Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | http://ri.ufs.br/jspui/handle/riufs/17008 |
Resumo: | Introduction: few studies assess the nature and prevalence of drug-related problems (DRPs) in hospitalized pregnant women, as well as studies on the impact of DRPs on hospitalized puerperal women are scarce. Thus, studies in this population may promote patient safety by avoiding undesirable outcomes. Aim of the study: to investigate the impact of DRPs on the length of hospital stay of postpartum women with pre-eclampsia. Methods: a prospective cohort study with postpartum women diagnosed with preeclampsia was carried out to determine the relationship between the manifestation of DRPs and length of hospital stay, followed by a systematic review to determine risk factors for prolonged hospital stay in postpartum women with preeclampsia. Finally, a research letter was developed to discuss the active search for manifested DRPs and medication review in hospitalized patients with preeclampsia. Results and Discussion: 600 women were included in the present study, of these 354 (59%) were exposed to at least one DRP. The most frequent DRPs were non-administration of a medication, non-prescription of a medication. In patients exposed to DRPs, the mean hospital stay was 5.4 (SD 3.6) days versus 4.4 (SD 3.3) days in patients not exposed to DRPs (p = 0.0001). In the systematic review, 1,662 studies were identified in the databases, four of which were included in the final sample. The main risk factors for the increase in length of hospital stay were: presence of ascites (p<0.001), cesarean delivery (p<0.0001), presence of manifested DRPs (p=0.0001), diastolic blood pressure above 10mmHg (p=0.006) and treatment time with MgSO4 equal or greater than 12 hours (0.014). All included studies presented a cohort design, with an overall methodological quality classified as good. To have a significant impact on length of hospital stay, as well as other hospital outcomes, medication review should focus on resolving manifested DRPs. In postpartum women with preeclampsia, this intervention should preferably take place in the first days after delivery. Conclusion: the manifestation of DRPs in postpartum women with preeclampsia significantly increased the length of hospital stay, being a main risk factor for alteration of this important hospital outcome. Medication review is a clinical pharmaceutical service that identifies and resolves these events, and has, therefore, the potential to decisively impact the clinical outcomes related to hospitalized postpartum women with preeclampsia. |
id |
UFS-2_306044beca00172b351a9d771f607748 |
---|---|
oai_identifier_str |
oai:ufs.br:riufs/17008 |
network_acronym_str |
UFS-2 |
network_name_str |
Repositório Institucional da UFS |
repository_id_str |
|
spelling |
Goes, Aline SantanaOliveira Filho, Alfredo Dias de2023-01-24T21:32:20Z2023-01-24T21:32:20Z2022-07-29GOES, Aline Santana. Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia. 2022. 133 f. Tese (Doutorado em Ciências Farmacêuticas) - Universidade Federal de Sergipe, São Cristóvão, 2022.http://ri.ufs.br/jspui/handle/riufs/17008Introduction: few studies assess the nature and prevalence of drug-related problems (DRPs) in hospitalized pregnant women, as well as studies on the impact of DRPs on hospitalized puerperal women are scarce. Thus, studies in this population may promote patient safety by avoiding undesirable outcomes. Aim of the study: to investigate the impact of DRPs on the length of hospital stay of postpartum women with pre-eclampsia. Methods: a prospective cohort study with postpartum women diagnosed with preeclampsia was carried out to determine the relationship between the manifestation of DRPs and length of hospital stay, followed by a systematic review to determine risk factors for prolonged hospital stay in postpartum women with preeclampsia. Finally, a research letter was developed to discuss the active search for manifested DRPs