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1.
Int. braz. j. urol ; 45(3): 435-448, May-June 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1012324

RESUMO

ABSTRACT Objectives: Prostate cancer is the most common and fatal cancer amongst Brazilian males. The quality of prostate cancer care in Brazil was systematically reviewed and compared to United Kingdom (UK) National Institute for Health and Care Excellence (NICE) guidelines, which are considered an international benchmark in care, to deter- mine any treatment gaps in Brazilian practice. Materials and Methods: A systematic review of Brazilian and UK literature was under- taken. Additionally, quality of life scores was measured using a FACT-P questionnaire of 36 prostate cancer patients attending the Farmácia Universitária da Universidade de São Paulo (FARMUSP). These scores were compared against NICE care measures for patient safety, clinical efficacy and quality of life indicators determined by either quantitative or qualitative methods. Key findings: The quality of prostate cancer care in Brazil was considered good when compared to NICE guidelines. However, FACT-P data strongly indicated a poor under- standing of treatment received by Brazilian patients and that their mental health needs were not being met. Conclusions: NICE quality statements that address the holistic needs of patients should be implemented into Brazilian outpatient care plans. Addressing the non-medical concerns of patients may improve quality of life and can be easily rolled-out through existing Brazilian pharmacy services at no financial cost to the Brazilian Unified Health System (SUS).

2.
Int Braz J Urol ; 45(3): 435-448, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038864

RESUMO

OBJECTIVES: Prostate cancer is the most common and fatal cancer amongst Brazilian males. The quality of prostate cancer care in Brazil was systematically reviewed and compared to United Kingdom (UK) National Institute for Health and Care Excellence (NICE) guidelines, which are considered an international benchmark in care, to determine any treatment gaps in Brazilian practice. MATERIALS AND METHODS: A systematic review of Brazilian and UK literature was undertaken. Additionally, quality of life scores was measured using a FACT-P questionnaire of 36 prostate cancer patients attending the Farmácia Universitária da Universidade de São Paulo (FARMUSP). These scores were compared against NICE care measures for patient safety, clinical effi cacy and quality of life indicators determined by either quantitative or qualitative methods. Key fi ndings: The quality of prostate cancer care in Brazil was considered good when compared to NICE guidelines. However, FACT-P data strongly indicated a poor understanding of treatment received by Brazilian patients and that their mental health needs were not being met. CONCLUSIONS: NICE quality statements that address the holistic needs of patients should be implemented into Brazilian outpatient care plans. Addressing the non-medical concerns of patients may improve quality of life and can be easily rolled-out through existing Brazilian pharmacy services at no fi nancial cost to the Brazilian Unifi ed Health System (SUS).


Assuntos
Assistência Ambulatorial/normas , Assistência Farmacêutica/normas , Neoplasias da Próstata/tratamento farmacológico , Garantia da Qualidade dos Cuidados de Saúde/métodos , Qualidade de Vida , Brasil , Lista de Checagem/normas , Humanos , Masculino , Padrões de Referência , Inquéritos e Questionários/normas , Reino Unido
3.
Res Social Adm Pharm ; 2018 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-30262211

RESUMO

BACKGROUND: One of the elements of quality improvement of medication management services is measuring the quality of care and key performance indicators (KPIs) can be used in this assessment. There has been no publishing yet about a KPI instrument developed for ambulatory setting. OBJECTIVES: To develop and validate KPI instrument for medication management services provided for outpatients in Brazilian context. METHODS: A working group established 7 possible KPIs for assessment of the expert panel. For content validity, 16 experts were invited to participate in an internet based 2-round Delphi approach. Expert panel rated 7 possible KPIs using 7 attributes on a 5-point Likert scale for consensus. In order to construct validity and reliability, an internet questionnaire was developed for pharmacists that work in primary care to understand their views. In addition, a comparison between expert and pharmacist views about the indicators relevance was performed. RESULTS: Eleven (68.8%) experts participated in the Delphi round 1 and nine (81.8%) experts completed the 2 Delphi rounds. A new KPI was develop after expert panel assessment in the first round. Overall, content and construct validity were reached for 6 KPIs: pharmaceutical consultation provided (I1), pharmacist interventions accepted by the prescriber (I2), drug therapy problems resolved (I3), patient clinical status (I4), patient satisfaction (I5), and patient quality of life (I6). CONCLUSIONS: A set of 6 KPIs was developed for medication management services provided for outpatients. The instrument presented a good reliability and validity evidence. It is expected that these KPIs will improve the quality of medication management services.

