O farmacêutico como autor principal da conciliação medicamentosa no âmbito hospitalar: uma revisão de literatura

Abstract

In the routine of the clinical pharmacist, the review of medications that are used by the patient is part of their work and this review is an intervention that clinical pharmacists often practice in order to improve medication safety, patient outcomes and also ensure the correct use of the medication by the patient. Medication conciliation includes obtaining the Best Possible Medication History (MHPM) as well as evaluating medication for suitability and possible occurrences of medicationrelated adverse events. The objective of the study was to carry out a systematic analysis of the medication conciliation service (MC) in the hospital environment. The present study of the bibliographic review type was based on searches in the Google Academic and Pubmed database. Thirteen articles were definitively chosen for study objects. In 85% of the articles obtaining the medication history occurred only in the first moment of contact with the patient, in 62% of the articles it was reported about the MC occurring only on admission, the omission was the most documented unintentional medication discrepancy (MD) in 77% articles and it was found that in 61% of the articles brought in their conclusion that the MC by the pharmacist increased patient safety. Through this study, it was observed that obtaining an accurate medication history is important to avoid the continuity of errors in the stages of care transitions, and performing this service in the other stages is also important. The MC on admission is essential because the MD can be corrected in a timely manner and also performing it at other times brings greater safety for the patient. It is said that the pharmacist is the most qualified to perform the MC and the effectiveness of this service by the professional is more prominent, they are able to relate their technical knowledge with the clinical condition of the patient. It was concluded from the study that the pharmaceutical professional is the most qualified of the multidisciplinary team to perform the MC precisely because of his training and knowledge about medications, being able to detect more discrepancies and through his interventions to reduce medication errors, adverse events, damages, costs and readmissions, providing better quality of care provided to the patient and promoting greater safety.