PHARMACEUTICAL INTERVENTIONS AND THEIR CLINICAL OUTCOMES IN AN INPATIENT POST-TRANSPLANT UNIT
Liana Silveira Adriano, Bruna Cristina Cardoso Martins, Lívia Falcão Lima, Rafaela Michele de Andrade Cavalcante, Francisco Roberto Pereira de Oliveira, Vanessa Pinto Magalhães, Paulo Yuri Milen Firmino, Marta Maria de França Fonteles, Eugenie Desirèe Rabelo Néri

Objective: To contribute to the formation of knowledge in Brazil about the impact of the clinical pharmacist's role in the care of inpatient post-transplant by analyzing the results of the pharmaceutical interventions performed.

Method: A descriptive study was conducted from January to July/2014. Data were collected from the records of the Clinical Pharmacy Service (medication reconciliation, prescription analysis and pharmacotherapeutic follow-up), including all patients with drug-related problems and documented pharmaceutical interventions. Epidemiological variables and related to the clinical activities of the pharmacist were described.

Results: A total of 131 patients had drug-related problems, especially, during “Pharmacoterapeutic follow-up”. The most frequent categories were: “not prescribed required medicine” (125; 21.7%), “overdosing” (97; 16.8%) and “underdosing” (93; 16.1%). The main drugs involved were “ganciclovir” (81; 13.4%) and “tacrolimus” (33; 5.5%). The pharmaceutical interventions included “dose/adequacy” (193; 33.4%), “inclusion” (122; 21.1%) or “suspension” (122; 21.1%) of medication. The main clinical outcomes were “prevention” (481; 83.4%) or “improvement” (59; 10.2%) of health problems, such as “adverse effects” (170; 29.5%), “infection” (133; 23%) and “rejection” (41; 7.1%), being identified a significant relationship (p

Descriptors: Clinical Pharmacy Service; Kidney transplantation; Liver transplantation; Patient safety.