4.
Eur J Clin Pharmacol ; 74(10): 1215-1233, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29905899

RESUMO

PURPOSE: To conduct an overview to summarize the efficacy and safety of aripiprazole for the treatment of schizophrenia. METHODS: A literature search was performed in PubMed, the Cochrane Library, LILACS, and the Centre for Reviews and Dissemination, for articles published until March 31, 2017. We included systematic reviews with meta-analyses of randomized controlled trials assessing the efficacy, and/or the safety of aripiprazole, for patients with schizophrenia. Two authors independently performed the study selection, data extraction, and quality assessment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the Risk of Bias in Systematic Review (ROBIS) tool were used to appraise the quality of evidence and the risk of bias in the reviews, respectively. RESULTS: Fourteen studies fulfilled the inclusion criteria. Aripiprazole showed efficacy similar to that of both typical and atypical antipsychotic drugs (except olanzapine and amisulpride). Aripiprazole caused significantly lower weight gain and alterations in glucose and cholesterol levels, as compared to clozapine, risperidone, and olanzapine. In addition, aripiprazole caused significantly fewer general extrapyramidal side effects, less use of antiparkinsonian drugs, and akathisia, compared with typical antipsychotic drugs and risperidone. The overall quality of evidence in the reviews ranged from "very low" to "moderate," principally because of the risk of bias of original trials, inconsistency, and imprecision in the outcomes. According to the ROBIS tool, there are four reviews with "high" risk of bias and five with "unclear" risk of bias. CONCLUSIONS: Aripiprazole exhibited efficacy similar to that of other antipsychotic drugs and a better safety profile than that of typical (i.e., less some extrapyramidal side effects) and atypical (i.e., less metabolic changes) antipsychotic drugs.

6.
J Eval Clin Pract ; 24(1): 22-30, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-27452158

RESUMO

RATIONALE, AIMS AND OBJECTIVES: This study aimed to evaluate the effect of a pharmacist-physician collaborative care model on clinical outcomes in patients with uncontrolled type 2 diabetes and determine characteristics that influence this effect. METHODS: A randomized controlled trial was conducted in a secondary care clinic for 80 patients with type 2 diabetes, aged 40-79 years and glycosylated haemoglobin (A1C) level ≥ 7.0%. The intervention group received individual, face-to-face pharmaceutical consultations and remote telephone support after a routine visit. The main measures were clinical outcomes (A1C, blood pressure, LDL cholesterol) and process indicators (medication adherence, medication regimen complexity, use of medicines). Multiple regression models were used to determine the variables that could explain the reduction and individualized control of A1C. RESULTS: From the initial sample of 80 patients, 73 completed this study. Compared with usual care, patients in the intervention group showed greater reduction in A1C (-0.79 vs. -0.16; P = 0.010); and an increase in the percentage of patients achieving the individualized goal of A1C (25.0% vs. 5.4%; P = 0.020). In addition, there was an increase in the percentage of adherent patients and in the average scores of medication adherence. Participation in the intervention group, higher baseline A1C levels and greater change in medication adherence were all significant predictors of improvement in A1C levels. CONCLUSIONS: The results suggest that the collaborative care model proposed is feasible and more effective than the usual care in the reduction and individualized control of A1C levels in patients with uncontrolled type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Colaboração Intersetorial , Equipe de Assistência ao Paciente/organização & administração , Farmacêuticos , Médicos , Adulto , Idoso , Brasil/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Modelos Organizacionais , Monitorização Fisiológica/métodos , Monitorização Fisiológica/estatística & dados numéricos
7.
Crit Rev Oncol Hematol ; 113: 195-212, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28427509

