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- Self-care improvement after a pharmaceutical intervention in elderly type 2 diabetic patientsPublication . Nascimento, Tânia; Braz, Nidia; Gomes, Eurico; Fernandez-Arche, Angeles; De La Puerta, RocioDiabetes mellitus involves long-term complications that affect diabetic patients’ quality of life. The best way to prevent these complications is that patients achieve good metabolic control. In order to reach this goal, patients are requested to acquire daily behaviours (self-care). Such behaviours are sometimes hard to adhere, because they require changes in habits acquired over time. The aim of the present study is to evaluate the improvement on self-care after a pharmaceutical intervention on home regime patients. We performed a controlled experimental comparative study with a follow up of 6 months, on 87 patients, randomized in control group (n=43) and intervention group (n=44). We accessed sociodemographic and clinical data (glycaemic profile), as well as adherence to drug therapy and self-assessed care (before-after).In the intervention group, mean age was 74.2±5.4 years, and the median time of T2DM diagnosis was 14.7±8.5years. At the end of study, the decrease in fasting blood glucose was higher in the intervention group patients than that observed in the control group (50.2mg/dL), with statistically significant difference (p<0.05), as well as the decrease verified in HbA1c. In self-care adherence, alterations in the levels of adherence of the general nutrition and physical exercise dimensions became evident, with an increase in the number of days of adherence. On medication adherence statistically significant alterations (p<0.05) were also recorded. We can conclude that an individualized pharmaceutical intervention can improve self-care behaviours, as well as medication adherence, contributing to better metabolic control.
- Consumo de medicamentos no internamento dos Serviços Clínicos de Psiquiatria e Saúde Mental e NeurologiaPublication . Lavaredas, Ana; Nascimento, Tânia; Estêvão, DulceNa realidade que a nossa sociedade vive actualmente, cada vez mais há patologias que envolvem Sistema Nervoso Central: transtornos da ansiedade generalizada e do pânico, comportamentos obsessivo-compulsivos, epilepsia, doença de Parkinson, cefaleias, demências, entre outros. O aumento da esperança média de vida leva a que incidência e prevalência esteja a agravar-se. Este trabalho teve como objectivo determinar os dez medicamentos mais consumidos durante um mês (Novembro de 2009), nos serviços clínicos (SC) de Psiquiatria e Saúde Mental e de Neurologia de um hospital da grande Lisboa, e perceber a relação entre estes consumos e as patologias mais frequentes nestes serviços.
- Characterization of potential intoxications with medicines in a regional settingPublication . Nascimento, Tânia; Santos, Teresa; Rato, Fátima; De Sousa-Coelho, Ana LuísaThe Portuguese Poison Information Center (from Portuguese—CIAV) is a call center that offers medical assistance in case of possible intoxication with any kind of product, including medicines. This center´s main goal is to inform and guide the general public and health professionals. This work aimed to analyze and compare data corresponding to the telephone calls from the Algarve region (South of Portugal), received by CIAV during 2019 and 2020, regarding potential intoxications with medicines. To this end, data provided by CIAV on possible cases of medication intoxication in the Algarve region were collected, including the number of calls received, the place of origin of the call, the age group and sex of the intoxicated individual, the route of exposure to the drug, the circumstances of contact with the substance, the existence of symptoms, and the drug or drugs involved in the potential intoxication. The results showed that the number of cases slightly decreased in 2020 (n = 1261) compared with 2019 (n = 1340), with a high number of cases of intoxication in children between one and four years old in both years (21.2%; n = 152 in 2019; 16.4%; n = 115 in 2020). The drugs belonging to the locomotor system group (paracetamol and ibuprofen) were the main drugs involved, followed by the central nervous system pharmacotherapeutic group, namely benzodiazepines (diazepam and alprazolam). Paracetamol was the main drug responsible for the calls to CIAV (n = 71 in 2019; n = 63 in 2020), while for the remaining drugs there were fluctuations in their positions between both years. In some cases, this swinging may be explained by the possible changes in therapy due to potential interactions with drugs used for the treatment of symptoms of COVID-19 or perhaps related to misleading information released by the media about the use of some drugs, such as ibuprofen, during lockdown periods. Although there has been a decrease in calls to report possible drug intoxication in the Algarve region, the profile of calls was very similar. Paracetamol was the drug with the highest number of reported cases and the group of psychotropic drugs showed the largest increase between 2019 and 2020.
