RESUMO
WHAT IS KNOWN: Documentation is a process indicator utilized to evaluate quality clinical pharmacist services. In this framework, documentation of dispensing, besides supporting patient care, allows evaluation of the impact of counselling. OBJECTIVE: To identify and assess studies of documentation by pharmacists in the dispensing process. METHOD: A systematic review was carried out according to the following steps: (i) identification of studies in the following databases: PubMed/Medline, Web of Science, Scopus and Lilacs, using the descriptors 'counselling', 'dispensing', 'community pharmacy services', 'pharmacies' and 'pharmacists' in different combinations; (ii) evaluation of studies, in which the title, abstract and full text of the studies, and the evaluation of the methodological quality of the selected studies were analysed. RESULTS: In total, 26 articles met the specific criteria. Few studies addressed documentation as part of the dispensing working process (3), and 16 articles reported documentation using non-electronic systems. The main variables documented were patient information, drug therapy problems and clinical interventions. Furthermore, 20 studies showed the effects of documentation in the dispensing process and 23 studies included statistical evidence. Eight articles met between 42% and 75% of the 28 items recommended by the STROBE initiative, and two articles met approximately 60% of the 36 items recommended by the CONSORT initiative. WHAT IS NEW AND CONCLUSION: Few studies address documentation as part of the dispensing working process. Thus, researchers should be concerned with standardizing documentation and implementing more robust designs and multicenter studies.
Assuntos
Serviços Comunitários de Farmácia/normas , Documentação , Farmácias/normas , Serviço de Farmácia Hospitalar/normas , Humanos , FarmacêuticosRESUMO
WHAT IS KNOWN AND OBJECTIVE: Elderly people are the principal consumers of prescription drugs. The more the medication used by the patient, the greater the likelihood there is of the patient being subjected to potentially inappropriate drug therapy (PIDT). PIDT has been measured in the literature with both implicit and explicit tools. The purpose of this review was to assess the use of tools to detect PIDT in various studies and to determine which terms are used to refer to PIDT in practice. METHODS: A systematic review was conducted according to the following steps: the first was identification. In this step, studies were selected from different combinations of the descriptors 'aged', 'elderly', 'inappropriate prescribing' and 'drug utilization' in three different languages, using the Embase, Medline, Scielo, Scopus and Web of Science databases. Second, the papers that satisfied the inclusion criteria for data extraction were carefully examined by three evaluators to determine the tools used and terms that referred to PIDT. RESULTS AND DISCUSSION: From the combinations of keywords, 8610 articles were found. At the end of the selection process, 119 of the articles complied with the specified criteria. The degree of agreement among evaluators was moderate for the study titles (κ1 = 0·479) and substantial for abstracts (κ2 = 0·647). With respect to the PIDT evaluation criteria used by the studies, 27·7% used two criteria. Of the 27 evaluation criteria identified, the Beers criteria were used by 82·3% of the studies. More than 50 different terms to identify PIDT were found in the literature. WHAT IS NEW AND CONCLUSION: This review is the first study to conceptualize and discuss terms that refer to PIDT. At present, there is no consensus regarding terms used to refer to PIDT, with over 50 different terms currently in use. This review shows an increase in the number of articles aimed at evaluating PIDT using implicit and explicit tools.
Assuntos
Uso de Medicamentos/estatística & dados numéricos , Prescrição Inadequada/estatística & dados numéricos , Polimedicação , Padrões de Prática Médica/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Idoso , Bases de Dados Factuais/estatística & dados numéricos , HumanosRESUMO
AIM OF STUDY: To analyze the quality of prescriptions in a hospital in Brazil. METHODS: A cross-sectional pilot study of the quality of prescriptions of adult patients admitted at the cardiovascular ward. Data were collected with the help of a structured form developed by the researchers based on related literature, with items about medications and completeness of prescriptions. The form was divided into four categories of prescription quality indicators: prescription type, legibility and readability of handwriting, and completeness. MAIN OUTCOME MEASURES 100 patients participated in the study, with ages between 20 and 94 years (mean of 67.12 ± 16.6 years), We analyzed 5,030 on 496 prescriptions for 100 patients. Of 11% the handwriting was considered to be less legible and 17% considered illegible. In terms of readability, a high incidence of medications were prescribed by their brand names (89%), and 13,707 abbreviations (mean of 27.6 per prescription) were used mainly to refer to the route of administration (31%), concentration (27%), and indications for use (20%). In relation to completeness, 471 (95%) prescriptions were considered incomplete, mainly medication data. CONCLUSION: The quality indicators used in this study revealed a high rate of prescription problems and errors.