Quality indicators of hospitalized children influenced by clinical pharmacist services: A systematic review.

BACKGROUND: Care for children who are hospitalized can be optimized if the pharmacist, in conjunction with the multidisciplinary team, promotes the rational use of medicines. In this sense, the evaluation of the quality of these clinical services through indicators is important in the planning, decision making of pharmacists and managers of these services. OBJECTIVE: To characterize which health indicators were influenced by the pharmaceutical clinical services for the care of children in hospitals. METHODS: A systematic review was performed. The search for data was made on the bases: Cochrane, Embase, Lilacs, Pubmed and Web of Science. Then, the search included studies in which evaluated the impact of pharmaceutical clinical services on clinical, economic and humanistic outcomes. RESULTS: The search resulted in 11 included studies. In this review, four pharmaceutical clinical services were found: pharmacotherapy review, multiprofessional team interventions, antimicrobial stewardship program and pharmaceutical services at discharge hospital. The most influenced outcome indicators were length of hospital stay, with average time in the group that received the pharmacotherapy review service, and interventions multiprofessional team with a 6.45-day vs. 10.83 days in the control group; hospital readmissions with a significant reduction of non-scheduled readmission of 30 days in the ntimicrobial stewardship program; reduction of hospital costs and caregiver satisfaction. CONCLUSION: In this study, we can highlight that pharmacotherapy review, multiprofessional team interventions and Antimicrobial Stewardship Program that significantly reduced the clinical results of length of hospital stay and hospital readmission, as well as a significant reduction of hospital costs.

The Pharmacoeconomic Impact of Pharmaceutical Care in the Hospital: Protocol for an Overview of Systematic Reviews.

BACKGROUND: The clinical activities developed by pharmacists in a hospital environment can improve health outcomes and generate savings for hospitals. However, to determine whether pharmaceutical interventions are cost effective, it is essential to define a method according to which cost-effectiveness is intended to be measured. In addition, the quality of economic assessments and the amount of information present in systematic reviews in the literature make it difficult to analyze the effects of this intervention. OBJECTIVE: This paper aims to provide an overview of systematic reviews on the pharmacoeconomic impact of the performance of pharmaceutical care in hospitals. METHODS: A systematic search of the Cochrane Library databases, PubMed or MEDLINE, LILACS, Scopus, Web of Science, Google Scholar, and Open Thesis will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search will involve the use of keywords determined using the Medical Subject Headings database to define the search terms and include the following terms: "pharmacoeconomics," "pharmaceutical care," and "hospital." The study designs to be included will be systematic reviews of good quality. Studies will be included that address pharmacoeconomics; studies that evaluated pharmaceutical care in hospitals; and studies published in Portuguese, English, or Spanish. The primary outcome sought in the systematic reviews will be the cost ratio in monetary units and the outcomes in monetary or natural units. The secondary economic outcomes considered will be determined based on factors associated with the drugs and translated into benefit, efficacy, or utility. RESULTS: It is intended to start this overview in January 2023. Thus far, only previous searches have been carried out to contextualize the theme and build the protocol. CONCLUSIONS: This overview will determine the pharmacoeconomic impact of pharmaceutical care interventions in the hospital environment. In addition, this study will point out which clinical outcomes in natural units are impacted by the performance of pharmaceutical care and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work. TRIAL REGISTRATION: PROSPERO CRD42019140665; https://tinyurl.com/bddwnz43.

Understanding the provision of a clinical service in mental health and the role of the pharmacist: a qualitative analysis / Compreendendo a provisão de um serviço clínico na saúde mental e o papel do farmacêutico: uma análise qualitativa / Comprender la prestación de un servicio clínico en salud mental y el papel del farmacéutico: un análisis cualitativo

Pharmacists have important roles in mental health disease; however, their performance in Brazilian Psychosocial Care Centers (CAPS) is unknown. This qualitative study was conducted in a CAPS, Brazil; using interviews and analyzes from the perspective of Bardin, in which categories arising from the perceptions of patients and the health team emerged in relation to the provision of the medication review with follow up (MR) service and the role of the pharmacist in mental health. According to the participants, the MR service is essential and important because it allows professional recognition, beyond the identification of professional attributes of the pharmacists. Moreover, there was a duality in the pharmacist's role between the logistic and clinical attributes of mental health. Thus, this perception helps to elucidate the pharmacist's process of work in mental health and supports future strategies of action in this area. (AU)

Farmacêuticos têm papéis importantes na área da saúde mental; entretanto, sua atuação nos Centros de Atenção Psicossociais (CAPS) brasileiros é desconhecida. Este estudo qualitativo foi realizado em um CAPS, Brasil; utilizando-se de entrevistas e análises sob a perspectiva de Bardin, no qual categorias em relação à prestação do serviço de acompanhamento farmacoterapêutico (AFT) e ao papel do farmacêutico na saúde mental emergiram através das percepções dos pacientes e equipe de saúde. Segundo os participantes, o serviço de AFT é essencial e importante porque permite o reconhecimento profissional, além da identificação dos atributos profissionais dos farmacêuticos. Além disso, houve uma dualidade no papel do farmacêutico em relação aos atributos logísticos e clínicos na saúde mental. Assim, essas percepções ajudam a elucidar o processo de trabalho do farmacêutico em saúde mental, subsidiando futuras estratégias de ação nesta área. (AU)

