Analysis of potential drug interactions in the medication reconciliation process in an oncology hospital
Article Sidebar
Main Article Content
Abstract
Objective: To identify and analyze potential drug interactions involving reconciled medications in hospitalized cancer patients. Methods: This is a descriptive, quantitative and retrospective study carried out in an oncology reference hospital in the State of Rio de Janeiro, belonging to the Unified Health System (SUS). Results: During the study period, 516 patients were admitted to the hospital, and 224 were interviewed by the team of medication reconciliation, of which 188 patients were included in the study. The main comorbidity present in these patients was systemic arterial hypertension, followed by diabetes, nephropathy, thrombosis, heart disease, and hypothyroidism. During medication reconciliation, 112 medications were informed by patients as their usual use before hospitalization. The most prevalent were antihypertensive, hypoglycemic, antihypercholesterolemic, and antiulcer drugs. Around 109 patients had at least one potential drug interaction (57.98%), totaling 112 potential drug interactions, classified as major (47.32%) and moderate (52.68%). Conclusion: Medication reconciliation is a valuable tool for identifying and preventing drug interactions and early detection of other medication errors. The joint action of clinical pharmacists and oncologists makes it possible to avoid drug-related problems and improve the care provided to these patients.
Article Details
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
References
2. ANVISA. Agência Nacional de Vigilância Sanitária (Brasil). Resolução da Diretoria Colegiada nº 220, de 21 de setembro de 2004. Aprova o regulamento técnico de funcionamento de Serviços de Terapia Antineoplásica. Diário Oficial da União. 23 setembro 2004.
3. BADIN RC, et al. Pharmacological profile and potential drug interactions in ovarian cancer hospitalized patients. Journal of Oncology Pharmacy Practice, 2022; 10781552221091298.
4. BELDA-RUSTARAZO S, et al. Medication reconciliation at admission and discharge: an analysis of prevalence and associated risk factors. In J Clin Pract., 2015; 69(11): 1268-1274.
5. BRASIL. Ministério da Saúde. Institui o Programa Nacional de Segurança do Paciente (PNSP). Diário Oficial [República Federativa do Brasil], Portaria nº 529, 1 de abril de 2013.
6. BERARDINELLI MBM, et al. Potenciais repercussões clínicas decorrentes de interações medicamentosas em terapia intensiva. Enfermagem em Foco, 2020; 11(2).
7. CÂNDIDO SHS, et al. Retrato do uso de carbapenêmicos em um hospital pertencente ao sistema único de saúde. Research, Society and Development, 2022; 11(9): e16811931647.
8. CARIBÉ RA, et al. Potenciales interacciones medicamentosas en pacientes con sepsis internados en la unidad de terapia intensiva. Farmacia hospitalaria, 2013; 37(5): 383-387.
9. CONSELHO FEDERAL DE FARMÁCIA (CFF). Farmácia Hospitalar: coletâneas de práticas e conceitos. Brasília, Conselho Federal de Farmácia, 2017. 1ª reimpressão. 207p.
10. CRONIN-FENTON DP, et al. Hospitalisation for venous thromboembolism in cancer patients and the general population: a population-based cohort study in Denmark, 1997–2006. British journal of cancer, 2010; 103(7): 947-953.
11. DA SILVA GGS, et al. Importância do farmacêutico clínico na diminuição das interações medicamentosas ao paciente oncológico na unidade de terapia intensiva. Brazilian Journal of health Review, 2020; 3(5): 15542-15556.
12. DA SILVA TB, et al. Conciliação medicamentosa em uma unidade de internação de hospital público do Sul do Brasil. Infarma-Ciências Farmacêuticas, 2021; 33(2): 158-166.
13. DE CASTRO BRITO TC, et al. Conciliação de medicamentos na admissão hospitalar para a segurança do paciente: uma revisão Reconciliation of medications at hospital admission for patient safety. Brazilian Journal of Health Review, 2022; 5(1): 1228-1243.
14. ELBEDDINI A, et al. Importance of medication reconciliation in cancer patients. Journal of Pharmaceutical Policy and Practice, 2021; 14(1): 1-10.
