Evaluación de problemas relacionados a medicamentos en pacientes de la Unidad de Tratamiento Intermedio : Instituto Nacional del Tórax
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Fecha
2023
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es
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Universidad Andrés Bello
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Licencia CC
Licencia CC
Resumen
Los problemas relacionados a medicamentos (PRM) fueron definidos por Strand et
al. en 1990 como “una experiencia indeseable del paciente que involucra a la
farmacoterapia y que interfiere real o potencialmente con los resultados deseados en
el paciente”. Luego, con sus colegas de la Universidad de Minnesota elaboraron una
clasificación para estos PRM, categorizándolos en: necesidad, efectividad, seguridad
y adherencia. Existen factores de riesgo (FR) que pueden condicionar la
presentación de un PRM, tales como: insuficiencia renal, insuficiencia hepática, ser
adulto mayor, tener polifarmacia, desórdenes nutricionales, comorbilidades y,
diferentes grupos farmacológicos. Además, los PRM pueden provocar problemas a la
salud, lo que puede contribuir a una prolongación en la hospitalización y generar un
incremento de los costos asociados a la salud.
El Instituto Nacional del Tórax (INT) de Santiago de Chile, es un hospital que atiende
pacientes con patologías torácicas de alta complejidad. Dependiendo de su estado
de gravedad algunos requieren ser hospitalizados en unidades de paciente crítico,
como la Unidad de Tratamiento Intermedio (UTI), en donde reciben terapias
farmacológicas según lo requiera su condición clínica para su rehabilitación y
recuperación.
Objetivo General: Evaluar los problemas relacionados a medicamentos dentro de la
Unidad de Tratamiento Intermedio en el INT.
Metodología: Se realizó un estudio descriptivo prospectivo observacional
aleatorizado utilizando el modelo Minnesota en 415 pacientes de la UTI del INT. El
software utilizado para el análisis estadístico fue SPSS®.
Resultados: 289 pacientes presentaron PRM, los que sumaron un de 513, dando una
prevalencia del 69,6%, en donde la categoría más destacada fue necesidad con un
54%, seguido de la efectividad con un 27% y seguridad con un 19%. La gravedad de
estos PRM fue principalmente leve (74%) y posiblemente prevenible (71%). Los
principales FR identificados para generar un PRM fue la hipertensión arterial (OR:
2.08, IC: 1.36 – 3.18, p: 0.001), insuficiencia renal (OR: 2.03, IC: 1.06 – 4.06, p:
0.046) y presentar siete comorbilidades (OR: 3.40, IC: 1,17 – 9.89, p: 0.02). Los
grupos farmacológicos mayormente involucrados fueron: antihipertensivos,
anticoagulantes y electrolitos plasmáticos. Finalmente, se cuantificaron 24 problemas
de salud con una suma total de 160, correspondiendo a un 31,2% del total de los
PRM.
Conclusión: Los PRM tienen una alta prevalencia en la UTI del INT, primordialmente
de necesidad. La hipertensión arterial junto con los medicamentos antihipertensivos
son un factor de riesgo para presentar un PRM, así como la insuficiencia renal y
fármacos del grupo de anticoagulantes. Los principales problemas de salud
causados por PRM fueron hipertensión arterial, dolor y somnolencia.
