recurrence in 49.0% of cases. A total of 140 CMM consultations were performed, 72.0% in the pre-RIT period. A total of 118 drug therapy problems were identified, of which 41.5% were resolved. A total of 186 interventions were performed: 114 with the medical team, with an acceptability of 33.6%; and 59 interventions with patients, with an acceptability of 42.4%. It is concluded that the CMM service for people with DTC undergoing RIT should be encouraged in the field of nuclear medicine and radiopharmacy, as it is a viable alternative for managing the pharmacotherapy of these patients, with emphasis on the context of pre-RIT preparation. This study emphasizes the importance of expanding the CMM service, which, although successfully implemented, has potential for growth.