Pharmaceutical care in transplant patients in a university hospital: pharmaceutical interventions

Abstract

A descriptive and prospective study was conducted on the pharmaceutical care in the post-transplant outpatient clinic of Hospital Universitario Walter Cantidio of Universidade Federal do Ceará (HUWC/UFC), in Fortaleza- Ceará in the period of April to October of 2011. The aim of the present study was to describe the pharmaceutical interventions performed in a Pharmaceutical Care service structured in the liver and kidney transplant outpatient clinic of an academic hospital. The Pharmaceutical interventions (PI) were classified according to Sabater et al.(2005), with significance based on Riba et al.(2000) and the Negative Outcomes associated with Medication (NOM) established at the Third Consensus of Granada. Statistical analyses were performed using the Epi Info v.3.5.1 program and hypothesis tests were done with the SigmaPlot v.10.0 program. A chi-squared (X²) test was utilized for statistical analysis of the sample. A total of 97 patients were followed, where 54 problems related to medications were identified and 139 PI performed. The main PI were in education of the patient about treatment (n=111; 80%) (p<0.05), while the significance of all interventions were appropriate, where 83.4% (n=116) of PI performed in the study period were shown to be "significant" (p<0.05). Through pharmaceutical care, the pharmacist is capable of monitoring the pharmacotherapeutic treatment and intervening when necessary, while being part of the multiprofessional team caring for the transplant patient.

Pharmaceutical recommendations in a university hospital transplant unit

“…Substituição do medicamento 6 (24,0) Dose (adequação) 4 (16,0) transplantados são relatadas na literatura 9,27 . Em muitos centros, os farmacêuticos da equipe do transplante são envolvidos na educação do paciente sobre o seu regime medicamentoso, a fim de conscientizá-lo de que a adesão ao tratamento é essencial para o sucesso pós-transplante e prevenção das readmissões hospitalares 6 .…”

Cultura de segurança no processo de doação de órgãos: revisão de literatura

“…(16,24) The findings enabled the understanding that when greater patient involvement is obtained in the manipulation of medications, a greater level of treatment adherence is achieved, leading to an improvement in the patient's clinical condition, reducing infection rates, re-admission, and graft rejection. (12,(21)(22)(23) Category 2 -Culture of patient safety in the transplant units The category presents questions related to the safety culture of patients undergoing renal, (18,19) hepatic, (11) abdominal, (24) pancreatic, (20) and bone marrow transplantation, (14) in the pre-and intra-operative periods.…”

“…The preparation of islets prior to implantation and the administration of appropriate antibiotics prevent contamination of the patient, promote safety, and decrease possible complications in immunosuppressed patients. (21) Brazil. Level IV evidence A pharmaceutical care service enables monitoring of pharmacotherapeutic treatment and intervention in a manner that provides greater team and patient safety.…”

Percepção dos pacientes transplantados renais sobre a farmacoterapia imunossupressora: perspectivas e dificuldades

“…Um dos aspectos mais relevantes para o sucesso do transplante consiste no fato de o paciente seguir orientações e recomendações da equipe especializada após o procedimento, sobretudo no que se refere ao regime medicamentoso complexo que deverá ser seguido. Para o êxito desse tipo de tratamento, devem ser incluídas também variáveis como as características demográficas, sociais e econômicas, pois tem forte influência para o desfecho clínico após o transplante (MARTINS BCC, et al,2013).…”

“…O tratamento farmacológico, com a associação de imunossupressores e outros fármacos, requer do paciente dedicação, compreensão e capacidade para administração dos mesmos. Assim, a alternativa do transplante deve ser avaliada criteriosamente e individualmente para cada paciente, desenvolvendo critérios e estratégias singulares para pacientes com dificuldades de adesão (CHISHOLM- BURNS MA, et al, 2008;MARTINS BCC, et al, 2013).…”