Drug-related problems (DRPs) were defined by Strand et al. in 1990 as “an undesirable patient experience involving pharmacotherapy and actually or potentially interfering with desired patient outcomes”. Then, with their colleagues at the University of Minnesota, they developed a classification for these DRPs, categorizing them into necessity, effectiveness, safety, and adherence. There are risk factors (RFs) that can condition the presentation of a DRP, such as: kidney failure, liver failure, being an older adult, having polypharmacy, nutritional disorders, having comorbidities and different pharmacological groups. Also, DRPs can cause health problems, which can contribute to prolonged hospitalization and generate an increased in the costs associated with health. The Instituto Nacional del Tórax (INT) from Santiago, Chile, is a hospital that cares for patients with highly complex thoracic pathologies. Depending on their seriousness, some require hospitalization in critical patient units, such as Intermediate Treatment Unit (ITU), where they receive pharmacological therapies as required by their clinical condition for their rehabilitation and recovery. General Objective: Evaluate the problems related to medications within the intermediate treatment unit at the INT. Methodoly: A randomized observational prospective descriptive study was carried out using the Minnesota model in 415 patients from the INT ITU. The software used for statistical analysis was SPSS®. Results: 289 patients presented DRPs, which totaled 513, giving a prevalence of 69.6%, where the most outstanding category corresponds to the necessity with 54%, followed by effectiveness with 27% and safety with 19%. The severity of these DRPs was mainly mild (74%), and possibly preventable (71%). The main RFs identified were arterial hypertension (OR: 2.08, IC: 1.36 – 3.18, p: 0.001), renal failure (OR: 2.03, IC: 1.06 – 4.06, p: 0.046 and presence of seven comorbidities (OR: 3.40, IC: 1,17 – 9.89, p: 0.02). The most common pharmacological groups corresponded to antihypertensives, anticoagulant and plasmatic electrolytes. Twenty-four health problems were quantified with a total of 160, corresponding to 31.2% of the total PRM. Conclusion: DRPs have a high prevalence in the ITU of the INT, primarily for necessity. Arterial hypertension with antihypertensive drugs are a risk factor for presenting a DRP, as well as renal failure and drugs from anticoagulants group. Health problems caused by DRPs are mainly due to high blood pressure, pain and sleepiness.
Drug-related problems (DRPs) were defined by Strand et al. in 1990 as “an undesirable patient experience involving pharmacotherapy and actually or potentially interfering with desired patient outcomes”. Then, with their colleagues at the University of Minnesota, they developed a classification for these DRPs, categorizing them into necessity, effectiveness, safety, and adherence. There are risk factors (RFs) that can condition the presentation of a DRP, such as: kidney failure, liver failure, being an older adult, having polypharmacy, nutritional disorders, having comorbidities and different pharmacological groups. Also, DRPs can cause health problems, which can contribute to prolonged hospitalization and generate an increased in the costs associated with health. The Instituto Nacional del Tórax (INT) from Santiago, Chile, is a hospital that cares for patients with highly complex thoracic pathologies. Depending on their seriousness, some require hospitalization in critical patient units, such as Intermediate Treatment Unit (ITU), where they receive pharmacological therapies as required by their clinical condition for their rehabilitation and recovery. General Objective: Evaluate the problems related to medications within the intermediate treatment unit at the INT. Methodoly: A randomized observational prospective descriptive study was carried out using the Minnesota model in 415 patients from the INT ITU. The software used for statistical analysis was SPSS®. Results: 289 patients presented DRPs, which totaled 513, giving a prevalence of 69.6%, where the most outstanding category corresponds to the necessity with 54%, followed by effectiveness with 27% and safety with 19%. The severity of these DRPs was mainly mild (74%), and possibly preventable (71%). The main RFs identified were arterial hypertension (OR: 2.08, IC: 1.36 – 3.18, p: 0.001), renal failure (OR: 2.03, IC: 1.06 – 4.06, p: 0.046 and presence of seven comorbidities (OR: 3.40, IC: 1,17 – 9.89, p: 0.02). The most common pharmacological groups corresponded to antihypertensives, anticoagulant and plasmatic electrolytes. Twenty-four health problems were quantified with a total of 160, corresponding to 31.2% of the total PRM. Conclusion: DRPs have a high prevalence in the ITU of the INT, primarily for necessity. Arterial hypertension with antihypertensive drugs are a risk factor for presenting a DRP, as well as renal failure and drugs from anticoagulants group. Health problems caused by DRPs are mainly due to high blood pressure, pain and sleepiness.
Notas
Seminario (Química Farmacéutica)
Palabras clave
Medicamentos, Efectos Adversos, Evaluación, Unidad de Tratamiento Intermedio