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Revista Portuguesa de Clínica Geral

versión impresa ISSN 0870-7103

Rev Port Clin Geral v.27 n.2 Lisboa mar. 2011

 

Omissão de fármacos modificadores do risco cardiovascular em idosos admitidos numa Unidade de Acidentes Vasculares Cerebrais

 

Elisabete Pinto Borges,* Ana Filipa Macedo**

*Mestre em Medicina pela Faculdade de Ciências da Saúde da Universidade da Beira Interior.

**Doutora em Farmácia na Especialidade de Farmácia Clínica. Professora Auxiliar da Faculdade de Ciências da Saúde da Universidade da Beira Interior. Membro do Centro de Investigação em Ciência da Saúde (CICS) da Universidade da Beira Interior, Covilhã. Membro do Conselho Cientifico da Unidade de Farmacovigilância do Centro, AIBILI, Coimbra.

Endereço para Correspondência

 

Resumo

Objectivos: Quantificar e caracterizar omissões de prescrição de fármacos modificadores do risco cardiovascular utilizando os critérios START (Screening Tool to Alert Doctors to The Right Treatment).

Tipo de Estudo: Estudo observacional descritivo.

Local: Unidade de Acidentes Vasculares Cerebrais (UAVC) do Centro Hospitalar da Cova da Beira (CHCB).

População: Idosos (idade ≥ 65 anos) internados com doença aguda cardiovascular.

Métodos: Os processos clínicos de todos os idosos internados entre 1 de Outubro e 31 de Dezembro de 2009 foram revistos e os critérios START aplicados à medicação nos momentos de admissão e de alta clínica.

Resultados: Durante o período de estudo foram admitidos na UAVC 56 doentes idosos. No momento de internamento detectaram-se 63 omissões de prescrição em 69,8% dos idosos (média 1,19 omissões por doente), que em 74,5% (n=38) dos casos foram corrigidas no momento de alta. Nos doentes medicados com 5 ou mais medicamentos diários detectaram-se omissões de prescrição à admissão em 80,9% dos casos. Em 10 doentes, 13 omissões detectadas à entrada permaneciam por corrigir e em 3 doentes registaram-se 3 novas omissões de prescrição.

Os critérios START identificaram, tanto na entrada hospitalar como na alta clínica, omissões de prescrição sobretudo de me-dicação do sistema cardiovascular e do sistema endócrino.

Conclusões: A omissão de fármacos em idosos admitidos no hospital com doença aguda cardiovascular é frequente. Os critérios START revelaram-se um instrumento útil de validação da prescrição farmacológica, de acordo com a evidência das normas de orientação clínica actuais, sobretudo em termos de prevenção cardiovascular.

Palavras-Chave: Idoso; Reacção Adversa a Medicamento; Prescrição de Medicamentos; Acidente Vascular Cerebral; Doenças Cardiovasculares.

 

Prescribing omissions of cardiovascular risk management therapy in acutely-ill elderly patients admitted at a Stroke Unit

Abstract

Goals: To quantify and characterize prescribing omissions of cardiovascular risk management therapy using START (Screening Tool to Alert Doctors to the Right Treatment) criteria.

Type of Study: Descriptive observational study

Local: Stroke Unity of the “Centro Hospitalar da Cova da Beira (CHCB)”.

Population: Elderly patients (age ≥65 years) admitted with acute cardiovascular disease.

Methods: Medical records from elderly patients admitted between October and December 2009 were consulted and the START criteria applied to data on prescribed medicines.

Results: Our study included 56 elderly in-patients. We detected 63 prescribing omissions in 69,8% of these elderly (average of 1,19 omissions by patient), from which 74,5% (n=38) were corrected. Prescribing omissions were also detected in 80,9% of patients taking 5 or more medications simultaneously. In 10 patients, 13 omissions detected at hospital admission were not corrected and in 3 patients, 3 new prescribing omissions were detected.

Conclusions: The prevalence of omission of evidence-based appropriate drug therapy in cardiac acutely-ill hospitalized elderly patients is high. START criteria are a useful instrument to validate essential drug therapy, particularly in relation to cardiovascular disease prevention.

Keywords: Elderly; Adverse Drug Reaction; Drug Prescriptions; Stroke; Cardiovascular Disease.

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

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CONFLITOS DE INTERESSE

As autoras declaram não existirem conflitos de interesse na elaboração deste artigo.

 

ENDEREÇO PARA CORRESPONDÊNCIA

Ana Filipa Macedo

Faculdade de Ciências da Saúde

Universidade da Beira Interior

Av. Infante D. Henrique, 6200-506 Covilhã

Email: filipa@fcsaude.ubi.pt

 

Recebido em 12/09/2010

Aceite para publicação em 15/02/2011