Pharmaceutical interventions and factors associated with their acceptance in intensive care units in Brazil / Intervenciones farmacéuticas y factores asociados a su aceptación en unidades de cuidados intensivos en Brasil

Objetivo: El propósito de este estudio es evaluar las intervenciones farmacéuticas (IF) realizadas sobre PRM y los factores asociados a su aceptación. Método: Se trata de un estudio descriptivo y transversal que analizó las IF realizadas a pacientes adultos de dos UCI de Fortaleza, Brasil, en 2019. Las IF se analizaron en las categorías cantidad de fármaco y estrategia farmacológica, utilizando la clasificación propuesta por Sabater et al. Los fármacos se clasificaron además por el Sistema de Clasificación Anatómica, Terapéutica, Química y por la clasificación de Fármacos de Alta Vigilancia (FAV). Resultados: Se incluyeron 305 pacientes, siendo la mayoría del sexo masculino (55,1 %), ancianos (52,8 %) y atendidos en la UCI quirúrgica (51,4 %). Se analizaron 1.317 IF y se aceptaron el 88,0 %, siendo la sustitución de uno o más fármacos (28,0 %) y la adición de uno o más fármacos (27,7 %) las más frecuentes. La clase terapéutica más prevalente fue antiinfeccioso de uso sistémico (24,1 %) y los FAV estuvieron implicados en el 21,7 % de las IF. Se observó asociación entre las IF aceptadas e ingreso en UCI clínica (p<0,0001), FAV (p=0,0013), sustitución de uno o más fármacos (p=0,0062) y la clase sustitutos sanguíneos y soluciones de perfusión (p= 0,0187). Conclusiones: Se realizaron y aceptaron un elevado número de IF, lo que refuerza la importancia del farmacéutico en la revisión de las prescripciones médicas en UCI. (AU)

Objective: The purpose of this study is to evaluate the pharmaceutical interventions (PI) performed in PRM and the factors associated with their acceptance.Method: This is a descriptive and cross-sectional study that analyzed PIs performed on adult patients from two ICUs in Fortaleza, Brazil, in 2019. PIs were analyzed in the categories quantity of drug and pharmacological strategy, using the classification proposed by Sabater et al. The drugs were also classified by the Anatomical, Therapeutic, and Chemical Classification System and by the High Surveillance Drugs (FAV) classification.Results: 305 patients were included, most of them male (55.1 %), elderly (52.8 %) and treated in the surgical ICU (51.4 %). 1,317 PIs were analyzed and 88.0 % were accepted, being to replace one or more drugs (28.0 %), to add one or more drugs (27.7 %) and to change the dose (24.8 %) the most frequent types. The most prevalent therapeutic class was anti-infectives for systemic use (24.1 %) and AVFs were involved in 21.7 % of the PIs. An association was observed between PIs accepted and admission to the clinical ICU (p<0.0001), AVF (p=0.0013), substitution of one or more drugs (p=0.0062) and the class of blood substitutes and perfusion solutions. (p= 0.0187).Conclusions: A high number of PIs were performed and accepted, which reinforces the importance of the pharma-cist in the review of medical prescriptions in the ICU. (AU)

Incidence of variant hemoglobins in newborns attended by a public health laboratory.

OBJECTIVE: To evaluate the incidence of variant hemoglobins in different health regions. METHODS: A descriptive, observational, and cross-sectional study with a quantitative approach based on secondary data in the internal records of the neonatal screening service - Laboratório Central de Saúde Pública do Estado do Piauí (PI, Brazil). The variables related to sex, ethnicity and positive diagnosis for variant hemoglobins were analyzed, with further population distribution of hemoglobinopathies among the macroregions of the state. RESULTS: A total of 69,180 samples of newborns were analyzed, and 3,747 were diagnosed as hemoglobinopathies, from February 1st, 2014 and December 31st, 2015. Sickle cell trait was the most frequent (4.1%), followed by hemoglobinopathy C in 0.9%; homozygous hemoglobin S cases 0.1% stood out and there were no cases of hemoglobinopathy D in the state. It is also worth noting that the highest frequencies of hemoglobin alterations in Piauí were in males (49.8%) and of parda skin color (38.5%). The region of Piauí presenting the highest incidence of heteroygous variant hemoglobins was Tabuleiros do Alto Parnaíba and Vale do Sambito, due to importance of the region's population Entre Rios. CONCLUSION: Neonatal screening programs are important for screening, orientations regarding health actions and monitoring of families with hemoglobinopathies, in order to reduce morbidity and mortality rates.