RESUMO

This overview summarizes evidence for the efficacy and safety of bortezomib, thalidomide, and lenalidomide in patients with multiple myeloma. We searched the Medline, Scopus, and LILACS databases through August 2016, including systematic reviews with meta-analyses of randomized controlled trials assessing the efficacy and/or safety of bortezomib, thalidomide, or lenalidomide in patients with multiple myeloma. Two authors performed study selection, data extraction, and quality assessment using AMSTAR and GRADE instruments. Twenty-nine studies satisfied the inclusion criteria. All three drugs significantly improved overall response and progression-free survival; however, only bortezomib showed significantly greater overall survival compared with the control arm (induction therapy, continuous therapy, or at any phase of treatment). The main concerns on adverse events were thrombosis/embolism events, peripheral neuropathy, and second primary malignancies. The most common problems detected in systematic reviews were non-registration of the study protocol and conflicts of interest not clearly acknowledged. Future research should adhere to quality assessment tools so that best evidence can be used in decision-making. Protocol PROSPERO registration number: CRD42016036062.


Assuntos
Bortezomib/uso terapêutico , Mieloma Múltiplo/tratamento farmacológico , Talidomida/análogos & derivados , Talidomida/uso terapêutico , Bortezomib/efeitos adversos , Humanos , Lenalidomida , Mieloma Múltiplo/mortalidade , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Talidomida/efeitos adversos
8.
Int J Clin Pharm ; 39(2): 386-393, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28188508

RESUMO

Background The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria is used to identify instances of potentially inappropriate prescribing in a patient's medication regimen. Objective To determine the prevalence and predictors of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients at hospital discharge. Setting A university hospital medical clinic in Brazil. Method Discharge prescriptions were examined using the STOPP/START criteria. Subjects were inpatients aged ≥60 years receiving at least one medication prior to hospitalization and with a history of cardiovascular disease. The prevalence of PIMs and PPOs was determined and a multivariable binary regression analysis was performed to identify independent predictors associated with PIMs or PPOs. Main outcome measure Prevalence of PIMs and PPOs. Results Of the 230 subjects, 13.9% were prescribed at least one PIM. The most frequently prescribed PIMs were glibenclamide or chlorpropamide prescribed for type 2 diabetes mellitus (31.0%), and aspirin at doses >150 mg/day (14.3%). Ninety patients had at least one PPO (39.1%). The most prevalent PPOs were statins (29.8%) and antiplatelet therapy (13.7%) for diabetes mellitus when coexisting major cardiovascular risk factors were present. No predictors for PIMs were found. In contrast, diabetes was a risk factor while dyslipidaemia was a protective factor for PPOs. Conclusion PIMs and PPOs commonly occur with elderly people at hospital discharge. Diabetes and dyslipidaemia were significantly associated with PPOs. Our findings show the need for interventions to reduce potentially inappropriate prescribing, such as a pharmacist medication review process at hospital discharge.


Assuntos
Prescrição Inadequada/estatística & dados numéricos , Lista de Medicamentos Potencialmente Inapropriados/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Prevalência , Fatores de Risco
10.
Braz. j. pharm. sci ; 52(3): 391-401, July-Sept. 2016. tab
Artigo em Inglês | LILACS | ID: biblio-828266

RESUMO

ABSTRACT The purpose of the work was to assess the incidence of potential drug interactions (pDDI), major pDDI, and the use of potentially inappropriate medication (PIM) at hospital admission, during hospitalization, and at discharge to evaluate whether hospital admission provides an opportunity for improving pharmacotherapy in elderly patients at a University hospital that has a clinical pharmacist. A prospective cohort study was carried out using data from the medical records of patients admitted to an internal medicine ward. All admissions and prescriptions were monitored between March and August 2006. Micromedex(r) DrugReax(r) and Beers Criteria 2015 were used to identify pDDI, major pDDI, and PIMs, respectively. A comparison of admission and discharge prescriptions showed the following: an increase in the proportion of patients using antithrombotic agents (76 versus 144; p<0.001), lipid modifying agents (58 versus 81; p=0.024), drugs for acid-related disorders (99 versus 152; p<0.001), and particularly omeprazole (61 versus 87; p=0.015); a decrease in the number of patients prescribed psycholeptics (73 versus 32; p<0.001) and diazepam (54 versus 13; p<0.001); and a decrease in the proportion of patients exposed to polypharmacy (16.1% versus 10.1%; p=0.025), at least one pDDI (44.5% versus 32.8%; p=0.002), major pDDI (19.9% versus 12.2%; p=0.010) or PIM (85.8% versus 51.9%; p<0.001). The conclusion is that admission to a hospital ward that has a clinical pharmacist was associated with a reduction in the number of patients exposed to polypharmacy, pDDI, major pDDI, and the use of PIMs among elderly inpatients.


