Influência das discrepâncias medicamentosas não intencionais sobre desfechos clínicos, econômicos e humanísticos em pacientes adultos hospitalizados

Abstract

Introduction: Unintentional medication discrepancies are among the most important events in patient safety, leading to the development of medication reconciliation services, however the impact of discrepancies on clinical, economic and humanistic outcomes is still poorly understood. Objective: To evaluate the influence of unintentional medication discrepancies on clinical, economic and humanistic outcomes in adult hospitalized patients. Method: It was performed a systematic review of studies that verified the association between unintentional discrepancies and clinical, economic or humanistic outcomes published until May 2021, identified from a search in PubMed/Medline, Scopus, Embase, LILACS, Web of Science, Cochrane Library and CINAHL databases. The search strategy involved words including the terms MESH - Medication Reconciliation, Patient Admission, Patient Transfer, Patient Discharge and non-MESH Mortality, Drug Costs and Quality of life. Results: Around 6600 articles were identified, of which 53 studies were selected for full text reading. At the end of the selection process, four studies were included in this review. Although unintentional medication discrepancies can cause adverse drug events and, consequently, harm to patients, the studies included in the final sample did not observe an association of such discrepancies with clinical outcomes such as: hospital readmission, length of stay and mortality. The methodological quality of most studies was considered satisfactory. Conclusion: Scientific literature indicates that, so far, unintentional medication discrepancies do not significantly affect health outcomes. Given the small number of studies and the use of few outcomes, especially those related to economic and humanistic components – there is a need to investigate the real impact of discrepancies in additional studies.