Background Little is known about community pharmacist-patient interaction within a consultation room, particularly in terms of patient activation and engagement.

Introduction: Hypoglycemia leading to hospitalization is associated with adverse economic outcomes, although the real burden is unknown. The HIPOS-WARD (Hypoglycemia In Portugal Observational Study-Ward) aimed to characterize ward admissions due to hypoglycemia episodes in treated patients with diabetes and assess their economic impact to the National Health System. Methods: Observational, cross-sectional study, conducted in 16 Portuguese centers for 22 months. The applied microcosting approach was based on healthcare resource data, collected from patients' charts upon ward admission until discharge, and unitary costs from official/ public data sources. Absenteeism was also Digital Features To view digital features for this article go to

Background We intended to estimate the proportion hypoglycemic/hyperglycemic emergency episodes in treated diabetes mellitus (DM) patients admitted to a hospital ward, and calculate the prevalence of risk factors for hypoglycemia and diabetic complications. Methods In this cross-sectional, multicentered study, the observational data was collected by physicians from patient’s hospitalization to discharge/death. Statistical tests were 2-tailed considering 5% significance level. Results There were 646 ward admissions due to hyperglycemic emergencies and 176 hypoglycemic episodes with a ratio hypoglycemia/hyperglycemia 0.27 for all DM patients. In T2DM patients the ratio was 0.38. These were mainly female (55.1%), functionally dependent (61.4%) and retired/disabled (73.1%). Median age was 75 years and median duration of disease 11 years. Half the patients were on insulin-based therapy and 30.1% on secretagogue-based therapy. Approximately 57% of patients needed occasional/full assistance to manage the disease. The most frequent risk factor for hypoglycemia was polypharmacy (85.0%). Hypoglycemia in the 12 months before admission was higher in insulin-based therapy patients (66.1%; p = 0.001). Conclusions Hyperglycemic emergencies are the most frequent cause of hospitalization in Portugal, although severe hypoglycemic events represent a health and social problem in elderly/frail patients. There is still the need to optimize therapy in terms of the potential for hypoglycemia in this patient group and a review of anti-hyperglycemic agents to add on to insulin.

Objectives: The purpose of this study was to analyse longitudinally two decades of Portuguese general practitioner (GP) residents' consultation features, such as consultation length-estimating its major determinants-as well as to compare with GP residents from other Western practices. Methods: This pilot study followed a retrospective and descriptive design, comprising of the analysis of videotaped consultations with real patients from GP residents (southern Portugal), between 1990 and 2008. Main studied variables were consultation length and purpose, participant demographics and residency site characteristics. Results: From 516 residents, 68.0% were females, mainly between 26-35 years old (50.6%). Female patients' proportion equalled doctors', with the most frequent age group being the 46-65 years old (41.3%). The consultation took on average 22 minutes and 22 seconds, with no significant differences by year and residency location. Main consultation purposes were previous scheduling (31.6%) and acute symptoms (30.0%). Duration was consistently longer than practising GPs from other countries, keeping in mind the supervised practice. Significant and positive predictors of consultation length were number of attendants and patients' frequency at the residency site.Conclusions: South Portugal GP residency program consultations were lengthier in comparison to similar practice in Europe and other Western countries. Length correlated preferably with patient related variables than with professionals', while confirming the longitudinal homogeneity in the residency consultation format for the last two decades.

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