This review aims to determine the prevalence of clinically manifested drug-drug interactions (DDIs) in hospitalized patients. Methods PubMed, Scopus, Embase, Web of Science, and Lilacs databases were used to identify articles published before June 2019 that met specific inclusion criteria. The search strategy was developed using both controlled and uncontrolled vocabulary related to the following domains: "drug interactions," "clinically relevant," and "hospital." In this review, we discuss original observational studies that detected DDIs in the hospital setting, studies that provided enough data to allow us to calculate the prevalence of clinically manifested DDIs, and studies that described the drugs prescribed or provided DDI adverse reaction reports, published in either English, Portuguese, or Spanish. Results From the initial 5,999 articles identified, 10 met the inclusion criteria. The pooled prevalence of clinically manifested DDIs was 9.2% (CI 95% 4.0-19.7). The mean number of medications per patient reported in six studies ranged from 4.0 to 9.0, with an overall average of 5.47 ± 1.77 drugs per patient. The quality of the included studies was moderate. The main methods used to identify clinically manifested DDIs were evaluating medical records and ward visits (n = 7). Micromedex® (27.7%) and Lexi-Comp® (27.7%) online reference databases were commonly used to detect DDIs and none of the studies evaluated used more than one database for this purpose.

Chest radiography is a safe and useful as a diagnostic tool of LVH in CKD patients on HD.

SUMMARYWhat is known: Documentation is a process indicator utilized to evaluate quality clinical pharmacist services. In this framework, documentation of dispensing, besides supporting patient care, allows evaluation of the impact of counselling. Objective: To identify and assess studies of documentation by pharmacists in the dispensing process. Method: A systematic review was carried out according to the following steps: (i) identification of studies in the following databases: PubMed/Medline, Web of Science, Scopus and Lilacs, using the descriptors 'counselling', 'dispensing', 'community pharmacy services', 'pharmacies' and 'pharmacists' in different combinations; (ii) evaluation of studies, in which the title, abstract and full text of the studies, and the evaluation of the methodological quality of the selected studies were analysed. Results: In total, 26 articles met the specific criteria. Few studies addressed documentation as part of the dispensing working process (3), and 16 articles reported documentation using nonelectronic systems. The main variables documented were patient information, drug therapy problems and clinical interventions. Furthermore, 20 studies showed the effects of documentation in the dispensing process and 23 studies included statistical evidence. Eight articles met between 42% and 75% of the 28 items recommended by the STROBE initiative, and two articles met approximately 60% of the 36 items recommended by the CONSORT initiative.

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Objective The aim of the study was to determine the prevalence and main types of harm caused by high-alert medication after medication errors (MEs) in hospitals. Method A literature systematic review was conducted on PubMed, Scopus, Web of Science, and Lilacs. Eligible studies published until June 2017 were included. Result Of 6244 studies identified through searching four electronic databases, five studies meeting the selection criteria of this study were analyzed. There was wide variation in the overall prevalence of harm due to MEs involving HAM, from 3.8% to 100%, whereas the pooled prevalence was 16.3%. Overall, 0.01% of harm caused by MEs involving HAM resulted in death. The severity of errors ranged from 0.1% to 19.2% for moderate errors, 0.2% to 15.4% for serious errors, and 1.9% lethal to the patients. The highest prevalences of harm occurred after errors involving potassium chloride 15%, insulin, and epoprostenol. The lowest prevalence of harm was related to errors of anticoagulants administration. The methodological heterogeneity limited direct comparisons among the studies. Conclusions Of the 15 drugs on the list of Institute for Safe Medication Practices HAMs in the United States and Brazil, nine did not present scientific evidence of the potential for harm. In general, few studies, characterized by methodological and conceptual heterogeneity, were performed to determine the harm prevalence resulting from errors involving these drugs.

Resistant Hypertension manifests when blood pressure (BP) remains above the recommended levels, despite regular use of three classes of antihypertensive drugs, including diuretics. This study aimed to identify resistant hypertension and pseudo-resistant hypertension in patients enrolled in a Family Health Unit. It was a cross-sectional study in hypertensive patients using antihypertensive medications seen at Basic Health Unit (BHU), located in the city of Maceio, through interviews with a structured questionnaire during home visits, as well as searching information from patients medical records at BHU. Patients were monitored for three consecutive weeks. The adherence was determined by applying the Morisky Adherence Scale Therapeutics eight items (MMAS-8). The antihypertensive drug therapy was evaluated according to the Brazilian Guidelines on Hypertension. Fifty 50 patients were investigated, with mean age of 66.4 years (SD = 13.5). Most hypertensive patients studied were female (74%). Among the patients, 39 were classified as pseudo-resistant hypertension (78%), and 28 patients used antihypertensive regimens are considered inappropriate and 11 were non-adherent to treatment. In this study, 8% of hypertensive patients were diagnosed with resistant hypertension. Regarding SBP and DBP, gender, smoking habits and physical activity were not influencing factors. On the other hand, the proper prescription was correlated with the control of SBP, but not with the DBP control. The degree of adherence influenced both SBP and DBP. It was also observed the influence of subtype of hypertension on the SBP and DBP.Key Words: medication adherence; hypertension; inappropriate prescribing RESUMO A Hipertensão Resistente (HAR) se manifesta quando os valores de pressão arterial (PA) permanecem acima da meta, apesar do uso regular de três classes de fármacos anti-hipertensivos, incluindo um diurético. Este estudo teve como objetivo identificar a HAR e a hipertensão pseudo-resistente em pacientes atendidos em uma Unidade de Saúde da Família. Foi realizado um estudo transversal com pacientes hipertensos em uso de medicamentos anti-hipertensivos atendidos em uma Unidade Básica de Saúde localizada no município de Maceió, por meio de entrevistas, com aplicação de questionário estruturado durante visitas domiciliares. Os valores de PA dos pacientes foram monitorados durante três semanas consecutivas. A adesão terapêutica foi determinada por meio da aplicação da Escala de Adesão Terapêutica de oito itens de Morisky (MMAS-8). Foram investigados 50 pacientes, com média de idade de 66,4 anos (DP = 13,5), sendo que a maioria dos pacientes era do sexo feminino (74%). Entre os pacientes estudados, 39 foram

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