Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
dARK ID: | ark:/38995/0013000008h86 |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/9876 |
Resumo: | Adverse drug events are damage caused by drugs. Their detection is important to identify risks that affect health system users and to design strategies that improve quality on healthcare. This study aimed to apply different methods of adverse drug event detection in patients admitted to intensive care unit of a public tertiary hospital in the Brazilian Midwest from September 2015 to April 2016. This study was approved by Hospital Alberto Rassi Ethics Committee on Research by report number 1,177,803 and the patients were invited to join voluntarily by signing the Informed Consent Form. In order to achieve the above objectives, this research was conducted in two phases. In the first phase, an analytical, retrospective study compared the use of trigger tool and a non-targeted chart review regarding to adverse drug event detection during hospitalization. Identified events were analyzed by multiprofessional team and classified as their causality, predictability, severity and damage level. In the second phase, this is an analytic, interventional study with purpose of evaluate the impact of medication therapy management on detection of drug-related problems and prevention of adverse drug events. Results found in two phases of this study allowed to recognize that all these tested methods were suitable for the purpose. The search for adverse events performed by trigger tool and a non-targeted chart review allowed identification of similar amounts of events, type of event and related drugs. In both groups the most frequently encountered events were related to metabolic, gastrointestinal, cardiovascular and hematological systems. In this phase, trigger tool application showed to be, among the strategies evaluated, the most convenient. The similar performance to non-targeted chart review supports the use of trigger tool in intensive care units routine, since this method requires less time to retrieve information from medical records. However, the possibility of early identifying a drug-related problem, preventing it from reaching the patient, and the possibility of intervening in non-preventable events, reducing harm, confer an advantage on medication therapy management. The proposed clinical pharmaceutical service allowed the detection of 50 adverse drug events, a low frequency compared to other methodologies. Although, this method was not considered inappropriate for the purpose, since it allowed identification and intervention in 170 other drug-related problems that had potential to cause patient damage. Problems identified at this phase were more often related antibacterials use, caused by improper drug combinations, inadequate dosing, and led to interventions that were accepted by the multiprofessional team, with more than 85% of adherence and total problem solving. These proposed detection methods allowed us to recognize characteristics of adverse drug events occurring in the institution. This information can be used later in order to outline strategies for improvement on healthcare quality. Inserting a clinical pharmacist into the multiprofessional team was a protective factor for critically ill patients, since this professional set up an additional barrier in order to detect and prevent adverse drug events, improving the safety on pharmacotherapy. |
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Lopes, Flavio Marqueshttp://lattes.cnpq.br/5357681644138108Lopes, Flavio MarquesSilva, Ana Elisa Bauer de CamargoDewulf, Nathalie de Lourdes SouzaSantos, Sílvia Helena Rabelo dosPereira, Edna Regina Silvahttp://lattes.cnpq.br/5357681644138108Martins, Renato Rocha2019-08-02T13:28:52Z2016-12-06MARTINS, Renato Rocha. Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira. 2016. 135 f. Dissertação (Mestrado em Assistência e Avaliação em Saúde) - Universidade Federal de Goiás, Goiânia, 2016.http://repositorio.bc.ufg.br/tede/handle/tede/9876ark:/38995/0013000008h86Adverse drug events are damage caused by drugs. Their detection is important to identify risks that affect health system users and to design strategies that improve quality on healthcare. This study aimed to apply different methods of adverse drug event detection in patients admitted to intensive care unit of a public tertiary hospital in the Brazilian Midwest from September 2015 to April 2016. This study was approved by Hospital Alberto Rassi Ethics Committee on Research by report number 1,177,803 and the patients were invited to join voluntarily by signing the Informed Consent Form. In order to achieve the above objectives, this research was conducted in two phases. In the first phase, an analytical, retrospective