| Popis: |
Stroke affects millions of people worldwide each year. There are some types of stroke like ischemic stroke, when stroke patients need secondary prevention of new events. One of the options of a secondary prevention is through the use of oral anticoagulants such as dabigatran, rivaroxaban (direct oral anticoagulants - DOACS) and warfarin; however, the home use of such drugs is a matter of concern due to the risks of Adverse Drug Reaction (ADR) related to poor adherence to drug treatment, in addition to the difficulty of access to the drug by the population. Objective: To provide access to medication, monitor possible ADRs, and also to reduce patient dropout, and increase patient compliance. Methods: The Neurologist fills out the DOACS documents to be picked up at the State Citizen Pharmacy or prescribes warfarin. While still hospitalized, the patient receives pharmaceutical orientation, dispensation of the DOACS for 30 days of use and the date of the next laboratory test, requested every 6 months, or monthly for warfarin. The evaluation of the results and the orientation is done by the Neurologist. Faced with possible questions that arose, patient evasion reached 60% in one year. The Clinical Pharmacy team was inserted in the outpatient clinic, with the following flow: the patient does TAP/INR or creatinine and the result is evaluated by Neurology. Prescriptions and medical reports are forwarded to the Clinical Pharmacy, which delivers to the patients in the pharmaceutical consultation; at this moment, adherence to drug treatment and ADR monitoring are evaluated. Results: From March/2019 to August/2020, 1,892 consultations were scheduled, being 946 pharmaceutical consultations, with 805 face-to-face visits (85% adherence). Regarding the users’ profile: 8 rivaroxaban (4%), 58 warfarin (26%) and 156 dabigatran (70%). Conclusion: Multiprofessional outpatient care with clinical pharmacy consultation contributed to reduce patient dropout, provided access to medication, monitored ADRs, ensuring patient safety when using oral anticoagulants in SUS. |