and medication review in hospitalized patients with preeclampsia. Results and Discussion: 600 women were included in the present study, of these 354 (59%) were exposed to at least one DRP. The most frequent DRPs were non-administration of a medication, non-prescription of a medication. In patients exposed to DRPs, the mean hospital stay was 5.4 (SD 3.6) days versus 4.4 (SD 3.3) days in patients not exposed to DRPs (p = 0.0001). In the systematic review, 1,662 studies were identified in the databases, four of which were included in the final sample. The main risk factors for the increase in length of hospital stay were: presence of ascites (p<0.001), cesarean delivery (p<0.0001), presence of manifested DRPs (p=0.0001), diastolic blood pressure above 10mmHg (p=0.006) and treatment time with MgSO4 equal or greater than 12 hours (0.014). All included studies presented a cohort design, with an overall methodological quality classified as good. To have a significant impact on length of hospital stay, as well as other hospital outcomes, medication review should focus on resolving manifested DRPs. In postpartum women with preeclampsia, this intervention should preferably take place in the first days after delivery. Conclusion: the manifestation of DRPs in postpartum women with preeclampsia significantly increased the length of hospital stay, being a main risk factor for alteration of this important hospital outcome. Medication review is a clinical pharmaceutical service that identifies and resolves these events, and has, therefore, the potential to decisively impact the clinical outcomes related to hospitalized postpartum women with preeclampsia.Introdução: Poucos estudos avaliam a natureza e prevalência de problemas farmacoterapêuticos (PFTs) em gestantes internadas, bem como estudos sobre o impacto de PFTs sobre mulheres puérperas hospitalizadas não é observado, estudos dessa natureza podem auxiliar a segurança dessas pacientes evitando desfechos indesejáveis. Objetivo: Investigar o impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia. Metodologia: Foi realizado um estudo de coorte prospectivo com mulheres pós-parto diagnosticadas com pré-eclâmpsia para determinar a relação entre a manifestação de PFTs e o tempo de internação, seguido da realização de uma revisão sistemática para determinar os fatores de risco para prolongamento de internação pós-parto em puérperas com pré-eclâmpsia. Por fim, foi desenvolvida uma research letter para discutir a busca ativa de PFTs manifestados e a revisão da farmacoterapia em pacientes hospitalizadas com PréEclâmpsia. Resultados e Discussão: 600 mulheres foram incluídas, dessas 354 (59%) foram expostas a pelo menos um PFT. Os PFTs mais frequentes foram a não administração de medicamento prescrito, a falta de prescrição de um medicamento, em pacientes expostas a PFTs o tempo médio de internação pós – parto foi de 5,4 (D.P. 3,6) dias versus 4,4 (D.P. 3,3) dias em pacientes não expostas para PFT (p = 0,0001). Na revisão sistemática foram identificados 1662 estudos nas bases de dados dos quais quatro foram incluídos na amostra final. Os principais fatores de risco para o aumento do tempo de internação foram: presença de Ascite (p<0,001), parto cesáreo (p<0,0001), presença de PFTs manifestado (p=0,0001), pressão arterial diastólica acima de 10mmHg (p= 0,006) e duração de tratamento com MgSO4 igual ou maior que 12horas (0,014). Todos os estudos incluídos apresentaram delineamento de coorte, com qualidade metodológica geral considerada boa. Para apresentar impacto significativo sobre o tempo de internação hospitalar, bem como sobre outros desfechos hospitalares, a revisão da farmacoterapia deve ser centrada na resolução de PFTs manifestados. Em puérperas com pré-eclâmpsia, essa intervenção deve ocorrer preferencialmente nos primeiros dias pós-parto. Conclusão: A manifestação de problemas farmacoterapêuticos no período pós-parto de mulheres com pré-eclâmpsia aumenta significativamente o tempo internação