Banca de DEFESA: CASSIO ALEXANDRE OLIVEIRA RODRIGUES

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : CASSIO ALEXANDRE OLIVEIRA RODRIGUES
DATE: 12/12/2025
TIME: 09:00
LOCAL: Auditório do CCS no prédio do curso de Farmácia
TITLE:

Clinical and Economic Analysis of Intravenous-to-Oral Conversion of Pantoprazole in Critically Ill Patients

KEY WORDS:

Pantoprazole; Intravenous Administration; Oral Administration; Economic Evaluation; Pharmaceutical Care

 

PAGES: 48
BIG AREA: Ciências da Saúde
AREA: Farmácia
SUBÁREA: Farmácia clínica, assistência e atenção farmacêuticas
SUMMARY:

Introduction: Proton Pump Inhibitors (PPIs) are widely prescribed in hospital care, mainly for stress-related gastric ulcer prophylaxis in critically ill patients. However, many prescriptions have inappropriate indications, and there is excessive use of the intravenous (IV) route even when the oral (PO) route is eligible, an endemic problem in this setting, further intensified by care dynamics. Objective: To evaluate the clinical and economic outcomes of interventions promoting intravenous to oral therapy conversion in critically ill patients receiving intravenous pantoprazole, including physician acceptance and the effects on duration of use by route of administration, length of hospital stay and mortality. Method: A quasi-experimental cost-minimization study conducted in a private ICU from 2019 to 2023, including 172 patients (86 in the intervention group – IG; 86 in the control group – CG). In the IG, the pharmacist recommended IV-to-PO conversion to physicians; in the CG, patients were only observed. Costs (medications and supplies), conversion rate, and clinical outcomes were compared using univariate analysis (p < 0.05). Results: Intravenous to oral therapy conversion occurred in 100% of patients in the IG versus 17.4% in the CG (p < 0.001). The daily cost of oral therapy was 50 times lower (R$ 0.23 vs. R$ 11.12; p < 0.001), resulting in a substantial reduction in total cost (R$ 178.71 vs. R$ 13,959.30). There was also a shorter mean duration of IV use (4.4 vs. 10.5 days; p = 0.001) and longer oral use (7.1 vs. 1.5 days; p < 0.001), with no differences in mortality or length of hospital stay. Conclusion: interventions promoting intravenous to oral therapy conversion reduced costs and the unnecessary use of intravenous pantoprazole, with high physician acceptance and no adverse clinical impact, establishing it as a sustainable, multidisciplinary strategy for optimizing pharmacotherapy in critically ill patients.

COMMITTEE MEMBERS:
Presidente - 3315645 - FRANCISCA SUELI MONTE MOREIRA
Externa à Instituição - LUANA CRISTINA LINS DE MEDEIROS OLIVEIRA
Interno - 1052612 - RODRIGO DOS SANTOS DINIZ