<div>O objetivo deste trabalho foi caracterizar os pacientes e as reações adversas a medicamentos (RAMs ) notificadas ao Centro de</div><div>Farmacovigilância de um hospital universitário no Brasil. Sabe-se que a taxa de RAM em pacientes hospitalizados é de 10% a</div><div>20% e que a frequência de hospitalização por RAM é de 0,5% a 6,5%. As RAMs contribuem para o aumento do tempo de internação</div><div>e dos custos em saúde. Os pacientes expostos às RAMs têm uma taxa de mortalidade aumentada, embora cerca de 60% a 80%</div><div>sejam passíveis de prevenir. Um estudo descritivo foi conduzido em um hospital universitário do Nordeste do Brasil, onde todas</div><div>as notificações espontâneas foram analisadas durante um período de dois anos. Para o processo de notificação das suspeitas</div><div>de RAM, foi utilizada a definição de reação da OMS. Após o recebimento das notificações, as relações de causalidade das</div><div>suspeitas de RAM, foram analisadas pelos membros do CFV, com o uso de três algoritmos diferentes, e também classificadas de</div><div>acordo com a gravidade e tipo. Setenta e oito suspeitas de RAM foram notificadas espontaneamente. O gênero feminino</div><div>representou 55% dos casos. A raça mulata e a negra representaram 70%. O órgão e sistema mais frequentemente afetado foi</div><div>a pele, tendo os anti-infecciosos e antiparasitários como principais desencadeadores. Na análise da relação causal, as reações</div><div>certas e prováveis representaram cerca de 55%. As RAMs foram moderadas em 41% dos casos, embora mais de 60% fossem</div><div>passíveis de prevenir, portanto evitáveis. As RAMs são um grande problema, e medidas devem ser adotadas para minimizá-las.</div>
The prevalence of ADR admission was similar to those described in the literature and only one patient died. As this is the first national study will form the basis for future investigations.
CONTEXT AND OBJECTIVE: In 2004, the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária, ANVISA) published a resolution establishing guidelines for albumin use. Although the published data do not indicate any definitive conclusions about the benefits of albumin use in patients with nephrotic syndrome (NS), the guidelines recommend this procedure only in cases of edema that is refractory to use of diuretics.The aim here was to analyze albumin use among patients with nephrotic syndrome. DESIGN AND SETTING: Pharmacoeconomic study conducted in four large public referral hospitals for nephrology services in northeastern Brazil. METHOD: Cost-effectiveness and cost-utility economic evaluations were performed on a concurrent cohort of patients with nephrotic syndrome, who were divided into two groups according to compliance or noncompliance with the guidelines. Quality-of-life data were obtained from the SF36 and CHQ-PF50 questionnaires.RESULTS: This study enrolled 109 patients (60% adults and 56% women); 41.3% were using albumin in accordance with the guidelines. The weight, diuresis and fluid balance parameters were more cost-effective for patients who adhered to the guidelines. Regarding days of hospitalization avoided, the incremental ratio showed a daily cost of R$ 55.33, and guideline-compliant patients were hospitalized for five days or fewer. The quality of life improved by 8%, and savings of R$ 3,458.13/QALY (quality-adjusted life year) for the healthcare system were generated through guideline compliance. CONCLUSION:The economic analyses of this study demonstrated that there were greater cost benefits for patients whose treatment followed the guidelines. RESUMO
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