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- Exploring adverse drug reactions in psychotropic medications: A retrospective analysis of portuguese pharmacovigilance dataPublication . Bandarra, Ana; Costa, César; Angelova, Kristina; Leonardo, Lília; Espírito-Santo, MargaridaPsychotropic drugs (PDs) include anxiolytics, sedatives and hypnotics, antidepressants, and antipsychotics, and they are available as medicines with different safety profiles. Given Portugal’s high anxiolytic consumption and the rising prevalence of mental disorders, safety monitoring is crucial. This study aimed to analyze the individual case safety reports (ICSR) of suspected adverse drug reactions (ADRs) related to PDs, obtained through spontaneous reporting, and recorded in the Portuguese National Pharmacovigilance System between January 2017 and December 2021. This observational and retrospective study analyzed the ICSRs of suspected ADRs to PDs. Most reports pertained to female individuals (67.78%) between 18 and 64 years of age (63.71%). The pharmaceutical industry was the primary source of these reports (62.16%). Antidepressants were responsible for most ICSRs (61.90%). At least one serious ADR was recorded in 58.44% of the reports, and 43.84% of ADRs evolved into “cure”. The most-observed ADRs were nausea (10.92%), dizziness (10.70%), and off-label use (10.30%). In the causality assessment, 45.49% of ADRs were classified as “possible”, and only 4.96% were classified as “definitive”. The current analysis helps to strengthen the safety evidence for PDs. In the future, some measures could be implemented to improve the use of and/or access to PDs, as well as to reinforce the rate of suspected ADR reports within the community, contributing to the safety data available.
- The volunteer functions inventory (VFI): Adaptation and psychometric properties among a portuguese sample of volunteersPublication . Martins, Cátia; da Silva, José Tomás; Jesus, Saúl; Ribeiro, Conceição; Estêvão, M. Dulce; Baptista, Ricardo; Carmo, Cláudia; Brás, Marta; Santos, Rita; Nunes, C.: The Volunteer Functions Inventory (VFI) is an instrument widely used to assess volunteers’ motivation based on the Functionalist Model of Omoto and Snyder. It assesses six factors that reflect several motivational functions. The VFI has been translated into various languages and validated in different cultural contexts, but some studies have reported different factor structures (e.g., five or four factors). In the Portuguese context, previous studies have also shown inconsistent results. The aim of this study was to adapt and validate the VFI for Portuguese volunteers, testing several alternative models (nine models) using confirmatory factor analysis. The sample comprised 468 volunteers (76.3% women), aged from 13 to 81 years (M = 36.66, SD = 14.93). The results support the original interrelated six-factor model as the best-fitting one. The VFI showed good internal consistency and convergent validity. Significant correlations were found between the VFI factors, organizational commitment, and volunteers’ satisfaction. Overall, the six-factor VFI is a valid and reliable tool for measuring the motivational functions of Portuguese volunteers, with implications for practice and research in the volunteering field.
- Patient information leaflets of drugs used in cardiometabolic disorders: Suitability for use by older personsPublication . Espírito-Santo, Margarida; Nascimento, Tânia; Pinto, Ezequiel; Estêvão, M. DulceIn the European Union, all medicines must include appropriate labelling and the respective patient information leaflet (PIL), which is the most reachable source of medicine’s information for patients. This document includes a set of information understandable by their potential users and complementary to the information provided by health professionals. The ageing of the Portuguese population raises the need for the appropriateness of medicine’s information for older consumers, taking into account their specific needs arising from physiological changes impacting drug action. This project aimed to analyse the content of medicines’ PILs, specifically directed at older persons. A sample of medicines was selected considering the 100 active substances more consumed in Portugal by patients with chronic pathologies such as diabetes mellitus, hypertension, and dyslipidaemia. The analysis included readability, legibility, and content (directly and indirectly related to the use of medicines by older persons). A total of 69 PILs were analysed, and it was observed that the information provided about the drugs was included in most of these PILs (95.7%; n = 66) but without any specific information for patients belonging to different age groups. Signalling-specific warnings for older persons were only available in less than half of the PILs (46.4%; n = 32). The presence of relevant information on the appropriate use of the drug such as the recommended dose was only specified for older persons in 28% (n = 19) of the analysed PILs. The information available in PILs which can be considered as specifically directed to older persons is relatively scarce, even in areas as critical as the instructions for use. Hopefully, these results will contribute to increasing awareness regarding the need to adapt PILs’ content to specific consumers and to test them to guarantee that they are adequate for all potential consumers.
