Analysis of the interventions in antineoplastic therapy by a clinical pharmacy service at a tertiary hospital in Brazil

2021 ◽  
pp. 107815522110176
Author(s):  
Camile da Rocha ◽  
Juliane Carlotto ◽  
Jose Zanis Neto
Keyword(s):  
Monoclonal Antibodies ◽  
Antineoplastic Therapy ◽  
Clinical Significance ◽  
Clinical Pharmacy ◽  
Tertiary Hospital ◽  
Clinical Pharmacy Service ◽  
Drug Related Problems ◽  
Lack Of Information ◽  
Clinically Significant ◽  
Pharmaceutical Interventions

Background Medication errors are avoidable occurrences that can assume clinically significant dimensions and impose relevant costs to the health system, especially in the context of antineoplastic therapy. Objective Assess the clinical significance and economic impacts of a clinical pharmaceutical service. This retrospective study consists of an analysis of pharmacy interventions and drug-related problems found in a review of electronic prescriptions referring to antineoplastic therapy of a public teaching tertiary hospital in Brazil. Method Retrospective descriptive study obtained from electronic records of drug-related problems and pharmaceutical interventions related to antineoplastic therapy for oncological and hematological diseases, obtained through the pharmacotherapy review service. The accepted interventions were analyzed for the financial impact generated, evaluating your direct costs. The perception of clinical significance of a random sample of interventions was ascertained by the experts' opinion, using the Delphi method. Results The most frequent problem was a “lack of information to professionals” (25.06%), “problems as to the frequency and interval of doses” (22.90%), and “medication underdosing” (16.20%). Dose adjustment (31.50%) and clarifications (30.90%) were the most frequent pharmaceutical interventions. In the second round of Delphi, experts rated 77.77% of interventions as extremely significant and very significant. The main drugs reported in the interventions were cyclophosphamide, carboplatin, methotrexate, folinic acid, and monoclonal antibodies. The savings amounted to US$1,193,970.18 and involved mainly bortezomib, dactinomycin, and monoclonal antibodies. Conclusion Clinical pharmacy services contributed to the rational use of medicines presenting clinical significance and avoiding waste of financial resources.

Clinical pharmacy service practice in a Chinese tertiary hospital

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Bing Chen ◽  
Jing-Jing Huang ◽  
He-feng Chen ◽  
Bei-ming Xu
Keyword(s):  
Clinical Pharmacy ◽  
Early Stage ◽  
Tertiary Hospital ◽  
Training System ◽  
Pharmacy Service ◽  
Clinical Pharmacy Service ◽  
Therapeutic Drug ◽  
Clinical Pharmacokinetics ◽  
Clinical Pharmacists ◽  
Medication Therapy

AbstractClinical pharmacy service is focused on the rationality and safety of medication therapy. Clinical pharmacists play an important role in designing therapeutic regimen, preventing medication errors, reducing the incidence of adverse drug reaction, and saving medical costs. Although clinical pharmacy service in China is in its early stage, its development is rapid. In this manuscript, the working model of clinical pharmacists in a Chinese tertiary hospital is introduced, including ward rounds, consultation, stewardship of antimicrobial therapy, drug adverse reaction monitoring, therapeutic drug monitoring, clinical pharmacokinetics and pharmacogenetics, and training system. With the efforts of clinical pharmacists, there will be a significant increase in the optimization of medication therapy and a notable reduction in preventable adverse drug events as well as health-care cost in China.

scholarly journals A Cost Effectiveness Comparison of a Pharmacist Using Three Methods for Identifying Possible Drug Related Problems

1975 ◽  
Vol 9 (5) ◽  
pp. 257-262 ◽  
Author(s):  
M. Lawrence Dick ◽  
Henry W. Winship ◽  
George C. Wood
Keyword(s):  
Cost Effectiveness ◽  
Clinical Significance ◽  
Chart Review ◽  
Drug Related Problems ◽  
Productivity Cost ◽  
Drug Profile ◽  
Clinically Significant ◽  
The Cost

A study was carried out to determine the cost effectiveness of a pharmacist in identifying possible drug-related problems (PDRPs) using three methods: Chart reviews, rounding with physicians, and patient drug profiles. The clinical significance of the PDRPs was also determined. The type of drug-related problems being sought and the parameters to determine clinical significance of the PDRPs detected were defined. The patient drug profile system was the most productive and the least expensive method for screening for PDRPs. However, only 14 percent of those detected by this method were clinically significant PDRPs. Over half of the PDRPs identified while rounding with physicians were clinically significant. This method had many advantages the patient drug profile system lacked. The chart review method produced the median of productivity, cost, and significance.

scholarly journals Medication reconciliation in orthopedic and neurological patients in a public hospital

