Mapping of drug-related problems involving the prescription of opioid drugs in a teaching hospital in Curitiba

Abstract

Introduction: Drug-Related Problems (DRPs) are unwanted events presented in pharmacotherapy that negatively affect the treatment of a disease and the actions of Clinical Pharmacy in pharmacovigilance of prescriptions aims on the minimization of these problems. Considering that referral hospitals for trauma often use opioid drugs in trauma patients’ management, it is necessary to carry out an investigation into DRPs involving the prescription of opioids in these hospitals. Objective: To map the DRPs identified in the prescription of opioid drugs in the management of patients in the ward of a teaching hospital in Curitiba. Methods: The research was retrospective and observational. Prescription data was collected from February 2019 to April 2021. From the 14.014 prescriptions analyzed in the period, it was calculated through the DOT (Days of Therapy) that 6.996 of them contained opioids. Of the prescriptions evaluated, 9.075 had DRPs, 1.550 of which were related to opioids. Results: The main problem involving the prescription of opioids in the wards is cost-effectiveness (73,61%); the main cause of DRP is the prescription of the inappropriate drug form for the patient in question (73,23%). In 87,74% of the cases, an intervention was proposed to the prescriber; however, in only 35,61% of the cases the proposed intervention was accepted and fully implemented, so that the problem was fully resolved in only 36,6% of the cases. In 29,55% of the cases, the problem was not resolved due to lack of cooperation on the part of the prescribing physician. Also, a steady decrease in the incidence rate of DRPs was observed over time, as consequence of pharmacovigilance of prescriptions and prescribers. Conclusion: The research was not only fruitful in designing a complete mapping of opioidrelated DRPs in the hospital, but also highlighted the effectiveness of the educational action of pharmacists on prescribers.