Efecto que posee la intervención farmaceútica brindada al momento del alta hospitalaria en la adherencia terapéutica en los pacientes hospitalizados en el servicio de geriatría del Hospital Rafael Ángel Calderón Guardia (HCG) durante enero y febrero del 2021
Fecha
2023-12
Tipo
tesis de maestría
Autores
Chaves Brenes, Ana Victoria
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Resumen
1. Diseño del estudio: estudio cohorte observacional
2.Objetivo principal: Evaluar el efecto de las intervenciones farmacéuticas
realizadas al egreso hospitalario sobre la adherencia terapéutica, en los pacientes
ingresados al servicio de Geriatría del Hospital Rafael Ángel Calderón Guardia
(HCG) durante enero y febrero del 2021, para la optimización en el uso de sus
medicamentos.
3. Metodología: Completaron el estudio 19 pacientes, incluidos por ser no
adherentes a su tratamiento previo al ingreso hospitalario, ingresados por el
servicio de geriatría en el mes de enero y febrero del 2021. A estos se les realizó
una entrevista en los primeros días del hospitalización, se valoró su adherencia
por tres métodos: revisión de retiros de medicamentos según el Servicio integrado
de farmacia (SIFA), escala de Morisky de 8 ítems (MMSA-8) y evaluación de
conocimiento. Se caracterizó la población adulta mayor no adherente a su
tratamiento y se analizó la diferencia de estos tres antes y después de las
intervenciones realizadas por la farmacéutica el momento del egreso.
4. Resultados: Las pacientes estudiados, no adherente a sus tratamientos
crónicos, eran tenían todos pluripatología, eran polimedicados, la mayoría con
hipertensión, diabetes, discapacidad visual y consideraban difícil cumplir su
esquema terapéutico. Los pacientes adherentes medidos con MMSA-8, pasaron
de un total de 21% a un 95%, después de la intervención farmacéutica (valor p:
0,000019). El porcentaje. de retiros registrados en SIFA pasaron de 76% a un 94%
(valor p:0.009) y el conocimiento pasó de 52,5% a 89.7%, (valor p: 0.000005),
todos aumentos estadísticamente significativos.
5. Conclusiones: Las intervenciones realizadas por parte del farmacéutico al
egreso hospitalario del adulto mayor, permiten conciliar los cambios dados en la
transición, así como mejora significativamente la adherencia y el conocimiento.
Estas se deben priorizar en el adulto mayor polimedicado, hipertenso, diabético,
cuyo esquema terapéutico sea complejo.
Palabras clave: Intervención farmacéutica, egreso hospitalario, geriatría.
1. Study design: observational cohort study 2. Main objective: To evaluate the effect of pharmaceutical interventions performed at hospital discharge on therapeutic adherence, in patients admitted to the Geriatrics service of the Rafael Ángel Calderón Guardia Hospital (HCG) during January and February 2021, for optimization in the use of their medications. 3. Methodology:The study was completed by 19 patients, included because they were non-adherent to their treatment prior to hospital admission, admitted in the geriatric service in January and February 2021. They were interviewed in the first days of hospitalization, adherence was assessed using three methods: review of drug withdrawals according to the Integrated Pharmacy Service (SIFA), 8-item Morisky scale (MMSA-8) and knowledge assessment. The elderly population nonadherent to their treatment was characterized and the difference between these three was analyzed before and after the interventions carried out by the pharmacist at the time of discharge. 4. Results: The patients studied, non-adherent to their chronic treatments, all had multiple pathologies, were polymedicated, the majority with hypertension, diabetes, visual impairment and considered it difficult to comply with their therapeutic regimen. The adherent patients measured with MMSA-8, went from a total of 21% to 95%, after the pharmaceutical intervention (p value: 0.000019). The percentage. withdrawals registered in SIFA went from 76% to 94% (p-value: 0.009) and knowledge went from 52.5% to 89.7%, (p-value: 0.000005), all statistically significant increases, with a confidence level of 95% 5.Conclusions: The interventions carried out by the pharmacist at the hospital discharge of the elderly allow reconciling the changes given in the transition, as well as significantly improving adherence and knowledge. These interventions, should be prioritized in the elderly polymedicated, hypertensive, diabetic, whose therapeutic scheme is complex. Keywords: Pharmaceutical intervention, hospital discharge, geriatrics.
1. Study design: observational cohort study 2. Main objective: To evaluate the effect of pharmaceutical interventions performed at hospital discharge on therapeutic adherence, in patients admitted to the Geriatrics service of the Rafael Ángel Calderón Guardia Hospital (HCG) during January and February 2021, for optimization in the use of their medications. 3. Methodology:The study was completed by 19 patients, included because they were non-adherent to their treatment prior to hospital admission, admitted in the geriatric service in January and February 2021. They were interviewed in the first days of hospitalization, adherence was assessed using three methods: review of drug withdrawals according to the Integrated Pharmacy Service (SIFA), 8-item Morisky scale (MMSA-8) and knowledge assessment. The elderly population nonadherent to their treatment was characterized and the difference between these three was analyzed before and after the interventions carried out by the pharmacist at the time of discharge. 4. Results: The patients studied, non-adherent to their chronic treatments, all had multiple pathologies, were polymedicated, the majority with hypertension, diabetes, visual impairment and considered it difficult to comply with their therapeutic regimen. The adherent patients measured with MMSA-8, went from a total of 21% to 95%, after the pharmaceutical intervention (p value: 0.000019). The percentage. withdrawals registered in SIFA went from 76% to 94% (p-value: 0.009) and knowledge went from 52.5% to 89.7%, (p-value: 0.000005), all statistically significant increases, with a confidence level of 95% 5.Conclusions: The interventions carried out by the pharmacist at the hospital discharge of the elderly allow reconciling the changes given in the transition, as well as significantly improving adherence and knowledge. These interventions, should be prioritized in the elderly polymedicated, hypertensive, diabetic, whose therapeutic scheme is complex. Keywords: Pharmaceutical intervention, hospital discharge, geriatrics.
Descripción
Palabras clave
Intervención, Farmacéutica, Egreso, Hospitalario, Geriatría