Incidence of variant hemoglobins in newborns attended by a public health laboratory / Incidência de hemoglobinas variantes em neonatos assistidos por um laboratório de saúde pública

ABSTRACT Objective To evaluate the incidence of variant hemoglobins in different health regions. Methods A descriptive, observational, and cross-sectional study with a quantitative approach based on secondary data in the internal records of the neonatal screening service - Laboratório Central de Saúde Pública do Estado do Piauí (PI, Brazil). The variables related to sex, ethnicity and positive diagnosis for variant hemoglobins were analyzed, with further population distribution of hemoglobinopathies among the macroregions of the state. Results A total of 69,180 samples of newborns were analyzed, and 3,747 were diagnosed as hemoglobinopathies, from February 1st, 2014 and December 31st, 2015. Sickle cell trait was the most frequent (4.1%), followed by hemoglobinopathy C in 0.9%; homozygous hemoglobin S cases 0.1% stood out and there were no cases of hemoglobinopathy D in the state. It is also worth noting that the highest frequencies of hemoglobin alterations in Piauí were in males (49.8%) and of parda skin color (38.5%). The region of Piauí presenting the highest incidence of heteroygous variant hemoglobins was Tabuleiros do Alto Parnaíba and Vale do Sambito, due to importance of the region's population Entre Rios. Conclusion Neonatal screening programs are important for screening, orientations regarding health actions and monitoring of families with hemoglobinopathies, in order to reduce morbidity and mortality rates.

RESUMO Objetivo Avaliar a incidência de hemoglobinas variantes em diferentes regiões de saúde. Métodos Estudo descritivo, observacional e transversal com abordagem quantitativa baseada em dados secundários presentes nos registros internos do serviço de triagem neonatal do Laboratório Central de Saúde Pública do Estado do Piauí (PI, Brasil). Foram analisadas as variáveis referentes a sexo, etnia e diagnóstico positivo para hemoglobinas variantes, com posterior distribuição populacional das hemoglobinopatias entre as macrorregiões do Estado. Resultados Foram analisadas 69.180 amostras de recém-nascidos, e 3.747 diagnosticados com hemoglobinopatias, entre 1° de fevereiro de 2014 e 31 de dezembro de 2015. Constatou-se maior ocorrência do traço falciforme em 4,1% da amostra e da hemoglobinopatia C em 0,9%, com destaque para os casos de hemoglobina S em homozigose (0,1%) e ausência de hemoglobinopatia D no Estado. Destacou-se, ainda, o fato de as maiores frequências de alteração hemoglobínica do Piauí estarem presentes em recém-nascidos do sexo masculino (49,8%) e de etnia parda (38,5%). As regiões do Piauí que apresentaram as maiores incidências de hemoglobinas variantes em heterozigose foram Tabuleiros do Alto Parnaíba e Vale do Sambito, devendo-se ressaltar a relevância populacional da região Entre Rios. Conclusão Os programas de triagem neonatal são importantes para rastreamento, orientação de ações de saúde e acompanhamento de famílias acometidas com hemoglobinopatias, a fim de diminuir a morbimortalidade provocada por estas patologias.

Profile of diabetic patients accompanied by the pharmaceutical assistance of Piauí, Brazil / Perfil dos pacientes diabéticos acompanhados pela assistência farmacêutica do Piauí, Brasil

Diabetes mellitus consists of a chronic disease that currently stands out for its associated morbidity and mortality. The therapy is based on the association of different drugs and requires a change in the habits of the patients. The objective of the present study was to analyze the clinical and epidemiological profile of patients with type 2 diabetes mellitus assisted by the Specialized Component of Pharmaceutical Assistance of the state of Piauí. This was a descriptive, crosssectional study and analysis of social, demographic, economic, biochemical and anthropometric parameters. From the 93 participants, 66.7% were female, 57% had an average age of 60.5 years and 50.5% had a weight above 69 kg. The predominant family income was one minimum wage salary and the level of education reported was completed secondary education. It was found that 53.8% of the participants practiced regular physical activity and 87.1% had food restrictions. The most commonly used drug was vildagliptin. It was proven that 52.7% had unsatisfactory glycemic control considering the levels of HbA1c, as well as a necessity of a public state clinical protocol that regulates the dispensation of oral hypoglycemic agents in the state.

O diabetes mellitus consiste em uma doença crônica que atualmente se destaca por sua morbimortalidade associada. A terapia baseia-se na associação de diferentes fármacos e exige mudança nos hábitos de vida dos pacientes. O objetivo da presente pesquisa foi analisar o perfil clínico e epidemiológico dos pacientes com diabetes mellitus tipo 2 assistidos pelo Componente Especializado da Assistência Farmacêutica do estado do Piauí. Trata-se de uma pesquisa descritiva, de caráter transversal com análise de variáveis sociais, demográficas e econômicas e de parâmetros bioquímicos e antropométricos. Dentre 93 participantes, 66,7% eram do sexo feminino, 57% possuíam média etária de 60,5 anos e 50,5% apresentaram peso acima de 69 kg com renda familiar preponderante de um salário mínimo e grau de escolaridade referente ao ensino médio completo. Constatou-se que 53,8% dos participantes praticavam atividade física regularmente e 87,1% faziam restrição alimentar. O medicamento mais utilizado foi a vildagliptina. Foi evidenciado que 52,7% possuíam controle glicêmico insatisfatório quanto aos níveis de HbA1c, assim como a necessidade da existência de um protocolo clínico estadual público que regulamente a dispensação de hipoglicemiantes orais no estado.