Evaluation of the pharmacotherapeutic follow-up effectiveness in patients with dyslipidemia in the secondary health care in the Brazilian Unified Health System (SUS)

Abstract Cardiovascular diseases (CVD) are one of the main causes of mortality in the world. Dyslipidemia treatment can reduce the number of deaths caused by CVD, by decreasing the lipid profile. Evaluate the pharmacotherapeutic follow-up effectiveness in patients with dyslipidemia, regarding clinical and laboratory aspects. A quasi-experimental trial was performed in 12 months. The studied population was included patients with dyslipidemia who received a pharmacotherapeutic follow-up, which was evaluated according to the Pharmacotherapy Workup developed by the Brazilian Ministry of Health. Clinical and laboratory evaluations were performed at the baseline, after a 6 and 12-months period. The statistical analyzes were performed with the normality test of Lilliefors, Cramer Von Misses, and Anderson Darling, later the t-paired test. This study demonstrated that after 6-months of intervention, statistically significant results were verified in the reduction of LDL-cholesterol, total cholesterol, increase in HDL-cholesterol, and reduction in the blood pressure. It was observed that for high-risk patients, the achievement of targets in the lipid profile and HbA1C occurred only after 12-months, because, this population needs more aggressive targets and expressive interventions. Pharmacotherapeutic follow-up in patients with dyslipidemia reduced lipid blood levels and promoted positive clinical and laboratory outcomes.

Pharmaceutical care and evaluation of adherence to antiretroviral therapy in people living with HIV/AIDS

Abstract Highly Active Antiretroviral therapy (HAART) depends on optimal adherence to be effective. Pharmacotherapeutic follow-up can be used as a strategy for treatment fidelity. To provide pharmaceutical care for HAART patients, to assess adherence, to identify and resolve drug related problems (DRP). This is a prospective, interventional study aimed at people on HAART. Data was collected using the pharmacotherapeutic follow-up form and CEAT-VIH. There was a predominance of women (59%), older than 33 years (75%), mostly single (43%). Regarding adherence, 64% had insufficient adherence at the start of the study, while 36% had strict/adequate adherence. After the pharmacotherapeutic follow-up, 70% presented strict/adequate adherence. Regarding HAART, the relationship between adhesion versus time of HAART and adherence versus regimen used was significant, considering that less time of therapy and regimen containing protease inhibitors are predictors for insufficient adherence. Regarding the DRP identified (f=77), missed pills (32%), untreated disease, incorrect management frequency, and undue self-medication (12%) were the most frequent. Pharmaceutical interventions (f=137) were predominantly advising related to specific pharmacological treatment (32%), non-pharmacological measures (20%), and medication suspension (9%). Pharmaceutical care was shown to be animportant strategy, within the multi professional team, to improve adherence, besides identifying and resolving DRP.

Arterial Hypertension and other risk factors associated with cardiovascular diseases among adults / Hipertensão arterial e outros fatores de risco associados às doenças cardiovasculares em adultos / Hipertensión arterial y otros factores de riesgo asociados a las enfermedades cardiovasculares en adultos

OBJECTIVE: to identify the prevalence of arterial hypertension and its association with cardiovascular risk factors among adults. METHOD: cross-sectional, population-based, descriptive study conducted with 408 adult individuals. Data were collected through a questionnaire and measurements of weight, height and waist circumference. Person's Chi-square and multiple logistic regression were used in the data analysis. RESULTS: 23.03% of the individuals reported hypertension with a higher prevalence among women. Odds Ratio indicated that smoking, body mass index, waist circumference, diabetes mellitus and dyslipidemia were positively associated with arterial hypertension. CONCLUSION: high self-reported hypertension and its association with other cardiovascular risk factors such as diabetes, obesity and dyslipidemia show the need for specific nursing interventions and the implementation of protocols focused on minimizing complications arising from hypertension, as well as to prevent the emergence of other cardiovascular diseases. .

OBJETIVO: identificar a prevalência da hipertensão arterial e sua associação com fatores de risco cardiovasculares em adultos. MÉTODO: estudo transversal, descritivo, de base populacional, desenvolvido com 408 indivíduos adultos selecionados. Os dados foram coletados com utilização de um questionário e aferição de peso, estatura e circunferência abdominal. Para análise dos dados empregaram-se os testes estatísticos qui-quadrado de Pearson e Regressão Logística Múltipla. RESULTADOS: dentre os sujeitos, 23,03% referiram ser hipertensos, com prevalência maior no sexo feminino. O Odds Ratio apontou que tabagismo, índice de massa corporal, circunferência abdominal, diabetes mellitus e dislipidemia apresentaram associação positiva com hipertensão arterial. CONCLUSÕES: a elevada prevalência de hipertensão autorreferida e sua associação com outros fatores de risco cardiovasculares, como diabetes, obesidade e dislipidemia, apontam a necessidade de intervenções específicas de Enfermagem e implementação de protocolo de atendimento que tenha como foco minimizar as complicações decorrentes da hipertensão, como também prevenir o surgimento de outras doenças cardiovasculares. .

OBJETIVO: identificar la prevalencia de la hipertensión arterial y su asociación con factores de riesgo cardiovasculares en adultos. MÉTODO: estudio transversal, descriptivo, de base poblacional, desarrollado con 408 individuos adultos seleccionados. Los datos fueron recolectados utilizando un cuestionario; se midió el peso, la estatura y la circunferencia abdominal. Para el análisis de los datos se empleó las pruebas estadísticas Chi-cuadrado de Pearson y la Regresión logística múltiple. RESULTADOS: 23,03% de los sujetos refirieron ser hipertensos, con prevalencia mayor en el sexo femenino. El Odds Ratio apuntó que tabaquismo, índice de masa corporal, circunferencia abdominal, diabetes mellitus y dislipidemia presentaron asociación positiva con hipertensión arterial. CONCLUSIONES: la elevada prevalencia de hipertensión auto-referida y su asociación con otros factores de riesgo cardiovasculares como diabetes, obesidad y dislipidemia, apuntan la necesidad de realizar intervenciones específicas de enfermería e implementar un protocolo de atención que tenga como enfoque minimizar las complicaciones provenientes de la hipertensión, como también prevenir el surgimiento de otras enfermedades cardiovasculares. .