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- Knowledge assessment during the medication process use by older patients on clinical routine: A pilot studyPublication . Espírito-Santo, Margarida; Pinto, Ezequiel; Estêvão, M. Dulce; Nascimento, TâniaObjectives: The consumption of medicines has been increasing over the last decades. The lack of medication knowledge (MK) may affect the process of medication use and, consequently, may lead to negative health outcomes. This study carried out a pilot study using a new tool to assess MK in older patients in a daily clinical practice. Materials and Methods: An exploratory cross-sectional study was conducted, including older patients (>= 65 years), taking two or more medicines, followed in a regional clinic. Data were collected during a structured interview, which included an algorithm for assessing MK regarding the identification of the medicines and its use and storage conditions. Health literacy and treatment adherence were also assessed.Results: The study enrolled 49 patients, mainly between 65 and 75 years (n: 33; 67.3%) and polymedicated (n: 40; 81.6%), taking a mean of 6.9 +/- 2.8 medicines per day. A lack of MK (score <50%) was observed in 15 (30.6%) participant patients. "Drug strength" and "storage conditions" were the items which presented the lowest score. MK was positively correlated with higher scores for health literacy and treatment adherence. Younger patients (age <65 years old) also had a higher MK score.Conclusion: This study showed that the applied tool could evaluate the MK of the participants and identified specific gaps regarding MK within the process of medicine use. Further studies, with more participants, will allow the confirmation of these findings and will stimulate the development of specific strategies to improve MK, thus contributing to better health outcomes.
- Patient information leaflets of drugs used in cardiometabolic disorders: Suitability for use by older personsPublication . Espírito-Santo, Margarida; Pinto, Ezequiel; Estêvão, M. Dulce; Nascimento, TâniaIn 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.
- Potential impact of metabolic syndrome control on cardiovascular risk in elderly patients with diabetes: a cross-sectional studyPublication . Nascimento, Tânia; Estêvão, Maria Dulce da Mota Antunes de Oliveira ; Gonçalves, Adriana; Pinto, Ezequiel; De Sousa-Coelho, Ana Luísa; Neto Espírito-Santo, Margarida de FátimaMetabolic syndrome (MS), a complex pathology with features like abnormal body fat distribution, insulin resistance, and dyslipidaemia, contributes to higher cardiovascular (CV) risk. A cross-sectional study including 87 individuals assessed CV risk score in elderly patients with type 2 diabetes and MS in Algarve, Portugal. The 10-year CV risk score was estimated using the ADVANCE risk score calculator. The reductions in CV risk score were estimated by adjusting the data inputted on the online tool to achieve systolic blood pressure (SBP) <130 or <120 mmHg, and LDL cholesterol <70 mg/dL Beyond waist circumference, the mean number of clinical features of MS was 3.14 ± 0.84, without significant sex differences. The mean CV risk score was 22.5% (CI: 20.3–24.7). Sex-specific analysis showed higher risk score in males (24.2%, CI: 21.3–27.0) vs. females (19.7%, CI: 16.2–23.3; p = 0.028). Hypothetical risk score reductions show that lowering SBP to <130 mmHg could significantly lower the risk score by an average of 9.2% (CI: 7.7–10.7), whereas 34.5% of the participants would be out of the diagnostic criteria for MS. When comparing each potential intervention with current risk score, all interventions significantly reduce the 10-year CV risk score. The study highlights the potential of blood pressure control in reducing CV risk score and the importance of multifaceted risk score reduction strategies.