ABSTRACT
Abstract The objective of this study was to evaluate drug interactions based on medical records of patients hospitalized in University Hospital Lauro Wanderley (UHLW) in João Pessoa-PB, Brazil. This was a quantitative, descriptive study with a cross-sectional design. This research was conducted in the medical clinic of the above hospital by analyzing pharmaceutical intervention in medical records. The investigated samples consisted of all medical profiles with drug interaction information of patients hospitalized from June 2016 to June 2017. Most of these drug interactions were determined and classified by Micromedex® Solutions database. This research was approved by the Ethics Committee in Institutional Human Research, protocol number 2.460.206. In total, 331 drug interactions were found in 131 medical profiles. Dipyrone, enoxaparin, sertraline, ondansetron, quetiapine, tramadol, bromopride, amitriptyline, and simvastatin were medications that showed highest interactions. According to Anatomical Therapy Classification (ATC), drugs that act on the central nervous system result in more interactions. The most prevalent interaction was between dipyrone and enoxaparin. Some limitations of this study are the lack of notifications and data on drug interactions.
Subject(s)
Humans , Male , Female , Research , Medical Records/classification , Drug Interactions , Evaluation Studies as Topic , Inpatients/classification , Universities , Pharmaceutical Preparations , Dipyrone/adverse effects , Enoxaparin/supply & distribution , Simvastatin/supply & distribution , Sertraline/supply & distribution , Quetiapine Fumarate/supply & distribution , Amitriptyline/supply & distribution , Hospitals, University/organization & administrationABSTRACT
Resumo Objetivo Investigar os indicadores de qualidade em terapia nutricional enteral em idosos internados em unidade de terapia intensiva de um hospital universitário em João Pessoa, PB, Brasil. Métodos Estudo seccional, retrospectivo, realizado no período de março de 2018 a março de 2019. Os indicadores utilizados foram frequência de: medida de Índice de Massa Corporal (IMC) à admissão; estimativa de gasto energético e necessidade proteica; administração adequada do volume prescrito x infundido; pacientes em jejum antes do início da terapia nutricional enteral; diarreia e constipação intestinal conforme os parâmetros do International Life Sciences Institute do Brasil. Para a comparação entre os indicadores de qualidade e os desfechos clínico (alta hospitalar e óbito) e tempo de internação (≤14 e >14 dias), utilizou-se o teste do qui-quadrado, sendo consideradas significantes as associações com p< Resultados Foram 79 idosos com tempo de internação médio de 14 dias. Em relação aos indicadores, a frequência de medida de IMC à admissão e a estimativa de gasto energético e necessidade proteica atingiram as metas. Quando analisada a associação dos indicadores de qualidade com desfechos clínicos, observaram-se diferenças significativas (p=0,010) entre o indicador volume infundido x prescrito e alta hospitalar. Conclusão A frequência de administração adequada do volume prescrito x infundido teve associação significativa com desfecho sugerindo que esse seja um indicador a ser considerado no monitoramento da assistência nutricional de pessoas idosas, sendo, portanto, necessária a elaboração de planos de ação para garantir a efetividade dos processos, porém são necessários mais estudos.
Abstract Objective to investigate the quality indicators in enteral nutritional therapy in older patients admitted to the intensive care unit of a university hospital in the city of João Pessoa, Paraíba. Methods a retrospective, cross-sectional study was carried out with older adults admitted to the intensive care unit between March 2018 and March 2019. The indicators used were the frequency of measurement of Body Mass Index (BMI) at admission; estimated energy expenditure and protein requirement; adequate administration of prescribed vs. infused volume; patients fasting before starting enteral nutritional therapy; diarrhea and constipation according to the parameters of the International Life Sciences Institute of Brazil. For the comparison between quality indicators and clinical outcomes (hospital discharge and death) and length of stay (≤14 and >14 days), the chi-square test was used, with associations with p<0.05 being considered significant. Results there were 79 older adults, with an average hospital stay of 14 days. Regarding the indicators, the frequency of BMI measurement at admission and the estimate of energy expenditure and protein requirement reached the targets. When analyzing the association of quality indicators with clinical outcomes, significant differences (p=0.010) were observed between the infused vs. prescribed volume indicator and hospital discharge. Conclusion the indicator of the frequency of adequate administration of prescribed vs. infused volume had a significant association with the outcome, suggesting that this indicator should be considered in monitoring nutritional assistance for older adults. It is therefore necessary to develop action plans to ensure the effectiveness of the processes, although more studies are also needed.