Desprescrição e Cuidados Intensivos - Revisão Sistemática

• Autor(a) principal: Ariadne Dourado Barbosa
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/147410
• topic: Ciências médicas e da saúde; Medical and Health sciences

Introduction: deprescription has been widely used in palliative care, terminally ill patients and geriatric medicine in general. However, in the context of the intensive care unit (ICU), there is a great need to understand how to do this efficiently. Currently, there are few bibliographic references that support its promotion on a larger scale. The study aims to evaluate the amount of deprescription evidenced, what its common points are and what difficulties researchers encounter in promoting this practice. Method: Systematic review of studies published until 2022, based on active search in the databases Scopus, PubMed, ISI Web of Science and SciElo, between April and May 2022, using the keywords "deprescription" or "deprescribing" and "intensive care". Studies in palliative care or that addressed the theme end of life or terminality, studies on COVID, in pregnant women or pediatrics were excluded. Results: The research found 124 studies from the credentials exposed above, 75 in Pub Med, 12 on the web of science, 37 in Scopus, 0 in SciElo. After selecting 13 studies, excluding 7 by duplicity and including 2 from the references of the analyzed studies, 8 publications were analyzed. Among them, 4 refer to the management of acid suppressants in the prophylaxis of stress ulcers, two refer to the deprescription for the management of delirium, one refers to the deprescription of anticonvulsants after seizure control and one refers to the deprescription of amiodarone after control of atrial fibrillation. A total of 1,859 patients were analyzed, with an average of 232 patients per study. Conclusion: This review presented a total deprescription rate in the ICU of 23.3% and 34% at hospital discharge. When analyzing the rate of deprescription before and after the implementation of educational measures and electronic control of the prescription, it is noticed that it increased from 20.4% in the pre-intervention phases to 24.9% after the intervention. These figures are similar to those found when we evaluate deprescription outside the scope of intensive care. However, even though it is expressive, there is the possibility of improving this value after the expansion of knowledge about deprescription and the understanding that its practice should include all professionals related to patient care. Key words: deprescription, deprescribing, intensive care