Browsing by Author "Lopes, Manuel J."
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- Pharmacogenomic biomarkers as source of evidence of the effectiveness and safety of antidepressant therapyPublication . Correia, Catarina; Alcobia, Luciano; Lopes, Manuel J.; Advinha, Ana M.Objective: The main goal of this work was to identify, describe, characterize, and classify the scientifc evidence regarding the use of pharmacogenomic biomarkers in antidepressant treatment. Methods: The work was developed in two phases: i) a search for pharmacogenomic biomarkers in summaries of antidepressant drugs with marketing authorization in Portugal; and ii) a systematic literature review based on the data obtained in the frst phase, with the main objective of fnding international literature that could describe and characterize previously reported biomarkers and identify other relevant biomarkers. Finally, the levels of evidence and recommendation grades were classifed. Results: Among the 26 drugs with marketing authorization in Portugal, only 16 had pharmacogenomic information. The most widely studied pharmacogenomic biomarker was CYP2D6. These results were mostly supported by the systematic literature review, which yielded 103 papers, 63 of which were ultimately included in the review. The sys‑ tematic literature review also revealed the existence of other relevant biomarkers. Most of the included studies show a good level of evidence, which guarantees reliability and good recommendation grades. For the database (built during phase i), the results were informative but resulted in no specifc recommendations. Conclusions: Most pharmacogenomic variants are not studied or acknowledged by genetic tests, and more scien‑ tifc research is needed to confrm their usefulness. Therefore, only a small number of variants are considered when prescribing antidepressant drugs. In addition, genotyping of patients is not common in clinical practice.
- Probing pharmacists' interventions in Long-Term Care: a systematic reviewPublication . Goncalves, Joao R.; Ramalhinho, Isabel; Sleath, Betsy L.; Lopes, Manuel J.; Cavaco, Afonso M.Key summary pointsAim To investigate pharmacists' interventions and impact at institutional Long-Term Care (LTC) settings, particularly the therapeutic outcomes in elderly populations. Findings LTC pharmacists deliver a comprehensive set of activities, especially in clinical pharmacy (e.g. medication review, deprescribing) and education, addressing elderly populations under LTC and their therapeutic needs. Message Pharmacists' expertise in medicines optimisation is a useful resource in improving healthcare towards institutionalised LTC patients, often a geriatric population. Purpose Long-Term Care (LTC) systems have experienced recent developments driven by changes in healthcare and demography (e.g. population ageing). As well, pharmacists are changing from traditional roles to more patient-oriented services. The present study aimed to identify and assess pharmacists' and/or pharmacy-based interventions in institutional LTC settings, also mapping relevant medications. Methods The review was undertaken in general accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using three main literature databases (PubMed, Scopus, and Web of Knowledge). A set of 16 keywords, divided into three domains (professional, type of care and type of setting), were combined into search equations. Selected studies were assessed through the Quality Assessment Tool for Quantitative Studies. Results Twenty-six studies met the inclusion criteria, out of 794 initial hits. Most studies (12) described pharmacist/pharmacy-driven interventions assessing Medication Management Reviews' impact in different endpoints or outcomes. Other studies (3) assessed pharmacists' interventions on specific medication groups. Good Administration Practices, new pharmaceutical care models, antibiotic stewardship programs, and studies assessing other pharmacists' interventions, such as pharmacy-managed informatics and education, were addressed by 11 other papers. Six studies were classified as Strong after quality assessment. Conclusion LTC is a clinically complex type of care benefiting from interdisciplinary work. Despite the overall lower quality of the identified studies, pharmacists perform in a wide array of LTC areas. The broad implementation of pharmaceutical activities in institutional LTC settings opens opportunities to optimise medicines' use.