Abordagem dos eventos adversos de medicamentos recomendados para tratamento da depressão em guias de prática clínica de alta qualidade metodológica
Data
2022-02-09
Autores
Santos, Maiara Antunes Leite [UNIFESP]
Orientadores
Melo, Daniela Oliveira de [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A depressão é uma doença de alta prevalência, que acomete globalmente aproximadamente 280 milhões de pessoas. Eventos adversos são a maior razão da decisão de não iniciar um tratamento medicamentoso para a depressão. Os eventos adversos influenciam desde a escolha de iniciar um tratamento até o momento que as reações adversas à medicamentos e a ineficácia do tratamento contribuem para a descontinuação. A metodologia do cuidado da depressão na atenção primária pode impactar no diagnóstico, na prevenção de agravos, no tratamento, na redução de danos ou abando do tratamento, na reabilitação e na manutenção da saúde. Dentre as estratégias para melhorar a aderência ao tratamento da depressão, com a ajuda de guidelines, o profissional deve tomar a melhor decisão de medicamento baseado no atendimento individualizado. É importante que os guias de prática clínica estejam sempre bem amparados na melhor evidência disponível e que sejam elaborados em um processo sistemático e transparente, o que garante sua qualidade metodológica. Os principais objetivos da avaliação dos guias selecionados são discutir quantitativa e qualitativamente sobre a abordagem de efeitos adversos em suas recomendações e quais os efeitos adversos que mais são evidenciados nos guias de prática clínica, usando-se do método de busca ativa nos textos, organização dos dados em Excel, para posterior compilação e análise dos dados obtidos comparando a um banco de dados de saúde baseada em evidências. Com a verificação e discussão dos resultados, foi possível entender como os eventos adversos de interesse da farmacovigilância são descritos e o nível de informação presente em cada diretriz clínica, onde os 11 guias analisados retornaram dados da farmacovigilância dos efeitos adversos e todos os efeitos adversos obtidos do banco de dados foram citados em pelo menos um guia, entretanto nenhum guia de prática clínica abordou completamente todos os eventos adversos. Este trabalho permitiu evidenciar a discrepância entre documentos que foram classificados como alta qualidade metodológica pelo mesmo instrumento de avaliação, mas que apresentam formas muito distintas de abordar suas recomendações e necessitam serem usados em conjunto para melhor amparo ao profissional da saúde.
Depression is a common illness that affects approximately 280 million people globally. Adverse events are the biggest reason for the decision not to start drug treatment for depression. Adverse events influence from the choice to start a treatment to the moment that adverse drug reactions and treatment ineffectiveness contribute to discontinuation. The methodology of care for depression in primary care can impact diagnosis, prevention of diseases, treatment, harm reduction or abandonment of treatment, rehabilitation and health maintenance. Among the strategies to improve adherence to the treatment of depression, with the help of guidelines, the professional must make the best medication decision based on individualized care. It is important that clinical practice guidelines are always well supported by the best available evidence and that they are prepared in a systematic and transparent process, which guarantees their methodological quality. The main objectives of the evaluation of the selected guides are to discuss quantitatively and qualitatively about the approach of adverse effects in their recommendations and which adverse effects are most evident in the clinical practice guides, using the method of active search in the texts, organization of the data in Excel, for further compilation and analysis of the data obtained by comparing it to an evidence-based health database. With the verification and discussion of the results, it was possible to understand how adverse events of interest to pharmacovigilance are described and the level of information present in each clinical guideline, where the 11 analyzed guides returned pharmacovigilance data on adverse effects and all adverse effects obtained. from the database were cited in at least one guide, however no clinical practice guideline fully addressed all adverse events. This work made it possible to highlight the discrepancy between documents that were classified as having high methodological quality by the same evaluation instrument, but that present very different ways of approaching their recommendations and need to be used together to better support the health professional.
Depression is a common illness that affects approximately 280 million people globally. Adverse events are the biggest reason for the decision not to start drug treatment for depression. Adverse events influence from the choice to start a treatment to the moment that adverse drug reactions and treatment ineffectiveness contribute to discontinuation. The methodology of care for depression in primary care can impact diagnosis, prevention of diseases, treatment, harm reduction or abandonment of treatment, rehabilitation and health maintenance. Among the strategies to improve adherence to the treatment of depression, with the help of guidelines, the professional must make the best medication decision based on individualized care. It is important that clinical practice guidelines are always well supported by the best available evidence and that they are prepared in a systematic and transparent process, which guarantees their methodological quality. The main objectives of the evaluation of the selected guides are to discuss quantitatively and qualitatively about the approach of adverse effects in their recommendations and which adverse effects are most evident in the clinical practice guides, using the method of active search in the texts, organization of the data in Excel, for further compilation and analysis of the data obtained by comparing it to an evidence-based health database. With the verification and discussion of the results, it was possible to understand how adverse events of interest to pharmacovigilance are described and the level of information present in each clinical guideline, where the 11 analyzed guides returned pharmacovigilance data on adverse effects and all adverse effects obtained. from the database were cited in at least one guide, however no clinical practice guideline fully addressed all adverse events. This work made it possible to highlight the discrepancy between documents that were classified as having high methodological quality by the same evaluation instrument, but that present very different ways of approaching their recommendations and need to be used together to better support the health professional.