Pharmaceutical Care in Primary Care: an Experience with Hypertensive Patients in the North of Brazil

Abstract Background: Uncontrolled blood pressure has been associated with poor adherence to drug treatment. Objectives: To assess blood pressure control in hypertensive patients attending primary health centers after implementation of a pharmaceutical follow-up program in a city of the north of Brazil. Methods: Observational, cross sectional, descriptive study with 163 hypertensive patients attending public primary health care centers - one located on the riverside and one in the urban area of the city of Santarem, western Pará, Brazil. Adherence to the anti-hypertensive treatment was assessed using the eight-item Morisky test. Pharmacotherapy follow-up (Dader method) of patients with uncontrolled hypertension and non-adherent to anti-hypertensive treatment was performed. Results of the normality test showed that the data did not follow a normal distribution. Continuous variables were then compared using the Wilcoxon signed-rank test, and categorical variables by the likelihood ratio and the McNemar tests. Statistical significance was set at 5%. Results: Of the total sample, 94.5% were not adherent to anti-hypertensive drug therapy and 77.2% had uncontrolled hypertension. Adherence rate was higher in men than women (p=0.006). Pharmacotherapy follow-up improved blood pressure levels, particularly systolic blood pressure (p<0.001). Conclusion: An individualized pharmacotherapeutic follow-up, considering regional and cultural specificities, can contribute to the treatment of hypertensin in the primary care.

Hacia una medicina individualizada en el paciente con trastorno por déficit de atención e hiperactividad / Towards individualized medicine in patients with Attention Deficit/Hyperactivity Disorder

El trastorno por déficit de atención e hiperactividad (TDAH) es el trastorno del neurodesarrollo más frecuente en la infancia y la adolescencia, con una prevalencia global acumulada del 5,29%. La medicina individualizada (MI) está cada vez más implantada y debe tratarse de un proceso continuo, enfocado en el paciente y su entorno. En el TDAH la variabilidad asociada a su prevalencia, diagnostico, tratamiento y todos los posibles factores moderadores hace que la implantación de esta MI sea vital para el correcto manejo del trastorno. El abordaje del niño/adolescente con TDAH de una manera personalizada facilita la confección de un plan terapéutico ajustado a sus necesidades, permitiendo la correcta consecución de una respuesta adecuada a los objetivos marcados. Este trabajo explora y propone un modelo de aproximación para la implantación de la MI en el paciente con TDAH, basándose en el conocimiento especifico de cada individuo y de su situación y entorno biológico, psicólogico y social

Attention deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood and adolescence, with a cumulative overall prevalence of 5,29%. Treatment individualization (TI) is increasingly implemented and should be a continuous process focus in the patients and his environment. The variability associated with ADHD prevalence, diagnosis, treatment and all possible moderating factors make the implementation of this TI is essential for the correct management of the dissorder. The approach to the child/adolescent with ADHD from a personalized perspective allows creating a therapeutic plan according to their needs, getting the achievement of the adequate response. This paper proposes an approach model for the implementation of TI in patients with ADHD, based on the specific knowledge of each individual and their situation and biological, psychological and social environments

Metodología participativa como estrategia para la personalización de los cuidados / Participative method as a strategy to personalize nursing care

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Aprendiendo a promover la salud / Learning how to promote the health

Contiene: Enfoques y planes, como aprendre viendo haciendo y pensando, para parender a usar el libro donde hay doctor, actividades con madres y niños, la salud en relacion conla alimentacion, la tierra y los problemas sociales, un llamado al valor y a la precaucion