Atuação clínica do farmacêutico na adesão ao tratamento de pacientes oncológicos em cuidados paliativos

Abstract

Introduction: It is common for patients in palliative care to have more than one symptom simultaneously and be polymedicated, requiring special attention and support from a multidisciplinary team, including the pharmacist. Objective: To study aspects of the pharmacist's clinical performance in the care of cancer patients in Palliative Care as an active member of a multiprofessional team. Methods: Interventional study with a quantitative, prospective and analytical approach. Data were collected from 36 patients over a six-month period at the Ambulatory of Palliative Care at of “Hospital de Messejana Dr. Carlos Alberto Studart Gomes” and divided into two groups, which received pharmaceutical guidance and the other which did not receive guidance. Results: The study, in its majority, is composed of elderly patients, male, smokers for more than 45 years and with low education. These are critical patients, with several comorbidities, polymedicated and with physical limitations for daily activities. Treatment adherence was significantly increased in the group that received pharmaceutical guidance (p = 0.011). The BMQ adherence test obtained p = 0.007, with strong evidence of the difference in results, in the pharmaceutical consultation, between the groups with and without pharmaceutical guidance. It was observed that in the group with pharmaceutical guidance the value of PPS increased or was maintained in most cases, representing an improvement in the functional status of patients. Regarding the symptoms evaluated by the application of the ESAS scale, the difference in the median for seven symptoms was considerable between the groups, in the group with pharmaceutical guidance there was a considerable clinical improvement, based on the control of physical and psychological symptoms, which shows the expected result of the use of drug therapy instituted in a safe and rational manner based on pharmaceutical guidance, intervening to improve the care, comfort and relief of patients' suffering. Conclusion: The findings reinforce that the pharmaceutical guidelines contributed to the probable adherence to treatment, reflecting on the patient's clinical improvement. Which shows the pharmaceutical collaboration in the optimization of pharmacotherapy, guaranteeing the access and the safe use of the medicine. With this attention, it makes the palliative care approach more humanistic for those who suffer from a disease as difficult as cancer.