Los farmacéuticos tienen un papel importante en el área de la salud mental; sin embargo, se desconoce su desempeño en los Centros de Atención Psicosocial de Brasil (CAPS). Este estudio cualitativo se llevó a cabo en un CAPS, Brasil; utilizando entrevistas y análisis desde la perspectiva de Bardin, en las que de las percepciones de los pacientes y del equipo de salud surgieron categorías en relación a la prestación del servicio de seguimento farmacoterapéutico (SFT) y el papel del farmacéutico en la salud mental. Según los participantes, el servicio de SFT es fundamental e importante. Además, existía una dualidad en el rol del farmacéutico en relación a los atributos logísticos y clínicos en salud mental. Así, estas percepciones ayudan a dilucidar el proceso de trabajo del farmacéutico en salud mental, apoyando futuras estrategias de actuación. (AU)

Influência da propaganda na utilização de medicamentos em um grupo de idosos atendidos em uma unidade básica de saúde em Aracaju (SE, Brasil) / The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil)

O crescimento da população idosa brasileira tem levado a uma maior tendência ao uso de medicamentos. A sua utilização inadequada pode ser induzida por vários fatores, dentre eles a propaganda, podendo trazer danos à saúde do usuário. O objetivo do estudo foi avaliar a influência da propaganda no consumo de medicamentos por um grupo de idosos atendidos em unidade básica de saúde de Aracaju, Sergipe. No período de abril a junho de 2007, um grupo de 230 idosos, com idade acima de 60 anos, de ambos os gêneros, foi entrevistado. A maioria dos entrevistados (73 por cento) possuía pelo menos uma doença crônica e 73,9 por cento consumiam pelo menos um medicamento regularmente. Do total de entrevistados, 17,8 por cento da amostra relataram utilizar medicamentos por influência da propaganda; 2,2 por cento consideraram que os medicamentos veiculados na mídia nunca fazem mal e 6,5 por cento acreditavam que eles sempre fazem bem. No estudo, correlações foram feitas e demonstraram que quem mais consome medicamentos influenciados pela propaganda também considera que eles sempre fazem bem e vice-versa (p= 0,04). Os dados revelaram que parte dos idosos sofreu influência da propaganda no consumo de medicamentos, não levando em consideração os riscos que estes poderiam causar.

The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73 percent) has at least a chronic health condition and 73.9 percent consumed regularly at least one medication. 17.8 percent of the sample informed to use medication motivated by publicity influence; 2.2 percent had considered that the medication never cause damages and 6.5 percent believed that always it makes well. In this study, correlations have been made and demonstrated that those who presented a higher level of consumption influenced by advertising also think that drugs used are always beneficial and vice versa (p= 0.04). The data showed that part of elderly suffered influence of advertisement to medication use, and are not conscious of risks involved.

Bulas de medicamentos usados por idosos com hipertensão: adequação da informação à regulamentação sanitária e possíveis implicações para a saúde / Medication leaflets used by elderly with hypertension: adequacy of information for sanitary regulation and possible implications for health

As bulas representam a principal fonte de informação escrita fornecida aos pacientes, especialmente aos idosos. O presente trabalho visou analisar o conteúdo das bulas dos medicamentos frequentemente prescritos para idosos com hipertensão, bem como a sua adequação à regulamentação sanitária e possíveis implicações para a saúde. Foi realizado um estudo descritivo em duas etapas: etapa A, em julho de 2002, e B em julho de 2007. Em cada etapa foram analisadas 34 bulas de sete fármacos anti-hipertensivos que constam na Relação Nacional de Medicamentos Essenciais (2006). Entre as 68 bulas analisadas, a maioria não continha todas as informações exigidas pela Portaria n° 110/1997 na etapa A (89,5 por cento) e pela RDC n°140/2003 na B (100 por cento). Alguns itens importantes como via de administração, modo de uso e superdose não constavam em 76 por cento das bulas analisadas. A falta dessas informações é relevante para a segurança dos pacientes. Com base nos dados obtidos, foi possível constatar o não cumprimento da legislação vigente nas duas etapas do estudo. Logo, é necessária maior atuação da Anvisa para assegurar o uso racional dos medicamentos e a redução dos riscos à saúde dos idosos.

The medication leaflets represent the main source of written information supplied to the patients, in special to the elderly. This study aimed to analyze the content of the leaflets of drugs often prescribed for elderly people with hypertension, as well as their adequacy to the sanitary regulations and possible health implications. A descriptive study was conducted in two stages: A, in July 2002, and B, in July 2007. In each stage were analyzed 34 medication leaflets of seven antihypertensive drugs of the National Essential Drugs List (2006). Among the 68 leaflets analyzed, most did not contain all the information required by Portaria nº 110/1997 (89.5 percent) in the stage A and the RDC nº 140/2003 (100 percent) in B. In 100 percent of the leaflets, the legislation had not been fulfilled. Some important topics as way of administration, how to use and overdose had been absent in 76 percent of the leaflets, the lack of this information has an impact in the security of the antihypertensive users. Based on these data, it was possible to evidence inadequate contents of the medication leaflets. So, it is necessary greater surveillance by Anvisa, to ensure the rational use of medicines and the reduction of the risks to the elderly health.

A farmacoterapia no idoso: revisão sobre a abordagem multiprofissional no controle da hipertensão arterial sistêmica / Pharmacotherapy in the elderly: a review about the multidisciplinary team approach in systemic arterial hypertension control

A maior prevalência de doenças crônicas entre os idosos, como a hipertensão arterial sistêmica, implica no crescimento do consumo de medicamentos. Em conseqüência, ocorre o aumento na incidência dos problemas relacionados aos medicamentos (PRM), deixando essa população vulnerável aos vários problemas de saúde. Fundamentados na literatura, destaca-se a abordagem multiprofissional (médico, enfermeiro e farmacêutico) nas atividades ligadas diretamente à farmacoterapia da hipertensão arterial sistêmica, para proporcionar ao idoso a conscientização quanto aos seus cuidados com a saúde, reduzir os PRM e obter a adesão satisfatória.