Clinical pharmacy in hospital palliative medicine: non-randomised clinical trial.

Autor:	Cavalcante-Santos LM; Department of Pharmaceutical Sciences, Pharmaceutical Care and Clinical Pharmacy Research Center, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil., Guarnieri AC; Department of Pharmaceutical Sciences, Pharmaceutical Care and Clinical Pharmacy Research Center, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil., Conegundes FSL; Department of Pharmaceutical Sciences, Pharmaceutical Care and Clinical Pharmacy Research Center, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil., Giardini MH; Ribeirão Preto State Hospital, Ribeirão Preto, São Paulo, Brazil., Pereira LRL; Department of Pharmaceutical Sciences, Pharmaceutical Care and Clinical Pharmacy Research Center, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil., Varallo FR; Department of Pharmaceutical Sciences, Pharmaceutical Care and Clinical Pharmacy Research Center, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil frvarallo@fcfrp.usp.br.
Jazyk:	angličtina
Zdroj:	BMJ supportive & palliative care [BMJ Support Palliat Care] 2023 Dec 21. Date of Electronic Publication: 2023 Dec 21.
DOI:	10.1136/spcare-2023-004620
Abstrakt:	Objective: To assess the impact of pharmaceutical care on hospital indicators and clinical outcomes of palliative care (PC) patients admitted to a secondary hospital. Methods: A non-randomised clinical trial was carried out in the PC ward of a secondary hospital in São Paulo, Brazil. Pharmaceutical care for all patients aged 18 and above, admitted between October 2021 and March 2022, with stays exceeding 48 hours, was provided. The interventions required were performed in collaboration with healthcare teams, patients and caregivers. Assessments occurred at admission and discharge, using PC performance scales and pharmacotherapy tools, with Research Ethics Committee approval. Results: Over 6 months, 120 hospitalisations were analysed, primarily involving women (58.9%), averaging 71.0 years, with neoplasm diagnoses (20.5%). A total of 170 drug-related problems were identified in 68.3% of patients. Following assessment, 361 interventions were performed, with a 78.1% acceptance rate, including medication dose adjustments, additions and discontinuations. Addressing unintentional pharmacotherapy discrepancies at admission led to reduced hospital stays (p<0.05). Pharmaceutical interventions also decreased pharmacotherapy complexity (p<0.001), inappropriate medications for the older people (p<0.001) and improved symptom management, such as pain (p<0.05). Conclusions: Pharmaceutical care services integrated within the multiprofessional health team contributed to reducing drug-related problems associated with polypharmacy as well as improved the management PC symptoms in end-of-life patients, which reduced hospitalisation time. Competing Interests: Competing interests: The authors have no relevant financial or non-financial interests to disclose. This work was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) (Grant number 88887.483243/2020-00). Author LMC-S has received research support from CAPES. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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