Cuidado farmacêutico na alta hospitalar de pacientes submetidos à angioplastia coronariana

Autores

DOI:

https://doi.org/10.18316/sdh.v11i2.9578

Palavras-chave:

Doenças cardiovasculares, Adesão a medicação, Fatores de risco, Qualidade de Vida.

Resumo

Introdução: A angioplastia coronariana é uma técnica endovascular realizada no tratamento da doença aterosclerótica. Diversos fatores limitam a eficácia da técnica, favorecendo o agravamento da doença. O cuidado farmacêutico (CF) tem contribuído positivamente na terapêutica do paciente, garantindo maior segurança na eficácia clínica em diversos tratamentos. Objetivo: O estudo verificou os efeitos do CF na alta hospitalar sobre os hábitos de vida, adesão farmacoterapêutica e problemas relacionados a medicamentos (PRM) em pacientes submetidos à angioplastia coronariana. Materiais e métodos: Estudo de caráter experimental, realizado com indivíduos de ambos os sexos distribuídos em grupo Controle e grupo Intervenção. Resultados: Ao total 93% dos pacientes faziam uso de múltiplos medicamentos apresentando PRM ligados a efetividade e segurança terapêutica, no grupo Intervenção 52% dos PRM foram resolvidos pelo CF mostrando eficácia no serviço prestado. Pelo Teste de Morisky Green observou-se que o CF contribuiu significativamente e obteve impacto positivo para a melhoria da adesão a farmacoterapia. Os pacientes apresentaram também melhor gerenciamento dos hábitos de vida após a alta hospitalar, através do fornecimento de orientações relevantes para sua melhoria. Conclusão: O CF prestado no momento da alta hospitalar é de suma importância e contribui para diversos aspectos voltados para terapêutica do paciente.

Referências

Koganti S, Eleftheriou D, Brogan PA, Kotecha T, Hong Y, Rakhit RD. Microparticles and their role in coronary artery disease. Int J Cardiol 2017; 230:339-345.

World Health Organization. The top 10 causes of death. Geneva: World Health Organization; 2020.

Siqueira ASE, Siqueira-Filho AG, Land MGP. Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil. Arq Bras Cardiol 2017; 109:39-46.

Marti AS, Diago EB, Benito AV, Juste CT, Lasaosa SS. Headache after carotid artery stenting. Neurologia 2019; 34:445-450.

Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Jüni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2014; 35:2541-619.

Iqbal J, Gunn J, Serruys PW. Coronary stents: historical development, current status and future directions. Br Med Bull 2013; 106:193-211.

Aoki J, Tanabe K. Mechanisms of drug-eluting stent restenosis. Cardiovasc Interv Ther 2020; 36:23-29.

Elmore JB, Mehanna E, Parikh SA, Zidar DA. Restenosis of the Coronary Arteries: Past, Present, Future Directions. Interv Cardiol Clin 2016; 5:281-293.

Pleva L, Kukla P, Hlinomaz O. Treatment of coronary in-stent restenosis: a systematic review. J Geriatr Cardiol 2018; 15:173-184.

Omeh DJ, Shlofmitz E. Restenosis. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545139/ (accessed Nov 20, 2020).

Yu X, Lu J, Li J, Guan W, Deng S, Deng Q, Ye H, Han W, Yu Y, Zhang R. Serum Triglyceride Lipase Concentrations are Independent Risk Factors for Coronary Artery Disease and In-Stent Restenosis. J Atheroscler Thromb 2019; 26:762-774.

Matozinhos FP, Felisbino-Mendes MS, Gomes CS, Jansen AK, Machado IE, Lana FCF, Malta DC, Velaquez-Melendez G. Cardiovascular health in Brazilian state capitals 1. Rev. Latino-Am. Enfermagem 2017; 25:2971.

Klein LW, Gopalakrishnan M. The Correlation Between Cigarette Smoking and Other Risk Factors With Coronary Stenosis Composition. J Invasive Cardiol 2015; 27:359-61.

O'Keefe JH, Bhatti SK, Bajwa A, DiNicolantonio JJ, Lavie CJ. Alcohol and cardiovascular health: the dose makes the poison…or the remedy. Mayo Clin Proc 2014; 89:382-93.

Wallner S, Watzinger N, Lindschinger M, Smolle KH, Toplak H, Eber B, Dittrich P, Elmadfa I, Klein W, Krejs GJ, Wascher TC. Effects of intensified lifestyle modification on the need for further revascularization after coronary angioplasty. Eur J Clin Invest 1999; 29:372-9.

Peñalvo JL, Fernández-Friera L, López-Melgar B, Uzhova I, Oliva B, Fernández-Alvira JM, Laclaustra M, Pocock S, Mocoroa A, Mendiguren JM, Sanz G, Guallar E, Bansilal S, Vedanthan R, Jiménez-Borreguero LJ, Ibañez B, Ordovás JM, Fernández-Ortiz A, Bueno H, Fuster V. Association Between a Social-Business Eating Pattern and Early Asymptomatic Atherosclerosis. J Am Coll Cardiol 2016; 68:805-14.

Nahrendorf M, Swirski FK. Lifestyle effects on hematopoiesis and atherosclerosis. Circ Res 2015; 116:884-94.

Zhang G, Li S, Lin P, Chen Y. An analysis of factors related to the development of in-stent restenosis after percutaneous coronary intervention. Medicine 2020; 99:18915.

