Implantação do Cuidado Farmacêutico na Geriatria: Estratégias Adotadas e Experiências Adquiridas

Abstract

OBJECTIVES: To describe the steps, strategies adopted, and experiences accumulated during the implementation of pharmaceutical care in a geriatric ward.

METHOD: A mixed-methods study was proposed and executed in three stages to implement pharmaceutical care (medication reconciliation, medication review, and pharmacotherapeutic follow-up) in a geriatric ward at the University of São Paulo Hospital. In the first stage, a scoping review was conducted using PubMed, EMBASE, and Web of Science databases. The second stage consisted of developing a situational diagnosis of the ward and adapting procedures accordingly. The third stage included a single-arm clinical trial with follow-up for up to 90 days post-discharge, aiming to identify and resolve drug-related problems (DRPs) and analyze associated clinical outcomes.

RESULTS: In the first stage, after screening 3,640 articles on pharmaceutical interventions in geriatrics, 35 were included in the review. Interventions frequently used the STOPP/START criteria and Beers criteria. The main barriers were a lack of specific training and limitations on service continuity. This stage provided a scientific foundation for project development. In the second stage, the situational diagnosis addressed the ward’s structure and epidemiological profile. Pharmaceutical services were validated by a multidisciplinary team and well-accepted. In the third stage, 88.3% of patients presented at least one DRP, with an average of 1.4 DRPs per patient. Polypharmacy and multimorbidity increased the likelihood of DRPs (p=0.03).

CONCLUSION: The planned method was effective in implementing pharmaceutical care, resulting in the creation of informational materials and evidence-based strategies. This approach stands out as an innovation in a Latin American country and may serve as a model for initiatives in similar settings.