“Desprescrever” nos Doentes em Fim de Vida: Um Guia para Melhorar a Prática Clínica

Autores

  • Inês Romero Serviço de Medicina II; Hospital Prof. Doutor Fernando Fonseca; Amadora; Portugal
  • Beatriz Braga Serviço de Medicina Interna; Hospital do Divino Espírito Santo de Ponta Delgada; São Miguel; Portugal
  • Joana Rodrigues Serviço de Medicina 1C; Centro Hospitalar Lisboa Norte - Hospital de Santa Maria; Lisboa; Portugal
  • Rui Rodrigues Serviços Farmacêuticos; Hospital da Luz; Lisboa; Portugal
  • Isabel Galriça Neto Unidade de Cuidados Continuados e Paliativos; Hospital da Luz; Lisboa; Portugal

DOI:

https://doi.org/10.24950/rspmi/Revisao/139/1/2018

Palavras-chave:

Cuidados Terminais, Desprescrever, Polifarmácia, Prescrição Inadequada

Resumo

A desprescrição consiste numa avaliação sistemática dos
riscos e benefícios potenciais de cada fármaco para determinado doente, considerando a sua condição clínica e
prognóstico vital. Este processo deve integrar-se no plano
de cuidados de todos os doentes, mas sobretudo nos doentes em fim de vida, i.e., últimos 12 meses de vida, tratando-
-se assim de uma matéria de enorme pertinência no âmbito dos Cuidados Paliativos. Devem ser descontinuados os
fármacos cuja expectativa temporal para benefício excede
a sobrevida expectável do doente - geralmente fármacos
utilizados para prevenção primária, como é o caso das estatinas. A manutenção de outros grupos de fármacos, após
correta avaliação, poderá estar indicada, mas com a devida
adequação aos objetivos de cuidados nestes doentes (ex.:
antimicrobianos, anticoagulantes, inibidores da bomba de
protões e agentes hipoglicemiantes). O ato de desprescrever visa evitar ou reduzir a polifarmácia e, assim, minimizar
as potenciais iatrogenias medicamentosas e a sobrecarga
terapêutica que tomam especial relevância no fim de vida.

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Publicado

13-03-2018

Como Citar

1.
Romero I, Braga B, Rodrigues J, Rodrigues R, Galriça Neto I. “Desprescrever” nos Doentes em Fim de Vida: Um Guia para Melhorar a Prática Clínica. RPMI [Internet]. 13 de Março de 2018 [citado 2 de Julho de 2022];25(1):48-57. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/440

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