Reconciliação medicamentosa em pacientes cirúrgicos em um hospital do Estado de Sergipe

Abstract

The medication reconciliation process (RIM) have great impact in preventing adverse events and errors related to drugs and is a formal process of obtaining a complete and accurate listing of household medication that is compared to the hospital prescription list. The discrepancies found during this process can cause harm to patients. This becomes more serious when polymedicated patients, using three or more medications at home, undergo surgical procedure of urgency. OBJECTIVE. Evaluate occurrence of discrepancies in the pharmacotherapy of surgical patients at a hospital in the state of Sergipe. METHODOLOGY. This was an observational study of descriptive exploratory, cross-sectional study between August and November 2014, to assess the occurrence of discrepancies in the pharmacotherapy of patients admitted to the surgical hospital admission. Polymedicated patients were considered those who used three or more drugs. In the initial interview we consider as sources of information the patient himself, the companion, the domestic use of drugs led to hospitalization and consultation of the record. Discrepancies were classified as unintentional variation among the drugs used before admission and the prescribed medication list after surgery may be: failure of drugs, differences in dose, differences in the frequency / schedule of administration, duplicity therapy and interaction between medications. The data were tabulated and analyzed. RESULTS. No período do estudo 422 pacientes foram admitidos no internamento pós-cirúrgico. Desses, 80 (19%) atenderam ao critério de inclusão, composto por 43 (53,8%) mulheres e 37 (46,3%) homens, com média de idade 64,14 anos ± 17,0. O motivo de internação mais prevalente foi amputação de membro inferior ou superior 33 (41,3%); a média de medicamentos do domicílio foi 4,7 ± 1,9. Foi encontrado um total de 444 discrepâncias, com uma média por paciente de 5,5 ± 2,78, as mais prevalentes foram interação, que representou mais da metade de todas as discrepâncias identificadas, 53,4% (n=237) e a omissão que constituiu 25,7% (n=114). Foram realizadas 106 intervenções e apenas n=15 (14,2%) foram aceitas. CONCLUSION. Polymedicated patients undergoing surgery require special care since they are under the care of medical specialists focused on meeting the reason for his hospitalization. The study suggests that the discrepancies found may represent high risk for safety of these patients, a more effective process of identification of home therapy is necessary when the patient is subjected to hospitalization; some comorbidities are related to the large number of medications. Thus, actions to promote patient safety in hospital admission and reduce medication errors should be practiced.