- Hepatitis C treatment in a district HospitalPublication . Espírito Santo, Margarida; Guerreiro, Luisa; Nascimento, TâniaThe aim of this study was the characterization of patients with Hepatitis C (HCV) under treatment. Patients included in this study were followed in a Portuguese District Hospital between January 2012 and September 2014, have received treatment for HCV and who had at least one infectiology consultation in this period. Data were collected from the hospital computer system, and patient´s data were collected anonymously, without patient identification. Data analysis was performed using SPSS v22.0. Were included in this study 87 patients who met the inclusion criteria, 75% (n=65) were males and 25% (n=22) female, with a mean age of 45±10 years. Most patients included in this study were Portuguese, resident in the Hospital district and nearby districts. Patients were diagnosed with HCV with a mean age of 3311 years, were followed on average for 53.5 years in this Hospital, and were diagnosed with HCV on average 126.9 years ago. Among these patients, 44% (n=38) had genotype 1, 2% (n=2) genotype 2, 17% (n=15) genotype 3, 13% (n=11) genotype 4 and 24% (n=21) with unknown genotype. Most frequent treatment regimens used by patients included in the study were the association of pegylated interferon alfa 2b (100mcg/week) and ribavirin (1000 mg/day) (52%; n=45); pegylated interferon alpha 2a (180mcg/week) and ribavirin (1000 mg/day) (42%; n=36). Other associations were used but less frequently: pegylated interferon alfa 2a + ribavirin + boceprevir (2%; n=2); pegylated interferon alfa 2b + ribavirin + boceprevir (3%; n=3); and pegylated interferon alfa 2a + ribavirin + telaprevir (1%; n=1). Among included patients, 55 (63%) have performed, to date, one treatment for HCV, 19 (22%) have performed two treatments for HCV (using two different regimens or by using the same regimen twice), 9 (10%) already underwent treatment three times, 3 (3%) already underwent treatment four times and only one patient (1%) has conducted five treatments for HCV. Excluding patients who were receiving treatment at the time of data collection (September 2014), the average length of all other treatments performed by the patients was 82 months, and most (40%; n=51) of treatments performed by patients had a duration from 6 to 9 months. From the results, the standard treatment for patients with HCV appears to be in accordance with the existing guidelines for the treatment of this pathology. In the future it would be advisable further analysis and extended to other hospitals to assess the degree of compliance with currently existing national guidelines for the treatment of this pathology.
- Medication adherence and cardiometabolic control in type 2 diabetesPublication . Espírito Santo, Margarida; Gomes, Eurico; Nascimento, Tânia; Puerta Vázquez, Rocío; Arche, María-ÁngelesDiabetes mellitus type 2 is a disease that affects 12.9% of individuals in Portugal and whose control is difficult to achieve. Non-adherence to diabetes treatment is probably one of the causes of uncontrolled diabetes.
- Health literacy assessment: Translation and cultural adaptation to the Portuguese populationPublication . Espírito Santo, Margarida; Nascimento, Tânia; Pinto, Ezequiel; De Sousa-Coelho, Ana Luísa; Newman, JeffHealth literacy (HL) has been widely referenced as a determinant of health outcomes, making the assessment of low HL a fundamental step to plan educational interventions. This study aimed to translate and adapt the Short Assessment of Health Literacy-Spanish and English (SAHL-S&E) questionnaire into European Portuguese.
- Caracterização da unidade de cuidados paliativos do Hospital do Litoral Alentejano.Publication . Jordão, Milene; Nascimento, Tânia; Estêvão, DulceNos Cuidados Paliativos (CP), os sintomas são “encobertos” com tratamentos cuja finalidade primária é a de promover o conforto do doente. Todavia, os CP estendem-se muito para além do alívio dos sintomas físicos; procurando integrar os aspetos físicos, psicológicos e espirituais no tratamento, de modo a que os doentes se possam adaptar à sua morte iminente de forma tão completa e construtiva quanto seja possível. O controlo dos sintomas poderá favorecer, para além da qualidade de vida, a quantidade de vida. O objetivo do trabalho foi caracterizar os utentes internados na Unidade de CP e o seu perfil farmacoterapêutico.