hospitalar, estando entre os principais fatores de risco para alteração deste importante indicador. A revisão da farmacoterapia serviço clínico farmacêutico que identifica e resolve estes eventos tem, portanto, o potencial para impactar decisivamente nos desfechos clínicos relacionados a puérperas hospitalizadas com pré-eclâmpsia.São CristóvãoporTratamento farmacológicoPré-eclâmpsiaMulheres grávidasPuerpérioProblemas farmacoterapêuticosFatores de riscoMulheres gestantesMulheres puérperasDrug-related problemsRisk factorsPre-eclampsiaPregnant womenPostpartum womenCIENCIAS BIOLOGICAS::FARMACOLOGIAImpacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsiaImpact of drug-related problems on length of hospital stay of puerperal women with pre-eclampsiainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisPós-Graduação em Ciências FarmacêuticasUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/17008/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALALINE_SANTANA_GOES.pdfALINE_SANTANA_GOES.pdfapplication/pdf1766783https://ri.ufs.br/jspui/bitstream/riufs/17008/2/ALINE_SANTANA_GOES.pdf2a8340f92e451172b2426ba92d6bbf77MD52TEXTALINE_SANTANA_GOES.pdf.txtALINE_SANTANA_GOES.pdf.txtExtracted texttext/plain248331https://ri.ufs.br/jspui/bitstream/riufs/17008/3/ALINE_SANTANA_GOES.pdf.txt63485fabf645bb472a9356ba8322feebMD53THUMBNAILALINE_SANTANA_GOES.pdf.jpgALINE_SANTANA_GOES.pdf.jpgGenerated Thumbnailimage/jpeg1375https://ri.ufs.br/jspui/bitstream/riufs/17008/4/ALINE_SANTANA_GOES.pdf.jpg1359fd0d5427861f152a2a733833ec0aMD54riufs/170082023-01-24 18:32:21.052oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2023-01-24T21:32:21Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia |
dc.title.alternative.eng.fl_str_mv |
Impact of drug-related problems on length of hospital stay of puerperal women with pre-eclampsia |
title |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia |
spellingShingle |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia Goes, Aline Santana Tratamento farmacológico Pré-eclâmpsia Mulheres grávidas Puerpério Problemas farmacoterapêuticos Fatores de risco Mulheres gestantes Mulheres puérperas Drug-related problems Risk factors Pre-eclampsia Pregnant women Postpartum women CIENCIAS BIOLOGICAS::FARMACOLOGIA |
title_short |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia |
title_full |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia |
title_fullStr |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia |
title_full_unstemmed |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia |
title_sort |
Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia |
author |
Goes, Aline Santana |
author_facet |
Goes, Aline Santana |
author_role |
author |
dc.contributor.author.fl_str_mv |
Goes, Aline Santana |
dc.contributor.advisor1.fl_str_mv |
Oliveira Filho, Alfredo Dias de |
contributor_str_mv |
Oliveira Filho, Alfredo Dias de |
dc.subject.por.fl_str_mv |
Tratamento farmacológico Pré-eclâmpsia Mulheres grávidas Puerpério Problemas farmacoterapêuticos Fatores de risco Mulheres gestantes Mulheres puérperas |
topic |
Tratamento farmacológico Pré-eclâmpsia Mulheres grávidas Puerpério Problemas farmacoterapêuticos Fatores de risco Mulheres gestantes Mulheres puérperas Drug-related problems Risk factors Pre-eclampsia Pregnant women Postpartum women CIENCIAS BIOLOGICAS::FARMACOLOGIA |
dc.subject.eng.fl_str_mv |
Drug-related problems Risk factors Pre-eclampsia Pregnant women Postpartum women |
dc.subject.cnpq.fl_str_mv |
CIENCIAS BIOLOGICAS::FARMACOLOGIA |
description |
