RESUMO
OBJECTIVE: To assess the impact of community pharmacists on clinical outcomes in Hispanic patients with type 2 diabetes. METHODS: 126 patients were enrolled in this longitudinal pre/post cohort study that took place in nine community and four workplace pharmacies in San Antonio, TX. Pharmacists provided education, point-of-care testing for glycemic and metabolic parameters, clinical assessment, goal setting, and drug therapy management with physicians. Study outcomes were changes in glycosylated hemoglobin (A1C) and accompanying metabolic parameters (blood pressure, lipid parameters, and body mass index) during a 1-year time frame. RESULTS: In the overall cohort, A1C was not reduced significantly from baseline to 12 months (7.8% vs. 7.6%, P = 0.516). However, statistically significant reductions occurred for fasting plasma glucose, triglycerides, and diastolic blood pressure. None of the other parameters was affected significantly. In the subgroup of patients not at target values at baseline, significant reductions occurred for A1C (9.2% vs. 8.6%, P = 0.001), systolic blood pressure (147 vs. 143 mm Hg, P = 0.031), diastolic blood pressure (91 vs. 87 mm Hg, P < 0.001), triglycerides (259 vs. 219 mg/dL, P < 0.001), LDL cholesterol (139 vs. 123 mg/dL, P < 0.001), and total cholesterol (237 vs. 222 mg/dL, P = 0.008). CONCLUSION: Interventions performed by community pharmacists are effective in improving clinical outcomes in a Hispanic cohort with diabetes. Pharmacists' efforts were most successful in patients not at target glycemic and metabolic levels.
Assuntos
Serviços Comunitários de Farmácia/organização & administração , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hispânico ou Latino , Farmacêuticos/organização & administração , Pressão Sanguínea , Estudos de Coortes , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Lipídeos/sangue , Estudos Longitudinais , Masculino , Educação de Pacientes como Assunto , Sistemas Automatizados de Assistência Junto ao Leito , Papel Profissional , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Texas , Resultado do TratamentoRESUMO
Descreve-se o caso de Doença de Chagas congênita em criança pré-termo, com sintomas digestivos desde o nascimento e hepatoesplenomegalia. Por apresentar suspeita de megacolon congênito foi feita biópsia de reto com atividade para acetilcolinesterase. A paciente foi tratada com benzonidazol com boa evoluçäo clínica e laboratorial