Assuntos
Serviço Hospitalar de Admissão de Pacientes/classificação , Tratamento Farmacológico/estatística & dados numéricos , Pacientes Internados , Prescrições de Medicamentos , Serviços de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos
11.
PLoS One ; 11(3): e0150999, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26963251

RESUMO

OBJECTIVE: To assess the effect of pharmacist interventions on glycemic control in type 2 diabetic patients and to examine factors that could explain the variation across studies. METHODS: A comprehensive literature search was performed in PubMed, Scopus, and LILACS databases for randomized controlled trials (RCTs) published up to July 2015. The search strategy included the use of MeSH terms or text words related to pharmacist interventions, type 2 diabetes, and randomized controlled trials. RCTs published in English, Portuguese, or Spanish that evaluated the effect of pharmacist intervention on glycemic control in type 2 diabetic outpatients were included. Two independent authors executed study selection, data extraction, and risk of bias assessment. Mean differences in glycosylated hemoglobin (HbA1c) were estimated using random-effect models, and heterogeneity was evaluated by subgroup and meta-regression analyses. RESULTS: The literature search yielded 963 records of potential interest, of which 30 were included in the systematic review and 22 in the meta-analysis. Most of these RCTs were conducted in the United States in patients in outpatient clinics using face-to-face contact only. All RCTs performed patient education, and most executed the medication review. The appraised sample showed uncertain or high risk of bias in most of the items evaluated, resulting in low-quality studies. In comparison with usual care, pharmacist interventions were associated with significant reductions in HbA1c levels (-8.5% [95% CI: -1.06, -0.65]; P < 0.0001; I2 = 67.3%). Subgroup analysis indicated differences of heterogeneity by country, baseline HbA1c levels, setting, intervention frequency, and random allocation. Age and HbA1c levels partly explained the variability across studies by meta-regression. CONCLUSIONS: Our findings confirmed that pharmacist interventions improve glycemic control in patients with type 2 diabetes compared with usual care and suggest that younger patients or with higher baseline HbA1c levels may be the main beneficiaries of pharmacist care. PROTOCOL PROSPERO REGISTRATION NUMBER: CRD42014007457.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobina A Glicada/metabolismo , Fatores Etários , Feminino , Humanos , Masculino , PubMed , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Rev. ciênc. farm. básica apl ; 36(3): 435-444, 01/07/2015.
Artigo em Inglês | LILACS | ID: biblio-2572

RESUMO

This study proposes to measure frequency and to characterize the profile of potential drug interactions (pDDI) in a general medicine ward of a teaching hospital. Data about identification and clinical status of patients were extracted from medical records between March to August 2006. The occurrence of pDDI was analyzed using the database monographs Micromedex® DrugReax® System. From 5,336 prescriptions with two or more drugs, 3,097 (58.0%) contained pDDI. The frequency of major and well document pDDI was 26.5%. Among 647 patients, 432 (66.8%) were exposed to at least one pDDI and 283 (43.7%) to major pDDI. The multivariate analysis identified that factors related to higher rates of major pDDI were the same age (p< 0.0001), length of stay (p< 0.0001), prevalence of hypertension [OR=3.42 (p< 0.0001)] and diabetes mellitus [OR=2.1 (p< 0.0001)], cardiovascular diseases (p< 0.0001) and the number of prescribed drugs (Spearman's correlation=0.640622, p< 0.0001). Between major pDDI, the main risk was hemorrhage (50.3%), the most frequent major pDDI involved combination of anticoagulants and antiplatelet drugs. Among moderate pDDI, 3,866 (90.8%) involved medicines for the treatment of chronic non-communicable diseases, mainly hypertension. In HU-USP, the profile of pDDI was similar among adults and elderly (the most frequent pDDI and major pDDI were same), the difference was only the frequency in either group. The efforts of the clinical pharmacists should be directed to elderly patients with cardiovascular compromise, mainly in use of anticoagulants and antiplatelet drugs. Furthermore, hospital managers should increase the integration between levels of health care to promote safety patient after discharge.