study compared the use of trigger tool and a non-targeted chart review regarding to adverse drug event detection during hospitalization. Identified events were analyzed by multiprofessional team and classified as their causality, predictability, severity and damage level. In the second phase, this is an analytic, interventional study with purpose of evaluate the impact of medication therapy management on detection of drug-related problems and prevention of adverse drug events. Results found in two phases of this study allowed to recognize that all these tested methods were suitable for the purpose. The search for adverse events performed by trigger tool and a non-targeted chart review allowed identification of similar amounts of events, type of event and related drugs. In both groups the most frequently encountered events were related to metabolic, gastrointestinal, cardiovascular and hematological systems. In this phase, trigger tool application showed to be, among the strategies evaluated, the most convenient. The similar performance to non-targeted chart review supports the use of trigger tool in intensive care units routine, since this method requires less time to retrieve information from medical records. However, the possibility of early identifying a drug-related problem, preventing it from reaching the patient, and the possibility of intervening in non-preventable events, reducing harm, confer an advantage on medication therapy management. The proposed clinical pharmaceutical service allowed the detection of 50 adverse drug events, a low frequency compared to other methodologies. Although, this method was not considered inappropriate for the purpose, since it allowed identification and intervention in 170 other drug-related problems that had potential to cause patient damage. Problems identified at this phase were more often related antibacterials use, caused by improper drug combinations, inadequate dosing, and led to interventions that were accepted by the multiprofessional team, with more than 85% of adherence and total problem solving. These proposed detection methods allowed us to recognize characteristics of adverse drug events occurring in the institution. This information can be used later in order to outline strategies for improvement on healthcare quality. Inserting a clinical pharmacist into the multiprofessional team was a protective factor for critically ill patients, since this professional set up an additional barrier in order to detect and prevent adverse drug events, improving the safety on pharmacotherapy.Eventos adversos a medicamentos são danos provocados pelo uso de fármacos e sua detecção tem importância fundamental para a identificação dos riscos que acometem usuários dos sistemas de saúde e para o delineamento de estratégias que melhorem a qualidade do cuidado. O presente trabalho buscou aplicar diferentes métodos de detecção de eventos adversos a medicamentos em pacientes internados na unidade de terapia intensiva de um hospital público terciário do centro-oeste brasileiro no período de setembro de 2015 a abril de 2016. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Alberto Rassi, pelo parecer número 1.177.803, com os participantes aderindo ao estudo por meio de assinatura de termo de consentimento livre e esclarecido. Para atingir o objetivo acima proposto, este trabalho foi conduzido em duas fases. Na primeira fase, trata-se de um estudo analítico, retrospectivo, que buscou comparar a utilização de trigger tool e a revisão abrangente de prontuário quanto a detecção de eventos adversos a medicamentos ocorridos durante internação. Os eventos detectados foram analisados por equipe multiprofissional e classificados quanto sua causalidade, previsibilidade, gravidade e tipo de dano envolvido. Na segunda fase, trata-se de um estudo analítico, de intervenção, com o intuito de avaliar impacto do acompanhamento farmacoterapêutico na detecção de problemas relacionados a medicamentos e prevenção de eventos adversos a medicamentos. Os resultados encontrados nas duas fases deste trabalho permitiram constatar que todos os métodos testados se adequavam à finalidade proposta. A busca de eventos adversos por meio de trigger tool e de revisão abrangente de prontuário possibilitou a identificação de quantidades semelhantes de eventos, tipo do evento e medicamentos relacionados. Em ambos grupos os eventos mais frequentemente encontrados estavam relacionados aos sistemas metabólico, gastrointestinal, cardiovascular e hematológico. Nesta etapa, a aplicação de trigger tool se mostra, dentre as estratégias avaliadas, a mais oportuna. O desempenho semelhante à revisão abrangente de prontuário favorece a utilização de trigger tool na rotina de unidades de terapia intensiva uma vez que essa metodologia