Introduction: few studies assess the nature and prevalence of drug-related problems (DRPs) in hospitalized pregnant women, as well as studies on the impact of DRPs on hospitalized puerperal women are scarce. Thus, studies in this population may promote patient safety by avoiding undesirable outcomes. Aim of the study: to investigate the impact of DRPs on the length of hospital stay of postpartum women with pre-eclampsia. Methods: a prospective cohort study with postpartum women diagnosed with preeclampsia was carried out to determine the relationship between the manifestation of DRPs and length of hospital stay, followed by a systematic review to determine risk factors for prolonged hospital stay in postpartum women with preeclampsia. Finally, a research letter was developed to discuss the active search for manifested DRPs and medication review in hospitalized patients with preeclampsia. Results and Discussion: 600 women were included in the present study, of these 354 (59%) were exposed to at least one DRP. The most frequent DRPs were non-administration of a medication, non-prescription of a medication. In patients exposed to DRPs, the mean hospital stay was 5.4 (SD 3.6) days versus 4.4 (SD 3.3) days in patients not exposed to DRPs (p = 0.0001). In the systematic review, 1,662 studies were identified in the databases, four of which were included in the final sample. The main risk factors for the increase in length of hospital stay were: presence of ascites (p<0.001), cesarean delivery (p<0.0001), presence of manifested DRPs (p=0.0001), diastolic blood pressure above 10mmHg (p=0.006) and treatment time with MgSO4 equal or greater than 12 hours (0.014). All included studies presented a cohort design, with an overall methodological quality classified as good. To have a significant impact on length of hospital stay, as well as other hospital outcomes, medication review should focus on resolving manifested DRPs. In postpartum women with preeclampsia, this intervention should preferably take place in the first days after delivery. Conclusion: the manifestation of DRPs in postpartum women with preeclampsia significantly increased the length of hospital stay, being a main risk factor for alteration of this important hospital outcome. Medication review is a clinical pharmaceutical service that identifies and resolves these events, and has, therefore, the potential to decisively impact the clinical outcomes related to hospitalized postpartum women with preeclampsia. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022-07-29 |
dc.date.accessioned.fl_str_mv |
2023-01-24T21:32:20Z |
dc.date.available.fl_str_mv |
2023-01-24T21:32:20Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
GOES, Aline Santana. Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia. 2022. 133 f. Tese (Doutorado em Ciências Farmacêuticas) - Universidade Federal de Sergipe, São Cristóvão, 2022. |
dc.identifier.uri.fl_str_mv |
http://ri.ufs.br/jspui/handle/riufs/17008 |
identifier_str_mv |
GOES, Aline Santana. Impacto dos problemas farmacoterapêuticos sobre o tempo de internação hospitalar de pacientes puérperas com pré-eclâmpsia. 2022. 133 f. Tese (Doutorado em Ciências Farmacêuticas) - Universidade Federal de Sergipe, São Cristóvão, 2022. |
url |
http://ri.ufs.br/jspui/handle/riufs/17008 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.program.fl_str_mv |
Pós-Graduação em Ciências Farmacêuticas |
dc.publisher.initials.fl_str_mv |
Universidade Federal de Sergipe |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFS instname:Universidade Federal de Sergipe (UFS) instacron:UFS |
instname_str |
Universidade Federal de Sergipe (UFS) |
instacron_str |
UFS |
institution |
UFS |
reponame_str |
Repositório Institucional da UFS |
collection |
Repositório Institucional da UFS |
bitstream.url.fl_str_mv |
https://ri.ufs.br/jspui/bitstream/riufs/17008/1/license.txt https://ri.ufs.br/jspui/bitstream/riufs/17008/2/ALINE_SANTANA_GOES.pdf https://ri.ufs.br/jspui/bitstream/riufs/17008/3/ALINE_SANTANA_GOES.pdf.txt https://ri.ufs.br/jspui/bitstream/riufs/17008/4/ALINE_SANTANA_GOES.pdf.jpg |
bitstream.checksum.fl_str_mv |
098cbbf65c2c15e1fb2e49c5d306a44c 2a8340f92e451172b2426ba92d6bbf77 63485fabf645bb472a9356ba8322feeb 1359fd0d5427861f152a2a733833ec0a |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS) |
repository.mail.fl_str_mv |
repositorio@academico.ufs.br |
_version_ |
1802110698388455424 |