O estudo tem por objetivo descrever o perfil de interações medicamentosas potenciais (IMP) na clínica médica de um hospital escola. Dados sobre a identificação e estado clínico dos pacientes foram extraídos de prontuários médicos, entre março e agosto de 2006. A ocorrência de IMP foi analisada empregando-se o banco de monografias Micromedex DrugReax® System. Das 5.336 prescrições, 3.097 (58,0%) continham IMP. A frequência de IMP graves e bem documentadas foi de 26,5%. Entre os 647 pacientes, 432 (66,8%) foram expostos a pelo menos uma IMP e 283 (43,7%) uma IMP grave. A análise multivariada identificou que os fatores relacionados a maiores taxas de IMP e IMP graves foram os mesmos: idade (p< 0,0001), tempo de internação (p< 0,0001), prevalência de hipertensão [OR=3,42 (p< 0,0001)] e diabetes mellitus [OR=2,1 (p< 0,0001)] , doenças cardiovasculares (p< 0,0001) e o número de medicamentos prescritos (correlação de Spearman =0,640622, p< 0,0001). Entre as IMP graves, o principal risco foi hemorragia (50,3%) e as IMP graves mais frequentes envolviam a combinação de anticoagulantes e agentes antiplaquetários. Entre as IMP de gravidade moderada, 3.866 (90,8%) envolviam medicamentos para o tratamento de doenças crônicas não transmissíveis, particularmente hipertensão. No HU-USP, o perfil de IMP foi similar entre adultos e idosos (as IMP e IMP graves mais frequentes foram as mesmas), a diferença estava apenas na diferença na frequência em cada um dos grupos. Os esforços dos farmacêuticos clínicos deveriam ser direcionados aos pacientes idosos, com comprometimento cardiovascular, principalmente aqueles em uso de anticoagulantes e fármacos antiplaquetários. Além disso, deve-se aumentar a integração entre os níveis do cuidado a saúde para promover a segurança do paciente após a alta.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Interações de Medicamentos , Hospitais Universitários/estatística & dados numéricos , Medicina Interna
13.
Braz. j. pharm. sci ; 51(2): 383-392, Apr.-June 2015. tab, ilus
Artigo em Inglês | LILACS | ID: lil-755062

RESUMO

The aim of the present study was to assess the bioequivalence of two cephalexin tablet formulations available in the Brazilian market (product A as reference formulation and product B as test formulation). Dissolution efficiency (DE%) was calculated for both formulations to evaluate their in vitrobiopharmaceutical features. The oral bioequivalence study was performed in twenty-four healthy volunteers in a crossover design. Single oral dose (tablet containing 500 mg of cephalexin) of each product was administered with two weeks of washout period. Urinary concentrations of cephalexin were measured by high-performance liquid chromatography (HPLC) method and pharmacokinetics parameters were estimated by urinary excretion data. The bioequivalence was determined by the following parameters: the cumulative amount of cephalexin excreted in the urine, the total amount of cephalexin excreted in the urine and the maximum urinary excretion rate of cephalexin. DE values of immediate-release cephalexin tablets (500 mg) were 68.69±4.18% for product A and 71.03±6.63% for product B. Regarding the dissolution test of the two brands (A and B) analysed, both were in compliance with the official pharmacopeial specifications, since the dissolution of both formulations was superior to 80% of the amount declared in the label after 45 minutes of test (A=92.09%±1.84; B=92.84%±1.08). The results obtained indicated that the products A and B are pharmaceutical equivalents. Confidence intervals for the pharmacokinetic parameters were in compliance with the international standards, indicating that products A and B can be considered bioequivalents and, therefore, interchangeable...


