Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients

Obreli-Neto, Paulo Roque; Guidoni, Camilo Molino; Baldoni, André de Oliveira; Pilger, Diogo André; Cruciol, Joice Mara; Gaeti-Franco, Walderez Penteado; Cuman, Roberto Kenji Nakamura

doi:10.1007/s11096-011-9518-x

Cited by 96 publications

(119 citation statements)

References 24 publications

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“…A recent study conducted in Goiás between 2000 and 2008 showed that 17.2% of hospitalizations occurred as a result of cardiovascular conditions that could have been resolved at primary level (Batista et al, 2012). Therefore, Pharmaceutical Care may represent an important tool within the FHS, benefitting patients with hypertension by controlling their blood pressure (Castro et al, 2006;Lyra Júnior et al, 2008;Morgado et al, 2011;Obreli-Neto et al, 2011, Aguiar et al, 2012b, improving adherence to antihypertensive drugs (Souza et al, 2007;Aguiar et al, 2012b) and optimizing metabolic control of carbohydrates and lipids (Kicklighter et al, 2006;Correr et al, 2011;Obreli-Neto et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Pharmaceutical Care for hypertensive patients provided within the Family Health Strategy in Goiânia, Goiás, Brazil

Martins

Aquino

Provin

et al. 2013

Braz. J. Pharm. Sci.

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The aim of Pharmaceutical Care programs is to improve patients' quality of life, and such programs are particularly effective in the case of chronic diseases such as hypertension. The objective of this longitudinal study was to analyze a Pharmaceutical Care model for hypertensive patients receiving care within the Family Health Strategy (FHS). All patients were being seen by an FHS team affiliated to a primary healthcare unit in Goiânia, Goiás, Brazil. Fourteen patients participated in the study, with each patient receiving six home visits during the Pharmaceutical Care. Overall, 142 drug-related problems were reported, the most common concerning the ineffectiveness of treatment (33.8%). A total of 135 pharmaceutical interventions were performed, 92.6% of which involved pharmacist-patient communication, with 48.8% of these interventions being implemented. Cardiovascular risk decreased in three patients and remained unchanged in nine. In hypertensive patients with diabetes, fasting glucose levels were reduced in six out of nine cases. The Pharmaceutical Care model proposed here was effective in detecting drug-related problems and in proposing interventions to resolve or prevent these problems. Consequently, this may have contributed towards improving clinical parameters, such as fasting glucose levels and cardiovascular risk in hypertensive patients receiving care within the FHS.Uniterms: Pharmaceutical care. Hypertension. Primary health care.A Atenção Farmacêutica tem como objetivo conseguir resultados concretos que melhorem a qualidade de vida do paciente, contribuindo especialmente em doenças crônicas, como a Hipertensão Arterial. O objetivo deste estudo foi analisar um modelo de Atenção Farmacêutica a pacientes com Hipertensão Arterial assistidos pela Estratégia Saúde da Família (ESF). Trata-se de um estudo longitudinal realizado com pacientes assistidos pela ESF de uma Unidade Básica de Saúde de Goiânia-GO. Participaram do estudo, 14 pacientes que receberam seis visitas domiciliares para Atenção Farmacêutica. Registraramse 142 Problemas Relacionados a Medicamentos (PRM) sendo mais frequente a falta de efetividade do tratamento (33,8%). Realizaram-se 135 intervenções farmacêuticas, das quais 92,6% foram com a comunicação farmacêutico-paciente, em que 48,8% das intervenções foram implementadas. Observou-se redução do risco cardiovascular em três pacientes e nove pacientes não apresentaram alteração no nível de risco cardiovascular. Entre os pacientes hipertensos e diabéticos observou-se redução da glicemia de jejum em seis. O modelo de Atenção Farmacêutica proposto foi capaz de detectar PRM propondo intervenções para resolvê-los e preveni-los e, consequentemente, pode ter contribuído na melhora de parâmetros clínicos como glicemia de jejum e risco cardiovascular em pacientes hipertensos assistidos pela ESF.Unitermos: Atenção farmacêutica. Hipertensão arterial. Atenção primária à saúde.

