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Abstract
Objective To assess the impact of pharmaceutical care on hospital indicators and clinical outcomes of palliative care (PC) patients admitted to a secondary hospital.
Methods A non-randomised clinical trial was carried out in the PC ward of a secondary hospital in São Paulo, Brazil. Pharmaceutical care for all patients aged 18 and above, admitted between October 2021 and March 2022, with stays exceeding 48 hours, was provided. The interventions required were performed in collaboration with healthcare teams, patients and caregivers. Assessments occurred at admission and discharge, using PC performance scales and pharmacotherapy tools, with Research Ethics Committee approval.
Results Over 6 months, 120 hospitalisations were analysed, primarily involving women (58.9%), averaging 71.0 years, with neoplasm diagnoses (20.5%). A total of 170 drug-related problems were identified in 68.3% of patients. Following assessment, 361 interventions were performed, with a 78.1% acceptance rate, including medication dose adjustments, additions and discontinuations. Addressing unintentional pharmacotherapy discrepancies at admission led to reduced hospital stays (p<0.05). Pharmaceutical interventions also decreased pharmacotherapy complexity (p<0.001), inappropriate medications for the older people (p<0.001) and improved symptom management, such as pain (p<0.05).
Conclusions Pharmaceutical care services integrated within the multiprofessional health team contributed to reducing drug-related problems associated with polypharmacy as well as improved the management PC symptoms in end-of-life patients, which reduced hospitalisation time.
- clinical assessment
- drug administration
- hospital care
- symptoms and symptom management
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Footnotes
Contributors LMC-S was responsible for the study’s concept and design, data collection, analysis and interpretation, and article writing. LMC-S was also responsible for the overall content as the guarantor. Similarly, MHG, FRV and LRLP were responsible for the study’s concept and design, as well as writing and critically reviewing the study for relevant intellectual content. ACG and FSLC were responsible for collecting and analysing data related to the characterisation of patients’ pharmacotherapy.
Competing interests The authors have no relevant financial or non-financial interests to disclose. This work was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) (Grant number 88887.483243/2020-00). Author LMC-S has received research support from CAPES. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Provenance and peer review Not commissioned; externally peer reviewed.
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