requer menos tempo para resgatar informações dos prontuários. Contudo, a possibilidade de identificar precocemente um problema relacionado a medicamento, evitando que alcance o paciente, e a possibilidade de intervir em eventos não preveníveis reduzindo danos, conferem vantagem à atuação clínica do farmacêutico. O serviço de acompanhamento farmacoterapêutico proposto possibilitou a detecção de 50 eventos adversos a medicamentos, quantidade baixa se comparada a outras metodologias. Contudo este método não se demonstrou inadequado para a finalidade proposta visto que possibilitou a identificação e intervenção em outros 170 problemas relacionados a medicamento que tinham potencial para atingir o paciente causando danos. Os problemas identificados nesta fase estavam mais frequentemente relacionados ao uso de antibacterianos, causados por combinações impróprias e doses inadequadas de medicamentos e que ocasionaram intervenções bem aceitas pela equipe multiprofissional, com adesão e resolução total do problema em mais de 85% dos casos. Os métodos de detecção propostos permitiram conhecer o perfil dos eventos adversos a medicamentos que ocorrem na instituição, provendo informações que podem ser usadas posteriormente para delinear estratégias visando melhoria na qualidado do cuidado. A inserção do farmacêutico clínico na equipe assistencial constituiu um fator de proteção ao paciente crítico, uma vez que a atuação desse profissional configura uma barreira adicional para identificação e prevenção de eventos adversos a medicamentos, melhorando a segurança da farmacoterapia.Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2019-07-29T16:24:40Z No. of bitstreams: 2 Dissertação - Renato Rocha Martins - 2016.pdf: 3358728 bytes, checksum: f2bd2b50b3bef2f2771cb83374934777 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2019-08-02T13:28:52Z (GMT) No. of bitstreams: 2 Dissertação - Renato Rocha Martins - 2016.pdf: 3358728 bytes, checksum: f2bd2b50b3bef2f2771cb83374934777 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2019-08-02T13:28:52Z (GMT). No. of bitstreams: 2 Dissertação - Renato Rocha Martins - 2016.pdf: 3358728 bytes, checksum: f2bd2b50b3bef2f2771cb83374934777 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-12-06application/pdfporUniversidade Federal de GoiásPrograma de Pós-graduação em Assistência e Avaliação em Saúde (FF)UFGBrasilFaculdade Farmácia - FF (RG)http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessSegurança do pacienteEventos Adversos a medicamentosFarmacovigilânciaPatient safetyAdverse drug eventsPharmacovigilanceCIENCIAS DA SAUDE::FARMACIAAplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileiraApplication of different methods for the detection of adverse drug events in a brazilian intensive care unitinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis-2210887856090281960060060060102811615242093756997636413449754996reponame:Repositório Institucional da UFGinstname:Universidade Federal de Goiás (UFG)instacron:UFGLICENSElicense.txtlicense.txttext/plain; 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dc.title.eng.fl_str_mv |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira |
dc.title.alternative.eng.fl_str_mv |
Application of different methods for the detection of adverse drug events in a brazilian intensive care unit |
title |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira |
spellingShingle |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira Martins, Renato Rocha Segurança do paciente Eventos Adversos a medicamentos Farmacovigilância Patient safety Adverse drug events Pharmacovigilance CIENCIAS DA SAUDE::FARMACIA |
title_short |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira |
title_full |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira |
title_fullStr |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira |
title_full_unstemmed |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira |
title_sort |
Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira |
author |
Martins, Renato Rocha |
author_facet |
Martins, Renato Rocha |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Lopes, Flavio Marques |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5357681644138108 |
dc.contributor.referee1.fl_str_mv |
Lopes, Flavio Marques |
dc.contributor.referee2.fl_str_mv |
Silva, Ana Elisa Bauer de Camargo |
dc.contributor.referee3.fl_str_mv |
Dewulf, Nathalie de Lourdes Souza |
dc.contributor.referee4.fl_str_mv |
Santos, Sílvia Helena Rabelo dos |
dc.contributor.referee5.fl_str_mv |
Pereira, Edna Regina Silva |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5357681644138108 |
dc.contributor.author.fl_str_mv |
Martins, Renato Rocha |
contributor_str_mv |