15. FERNANDES MCP, et al. Conciliação Medicamentosa em Cuidados Paliativos Oncológicos. Revista Brasileira De Cancerologia, 2021; 67(4): e–031360.
16. FILHO FR, et al. Evaluation of a drug reconciliation service in private hospital in Fortaleza-CE: quality indicators. Rev Bras Farm Hosp Serv Saude, 2021; 12(1): 0556.
17. FRIZON F, et al. Reconciliação de medicamentos em hospital universitário [Medication reconciliation at a university hospital]. Revista enfermagem UERJ, 2014; 22(4): 454-460.
18. HERLEDAN C, et al. Clinical and economic impact of medication reconciliation in cancer patients: a systematic review. Supportive Care in Cancer, 2020; 28: 3557-3569.
19. INSTITUTO NACIONAL DE CÂNCER. Estimativa 2023: incidência de câncer no Brasil / Instituto Nacional de Câncer. – Rio de Janeiro: INCA, 2022.
20. KANE-GILL S, et al. Adverse-drug-event rates for high-cost and high-use drugs in the intensive care unit. American journal of health-system pharmacy, 2006; 63(19): 1876-1881.
21. MAIA APA e FREITAS LT. Hipertensão arterial e possíveis interações medicamentosas: Um olhar atento do farmacêutico no cuidado ao idoso. Brazilian Journal of Development, 2021; 7(5): 48245-48255.
22. MICROMEDEX, Soluções IBM. Disponível em: https://www.ibm.com/br-pt/watson-health/about/micromedex. Acessado em: 5 de maio de 2022.
23. MOSARLA RC, et al. Anticoagulation strategies in patients with cancer: JACC review topic of the week. Journal of the American College of Cardiology, 2019; 73(11): 1336-1349.
24. MUELLER SK, et al. Hospital-based Medication Reconciliation Practices: A Systematic Review. Arch Intern Med, 2012; 172(14): 1057 – 69.
25. OLIVEIRA MBM, et al. Interações medicamentosas potenciais em prescrições de pacientes internados em unidade de terapia intensiva. Brazilian Journal of Development, 2023; 9(1): 4912–4929.
26. ORGANIZAÇÃO MUNDIAL DA SAÚDE (OMS). The High 5s Project: Standard Operating Protocol. Genebra: WHO, 2014.
27. REINERT CA, et al. Drug interactions between antineoplastic and antidepressant agents: analysis of patients seen at an oncology clinic at a general hospital. Trends in Psychiatry and Psychotherapy, 2015; 37(2): 87-93.
28. REIS WCT, et al. Análise das intervenções de farmacêuticos clínicos em um hospital de ensino terciário do Brasil. Einstein (São Paulo), 2013; 11: 190-196.
29. ROBLEK T, et al. Drug-drug interaction software in clinical practice: a systematic review. Eur J Clin Pharmacol., 2015; 7: 131–142.
30. RODRIGUES FM, et al. Reconciliação de medicamentos e potencial de dano dos erros de medicação na admissão hospitalar de pacientes pediátricos. Revista Contexto & Saúde, 2023; 23(47): e13327.
31. SIMAN AG, et al. Practice challenges in patient safety. Revista Brasileira de Enfermagem, 2019; 72: 1504-1511.
32. SOARES RG, et al. Interações medicamentosas potenciais em prescrições de medicamentos na emergência de um hospital público: Potential drug interactions in drug prescriptions in public hospital emergency. Revista Científica Eletrônica do Conselho Regional de Farmácia da Bahia, 2022; 1(1): e01012204.
33. SUBRAMANIAN A, et al. Study of drug–Drug interactions among the hypertensive patients in a tertiary care teaching hospital. Perspect Clin Res., 2018; 9(1): 9–14.
34. TALEBIA MM, et al. Medication Interaction and Physiciansꞌ Compliance Assessment through Medication Reconciliation Forms in a University Affiliated Hospital. Iranian Journal of Pharmaceutical Research, 2018; 17: 159-167.
35. VOLPATO DC, et al. Idade e polifarmácia como fatores de risco para potenciais interações de drogas psicotrópicos via CYP450. Revista Contexto & Saúde, 2022; 22(46): e9543-e9543.