Evaluación de la calidad de dos modelos de atención farmacéutica en pacientes onco-hematológicos

Abstract

To compare the quality of two pharmaceutical care models (with and without pharmacist participation in the clinical team), in hospitalised onco-haematological patients. A prospective cohort study in the oncology and haematology departments of a university hospital over a 26-month period. A centralised model (model C) was used over 16 months and a decentralised integration model (model D) was used during the remaining 10 months. The Iaser (c) methodology was used to identify candidates for improved drug treatment and for the follow up of patients with drug-related problems (DRP). The results obtained were compared using a series of pharmaceutical care quality indicators. The rate of patients identified with DRP increased significantly (RR = 2.3; CI 95%: 1.8-2.8), as did the frequency of DRP (RR = 3.4; CI 95%: 2.8-4.0), in particular the frequency of preventable DRP (RR = 3.8; CI 95%: 2.5-4.2). The identification of the type of DRP relating to indication significantly increased (RR = 4.5; CI 95%: 3.4-5.8), followed by DRP relating to efficacy and safety. The acceptance of pharmaceutical care interventions did not improve proportionally (RR = 1.0; CI 95%: 0.9-1.1), although there was a significant increase in practices with clinical importance (RR = 4.1; CI 95%: 3.3-5.0), that showed an objective or subjective decrease in the risk of drug-related morbidity in patients (RR = 4.1; CI 95%: 3.1-5.4). Pharmacist participation in the interprofessional team improved the quality of pharmaceutical care, in particular with respect to the increased identification of possibilities to improve drug treatment and clinically significant pharmaceutical practices. As a result, the risk of drug-related morbidity can be reduced in patients.