O objetivo do presente estudo foi avaliar a bioequivalência de duas formulações de cefalexina disponíveis no mercado brasileiro (produto A como formulação referência e produto B como formulação teste). A eficiência de dissolução (DE%) foi calculada para ambas as formulações para avaliar suas características biofarmacêuticas. O estudo de bioequivalência oral foi realizado em vinte e quatro voluntários sadios utilizando um desenho cruzado. Uma dose oral única (comprimido contendo 500 mg de cefalexina) de cada produto foi administrada com um período de washout de duas semanas. Concentrações urinárias de cefalexina foram mensuradas por método de cromatografia líquida de alta eficiência (CLAE) e os parâmetros farmacocinéticos foram estimados por dados de excreção urinária. A bioequivalência foi determinada pelos seguintes parâmetros: quantidade acumulada da cefalexina excretada na urina, quantidade total da cefalexina excretada na urina e a taxa de excreção máxima da cefalexina. Os valores de DE dos comprimidos de liberação imediata de cefalexina (500 mg) foram 68,69±4,18% para o produto A e de 71,03±6,63% para o produto B. Com relação ao teste de dissolução das duas marcas analisadas (A e B), ambas apresentaram-se de acordo com as especificações farmacopéicas, uma vez que a dissolução de ambas formulações foi superior a 80% da quantidade declarada após 45 minutos de teste (A=92,09%±1,84; B=92,84% ±1,08). Os resultados obtidos indicaram que os produtos A e B são equivalentes farmacêuticos. Os intervalos de confiança para os parâmetros farmacocinéticos estavam de acordo com os padrões internacionais, demonstrando que os produtos A e B podem ser considerados bioequivalentes e, portanto, intercambiáveis...


Assuntos
Humanos , Cefalexina/farmacocinética , Cefalexina/farmacologia , Cromatografia Líquida de Alta Pressão , Equivalência Terapêutica , Urina/química
15.
Cien Saude Colet ; 20(2): 325-32, 2015 Feb.
Artigo em Português | MEDLINE | ID: mdl-25715126

RESUMO

The objective of this study was to evaluate the role of the pharmacist in dispensing medication by conducting cross-sectional exploratory-descriptive research in eight Adult Psychosocial Care Centers (CAPS) in São Paulo. The pharmacists responsible for each of the dispensing units studied filled out a semi-structured questionnaire about the service provided. Two Adult CAPS units were selected from each of the North, South, Eastand West regions of São Paulo. The central region has no Adult CAPS, and was therefore not included in the study. Most of the respondents were aged between 35 and 40 years and were predominantly female. It was found that half of the respondents performed only 25% of dispensations and few conducted an analysis of all prescriptions before dispensing medication. All respondents contacted the prescriber if any medication-related problems a rose. However, few pharmaceutical interventions were commonly performed. Furthermore, one respondent indicated that all his/her functions in the pharmacy could be delegated to another professional. These findings reveal the pressing need for actions that ensure the ongoing training of pharmacists to enable them to be clinically prepared to deal with patients with mental disorders.


Assuntos
Assistência Farmacêutica , Farmacêuticos , Papel Profissional , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas de Apoio Psicossocial , Saúde da População Urbana
16.
Ciênc. saúde coletiva ; 20(2): 325-332, 02/2015. tab
Artigo em Português | LILACS | ID: lil-742225

RESUMO

O presente estudo teve por objetivo avaliar a atuação do farmacêutico na dispensação de medicamentos, sendo realizada pesquisa transversal exploratório-descritiva em oito Centros de Atenção Psicossocial (CAPS) Adulto do Município de São Paulo. Questionário semiaberto sobre o serviço de dispensação foi aplicado aos farmacêuticos responsáveis de cada unidade estudada. Foram selecionadas duas unidades CAPS Adulto das regiões Norte, Sul, Leste e Oeste de São Paulo. A região central não dispõe de CAPS adulto, razão pela qual não fez parte do estudo. A maior parte dos entrevistados apresentou idade entre 35 e 40 anos, com predomínio do gênero feminino. Verificou-se que metade dos entrevistados realizou apenas 25% das dispensações e poucos fizeram a análise de todas as prescrições antes de dispensar o medicamento. Todos os respondentes entravam em contato com o prescritor na presença de algum problema relacionado ao medicamento. Entretanto, intervenções farmacêuticas não eram realizadas comumente. Ainda, um dos respondentes indicou que todas as suas funções na farmácia poderiam ser delegadas a outro profissional. Os dados reforçam a necessidade de ações que possibilitem o aprimoramento contínuo do farmacêutico a fim de que esteja apto à prática clínica voltada aos pacientes com transtornos mentais.