- Digital solutions available to be used by informal caregivers, contributing to medication adherence: A scoping reviewPublication . Espírito-Santo, Margarida; Santos, Sancha; Estêvão, M. DulceMedication adherence is essential for managing chronic diseases and achieving optimal health outcomes. However, this process is often challenging, particularly for patients with complex care needs. Informal caregivers play a pivotal role in supporting medication management, but they may face resource limitations and a lack of necessary support. Digital health tools offer a promising avenue to enhance medication adherence by providing reminders, education, and remote monitoring capabilities. This scoping review aimed to identify and evaluate digital solutions available to informal caregivers for improving medication adherence. A systematic search of PubMed and Web of Science was conducted using relevant keywords. Four studies were included in the review, examining a variety of digital tools including mobile apps, SMS messaging, and wearable devices. These tools demonstrated efficacy in improving medication adherence, managing disease symptoms, and enhancing quality of life for patients and caregivers. Digital health interventions hold the potential to revolutionize medication adherence among chronic disease patients. By empowering informal caregivers, these tools can bridge the gaps in medication management and contribute to better health outcomes. Further research is warranted to optimize the design, implementation, and evaluation of digital interventions for medication adherence.
- Assessing the Hands-on usability of the healthy Jeart App specifically tailored to young usersPublication . Roldán-Ruiz, Ana Maria; Merino-Godoy, María-de-los-Ángeles; Peregrín-Rubio, Antonio; Yot-Dominguez, Carmen; Costa, Emília IsabelBackground: The widespread adoption of mobile devices by adolescents underscores the potential to harness these tools to instill healthy habits into their daily lives. An exemplary manifestation of this initiative is the Healthy Jeart app, crafted with the explicit goal of fostering well-being. Methodology: This study, framed within an applied investigation, adopts an exploratory and descriptive approach, specifically delving into the realm of user experience analysis. The focus of this research is a preliminary examination aimed at understanding users’ perceived usability of the application. To glean insights, a comprehensive questionnaire was administered to 101 teenagers, seeking their evaluations on various usability attributes. The study took place during 2022. Results: The findings reveal a considerable consensus among users regarding the evaluated usability aspects. However, the areas for improvement predominantly revolve around managing the information density, particularly for a subset of end users grappling with overwhelming content. Additionally, recommendations are put forth to streamline the confirmation process for user suggestions and comments. Conclusion: This analysis illuminates both the strengths of the app and areas ripe for refinement, paving the way for a more user-centric and efficacious Healthy Jeart application.
- Establishment of local diagnostic reference levels for abdomen and chest radiographies in the region of Algarve, PortugalPublication . Arriaga, A.; Gonçalves, Cláudia; Teles, P.; Santos, Joana; Simãozinho, Paula; Sousa-Santos, Patrick Emanuell MesquitaPurpose: To assess doses variabilities in the same abdomen and chest RX exams for adults, to check the need for dose harmonization. To calculate Diagnostic Reference Levels (DRL), mandatory in the European Union, for the Algarve district in Portugal. Our results can be a valuable reference for the Portuguese official determination of DRLs, still in progress.Method: We considered 4,936 abdomen and 41,320 chest radiographs of adults, covering 7 health centres and 35 radiographers in Algarve. Entrance skin dose (ESD) was calculated for each radiograph and the corresponding uncertainty estimated. Mean doses per centre and per technician, and their uncertainties, were calculated to access dose variabilities. DRLs, set at the 3rd quartile of the total ESD distribution, were determined for a standard patient and for intervals of body mass index (BMI) to study their correlation with patient anatomical variations. Standard quartile errors were estimated.Results: Our results suggest significant dispersion in applied ESDs among different centres and radiographers. Estimates of DRLs also show small fluctuations across years and an important dependence on BMI intervals. For a standard patient, they are 8.7 +/- 0.1 (abdomen) and 0.44 +/- 0.01 (chest), while the European DRLs are, respectively, 5.1 and 0.2 (all in mGy).Conclusions: Results suggest that there is room for dose optimization and harmonization with European DRLs, urging a national dose survey and the establishment of official national DRLs. Official DRLs in intervals of BMI would be quite beneficial, to avoid unnecessary dose exposures.
- A comparative study on the quality of life of survivors of stroke and Acute Myocardial InfarctionPublication . Lourenço, Eva; Sampaio, Mário Rui dos Mártires; Sánchez-Ramos, José Luis; Costa, Emília IsabelBackground: Worldwide, cardiovascular diseases, particularly acute myocardial infarction and strokes, lead to significant fatalities. Survivors often experience profound impacts on various aspects of their lives, making the assessment of their Quality of Life crucial for understanding their condition and adaptation to the illness. Methods: A community-based, descriptive cross-sectional study was conducted to compare how survivors of stroke and acute myocardial infarction perceive their Quality of Life. The Portuguese version of the World Health Organization Quality of life instrument was administered to 204 acute myocardial infarction and stroke survivors. Clinical and sociodemographic variables were also compared. Results: Statistically significant differences (p < 0.05) were noted in overall, physical, and psychological aspects of Quality of Life between the two groups, with stroke survivors consistently showing lower values in these dimensions. Conclusions: The Quality-of-Life perception of stroke and acute myocardial infarction survivors may be affected by several sociodemographic and clinical factors, and the results support the idea that the vascular event conditions the person’s Quality of Life, particularly in variables related to the person’s physical condition, functionality, and autonomy.