2020 ◽  
Vol 11 (3) ◽  
pp. 354
Author(s):  
Cássia R. EIDELWEIN ◽  
Andréia C. SANCHES ◽  
Luciane F. CALDEIRA
Keyword(s):  
Clinical Pharmacy ◽  
Medication Reconciliation ◽  
Pharmacy Service ◽  
University Hospital ◽  
Clinical Pharmacy Service ◽  
Chi Square ◽  
Cross Sectional ◽  
Neurological Patients ◽  
Chi Square Test ◽  
Pharmaceutical Interventions

Objective: To evaluate the discrepancies found by the clinical pharmacy service during medication reconciliations in patients hospitalized for orthopedics and neurology in a university hospital. Methods: A cross-sectional, descriptive and retrospective study was carried out from January to June 2018 with the patients followed-up by the clinical pharmacy service (orthopedics and neurology). Data was collected through medical charts and pharmacotherapeutic follow-up forms. The differences between the list of medications that the patient was using at home and the prescription from the hospital was classified as a discrepancy (justified or unjustified). Medical acceptance of the pharmaceutical interventions was assessed. The medications involved in the discrepancies were classified according to the ATC classification in its 1st level. Descriptive statistics was performed using the Excel program and Pearson’s chi-square test. Results: Of the 939 medications used by the patients, 673 (71.7%) presented discrepancies and in 371 (55.1%), unjustified discrepancies were found. Of the 507 patients included in the study, 154 (30.4%) presented at least one medication error. In 96.8% of the cases, the pharmaceutical interventions were performed, and acceptability was 30.6%, avoiding 110 errors. Medication omission was the most common type of discrepancy and the medical group most frequently involved was the cardiovascular system. Conclusions: Medication errors in admission to the orthopedics and neurology sectors are frequent, but they can be identified and solved through medication reconciliation, with professional clinical pharmacists able to perform it, collaborating for the safety of the patients.

Impact of clinical pharmacy in oncology and hematology centers: A systematic review

2020 ◽  
pp. 107815522097680
Author(s):  
Cynara S Oliveira ◽  
Mauriele P Silva ◽  
Íngara K S P B Miranda ◽  
Rodrigo T Calumby ◽  
Renata F de Araújo-Calumby
Keyword(s):  
Clinical Pharmacy ◽  
Length Of Hospital Stay ◽  
Specific Area ◽  
Clinical Pharmacy Service ◽  
Chemotherapy Treatment ◽  
Hematological Cancer ◽  
The Impact ◽  
Pharmaceutical Interventions

Background Oncology and hematology is a complex and specific area that requires monitoring by a multidisciplinary team capable of personalizing the treatment of each patient. Clinical pharmacy services have the potential to contribute significantly to the effective and economical care of cancer patients. Objective To evaluate, synthesize and critically present the available evidence on the impact of the Clinical Pharmacy in the treatment of patients with hematological cancer. Method A review was carried out on the bases PubMed/MEDLINE, LILACS and Google Scholar. The included studies were: studies that evaluated the effects of pharmaceutical interventions in clinical in oncology and hematology services and having as a population patient with hematological cancer. Results 17 studies were selected among 745 identified. 4.771 patients were included, with an average follow-up time of 15.3 months. Patients affected by some type of hematological cancer, undergoing chemotherapy treatment, showed better adherence and continuity when accompanied by a clinical pharmacist, added to this professional in carrying out interventions, provides control of symptoms such as cancer pain, nausea and constipation and, thus, contributes to decrease the length of hospital stay. Conclusion The implementation of a Clinical Pharmacy service in oncology and hematology centers contributes significantly to the effectiveness of pharmacotherapeutic treatment, treatment costs reduction, safety increase in the use of medications and the patient’s quality of life.

scholarly journals Tamoxifen treatment adherence assessment by women with breast cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Caroline Oliveira Rangel ◽  
Christiane De Fátima Colet ◽  
Vanessa Adelina Casali Bandeira ◽  
Gabriela Tassotti Gelatti ◽  
Rodrigo Fernando dos Santos Salazar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Antineoplastic Therapy ◽  
Treatment Adherence ◽  
Tamoxifen Treatment ◽  
Control Group ◽  
Drug Related Problems ◽  
Before And After ◽  
Pharmaceutical Interventions

