RESUMO
Fundamento y objetivo: Evaluar la efectividad de un programa de conciliación perioperatoria de la medicación en pacientes de cirugía programada sobre el cumplimiento de los Protocolos de manejo de la medicación en el período perioperatorio. Material y método: Se trata de un estudio ambispectivo, que compara los resultados de cumplimiento de los Protocolos de manejo perioperatorio de la medicación para cada medicamento de uso habitual del paciente, entre una cohorte histórica previa a la implantación del Programa de conciliación y una cohorte posterior a la implantación del mismo. El Programa de conciliación perioperatoria de la medicación consiste en una propuesta de Farmacia 48h antes del ingreso sobre prescripción de medicación habitual (MH) que debe mantenerse/suspenderse durante el período perioperatorio con validación posterior por Anestesiología 24h antes del ingreso. En el momento en que el paciente ingresa, previa verificación con él de la MH que realmente toma, se le administra la medicación programada en el preoperatorio y el postoperatorio de acuerdo con los Protocolos. El indicador para la evaluación de la intervención fue el grado de cumplimiento de los Protocolos de manejo perioperatorio de la medicación a las 24, 48 y 72h de ingreso en los grupos intervención y control. Resultados: Se incluyeron 503 pacientes. En el Grupo A se realizaron propuestas de tratamiento relacionadas con 1.211 medicamentos; la actuación en el 94,9% de los casos coincidió con el Protocolo, mientras que en el Grupo B (previo a la implantación del Programa) solo el 32,4% de las actuaciones coincidían con la recomendación del Protocolo (p<0,001). Conclusiones: El Programa de conciliación aumenta de forma significativa el cumplimiento de las recomendaciones sobre utilización perioperatoria de la medicación crónica(AU)
Background and objective: Evaluation of the effectiveness of a perioperative medication reconciliation program in patients scheduled for elective surgery on perioperative medication management protocol adherence. Material and methods: Ambispective cross-cohort study: prospective cohort (Group A), and retrospective control cohort (Group B) without intervention. Forty eight hours before admission a pharmacist generates a proposal on medication active prior to admission to be maintained/discontinued during the perioperative period according to the hospital protocols. The Pharmacy proposal is validated/modified by an anesthesiologist 24h before admission. At the time of admission, after checking with the patient the medication list, the nurse initiates scheduled medication administration pre and postoperatively. The indicator for program effectiveness assessment is the degree of compliance with perioperative medication management protocols at 24, 48 and 72h of admission for intervention and control cohorts. Results: Five hundred and three patients were included. One thousand two hundred and eleven pharmacy medication management recommendations were performed in Group A (intervention), of which 94.9% agreed with protocol. In Group B (control before program implementation) action taken by physicians agreed with protocol only in 32.4% of all cases. Conclusions: The medication reconciliation program significantly increased compliance with the recommendations on chronic medication perioperative management(AU)
Assuntos
Humanos , Reconciliação de Medicamentos/métodos , Doença Crônica/tratamento farmacológico , Intercambialidade de Medicamentos , /métodos , Período Perioperatório , Avaliação de Eficácia-Efetividade de Intervenções , Erros de Medicação/prevenção & controleRESUMO
BACKGROUND AND OBJECTIVE: Evaluation of the effectiveness of a perioperative medication reconciliation program in patients scheduled for elective surgery on perioperative medication management protocol adherence. MATERIAL AND METHODS: Ambispective cross-cohort study: prospective cohort (Group A), and retrospective control cohort (Group B) without intervention. Forty eight hours before admission a pharmacist generates a proposal on medication active prior to admission to be maintained/discontinued during the perioperative period according to the hospital protocols. The Pharmacy proposal is validated/modified by an anesthesiologist 24h before admission. At the time of admission, after checking with the patient the medication list, the nurse initiates scheduled medication administration pre and postoperatively. The indicator for program effectiveness assessment is the degree of compliance with perioperative medication management protocols at 24, 48 and 72h of admission for intervention and control cohorts. RESULTS: Five hundred and three patients were included. One thousand two hundred and eleven pharmacy medication management recommendations were performed in Group A (intervention), of which 94.9% agreed with protocol. In Group B (control before program implementation) action taken by physicians agreed with protocol only in 32.4% of all cases. CONCLUSIONS: The medication reconciliation program significantly increased compliance with the recommendations on chronic medication perioperative management.