Sotoca Momblona JM, Canivell Fusté S, Alemany Vilches L, Sisó Almirall A, Codina Jané C, Ribas Sala J. Problemas relacionados con la medicación que causan ingresos hospitalarios [Drug related problems and hospital admissions]. Aten Primaria 2009; 41:141-6.

Garattini L, Padula A. Pharmaceutical care in Italy and other European countries: between care and commerce? Postgrad Med 2018; 130:52-54.

Swieczkowski D, Poniatowski P, Merks P, Jaguszewski M. The pharmaceutical care in asthma - Polish and global perspective. Pneumonol Alergol Pol 2016; 84:225-31.

Berenguer B, La Casa C, de la Matta MJ, Martín-Calero MJ. Pharmaceutical care: past, present and future. Curr Pharm Des 2004; 10:3931-46.

Bonetti AF, Bagatim BQ, Mendes AM, Rotta I, Reis RC, Fávero MLD, Fernandez-Llimós F, Pontarolo R. Impact of discharge medication counseling in the cardiology unit of a tertiary hospital in Brazil: A randomized controlled trial. Clinics 2018; 73:325.

Ben AJ, Neumann CR, Mengue SS. The Brief Medication Questionnaire and Morisky-Green test to evaluate medication adherence. Rev Saude Publica 2012; 46:279-89.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24:67-74.

Provin MP, Campos AP, Nielson SEO, Amaral RG. Atenção Farmacêutica em Goiânia: inserção do farmacêutico na Estratégia Saúde da Família. Saúde e Sociedade 2010; 19:717-724.

Hailu BY, Berhe DF, Gudina EK, Gidey K, Getachew M. Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions. BMC Geriatr 2020; 20:13.

Liu X, Yu S, Mao Z, Li Y, Zhang H, Yang K, Zhang H, Liu R, Qian X, Li L, Bie R, Wang C. Dyslipidemia prevalence, awareness, treatment, control, and risk factors in Chinese rural population: the Henan rural cohort study. Lipids Health Dis 2018; 17:119.

Estrada D, Sierra C, Soriano RM, Jordán AI, Plaza N, Fernández C; en nombre del equipo investigador. Grade of knowledge of hypertension in hypertensive patients. Enferm Clin 2020; 30:99-107.

Dagher NN, Modrall JG. Pharmacotherapy before and after revascularization: anticoagulation, antiplatelet agents, and statins. Semin Vasc Surg 2007; 20:10-4.

Wang Y, Nichol MB, Yan BP, Wu J, Tomlinson B, Lee VW. Descriptive analysis of real-world medication use pattern of statins and antiplatelet agents among patients with acute coronary syndrome in Hong Kong and the USA. BMJ Open 2019; 9:024937.

Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr 2017; 17:230.

Kim J, Parish AL. Polypharmacy and Medication Management in Older Adults. Nurs Clin North Am 2017; 52:457-468.

Rankin A, Cadogan CA, Patterson SM, Kerse N, Cardwell CR, Bradley MC, Ryan C, Hughes C. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev 2018; 9:008165.

Payne RA. The epidemiology of polypharmacy. Clin Med 2016; 16:465-469.

Rumel D. "Odds ratio": algumas considerações. Rev Saúde Pública, 1986; 20:253-258.

Szumilas M. Explaining odds ratios. J Can Acad Child Adolesc Psychiatry. 2010 Aug;19(3):227-9. Erratum in: J Can Acad Child Adolesc Psychiatry 2015; 24:58.

Farha RA, Saleh A, Aburuz S. The impact of drug related problems on health-related quality of life among hypertensive patients in Jordan. Pharm Pract 2017; 15:995.

Silva C, Ramalho C, Luz I, Monteiro J, Fresco P. Drug-related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention. Int J Clin Pharm 2015; 37:327-34.

Ali MAS, Khedr EMH, Ahmed FAH, Mohamed NNE. Clinical pharmacist interventions in managing drug-related problems in hospitalized patients with neurological diseases. Int J Clin Pharm 2018; 40:1257-1264.

Lima LF, Martins BC, Oliveira FR, Cavalcante RM, Magalhães VP, Firmino PY, Adriano LS, Silva AM, Flor MJ, Néri ED. Pharmaceutical orientation at hospital discharge of transplant patients: strategy for patient safety. Einstein (Sao Paulo) 2016; 14:359-365.

Moltó-Puigmartí C, Vonk R, van Ommeren G, Hegger I. A logic model for pharmaceutical care. J Health Serv Res Policy 2018; 23:148-157.

Jordan MA, Harmon J. Pharmacist interventions for obesity: improving treatment adherence and patient outcomes. Integr Pharm Res Pract 2015; 4:79-89.

Lenz TL. Therapeutic lifestyle changes and pharmaceutical care in the treatment of dyslipidemias in adults. J Am Pharm Assoc 2005; 45:492-502.

Gallagher R, McKinley S. Anxiety, depression and perceived control in patients having coronary artery bypass grafts. J Adv Nurs 2009; 65:2386-96.

Muthukrishnan A, Muralidharan TR, Subash J, Lathamangeswari C. Association of poor sleep quality with risk factors after coronary artery bypass graft surgery-A prospective cohort study. J Vasc Nurs 2020; 38:83-92.

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2023-07-12

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