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- Smoking cessation at the community pharmacy: determinants of success from a real-life practicePublication . Condinho, Mónica; Ramalhinho, Isabel; Sinogas, CarlosThe objectives of this study are to report the contribution of pharmacists to smoking cessa tion and study the determinants of smoking cessation success in eight pharmacies in Portugal (south) between 2009 and 2019. A real-life study was conducted with a sample of smokers who participated in pharmacist consultations. The sample included 135 smokers (average age of 47.9 ± 1.21 years), 79 (58.5%) of whom were male. In parallel with the motivation and behavioral approach, 116 (85.9%) smokers received pharmacological therapies: 108 (80.0%) were treated with nicotine replacement products and eight (5.9%) with non-nicotine medications. The interventions resulted in 70 (51.9%) smokers complying with the quit day, of whom 59 (43.7%) were smoking-abstinent at the end of the first month. Success rates were reduced to 32.6%, 28.1%, and 20.7% at the end of the 3rd, 6th, and 12th months, respectively. Smoking cessation was more successful for the participants receiv ing pharmacological therapies (Fisher’s exact test, p < 0.001) and those who participated in more pharmacist consultations (χ 2 = 59.994, p < 0.001) and more telephone sessions (χ 2 = 17.845, p < 0.001). Pharmacists can contribute significantly to the promotion of smoking cessation. Smokers who are more thoroughly followed up by pharmacists showed increased success rates when compared with smokers having fewer sessions with pharmacists.
- Antibiotic consumption in Portugal: 2010 and 2011Publication . Pinho, S.; Ramalhinho, Isabel; Filipe Mota, H.The use of antibiotics has contributed to a marked decrease in morbidity caused by communicable and infec- tious diseases over the past few years. The aim of our study is to evaluate the use of antibiotics in clinic in 2010 and 2011, considering two different methodologies: the defined daily dose per 1000 inhabitants per day (DHD) and the number of packages per 1000 inhabitants per day (PHD).
- 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.
- Urinary tract infections: outpatient antibiotic use and antimicrobial resistance in the Algarve regionPublication . Ramalhinho, Isabel; Magalhaes, J.; Pinho, S.; Ataide Ferreira, J.; Cavaco, A.; Mota Filipe, H.; Cabrita da Silva, J.Background and objective: Microbial resistance to antibiotics continues to emerge as a significant global health concern. The misuse of antibiotics is an important factor contributing to the development of antibiotic resistance by bacteria. Urinary tract infection is among the most common bacterial infections, being Escherichia coli the main etiological agent.
- Development of a platform to align education and practice: bridging academia and the profession in PortugalPublication . Alves da Costa, Filipa; Martins, Ana Paula; Veiga, Francisco; Ramalhinho, Isabel; Sousa Lobo, José Manuel; Rodrigues, Luís; Granadeiro, Luiza; Castro, Matilde; Barata, Pedro; Gomes, Perpétua; Seabra, Vítor; Caramona, Maria MargaridaLimited fitness for practice may result from a mismatch between education and practice. Aiming to meet the common interests of academics and practitioners, the Portuguese Pharmaceutical Society (PPS) developed the Education and Practice Platform (EPP). The EPP includes one representative from each pharmacy faculty, and all Councils of Speciality Boards of Practice. Brainstorming with involved parties enabled sharing of interests, concerns and identifying a common path. Aims, mission, vision and values were set. The EPP's mission is to: act as an enabler to foster the quality and adequacy of education through sharing best practices, ultimately leading to facilitate professional integration, and to foster quality development in teaching practices with recognition for autonomy in freedom to teach and to learn. Its vision is an alignment of education and practice with the PPS' statutes to ensure validation of the competences defined for each practice area, and compliance with international guidance. Key performance indicators (KPIs) were set. Activities developed include the creation of a national forum to discuss education and practice, development of workshops on teaching methods and pharmacy internships, enhanced representation in international events and response to global and national requests. Ongoing work focuses on the creation of a common training framework in hospital and community pharmacy practice adapted to Portugal. The EPP is a worldwide case study, encouraging the development of discussion contributing to an open climate of sharing best practices, indirectly leading to foster a better alignment between education and practice. Many of these results are so far intangible in scientific terms but worth describing.
- Analysis of pharmacotherapeutic profile in patients with type 2 diabetes mellitusPublication . Leal, I.; Ramalhinho, Isabel; Nascimento, TâniaIn the past years, the antimicrobial resistance has been increasing, partly due to its misuse, and this has been considered as a threat for the public health by WHO. The aim of this study was to evaluate behaviours and attitudes of antibiotics use among adults in the south region of Portugal, Algarve, particularly self-medication and knowledge about these drugs.
- Mental health evaluation in community pharmacies—a cross-sectional studyPublication . Condinho, Mónica; Ramalhinho, Isabel; Vaz-Velho, Catarina; Sinogas, CarlosPortugal has a high prevalence of anxiety and depression, and community pharmacists are well-placed to identify mental health problems and monitor their treatment. This study aimed to screen undiagnosed people for symptoms of anxiety and depression and to monitor these conditions in diagnosed patients. We conducted an observational, cross-sectional study of a sample of community pharmacy users. Anxiety and depression symptoms were assessed using the Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Altogether, 591 participants were enrolled between September 2020 and July 2021, 74.9% of whom were female. Of the 477 undiagnosed participants who completed the GAD-7, 87 (18.2%) had moderate or severe anxiety symptoms. Of the 485 participants who completed the PHQ-9, 59 (12.1%) had moderate or severe symptoms of depression. Of the 94 patients diagnosed with anxiety, 37 (39.4%) reported moderate to severe symptoms. Similarly, of the 97 patients with depression, almost half (49.5%) reported moderate to severe symptoms. Anxiety levels were lower among men and among those who reported not taking any medication (p < 0.001). Moderate or severe symptoms of depression were more common among women (p < 0.001), participants with lower education levels (p < 0.005), participants who live alone (p < 0.007), and those taking medication for insomnia (p < 0.001), pain (p < 0.001), anxiety (p < 0.001), and/or depression (p < 0.001). Screening for anxiety and depression revealed that a significant proportion of undiagnosed participants had clinically relevant symptoms of anxiety and depression. However, among participants diagnosed with anxiety and depression, between 40% and 50% were uncontrolled, respectively. These data highlight pharmacists' role in identifying customers at risk of anxiety and depression as well as the need for better monitoring of those already diagnosed.