Justification and objectives: oral antineoplastic therapy has advantages compared to other therapies for the treatment of cancer, as it is administered at home, in a simple and fast way. However, this therapy increases patients’ responsibility for their treatment, and compliance is critical to its effectiveness. Few studies are evident regarding pharmacotherapeutic follow-up in oral antineoplastic therapy. In this context, this study seeks to assess adherence to tamoxifen treatment in women with breast cancer, before and after pharmacotherapeutic follow-up. Methods: this is a randomized, quantitative clinical study. Data collection was carried out for six months. Random randomization was divided into a control group and a follow-up group, with the follow-up subdivided into before and after follow-up. The follow-up group received individual pharmaceutical interventions monthly. Adherence was assessed by The Brief Medication Questionnaire, Brazilian version and drug-related problems as to necessity, effectiveness, and safety. Results: after pharmaceutical follow-p, a difference was observed between the follow-up group and the control group regarding physical activity (p=0.043), treatment adherence (p=0.006), reduction of side effects (p=0.003) and associated diseases (p=0.002). The most frequent drug-related problems were safety and adherence, for which 54 pharmaceutical interventions were performed. The side effects described by patients mainly affected the genital system and gastrointestinal tract. Conclusion: it was evident that pharmacotherapeutic follow-up effectively contributed to adherence to treatment with tamoxifen and the pharmaceutical interventions performed contributed to prevention and reduction of drug-related problems.

scholarly journals Implementation and progress of clinical pharmacy in the rational medication use in a large tertiary hospital

2011 ◽  
Vol 9 (4) ◽  
pp. 456-460 ◽  
Author(s):  
Fábio Teixeira Ferracini ◽  
Silvana Maria de Almeida ◽  
Juliana Locatelli ◽  
Sandra Petriccione ◽  
Celina Setsuko Haga
Keyword(s):  
Patient Safety ◽  
Clinical Pharmacy ◽  
Medical Records ◽  
Positive Impact ◽  
Tertiary Hospital ◽  
Pharmacy Service ◽  
Clinical Pharmacy Service ◽  
Rational Use ◽  
Set Up ◽  
In The Beginning

ABSTRACT Objective: To show developments and contributions of a clinical pharmacy service in safety and rational use of medications in a large tertiary hospital. Methods: Clinical pharmacists were responsible for all issues using medications at the hospital. In the beginning this professional was responsible for analyzing medical prescriptions, horizontal visits, and to set up protocols. Afterwards, other activities were designated such as monitoring for drug safety, participating in committees and managed routines. If problems were found, the pharmacist reported them for the physician and, after intervention, registered the management on the prescription or in medical records. The data collected were presented as reports to medical managers. Results: There was an increase of clinical pharmacist employed in 2010, reaching 22 individuals. Interventions types also increased from 1,706 in 2003 to 30,727 in 2010. The adhesion observed in medical team in 2003 was 93.4%, reaching 99.5% of adhesion in 2010. Conclusion: Clinical pharmacy service shows a positive impact when it comes to performed interventions. It also promotes a rational use of medicines and increase patient safety. Pharmacists were included and their importance confirmed within the multidisciplinary team and in the process of patient safety.

Timeline for Maximal Subjective Outcome Improvement After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 47 (10) ◽  
pp. 2501-2509 ◽  
Author(s):  
Avinesh Agarwalla ◽  
Richard N. Puzzitiello ◽  
Joseph N. Liu ◽  
Gregory L. Cvetanovich ◽  
Anirudh K. Gowd ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Clinical Significance ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Pubmed Database ◽  
Patient Reported ◽  
Clinically Significant ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are one of the most common traumatic knee injuries experienced by athletes. Return to sport is considered the pinnacle endpoint among patients receiving ACL reconstruction. However, at the time of return to sport, patients may not be participating at their previous levels of function, as defined by clinical metrics. Purpose: To establish when patients perceive maximal subjective medical improvement according to patient-reported outcome measures (PROMs). Study Design: Systematic review. Methods: A systematic review of the PubMed database was conducted to identify studies that reported sequential PROMs up to a minimum of 2 years after ACL reconstruction. Pooled analysis was conducted for PROMs at follow-up points of 3 months, 6 months, 1 year, and 2 years. Clinically significant improvement was determined between pairs of intervals with the minimal clinically important difference. Results: This review contains 30 studies including 2253 patients who underwent ACL reconstruction. Clinically significant improvement in the KOOS (Knee injury and Osteoarthritis Outcome Score) was seen up to 1 year after ACL reconstruction, but no clinical significance was noted from 1 to 2 years. Clinically significant improvement in the IKDC (International Knee Documentation Committee) and Lysholm questionnaires was seen up to 6 months postoperatively, but no clinical significance was noted beyond that. Conclusion: After ACL reconstruction, maximal subjective medical improvement is established 1 year postoperatively, with no further perceived clinical improvement beyond this time point according to current PROMs. The KOOS may be a more responsive metric to subjective improvements in this patient cohort than other patient-reported outcomes, such as the IKDC and Lysholm. Clinical Relevance: After ACL reconstruction, patients perceive interval subjective improvements until 1 year postoperatively.

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