ABSTRACT
BACKGROUND: There is no gold-standard trigger for detecting drug-induced respiratory disorders, a type of Adverse Drug Event (ADE) with high morbimortality, particularly in older people. OBJECTIVE: To propose and evaluate the performance of triggers for detecting hospitalizations related to drug-induced respiratory disorders in older people. METHODS: A pilot cross-sectional study was conducted with older people (age ≥ 60) admitted to a Brazilian hospital. Electronic chart documentation was screened using ICD-10 codes; Global Trigger Tool (GTT); and drugs potentially associated with respiratory disorders. A chart and medication review were conducted to perform the causality assessment using the instrument developed by the World Health Organization. The performance of triggers was evaluated by the Positive Predictive Value (PPV), with values ≥ 0.20 indicating good performance. RESULTS: Among 221 older people, 72 were eligible. Potential drug-induced dyspnea and/or cough were detected in six older people (6/72), corresponding to a prevalence of 8.3 %. The overall PPV of the triggers was 0.14, with abrupt medication stop (PPV = 1.00), codeine (PPV = 1.00), captopril (PPV = 0.33), and carvedilol (PPV = 0.33) showing good performance. Two triggers were proposed for detecting therapeutic ineffectiveness associated with respiratory disorders: furosemide (PPV = 0.23) and prednisone (PPV = 0.20). CONCLUSION: The triggers enabled the identification that one in 12 hospitalizations was related to drug-induced respiratory. Although good performance was observed in the application of triggers, additional investigations are needed to assess the feasibility of incorporating them into clinical practice for the screening, detection, management, and reporting of these ADEs, which are considered to be underreported and difficult to detect.
Subject(s)
Hospitalization , Humans , Aged , Cross-Sectional Studies , Male , Female , Pilot Projects , Hospitalization/statistics & numerical data , Aged, 80 and over , Brazil , Middle Aged , Drug-Related Side Effects and Adverse Reactions , Respiration Disorders/chemically induced , Predictive Value of TestsABSTRACT
0 direito à saúde no Brasil tem como princípios universalidade, integralidade e equidade. Reconhecendo a diversidade de género e orientação sexual como determinantes sociais de saúde, são necessárias politicas para garantia dos direitos e da qualidade da saúde na população LGBTQIA+. Este artigo qualitativo de relato de experiência tem por objetivo descrever ações do Ambulatório Médico de Especialidades e Hospital Estadual Américo Brasiliense na promoção da saúde desta população, destacando-se a utilização do nome social no prontuário eletrônico multiprofissional. Em 2012, o hospital iniciou a discussão da sua adoção para usuários transexuais e travestis, respeitando o nome de sua preferência durante seu atendimento, sendo incorporado espaço reservado para o nome social no cadastro do prontuário, após nome e sobrenome de registro civil. Pulseiras de identificação e painel de chamadas também contém nome social, e nas telas do prontuário ha um ícone lilás alertando para a consideração do mesmo. A sensibilização institucional contou com palestras em parceria com a Assessoria Especial de Politicas Públicas para Diversidade Sexual de Araraquara e cursos do Ministério da Saúde na Politica Nacional de Saúde Integral LGBT. As ações auxiliam na garantia da equidade e respeito das minorias sexuais e de género.