Seguimiento farmacoterapéutico en pacientes hospitalizados en tratamiento con fentanilo transdérmico

Pain is the most frequent reason of consultation in pi mary care centres. Approximately, half of the populatio suffers from pain crisis at some time in the year, and or third of those suffers from chronic pain. The aims of th study are to describe the incidence and types of drug th rapy problems (DTP), understood as negative clinical ou comes from antinociceptive therapy with transdermal fetanyl in hospitalized patients, the pharmacist interventions, their acceptance by the clinicians and their resolution. As well as to compare the incidence of DTP, of pharmacist interventions, their acceptance and resolution according to the following variables: clinical service and oncologic diagnostic or not. Material and method: Evaluation and detection of DTP in patients who initiate treatment with transdermal fentanyl (TF) in a third level hospital. The follow-up to the patients was during 7 days or longer up to resolution of the DTP. For the assessment of the pain perception the Visual Analogic Scale (VAS) was used. Results: 30 patients (129 patients/day) were studied. A total of 51 DTP were detected. The DTP incidence in patients with non-oncologic pain has been major (p<0.05). The DTP types from major to minor incidence were DTP 1: 53% (the patient suffers from a health problem as a consequence of not receiving the medication that he needs), DTP 3: 15.6% (the patient suffers from a health problem as a consequence of a non-quantitative ineffectiveness of the medication), DTP 4: 15.6% (the patient suffers from a health problem as a consequence of a quantitative ineffectiveness of the medication), DTP 6: 7.8% (the patient suffers from a health problem as a consequence of a quantitative safety problem of a medicine), DTP 2: 5.8% (the patient suffers from a health problem as a consequence of receiving a medicine that he does not need) and DTP 5: 2% (the patient suffers from a health problem as a consequence of a non-quantitative safety problem of a medicine). The most common reason was that the rescue analgesic therapy was not prescribed. 45 interventions were realized. The global acceptance of the recommendations was of 84.45%. From 35 accepted interventions, 34 (97.14%) achieved to solve the PRM. Conclusions: They are prevalent DTP in analgesic therapy and to avoid them a pharmacotherapy follow-up is necessary. There would be necessary the achievement of studies including a higher number of patients and with a longer follow-up period; then there might detect other DTP that were not possible in this case.Objetivo: El dolor es una de las causas de consulta más frecuente en los centros de atención primaria. Aproximadamente la mitad de la población sufre crisis de dolor alguna vez al año, y un tercio de la misma sufre dolor crónico. Los objetivos del estudio son describir la incidencia y tipos de problemas relacionados con los medicamentos (PRM) de la terapia antiálgica con fentanilo transdérmico en pacientes hospitalizados, las intervenciones farmacéuticas realizadas, su aceptación por parte de los clínicos y su resolución. También comparar la incidencia de PRM, de intervenciones farmacéuticas, su aceptación y resolución según las variables: servicio clínico y diagnóstico, oncológico o no. Material y método: Evaluación y detección de PRM en pacientes que inician tratamiento con fentanilo transdérmico (FT) en un hospital de tercer nivel. El seguimiento de los pacientes fue de 7 días o superior hasta resolución de los PRM. Para la valoración del dolor se utilizó la Escala Visual Analógica (EVA). Resultados: Se estudiaron 30 pacientes, 129 pacientes-día. Se detectaron un total de 51 PRM. La incidencia de PRM ha sido mayor en pacientes con dolor de origen no oncológico (p