Deprescribing medicines in an intensive care unit of a university hospital from Ceará

Objectives: To evaluate the pharmaceutical deprescription recommendations made to patients hospitalized in an adult clinical Intensive Care Unit (ICU). Methods: This is a cross-sectional, descriptive, and quantitative study developed with pharmaceutical recommendations for drug deprescription, in th...

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Main Authors: Ana V. OLIVEIRA, Renata V. CORTEZ, Elana F. CHAVES, Liana M. MAGALHÃES, Romênio N. BORGES, Amanda M. CONCEIÇÃO, Cinthya C. ANDRADE, José M. ALCÂNTARA-NETO, Hilris R. SILVA
Format: Article
Language:English
Published: Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2022-12-01
Series:Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde
Online Access:https://rbfhss.org.br/sbrafh/article/view/851
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author Ana V. OLIVEIRA
Renata V. CORTEZ
Elana F. CHAVES
Liana M. MAGALHÃES
Romênio N. BORGES
Amanda M. CONCEIÇÃO
Cinthya C. ANDRADE
José M. ALCÂNTARA-NETO
Hilris R. SILVA
author_facet Ana V. OLIVEIRA
Renata V. CORTEZ
Elana F. CHAVES
Liana M. MAGALHÃES
Romênio N. BORGES
Amanda M. CONCEIÇÃO
Cinthya C. ANDRADE
José M. ALCÂNTARA-NETO
Hilris R. SILVA
author_sort Ana V. OLIVEIRA
collection DOAJ
description Objectives: To evaluate the pharmaceutical deprescription recommendations made to patients hospitalized in an adult clinical Intensive Care Unit (ICU). Methods: This is a cross-sectional, descriptive, and quantitative study developed with pharmaceutical recommendations for drug deprescription, in the adult ICU of a university hospital in Fortaleza - CE, from 2017 to 2018. Data from patients and recommendations were collected from patient records. The acceptability of the recommendations was measured from the visualization of the suggested alteration in 24 hours. The drugs included in the recommendations were categorized according to the Anatomical Therapeutic Chemical (ATC) and Potentially Dangerous Drug (MPP) classifications. The data were compiled and analyzed using the Microsoft Office Excel® 2013 software. Results: A total of 388 recommendations were made for the non-prescription of medications to 210 adult patients who were mostly male (58%) and with a mean age of 56 years. ± 16.8. The acceptability of the recommendations was 93.3% (n=362) and the average number of medications not prescribed per patient was 1.7 ± 0.7, all of which were abruptly discontinued. Problems related to deprescription were mainly prescription of unnecessary drugs (77.6%) contraindicated drugs (8.0%) and therapeutic duplicity (5.1%). The most frequent therapeutic classes are antibacterials for systemic use (11.3%), ophthalmic (20.8%) and medicines for functional gastrointestinal disorders (9.5%). The main drugs not prescribed were hypromellose eye drops + dextran (9.6%), bromopride (6.9%) and injectable potassium chloride (5.8%), the latter being considered an MPP. The class most associated with non-acceptance of deprescription other than corticosteroids is systemic use (23.1%). Conclusion: This study showed a high level of acceptance of deprescription recommendations, especially among antibacterials for systemic use. Injectable potassium chloride, considered an MPP, ranked third overall in terms of non-prescription. Future studies should evaluate the impact of deprescription recommendations on morbidity and mortality in the ICU and on the reduction of hospital costs.
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spelling doaj.art-200b5bc4b56047d6b8e638d3858c3ce42022-12-27T13:41:59ZengSociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdeRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde2179-59242316-77502022-12-0113485185110.30968/rbfhss.2022.134.08511234Deprescribing medicines in an intensive care unit of a university hospital from CearáAna V. OLIVEIRAhttps://orcid.org/0000-0002-9413-4717Renata V. CORTEZhttps://orcid.org/0000-0001-5323-8993Elana F. CHAVEShttps://orcid.org/0000-0002-5817-0999Liana M. MAGALHÃEShttps://orcid.org/0000-0002-2950-8540Romênio N. BORGEShttps://orcid.org/0000-0002-2950-8540Amanda M. CONCEIÇÃOhttps://orcid.org/0000-0002-4638-8130Cinthya C. ANDRADEhttps://orcid.org/0000-0001-5812-7213José M. ALCÂNTARA-NETOhttps://orcid.org/0000-0002-6354-6006Hilris R. SILVAhttps://orcid.org/0000-0002-5167-2822Objectives: To evaluate the pharmaceutical deprescription recommendations made to patients hospitalized in an adult clinical Intensive Care Unit (ICU). Methods: This is a cross-sectional, descriptive, and quantitative study developed with pharmaceutical recommendations for drug deprescription, in the adult ICU of a university hospital in Fortaleza - CE, from 2017 to 2018. Data from patients and recommendations were collected from patient records. The acceptability of the recommendations was measured from the visualization of the suggested alteration in 24 hours. The drugs included in the recommendations were categorized according to the Anatomical Therapeutic Chemical (ATC) and Potentially Dangerous Drug (MPP) classifications. The data were compiled and analyzed using the Microsoft Office Excel® 2013 software. Results: A total of 388 recommendations were made for the non-prescription of medications to 210 adult patients who were mostly male (58%) and with a mean age of 56 years. ± 16.8. The acceptability of the recommendations was 93.3% (n=362) and the average number of medications not prescribed per patient was 1.7 ± 0.7, all of which were abruptly discontinued. Problems related to deprescription were mainly prescription of unnecessary drugs (77.6%) contraindicated drugs (8.0%) and therapeutic duplicity (5.1%). The most frequent therapeutic classes are antibacterials for systemic use (11.3%), ophthalmic (20.8%) and medicines for functional gastrointestinal disorders (9.5%). The main drugs not prescribed were hypromellose eye drops + dextran (9.6%), bromopride (6.9%) and injectable potassium chloride (5.8%), the latter being considered an MPP. The class most associated with non-acceptance of deprescription other than corticosteroids is systemic use (23.1%). Conclusion: This study showed a high level of acceptance of deprescription recommendations, especially among antibacterials for systemic use. Injectable potassium chloride, considered an MPP, ranked third overall in terms of non-prescription. Future studies should evaluate the impact of deprescription recommendations on morbidity and mortality in the ICU and on the reduction of hospital costs.https://rbfhss.org.br/sbrafh/article/view/851
spellingShingle Ana V. OLIVEIRA
Renata V. CORTEZ
Elana F. CHAVES
Liana M. MAGALHÃES
Romênio N. BORGES
Amanda M. CONCEIÇÃO
Cinthya C. ANDRADE
José M. ALCÂNTARA-NETO
Hilris R. SILVA
Deprescribing medicines in an intensive care unit of a university hospital from Ceará
Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde
title Deprescribing medicines in an intensive care unit of a university hospital from Ceará
title_full Deprescribing medicines in an intensive care unit of a university hospital from Ceará
title_fullStr Deprescribing medicines in an intensive care unit of a university hospital from Ceará
title_full_unstemmed Deprescribing medicines in an intensive care unit of a university hospital from Ceará
title_short Deprescribing medicines in an intensive care unit of a university hospital from Ceará
title_sort deprescribing medicines in an intensive care unit of a university hospital from ceara
url https://rbfhss.org.br/sbrafh/article/view/851
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