RESUMO
Background Problems related to pharmacotherapy are common in patients admitted to the paediatric intensive care unit (PICU) and are associated with increased healthcare costs. Data on the impact of clinical pharmacist interventions to prevent pharmacotherapy-related problems and to minimize costs in the PICU are limited. Objectives To evaluate the number and type of clinical pharmacist interventions in the PICU and to determine cost savings associated with them. Setting a ten bed PICU of a tertiary-care university hospital in Brazil. Method This was a prospective, observational study conducted over 1-year. The Failure Mode and Effects Analysis (FMEA) tool was applied at the beginning of the study to assess drug-related risks in the PICU and to guide clinical pharmacist interventions. Main outcome measure Number and type of clinical pharmacist interventions and healthcare-related costs. Results One hundred sixty-two children were followed-up by the clinical pharmacist and 1586 prescriptions were evaluated; pharmacotherapy-related problems were identified in 12.4% of them. Sixteen of 75 failure modes identified by FMEA were potentially reduced by the clinical pharmacist interventions. There were 197 interventions with a cost saving of R$ 15,118.73 (US$ 4828.00). Clinical pharmacist interventions were related to drug interaction and therapeutic monitoring (34.5%), drug selection (22.3%), dosing and frequency (16.8%), prescription (13.2%) and administration (13.2%). Ninety-seven per cent of the clinical pharmacist interventions were accepted by the medical team. The interventions with larger cost savings were related to administration (39%). Conclusion The clinical pharmacist interventions minimized the risks of pharmacotherapy-related problems and contributed to the reduction of costs associated with medical prescription.
Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Unidades de Terapia Intensiva Pediátrica/economia , Erros de Medicação/economia , Erros de Medicação/prevenção & controle , Serviço de Farmácia Hospitalar/economia , Serviço de Farmácia Hospitalar/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos ProspectivosRESUMO
O acompanhamento farmacoterapêutico voltado para pacientes pediátricos constitui um importante desafio para a área farmacêutica, principalmente a farmácia clínica, isso se deve tanto pela escassez de estudos científicos direcionados à utilização de medicamentos por essa população como pela dificuldade imposta pelo processo fisiológico de crescimento da criança, que permite muitas variáveis tanto no diagnóstico quanto no tratamento do paciente pediátrico. O objetivo da presente pesquisa foi desenvolver e validar uma ferramenta (escore) para priorização de pacientes no acompanhamento farmacoterapêutico dos pacientes em um CTIP...