Admission medication reconciliation for patients with kidney disease
Keywords:
Clinical pharmacy, Nephrology, Reconciliation, Hospitalization.Abstract
Introduction: Pharmaceutical interventions (PI) aim to solve problems related to drug therapy and are carried out with the medical team. Objectives: To quantify, evaluate and analyze the outcome of PI performed during the admission conciliation of patients with kidney disease in a high-complexity hospital in southern Brazil. Methods: Data was collected from the AGHUse system on FIs carried out by clinical pharmacists specializing in nephrology for patients admitted between March/2021 and May/2022, except kidney transplant patients. The chi-squared test in Excel was used to assess adherence to FI by mode of communication, considering p<0.05 to be significant. Results and Conclusions: 618 FIs were carried out for 152 patients, resulting in an average of 4.1 FIs per patient. A discrepancy between home therapy and hospitalization prescription was observed in 61% (93) of patients, resulting in 381 FIs for resolution. Medicines for home use were absent from the initial prescription in 90% (84) of patients, with a request for inclusion being the most frequent cause of FI (78.5%, 299). According to the ATC classification, drugs for the digestive system and metabolism (group A) accounted for 26.4% (79) of inclusion FIs, followed by drugs for the blood and hematopoietic organs (group B) with 25.1% (75), the nervous system (group N) with 17.1% (51) and the cardiovascular system (group C) with 14.7% (44). The FI of the other anatomical groups accounted for 16.7% (50). The medical team included the requested medication 55.9% (167) of the time, with 85.3% (255) of the contacts made via the electronic system. FIs carried out in person had greater adherence (p<0.05). There is a significant risk of home medication omission during hospitalization. Interventions by the clinical pharmacist, especially when made in person, increase the chance of resolving these problems in pharmacotherapy. CAAE 02591218.2.0000.5327.
