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. 2014 Jan-Mar;12(1):27-30.
doi: 10.1590/s1679-45082014ao2526.

Implementation of vertical clinical pharmacist service on venous thromboembolism prophylaxis in hospitalized medical patients

Celina Setsuko Haga  1 , Cassio Massashi Mancio  1 , Micheline da Costa Pioner  1 , Fabricia Aparecida de Lima Alves  1 , Andreia Ramos Lira  1 , João Severino da Silva  1 , Fábio Teixeira Ferracini  1 , Wladimir Mendes Borges Filho  1 , João Carlos de Campos Guerra  1 , Claudia Regina Laselva  1
Affiliations

Implementation of vertical clinical pharmacist service on venous thromboembolism prophylaxis in hospitalized medical patients

Celina Setsuko Haga et al. Einstein (Sao Paulo). 2014 Jan-Mar.

Abstract
in English, Portuguese

Objective: To describe the vertical clinical pharmacist service's interventions in prevention of venous thromboembolism.

Methods: This prospective study was done at a private hospital. From January to May 2012, the clinical pharmacist evaluated medical patients without prophylaxis for thromboembolism. If the patient fulfilled criteria for thromboembolism and did not have contraindications, the clinical pharmacist suggested inclusion of pharmacologic agents and/or mechanical methods for venous thromboembolism prevention. In addition, the appropriate dose, route of administration, duplicity and replacement of the drug were suggested.

Results: We evaluated 9,000 hospitalized medical patients and carried out 77 pharmaceutical interventions. A total of 71 cases (92.21%) adhered to treatment so that non-adherence occurred in 6 cases (7.79%). In 25 cases pharmacologic agents were included and in 20 cases mechanical prophylaxis. Dose adjustments, route, frequency, duplicity and replacement made up 32 cases.

Conclusion: The vertical clinical pharmacist service included the prophylaxis for venous thromboembolism and promotion of appropriate use of medicines in the hospital.

Objetivo:: Descrever as intervenções do serviço do farmacêutico clínico vertical na prevenção do tromboembolismo venoso.

Métodos:: Estudo prospectivo, feito em hospital privado. Durante 5 meses, de janeiro a maio de 2012, o farmacêutico clínico avaliou os pacientes clínicos internados sem profilaxia para o tromboembolismo venoso. Se o paciente apresentasse critérios para desenvolver o tromboembolismo e não houvesse contraindicações para a profilaxia, o farmacêutico clínico sugeria a inclusão da profilaxia medicamentosa e/ou mecânica para equipe médica. Além disso, também foram feitas sugestões em relação à dose, via de administração, posologia, duplicidade terapêutica e substituição do medicamento profilático.

Resultados:: Foram avaliados 9.000 pacientes internados e feitas 77 intervenções farmacêuticas, houve adesão em 71 casos (92,21%); logo, a não adesão pelo médico ocorreu em 6 casos (7,79%). Em 25 casos houve a inclusão da profilaxia medicamentosa e, em 20 casos, a inclusão da profilaxia mecânica. Os ajustes de dose, via, frequência, duplicidade e substituição somaram 32 casos.

Conclusão:: A implantação do serviço do farmacêutico clínico vertical abrangeu a inclusão da profilaxia para tromboembolismo venoso e a promoção do uso correto de medicamentos no ambiente hospitalar.

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Conflict of interest statement

Conflict of interest: none.

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