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Section: Introductionmentioning

confidence: 99%

Pharmaceutical Care for hypertensive patients provided within the Family Health Strategy in Goiânia, Goiás, Brazil

Martins

Aquino

Provin

et al. 2013

Braz. J. Pharm. Sci.

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“…Unfortunately, this is the picture of the Brazilian public health system, thus no non-pharmacological intervention is performed and the burden is attributed only to the medicines to control diabetes. In this baseline, pharmaceutical care comes as a powerful tool to control glycemic levels and improves the adherence to treatment in patients with chronic diseases including diabetes [26][27][28][29][30]. Recently our group published two review articles that showed that a change in the current medical model is needed and to investigate other factors such as toxins, malnutrition, stress, infections and electromagnetic pollution in patients with chronic diseases [26,31].…”

Section: Discussionmentioning

confidence: 99%

Low Scores in the Auto-Compliance Method and Fast Medical Care Influence the Poor Adherence in Diabetics attended in the Basic Health Unit

Peres¹,

Foss²,

Pereira³

2017

Biol Med (Aligarh)

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Objective: To evaluate the factors that influences the adherence in diabetics and correlate with the low and high Morisky Green Test (MGT) scores. Subjects and methods:A total of 301 type 1 and type 2 diabetes patients aged 18 to 90 years using insulin and oral hypoglycemic agents were evaluated with instruments MGT, MedTaKe test (MT), Pharmacotherapy Complexity Index (CPI), Complication of Diabetes Index (CDI) and Auto-Compliance Test (ACT). The patients were divided into two groups: adherent diabetics with scores >80 in MGT and non-adherent diabetics with scores ≤ 80 in MGT, and their differences were compared with the student T-test and odds ratio with their respective confidence intervals.Results: Significant differences were found in the variables: MGT (91.3 ± 8.5 vs. 59.2 ± 10, p<0.00), MT (62.5 ± 19 vs. 56.3 ± 21.6, p<0.01), ACT (94 ± 23 vs. 69.9 ± 44, p<0.00) of the adherent diabetics compared to the nonadherent diabetics. ACT (r=0.23, p<0.02), marital status (r=0.90, p<0.00), and race (r=0.94, p<0.00) were correlated positively with the >80 MGT scores, and schooling level (r=-0.15, p<0.03) was correlated negatively. For the nonadherent diabetics, the attendance service time (r=0.21, p<0.01), ACT (r=0.34, p<0.00), marital status (r=0.73, p<0.00), and CPI section two (r=0.18, p<0.04) were correlated positively, and drug loads (r=-0.18, p<0.04) was correlated negatively. Linear regression analysis showed that race (p<0.00) may influence the >80 MGT scores and attendance service time (p<0.01), marital status (p<0.00) and race influenced the ≤ 80 MGT group scores.Conclusions: ACT, marital status, race and attendance service time may influence the low adherence in diabetics.

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“…Estimation on patient adherence to the use of dabigatran was done through the method of recording drug removal described by Obreli-Neto et al (2011), 13 and patients considered as having adhered were those with an agreement level of 80 to 115%.…”

Section: Methodsmentioning

confidence: 99%

Study of Dabigatran Use in a Brazilian Public Hospital Specialized in Cardiology

Martins

Silva

et al. 2017

International Journal of Cardiovascular Sciences

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Effect of a 36-month pharmaceutical care program on pharmacotherapy adherence in elderly diabetic and hypertensive patients

Abstract: These results indicated the effectiveness of pharmaceutical care in improving pharmacotherapy adherence, with positive effects in the clinical outcomes of the patients studied.

Cited by 96 publications

References 24 publications

Pharmaceutical Care for hypertensive patients provided within the Family Health Strategy in Goiânia, Goiás, Brazil

Pharmaceutical Care for hypertensive patients provided within the Family Health Strategy in Goiânia, Goiás, Brazil

Low Scores in the Auto-Compliance Method and Fast Medical Care Influence the Poor Adherence in Diabetics attended in the Basic Health Unit

Study of Dabigatran Use in a Brazilian Public Hospital Specialized in Cardiology

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