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- 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.
- 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.
- Adequação terapêutica da utilização de inibidores da bomba de protões: estudo exploratórioPublication . Espírito Santo, Margarida; De Sousa-Coelho, Ana Luísa; Duarte, Denise; Nascimento, TâniaO aumento acentuado do consumo de fármacos inibidores da bomba de protões (IBPs) que se tem verificado nos últimos cinco anos fez surgir a necessidade de analisar a sua utilização na prática clínica atual e avaliar as possíveis consequências associadas ao seu consumo. Pretendeu-se com este estudo analisar a adequação terapêutica da utilização de IBPs na prática clínica de uma farmácia comunitária.
- Laxative use by community pharmacy users in southern PortugalPublication . Lourenço, Laura; De Sousa-Coelho, Ana Luísa; Nascimento, Tânia; Assunção, Lucília; Espírito Santo, MargaridaThe aim of this study was the characterization of laxative use by Pharmacy users, including the prevalence of use, types of laxatives used, and places for acquiring and obtaining advice on laxatives. METHODS: A cross-sectional and descriptive study was carried, using a structured questionnaire, in a Community Pharmacy located in Faro, Portugal. During a period of 3 weeks, all Pharmacy users (≥18 years) who agreed to voluntarily participate in this study, were enrolled. Our study sample included 50 users, mainly women (74%), aged from 22 to 94 years (median of 59 years). RESULTS: Most of the participants (88%) reported to be suffering or to have previously suffered from constipation, whereas 62% indicated to be suffering with symptoms for more than 3 years. From those, 64% had presented symptoms of constipation more than once a week in the previous year. Whenever users felt constipated, more than half (58%) indicated to use a laxative. Contact laxatives were the more often used (63%), while 18% and 8% of the participants indicated to have used bulk-forming and osmotic laxatives, respectively, during the previous year. Over half of the participants (54%) indicated to use laxatives at least on a weekly basis, with 38% presenting a daily consumption. Elderly users, ≥60 years, were who used laxatives more often (65% daily; p<0.001). Whereas Pharmacies were the preferred place to purchase laxatives (85%), only about 40% of the users indicated to ask for health professional advise at the time of acquisition. CONCLUSIONS: A high rate and frequency of laxative use was identified in the study sample, particularly contact laxatives. It is imperative, therefore, to provide users with more information on non-pharmacological measures to avoid and approach constipation and its symptoms, as well as further information such as overuse complications, allowing the appropriate selection of the laxative. Pharmacy professionals have a key role on this area, and related education campaigns should be implemented.
- Pacientes diabéticos: como identificam os seus medicamentos?Publication . Espírito Santo, Margarida; Nascimento, Tânia; Newman, JeffA adesão à medicação, nas doenças crónicas, tem uma média estimada de 50% nos países desenvolvidos, sendo ainda menor em países em desenvolvimento, verificando-se uma diminuição na taxa de adesão ao longo do período de uso de medicação. O uso responsável do medicamento inclui o seu uso adequado, logo, a falta ou insuficiente conhecimento dos medicamentos utilizados pode contribuir para uma diminuição da efetividade dos tratamentos farmacológicos e conduzir a resultados clínicos negativos. Objetivo principal: caraterização do conhecimento dos pacientes diabéticos na identificação de medicamentos, respetivamente, o nome do medicamento, a dosagem, e a indicação terapêutica. Material e Métodos: estudo transversal num centro especializado na área de diabetes. Critérios de inclusão: idade ≥ 18 anos, diagnóstico de diabetes mellitus, a utilizar pelo menos um medicamento. Apenas os pacientes que aceitaram participar neste estudo e que deram o seu consentimento por escrito antes do início da recolha de dados foram incluídos. A recolha de dados foi realizada por meio de entrevista estruturada, realizada de forma sistemática através do preenchimento de um questionário. Foram incluídos neste estudo cento e sete (107) pacientes. Conclusão: Os resultados obtidos indicam que os pacientes têm algumas falhas na capacidade de identificação básica dos medicamentos utilizados. Os pacientes não sabiam indicar o nome dos medicamentos que utilizavam em 50% destes, mas conseguiam ler o nome da maioria (96,5%). Relativamente à dosagem, apenas em cerca de 25% dos medicamentos os pacientes conseguiram indicar o respetivo valor. Na maioria dos medicamentos (67,7%), os pacientes foram capazes de indicar a respetiva indicação terapêutica, em 16,8% dos medicamentos os pacientes não sabiam qual a respetiva indicação terapêutica, em 9,2% dos medicamentos a informação sobre indicação terapêutica foi incompleta, e em 6,3% dos medicamentos a indicação terapêutica indicada estava incorreta. No futuro, será desejável realizar uma análise mais extensa que inclua outras variáveis relacionadas com o conhecimento dos pacientes sobre medicamentos, incluindo modo de utilização, possíveis efeitos secundários e as condições de armazenamento, a fim de se conseguir estabelecer um plano de ação que permita dotar os pacientes com mais e melhores competências, contribuindo para o uso responsável do medicamento e para uma melhoria dos resultados clínicos.