- Caracterização farmacoterapêutica da unidade de doenças cérebro cardiovasculares do Hospital do Litoral Alentejano.Publication . Jordão, Carmen; Nascimento, Tânia; Estêvão, DulceO Acidente Vascular Cerebral (AVC) é um dos maiores problemas de saúde a nível mundial. Em Portugal, constitui a primeira causa de morte. Podemos considerar dois tipos de AVC: o isquémico caracterizado pela oclusão de um vaso, impedindo a passagem de sangue para uma determinada zona do cérebro, e o hemorrágico definido como a extravasão de sangue para o exterior dos vasos sanguíneos. A farmacoterapêutica do AVC consiste no uso de fármacos fibrinolíticos, anticoagulantes/antiagregantes plaquetários, antidislipidémicos, antihipertensores, ansiolíticos e anticonvulsivantes. O objetivo deste trabalho foi caracterizar o perfil farmacoterapêutico dos utentes internados na Unidade de Doenças Cérebro Cardiovasculares (DCCV) do Hospital do Litoral Alentejano, assim como analisar o consumo da terapêutica fibrinolítica no serviço de urgências.
- How diabetics’ patients identify their medicines?Publication . Espírito Santo, Margarida; Nascimento, Tânia; Newman, JeffThe main goal of this study was the characterization of diabetic patients´ knowledge in the identification of medicines, respectively the drug´s name, drug´s strength, and therapeutic indication. A cross-sectional study was developed at a specialized medical center in the diabetes area. Only patients that accepted to participate in this research and who gave their consent in writing before the start of the study were enrolled. In the study they were included patients aged 18 years and older, with diagnosis of diabetes mellitus, and using at least one medicine. Data collection was conducted through structured interviews, which was held during a consultation in a systematic way by completion of a questionnaire. Were included in this study one hundred and seven (107) patients, 41.1% female and 58.9% male, aged between 35 and 88 years, with a mean age of 65.6±10.5 years. The most prevalent health problems, beside diabetes mellitus, were hypertension (83.2%) and dyslipidaemia (74.8%), with a mean of 4.7±1.9 health problems per patient. Each patient was using a mean of 6.9±2.9 medicines and 0.2±0.4 food supplements per day. The therapeutic group often used was C (Cardiovascular System), A (Alimentary Tract and Metabolism) and N (Nervous System) with respectively 33.8%, 32.6% and 11.5%. Patients included in this study could not indicate the name of the medicines they were taking in 50% of the medicines, but were able to read the name of the medicine in most (96.5%) of them. When patients were questioned regarding drug´s strength only in about 25% of the medicines they managed to indicate the respective value. In most medicines (67.7%), patients were able to indicate the correct therapeutic indication for each medicine, although in 16.8% of medicines patients did not know the respective therapeutic indication, in 9.2% of medicines the information about therapeutic indication was incomplete, and in 6.3% of medicines patients have indicated an incorrect therapeutic indication. The results obtained indicate that patients have some lack of ability in the basic identification of the medicines used. In the future it will be desirable to perform a more extensive analysis that includes further variables related to the knowledge of the patients about medicines, including instructions of use, possible side effects and storage conditions, in order to be able to establish an action plan that can provide patients with more and better skills to achieve a responsible use of medicines.
- Polineuropatia amilóidótica familiar: investigação com vista a novas terapêuticasPublication . Oliveira, M. D.; Nascimento, Tânia; Estêvão, DulceA Polineuropatia Amiloidótica Familiar (PAF) é uma doença autossómica dominante progressiva, caracterizada pela deposição sistémica, extracelular de fibrilhas amilóides afectando particularmente o sistema nervoso periférico. Nesta doença, as fibrilhas de amilóide são compostas por uma variante da transtirretina em que a valina na posição 30 da molécula é substituída por uma metionina (TTR V30M). Actualmente, a única terapia que melhora a condição clínica dos portadores de PAF é o transplante hepático que, abolindo a síntese da proteína mutada, resulta numa paragem da deposição de amilóide. Contudo, trata-se de uma terapia bastante agressiva pelo que se pretende descobrir uma forma alternativa de tratar a doença. Várias equipas prosseguem estudos experimentais sobre o efeito de terapêuticas farmacológicas quer no sentido da disrupção da substância amilóide, quer no sentido da estabilização da transtirretina de modo a impedir a deposição de fibrilhas.
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