- Repurposing therapeutic drugs complexed to Vanadium in CancerPublication . De Sousa-Coelho, Ana Luísa; Fraqueza, Gil; Aureliano, M.Repurposing drugs by uncovering new indications for approved drugs accelerates the process of establishing new treatments and reduces the high costs of drug discovery and development. Metal complexes with clinically approved drugs allow further opportunities in cancer therapy—many vanadium compounds have previously shown antitumor effects, which makes vanadium a suitable metal to complex with therapeutic drugs, potentially improving their efficacy in cancer treatment. In this review, covering the last 25 years of research in the field, we identified non-oncology-approved drugs suitable as ligands to obtain different vanadium complexes. Metformin-decavanadate, vanadium-bisphosphonates, vanadyl(IV) complexes with non-steroidal anti-inflammatory drugs, and cetirizine and imidazole-based oxidovanadium(IV) complexes, each has a parent drug known to have different medicinal properties and therapeutic indications, and all showed potential as novel anticancer treatments. Nevertheless, the precise mechanisms of action for these vanadium compounds against cancer are still not fully understood.
- The Volunteer Motivation Scale (VMS): Adaptation and psychometric properties among a Portuguese Sample of VolunteersPublication . Martins, Cátia; Jesus, Saúl; da Silva, José Tomás; Ribeiro, Conceição; Estêvão, M. Dulce; Mocho, Helena; Ratinho, Elias; Nunes, C.Using self-determination theory, this study examined the autonomous motivation and regulatory styles of volunteers. The Volunteer Motivation Scale (VMS) is one of the main instruments available to assess these constructs, but it requires validation and adaptation for different contexts. Therefore, the goal of this study was to analyze the psychometric properties of the 12-item VMS in a sample of Portuguese volunteers. The sample consisted of 207 volunteers, mostly women (74.4%), aged from 14 to 81 years, from various areas of volunteering. The measures included self-regulation, basic psychological needs, causality orientation, and autonomy support. Confirmatory factor analysis using the lavaan package in R was performed to test a four-factor model and a two-factor model. The results indicated that the four-factor model had a better fit to the data. The VMS showed good internal consistency, discriminant validity, and convergent validity. The VMS can be viewed as a valuable tool for professionals and a promising avenue for future research on the motivations of volunteers.
- Limits and perspectives for the assessment of anxiety and fear of COVID-19 in pregnant women [Response To Letter]Publication . Muñoz-Vela, Francisco Javier; Fernández-Carrasco, Francisco Javier; Gómez-Salgado, Juan; Allande-Cussó, Regina; Marques Monteiro Dias Mendes, Isabel Margarida; Costa, Emília; Vázquez-Lara, Juana María; Fagundo-Rivera, Javier; Rodríguez-Díaz, LucianoThe authors would like to express sincere gratitude for the thoughtful and constructive feedback provided in this letter regarding the manuscript titled “Assessment of Levels of Anxiety and Fear of Covid-19 in a Population of Pregnant Women in Spain”. First of all, the assessments of the strengths and contributions of our research are welcomed; following this, the comments and suggestions have been thankfully received by the authors. The importance of highlighting these limita tions and opportunities for improvement is appreciated as, perhaps, these were not firmly underlined in the article. This study is the result of a series of academic research1,2 whose main aim was to improve the quality of life of pregnant women. Given this, all comments are greeted and will surely influence further investigations. Consequently, it is true that online survey administration eliminates the need for direct supervision, thus fostering honesty and freedom of response among the subjects in our sample. In the same vein, collecting data only in certain locations in Spain could affect the generalisability of the data. It is recognised the importance of obtaining a more comprehensive understanding of the variables studied in diverse geographical regions in Spain. The absence of the cultural variable as a mediator in our study is indeed a reasonable limitation, and it may have a potential impact on the interpretation of cultural constraints related to vaccine apprehension in certain nations. So, it is agreed that future research should incorporate the analysis of variables related to the cultural and religious context and should also incorporate mixed research methods that allow in-depth interviews3 with the sample in order to strengthen4 data collection on a topic as intricate as pregnant women’s mental health. In conclusion, this study undeniably provides valuable information that is relevant for clinical practice, intervention development, and evaluation of emotional symptoms in pregnant women. The identified limitations will serve as guides for future research in this same field of study. By adhering to recommended research and sampling strategies, upcoming studies can be built, allowing for improved robustness and applicability of the findings