Evaluation of clinical pharmacy services in a university hospital

Abstract

Objective: The objective of this research was to evaluate the most common DRPs, their interventions and resolutions evidenced in a university hospital. Methodology: This is a prospective study with a quantitative approach, carried out from January to July 2024 at the University Hospital of the Federal University of Piauí. Analysis came from data from the pharmaceutical interventions registration spreadsheet, which was subsequently double-checked. All interventions recorded in the spreadsheet were included and incomplete data without the possibility of identification were excluded, such as the lack of the medical record number and identification of the DRP, which totaled 11 records. The interventions were observed by classifying the clinically significant DRPs found. Results: During this period, 2,172 pharmaceutical interventions were performed with 75% of “medical acceptability”. Regarding medical non-acceptability, 23% of the cases were due to the absence of a statement by the signaled professional. The DRPs classified corresponded to problems regarding “drug selection” (49%), including ‘completion of antibiotic treatment’ (39%), as well as ‘logistics problems’ (9%), ‘dosage selection’ (9%) and ‘medical prescription’ (13%). Among the drug classes that underwent the most interventions were antibiotics, mainly the combination of piperacillin with tazobactam, vancomycin, meropenem, ceftriaxone, and metronidazole. This is mainly due to the robustness of the stewardship program adopted at the hospital. Problems such as treatment termination and antibiotics without justification were the main causes of interventions seen. Final Considerations: Therefore, the relevance of the clinical pharmacist’s role at HU-UFPI was evidenced, with a significant acceptability of 75% of medical adherence, and the effectiveness of interventions in the care and safety of the rational use of medications in this hospital.