The objective of this study was to evaluate the role of the pharmacist in dispensing medication by conducting cross-sectional exploratory-descriptive research in eight Adult Psychosocial Care Centers (CAPS) in São Paulo. The pharmacists responsible for each of the dispensing units studied filled out a semi-structured questionnaire about the service provided. Two Adult CAPS units were selected from each of the North, South, Eastand West regions of São Paulo. The central region has no Adult CAPS, and was therefore not included in the study. Most of the respondents were aged between 35 and 40 years and were predominantly female. It was found that half of the respondents performed only 25% of dispensations and few conducted an analysis of all prescriptions before dispensing medication. All respondents contacted the prescriber if any medication-related problems a rose. However, few pharmaceutical interventions were commonly performed. Furthermore, one respondent indicated that all his/her functions in the pharmacy could be delegated to another professional. These findings reveal the pressing need for actions that ensure the ongoing training of pharmacists to enable them to be clinically prepared to deal with patients with mental disorders.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Assistência Farmacêutica , Farmacêuticos , Papel Profissional , Brasil , Estudos Transversais , Sistemas de Apoio Psicossocial , Saúde da População Urbana
17.
Drug Dev Ind Pharm ; 41(7): 1066-72, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-24918173

RESUMO

Throughout the period of evaluation and selection in drug development, the assessment of the permeability potential of a compound to achieve an efficient refinement of the molecular structure has been widely appraised by the transport of substances across cell monolayers. This study aims to develop in vitro assays through Caco-2 cells in order to analyze the permeability of 5-nitro-heterocyclic compounds analogues to nifuroxazide with antimicrobial activity, especially showing promising activity against multidrug-resistant Staphylococcus aureus (MRSA). Caco-2 cell monolayers cultivated for 21 days in Transwell® plates were used for the in vitro permeability assays. The quantification of the nifuroxazide derivatives in the basolateral chambers was performed by a validated high performance liquid chromatography with UV (HPLC-UV) method. Apparent permeability values (Papp) show that these compounds can be considered as new drug candidates with the potential to present high absorption in vivo, according to the classifications of Yee and Biganzoli. The thiophenic derivatives showed permeability values higher than the furanic ones, being AminoTIO the compound with the greatest potential for the development of a new drug against MRSA, since it showed the best cytotoxicity, permeability and solubility ratio among all the derivatives.


Assuntos
Anti-Infecciosos/administração & dosagem , Hidroxibenzoatos/administração & dosagem , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Nitrofuranos/administração & dosagem , Anti-Infecciosos/farmacocinética , Anti-Infecciosos/farmacologia , Células CACO-2 , Cromatografia Líquida de Alta Pressão , Humanos , Hidroxibenzoatos/farmacocinética , Hidroxibenzoatos/farmacologia , Nitrofuranos/farmacocinética , Nitrofuranos/farmacologia , Permeabilidade , Solubilidade , Espectrofotometria Ultravioleta
19.
Rev. cuba. farm ; 48(3): 432-445, jul.-set. 2014. Ilus
Artigo em Espanhol | LILACS, CUMED | ID: lil-740918

RESUMO

INTRODUCCIÓN: a partir de 1990 se han desarrollado programas de Atención Farmacéutica en ambiente hospitalario, centrando su atención en el Seguimiento farmacoterapéutico, sin embargo, la comunidad científica internacional farmacéutica visualiza problemáticas como la ausencia de un ejercicio sistematizado, continuo y permanente. OBJETIVO: diseñar un sistema organizativo para implementar el ejercicio de la atención farmacéutica como práctica profesional, en el ámbito hospitalario cubano, específicamente en la provincia Santiago de Cuba. MÉTODOS: para el diseño del sistema se aplicaron herramientas del método sistémico; se definieron: partes componentes, principios, estructura y representación gráfica, así como, características y enfoque. RESULTADOS: se propuso un sistema organizativo complejo, dinámico, probabilístico, adaptable e inestable, dependiente de la integración de factores interactuantes que son: sistema de relaciones esenciales, estructura, proceso y resultado; aplicable a cualquier actividad farmacéutica hospitalaria orientada a la clínica, bajo los conceptos de la atención farmacéutica. CONCLUSIONES: la implementación del sistema propuesto se podrá constituir en elevada contribución para la atención farmacéutica hospitalaria en Cuba, en la medida en que las recomendaciones puedan ser adoptadas por las autoridades sanitarias cubanas.


