Brazilian Hospital Pharmacy: perception of the clinical attributions of pharmacists in view of the Basel Declaration of the FIP

Mariano, Kássia Rodrigues; Ramos, Aline Istéfane de Camargos; Baldoni, André de Oliveira; Sanches, Cristina; Rocha, Bruna Gabriela; Penm, Jonathan; Moles, Rebekah; Pereira, Mariana Linhares

doi:10.1590/s2175-97902024e23674

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Brasil

Brazilian Journal of Pharmaceutical Sciences

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Article • Braz. J. Pharm. Sci. 60 • 2024 • https://doi.org/10.1590/s2175-97902024e23674 copy

Brazilian Hospital Pharmacy: perception of the clinical attributions of pharmacists in view of the Basel Declaration of the FIP

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This descriptive study analyzed the perceptions of Brazilian hospital pharmacists towards their clinical attributions related to “interventions in the prescription” and “monitoring the use of medication” in view of the current Basel Declaration of the International Federation of Pharmacists (Federação Internacional de Farmacêuticos - FIP). Brazilian hospitals of high and medium complexity were identified and a pre-tested questionnaire based on the 65 recommendations of the Basel Statments was sent via e-mail, directed to the pharmacists of the 2,054 hospitals. The results were categorized into: a) they meet the statement, b) they do not meet, or c) they did not respond. Pharmacists from 111 hospitals returned the survey. For the recommendations of the theme “influences on prescribing”, the highest percentage of compliance was related to the effective performance of pharmacists in the Pharmacy and Therapeutics Committee (PTC), which occurred in 54.1% of the hospitals. While for the “monitoring the use of medication” was refered to the existence of an easily accessible system for notifying technical complaints, in 47.7 % of the hospitals. The results emphasize that these activities need to be reviewed and aligned, to offer better quality and more safety to the patient in relation to the use of medication.

Keywords:
Pharmacy Service,Hospital; Patient Safety; Statements; Drug Monitoring; Pharmacy and Therapeutics Committee

Recommendation

Met

n (%)

Unmet

n (%)

No response

n (%)

Hospitals should utilize a medication listing or therapeutic form (local, regional and/or national) linked to treatment guidelines and protocols based on the best available evidence.

(46.8%)

(44.1%)

(9.0%)

Hospital pharmacists must be key members of the PTC to oversee all medication management policies and procedures, including those related to off-label use and in clinical research.

(54.1%)

(38.7%)

(7.2%)

Hospital pharmacists should play a key role in educating prescribers, at all levels of training, in accessing and providing evidence for the responsible use of medication, including required monitoring parameters and subsequent prescribing adjustments.

(31.5%)

(61.2%)

(7.2%)

Hospital pharmacists should be part of the multidisciplinary team responsible for making therapeutic decisions in all areas of patient care.

(38.7%)

(55.8%)

(5.4%)

Hospital pharmacists must promote unceasing care, contributing to the transfer of information about medication, whenever patients move between and within levels of health care.

(39.6%)

(54%)

(6.3%)

Appropriately trained and credentialed hospital pharmacists should participate in collaborative prescribing.

(13.5%)

(71.1%)

(15.3%)

Recommendation

Met

n (%)

Unmet

n (%)

No response

n (%)

An easily accessible system for reporting technical complaints must be established and maintained. Medication technical complaint reports must be reviewed internally and forwarded in a timely manner to regional or national pharmacovigilance regulatory programs and to the manufacturer.

(47.7%)

(45.0%)

(7.2%)

An easily accessible system for reporting ADE should be in place and maintained. Adverse reaction reports must be reviewed internally and submitted in a timely manner to regional or national pharmacovigilance regulatory programs. These data should be regularly reviewed to improve the quality and safety of medication use.

(41.4%)

(51.3%)

(7.2%)

An easily accessible, nonpunitive reporting system for medication errors, including near miss events, should be implemented and maintained. Medication error reports should be reviewed internally and forwarded to regional or national pharmacovigilance regulatory programs. These data should be regularly reviewed to improve the quality and safety of medication practices.

(39.6%)

(50.4%)

(9.9%)

Medication use practices must be evaluated and compared with other services and with good practices, aiming to improve safety, clinical effectiveness and cost-effectiveness.

(43.2%)

(50.4%)

(6.3%)

The medication use process should be reviewed through an external audit or quality improvement program. Hospitals must act on reports to improve the quality and safety of their practices.

(37.8%)

(54.0%)

(8.1%)

The clinically relevant activities of pharmacists must be documented, collected, and analyzed to improve the quality and safety of medication use and therapeutic outcomes for patients. Activities that significantly impact patient care should be documented in the patient's record.

(35.1%)

(51.3%)

(13.5%)

Systematic approaches (e.g., adverse reaction trackers) should be used to provide quantitative data on ADE and appropriate medication use. These data should be regularly reviewed to improve the quality and safety of medication practices.

(22.5%)

(64.8%)

(12.6%)

Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Av. Prof. Lineu Prestes, n. 580, 05508-000 S. Paulo/SP Brasil, Tel.: (55 11) 3091-3824 - São Paulo - SP - Brazil
E-mail: bjps@usp.br

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[1] * marianapereira@ufsj.edu.br