Lopes, Flavio Marques Lopes, Flavio Marques Silva, Ana Elisa Bauer de Camargo Dewulf, Nathalie de Lourdes Souza Santos, Sílvia Helena Rabelo dos Pereira, Edna Regina Silva |
dc.subject.por.fl_str_mv |
Segurança do paciente Eventos Adversos a medicamentos Farmacovigilância |
topic |
Segurança do paciente Eventos Adversos a medicamentos Farmacovigilância Patient safety Adverse drug events Pharmacovigilance CIENCIAS DA SAUDE::FARMACIA |
dc.subject.eng.fl_str_mv |
Patient safety Adverse drug events Pharmacovigilance |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::FARMACIA |
description |
Adverse drug events are damage caused by drugs. Their detection is important to identify risks that affect health system users and to design strategies that improve quality on healthcare. This study aimed to apply different methods of adverse drug event detection in patients admitted to intensive care unit of a public tertiary hospital in the Brazilian Midwest from September 2015 to April 2016. This study was approved by Hospital Alberto Rassi Ethics Committee on Research by report number 1,177,803 and the patients were invited to join voluntarily by signing the Informed Consent Form. In order to achieve the above objectives, this research was conducted in two phases. In the first phase, an analytical, retrospective study compared the use of trigger tool and a non-targeted chart review regarding to adverse drug event detection during hospitalization. Identified events were analyzed by multiprofessional team and classified as their causality, predictability, severity and damage level. In the second phase, this is an analytic, interventional study with purpose of evaluate the impact of medication therapy management on detection of drug-related problems and prevention of adverse drug events. Results found in two phases of this study allowed to recognize that all these tested methods were suitable for the purpose. The search for adverse events performed by trigger tool and a non-targeted chart review allowed identification of similar amounts of events, type of event and related drugs. In both groups the most frequently encountered events were related to metabolic, gastrointestinal, cardiovascular and hematological systems. In this phase, trigger tool application showed to be, among the strategies evaluated, the most convenient. The similar performance to non-targeted chart review supports the use of trigger tool in intensive care units routine, since this method requires less time to retrieve information from medical records. However, the possibility of early identifying a drug-related problem, preventing it from reaching the patient, and the possibility of intervening in non-preventable events, reducing harm, confer an advantage on medication therapy management. The proposed clinical pharmaceutical service allowed the detection of 50 adverse drug events, a low frequency compared to other methodologies. Although, this method was not considered inappropriate for the purpose, since it allowed identification and intervention in 170 other drug-related problems that had potential to cause patient damage. Problems identified at this phase were more often related antibacterials use, caused by improper drug combinations, inadequate dosing, and led to interventions that were accepted by the multiprofessional team, with more than 85% of adherence and total problem solving. These proposed detection methods allowed us to recognize characteristics of adverse drug events occurring in the institution. This information can be used later in order to outline strategies for improvement on healthcare quality. Inserting a clinical pharmacist into the multiprofessional team was a protective factor for critically ill patients, since this professional set up an additional barrier in order to detect and prevent adverse drug events, improving the safety on pharmacotherapy. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016-12-06 |
dc.date.accessioned.fl_str_mv |
2019-08-02T13:28:52Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
MARTINS, Renato Rocha. Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira. 2016. 135 f. Dissertação (Mestrado em Assistência e Avaliação em Saúde) - Universidade Federal de Goiás, Goiânia, 2016. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/9876 |
dc.identifier.dark.fl_str_mv |
ark:/38995/0013000008h86 |
identifier_str_mv |
MARTINS, Renato Rocha. Aplicação de diferentes métodos para detecção de eventos adversos a medicamentos em uma unidade de terapia intensiva brasileira. 2016. 135 f. Dissertação (Mestrado em Assistência e Avaliação em Saúde) - Universidade Federal de Goiás, Goiânia, 2016. ark:/38995/0013000008h86 |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/9876 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.program.fl_str_mv |
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