INTRODUCTION: starting from 1990, several pharmaceutical care programs have been developed at the hospital setting, focused on the pharmacotherapeutic follow-up of the patient. However, the international scientific community of pharmacists has envisaged some problems such as the lack of systematic, continuous and permanent implementation. OBJECTIVE: to design an organizational system to support the pharmaceutical care as a professional practice at the Cuban hospital settings, particularly in Santiago de Cuba province. METHODS: the systemic method tools were used for the system design and the components, the principles, the structure and the graphic presentation as well as the characteristics and the approach were all defined. RESULTS: acomplex, dynamic, probabilistic, adaptive and unstable system was put forward, which will depend on the integration of interacting factors as the following: System of essential relationships, Structure, Process and Result will be applicable to any clinic-oriented pharmaceutical activity at hospital under the concepts of the Pharmaceutical Care. CONCLUSIONS: the implementation of the suggested system could represent a significant contribution to the pharmaceutical care at hospital in Cuba as long as the Cuban health authorities adopt the recommendations made in this respect.


Assuntos
Humanos , Serviço de Farmácia Hospitalar/provisão & distribução , Assistência Farmacêutica , Administração Sistêmica
20.
Rev. cuba. farm ; 48(3): 432-445, jul.-set. 2014.
Artigo em Espanhol | CUMED | ID: cum-61951

RESUMO

Introducción: a partir de 1990 se han desarrollado programas de Atención Farmacéutica en ambiente hospitalario, centrando su atención en el Seguimiento farmacoterapéutico, sin embargo, la comunidad científica internacional farmacéutica visualiza problemáticas como la ausencia de un ejercicio sistematizado, continuo y permanente. Objetivo: diseñar un sistema organizativo para implementar el ejercicio de la atención farmacéutica como práctica profesional, en el ámbito hospitalario cubano, específicamente en la provincia Santiago de Cuba. Métodos: para el diseño del sistema se aplicaron herramientas del método sistémico; se definieron: partes componentes, principios, estructura y representación gráfica, así como, características y enfoque. Resultados: se propuso un sistema organizativo complejo, dinámico, probabilístico, adaptable e inestable, dependiente de la integración de factores interactuantes que son: sistema de relaciones esenciales, estructura, proceso y resultado; aplicable a cualquier actividad farmacéutica hospitalaria orientada a la clínica, bajo los conceptos de la atención farmacéutica. Conclusiones: la implementación del sistema propuesto se podrá constituir en elevada contribución para la atención farmacéutica hospitalaria en Cuba, en la medida en que las recomendaciones puedan ser adoptadas por las autoridades sanitarias cubanas(AU)


Introduction: starting from 1990, several pharmaceutical care programs have been developed at the hospital setting, focused on the pharmacotherapeutic follow-up of the patient. However, the international scientific community of pharmacists has envisaged some problems such as the lack of systematic, continuous and permanent implementation. Objective: to design an organizational system to support the pharmaceutical care as a professional practice at the Cuban hospital settings, particularly in Santiago de Cuba province. Methods: the systemic method tools were used for the system design and the components, the principles, the structure and the graphic presentation as well as the characteristics and the approach were all defined. Results: acomplex, dynamic, probabilistic, adaptive and unstable system was put forward, which will depend on the integration of interacting factors as the following: System of essential relationships, Structure, Process and Result will be applicable to any clinic-oriented pharmaceutical activity at hospital under the concepts of the Pharmaceutical Care. Conclusions: the implementation of the suggested system could represent a significant contribution to the pharmaceutical care at hospital in Cuba as long as the Cuban health authorities adopt the recommendations made in this respect(AU)


Assuntos
Humanos , Assistência Farmacêutica , Administração Sistêmica , Serviço de Farmácia Hospitalar/provisão & distribução
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