Critical analysis of the compounded medication formulary dispensed at the outpatient pharmacy of a tertiary public hospital in São Paulo

Abstract

Objectives: To realize a critical analysis of the list of medicines compounded for the care of outpatients, identifying which medicines are registered, the quantity served and a bibliographical survey to support the therapeutic indication, concentration and pharmaceutical form, making a proposal for the exclusion, maintenance or replacement of the pertinent items. Methods: A cross-sectional, qualitative, and semi-quantitative study on medications compounded by the pharmacotechnical unit and supplied to the outpatient pharmacy of the Central Institute of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, regarding the quantity served between September 2023 and September 2024, therapeutic indication, concentration and pharmaceutical form. The quantity served and the medicines registered were obtained from two administrative reports (without patient identification) from the outpatient prescription and fulfillment system. A descriptive statistical analysis of the frequency of the collected data was performed. Results: A total of 172 medicines were identified for supply, in which oral solutions with 3,022,955 mL (44.96% of the quantity), had the highest consumption. Among the 172 medicines, 23 of them represent 80% of the quantity served, being vitamin B12 (11.06%), omeprazole (7.51%), hydroxyzine (5.56%), artificial saliva (5.42%), baclofen (5.09%), amitriptyline + lidocaine (4.86%), semi-solid petroleum jelly (4.03%), four presentations of magnesium sulfate (10.62%), massage ointment (3.74%), Eisenberg solution (3.38%), urea in cold cream (2.26%), carboxymethyl cellulose (CMC) gel (2.25%), polyethylene glycol (PEG) (1.78%), clonazepam (1.77%), propantheline (1.77%), codeine (1.59%), prednisone (1.58%), gentamicin + betamethasone (1.56%), urea in lanette cream (1.33%) and liquor carbonis detergens – LCD in lanette lotion (1.25%). With the bibliographic research, 133 medications (77.32%) were maintained, 28 (16.28%) were excluded and 11 medications (6.40%) were replaced. Conclusions: This study contributes to a better understanding of the productive capacity of the pharmaceutical technology sector, serving as a starting point for new studies, assisting in the redesign of compounding processes, improvements in infrastructure, and the alignment of the range of compounded medications with the needs of patients and the institution.