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Publication
Consulta farmacêutica hospitalar: caracterização da comunicação clínica e informação ao doente
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Advisor(s)
Abstract(s)
Introdução
Os doentes oncológicos têm cada vez um maior acesso a antineoplásicos para administração oral em ambulatório. O farmacêutico hospitalar tem contribuído para a utilização racional destes medicamentos, incluindo através do fornecimento de informação, em consulta hospitalar. Está descrita a importância da informação na autogestão da terapêutica. Esta compreende aspetos relativos à utilização do medicamento, tais como as indicações terapêuticas, posologia, instruções de administração e advertências e precauções. Este estudo tem como objetivo caracterizar consultas farmacêuticas hospitalares em termos de informação ao doente oncológico sobre a sua farmacoterapia.
Métodos
Realizou-se um estudo transversal de natureza observacional e descritiva, com uma análise ao conteúdo da comunicação que ocorreu durante 13 consultas farmacêuticas com doentes oncológicos num hospital central de Lisboa, entre setembro de 2019 e fevereiro de 2020. As gravações audio foram transcritas literalmente e importadas para o software de análise qualitiva QSR NVivo 12, sendo codificadas as passagens relativas às indicações terapêuticas, posologia, instruções de administração, e advertências e precauções para a terapêutica antineoplásica e seus coadjuvantes. Esta informação foi comparada com a informação estandardizada constante dos folhetos informativos dos medicamentos.
Resultados
A posologia foi o parâmetro mais abordado, ainda que de modo incompleto, em 59,4% das situações expectáveis. As instruções de administração apresentaram a prestação mais completa. A Abiraterona, a Capecitabina e a Loperamida apresentaram conteúdos dos quatro parâmetros simultaneamente numa consulta. Qualitativamente, os conteúdos das consultas tiveram pouca correspondência com os folhetos informativos.
Discussão e conclusões
A boa prática na comunicação clínica tem inerente a preservação da integridade da informação terapêutica. Em contexto prático é importante equilibrar a integridade com a seleção e a adaptação da informação mais relevante para aquele doente e sua terapêutica. Neste estudo, a informação transmitida pela farmacêutica foi diferente quantitativa e qualitativamente quando comparada com a do folheto informativo. As diferenças entre conteúdos podem justificar-se pela natureza da consulta. Nesta amostra de consultas farmacêuticas com terapêutica oncológica não foi possível identificar uma sistemática de informação ao doente. São necessários mais estudos que incluam a sistematização da informação transmitida, com a seleção da amostra consoante critérios, tais como o tipo de cancro e a terapêutica.
Introduction Cancer patients have increasing access to antineoplastic drugs for oral administration in an outpatient setting. Hospital pharmacists have contributed to the rational use of these medications, including by providing information in hospital consultations. The importance of information in self-management of therapy is described. These aspects include the ones related to medicine, such as therapeutic indications, posology, administration instructions and warnings and precautions. This study aims to characterize hospital pharmaceutical consultations in terms of information to cancer patients about their pharmacotherapy. Methods A cross-sectional study of an observational and descriptive nature was conducted, with a content analysis of the communication that took place during thirteen pharmaceutical consultations with cancer patients in a central hospital in Lisbon between September 2019 and February 2020. The audio recordings were literally transcribed and imported into the QSR NVivo 12 qualitative analysis software, with the utterances relating to therapeutic indications, posology, administration instructions, and warnings and precautions for antineoplastic therapy and its co-adjuvants codified. Results Posology was the most discussed parameter, albeit incompletely, attained in 59.4% of the expected situations. The administration instructions presented the most complete performance. Abiraterone, Capecitabine, and Loperamide presented contents of the 4 parameters simultaneously in 1 consultation each. Qualitatively, the content of the consultations had little correspondence to the information leaflets. Discussion and conclusions The preservation of the integrity of therapeutic information is inherent to the good practice in clinical communication. In a practical context, it is important to balance integrity with the selection and adaptation of the most relevant information for each patient and its therapy. In this study, the information transmitted by the pharmacist was quantitatively and qualitatively different when compared to the content of the information leaflets. Content differences may be justified by the nature of the consultation. In this sample of pharmaceutical consultations with cancer therapy, it was not possible to identify an information´s systematic to the patient. Further studies are required, including the systematization of the information transmitted, with the selection of the sample according to criteria, such as the type of cancer and treatment.
Introduction Cancer patients have increasing access to antineoplastic drugs for oral administration in an outpatient setting. Hospital pharmacists have contributed to the rational use of these medications, including by providing information in hospital consultations. The importance of information in self-management of therapy is described. These aspects include the ones related to medicine, such as therapeutic indications, posology, administration instructions and warnings and precautions. This study aims to characterize hospital pharmaceutical consultations in terms of information to cancer patients about their pharmacotherapy. Methods A cross-sectional study of an observational and descriptive nature was conducted, with a content analysis of the communication that took place during thirteen pharmaceutical consultations with cancer patients in a central hospital in Lisbon between September 2019 and February 2020. The audio recordings were literally transcribed and imported into the QSR NVivo 12 qualitative analysis software, with the utterances relating to therapeutic indications, posology, administration instructions, and warnings and precautions for antineoplastic therapy and its co-adjuvants codified. Results Posology was the most discussed parameter, albeit incompletely, attained in 59.4% of the expected situations. The administration instructions presented the most complete performance. Abiraterone, Capecitabine, and Loperamide presented contents of the 4 parameters simultaneously in 1 consultation each. Qualitatively, the content of the consultations had little correspondence to the information leaflets. Discussion and conclusions The preservation of the integrity of therapeutic information is inherent to the good practice in clinical communication. In a practical context, it is important to balance integrity with the selection and adaptation of the most relevant information for each patient and its therapy. In this study, the information transmitted by the pharmacist was quantitatively and qualitatively different when compared to the content of the information leaflets. Content differences may be justified by the nature of the consultation. In this sample of pharmaceutical consultations with cancer therapy, it was not possible to identify an information´s systematic to the patient. Further studies are required, including the systematization of the information transmitted, with the selection of the sample according to criteria, such as the type of cancer and treatment.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2021, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Consulta farmacêutica Oncologia Informação ao doente Folheto informativo Comunicação clínica Mestrado integrado - 2021