Browsing by Author "Andrade, Amanda de Oliveira"
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- Medication adherence and glycemic control in older adults with type 2 diabetes: a cross-sectional study in a community settingPublication . Nascimento, Tânia; Andrade, Amanda de Oliveira; Pinto, Ezequiel; Cabrita, Catarina; Pais, Sandra; Puerta, Rocío de laBackground/Objectives: Glycemic control is essential for preventing both short- and long-term complications of type 2 diabetes (T2D), requiring strict adherence to pharmacological therapy. Medication adherence directly influences therapeutic effectiveness, making its assessment in clinical practice crucial. This study aimed to evaluate medication adherence in elderly patients with T2D and its association with glycemic control. Methods: A descriptive cross-sectional study was conducted in the Algarve, Portugal, involving 133 elderly patients (≥60 years) with T2D. Cardiometabolic parameters and medication adherence (global, intentional, and unintentional) were assessed. Statistical analyses were performed using IBM SPSS Statistics 28.0. Results: The study population had a mean age of 71.7 ± 5.7 years, with a predominance of male participants (57.9%) and a high prevalence of dyslipidemia and/or hypertension. Cardiometabolic control was generally poor, with only 26.3% achieving blood pressure targets (≤140/90 mmHg), 8.5% maintaining fasting glycemia within the recommended range (70–110 mg/dL), and 13.6% attaining glycated hemoglobin (HbA1c) values ≤ 7%. Despite this, medication adherence was notably high (97.7%), with no significant association with cardiometabolic control (p > 0.05). Unintentional non-adherence behaviors, such as forgetfulness and inconsistent medication schedules, were the most frequently reported. Conclusions: Although elderly patients with T2D demonstrated high medication adherence rates, their cardiometabolic control remained suboptimal. Unintentional non-adherence behaviors may contribute to poor glycemic control. However, medication adherence alone does not fully explain these outcomes, highlighting the need to assess adherence to other self-care behaviors, particularly dietary and physical activity patterns. Future interventions should integrate comprehensive lifestyle modifications alongside pharmacological management to enhance overall disease control.
- Potentially inappropriate medication: a pilot study in institutionalized older adultsPublication . Andrade, Amanda de Oliveira; Nascimento, Tânia; Cabrita, Catarina; Leitao, Helena; Pinto, EzequielInstitutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles, and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ± 7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population.
- Revisão da medicação de idosos institucionalizados em estruturas residenciais para pessoas idosas no AlgarvePublication . Andrade, Amanda de Oliveira; Leitão, Helena Santos; Nascimento, TâniaO avanço da medicina e a melhoria dos cuidados de saúde possibilitam que os indivíduos vivam mais e com melhor qualidade de vida. O envelhecimento é um processo natural que conduz a alterações anatomofisiológicas e metabólicas que modificam a farmacocinética e farmacodinâmicas dos medicamentos num idoso. Além destas alterações, o avanço da idade diminui a autonomia e a perceção de autocuidado, sendo necessário recorrer a instituições de cuidados, como as Estruturas Residenciais para Pessoas Idosas (ERPI). A revisão da medicação é um processo eficaz que procura a otimização e gestão correta da medicação, além da identificação de problemas relacionados com uso de medicamentos, como interações medicamentosas e reações adversas. O principal objetivo deste trabalho foi a caracterização do perfil farmacoterapêutico, por meio da revisão da medicação, de idosos institucionalizados em ERPI, no Algarve. Foram analisados os perfis terapêuticos dos 96 pacientes, com média de idade de 86.57±7.86 anos. Os idosos utilizavam em média 9.13±4.15 medicamentos e mais de 90% eram polimedicados. A revisão terapêutica ainda revelou que mais de 44% dos pacientes apresentavam elevada complexidade farmacoterapêutica e 91.7% possuíam potenciais interações medicamentosas. Mais de 86% fazia uso de pelo menos um Medicamento Potencialmente Inapropriado, segundo a EU(7)-PIM List, sendo os medicamentos para o sistema nervoso central os mais utilizados. A população idosa institucionalizada possui inúmeros problemas de saúde e é tendencialmente polimedicada e com problemas relacionados à medicação. A revisão farmacoterapêutica é uma ferramenta completa que pode minimizar a ocorrência destes obstáculos, buscando melhorar a qualidade de vida dos pacientes, além de facilitar e potencializar o regime terapêutico.