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- 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.
- New food frequency questionnaire to estimate vitamin K intake in a Mediterranean populationPublication . Pinto, Ezequiel; Viegas, Carla; Martins, Paula Ventura; Nascimento, Tânia; Schurgers, Leon; Simes, DinaVitamin K is a multifunctional micronutrient essential for human health, and deficiency has been linked to multiple pathological conditions. In this study, we aimed to develop and validate a new food frequency questionnaire (FFQ) to estimate total vitamin K intake, over the course of a 30-day interval, in a Portuguese, Mediterranean-based, population. We conducted a prospective study in a non-random sample of 38 healthy adult volunteers. The FFQ was designed based on a validated Portuguese FFQ used in nationally representative studies and on literature reviews, to include foods containing ≥5 μg of vitamin K/100 g and foods with a lower vitamin K content, yet commonly included in a Mediterranean diet. Vitamin K intake was estimated from 24 h recalls and six days of food records. The final FFQ included 54 food items which, according to regression analyses, explains 90% of vitamin K intake. Mean differences in vitamin K intake based on food records (80 ± 47.7 μg/day) and on FFQ (96.5 ± 64.3 μg/day) were statistically non-significant. Further, we found a strong correlation between both methods (r = 0.7; p = 0.003). Our results suggest that our new FFQ is a valid instrument to assess the last 30 days of vitamin K intake in the Portuguese Mediterranean population.
- Mediterranean Diet favors Vitamin K intake: A descriptive study in a Mediterranean populationPublication . Pinto, Ezequiel; Viegas, Carla; Ventura Martins, Paula; Marreiros, Catarina; Nascimento, Tânia; Schurgers, Leon; Simes, DinaThe Mediterranean diet (MD) is associated with improved longevity and the prevention and management of chronic inflammatory diseases (CIDs). Vitamin K, which is present in MD core components such as leafy green vegetables, is also known as a protective factor for CIDs. Estimates of vitamin K intake in Mediterranean settings are still scarce, and the association between MD and vitamin K intake is yet to be established. This study analyzed vitamin K intake and MD adherence in the Algarve region, in Portugal. We conducted a cross-sectional study in a nonrandom sample of adults using an online questionnaire which included a validated food-frequency questionnaire and a screener for MD adherence. A total of 238 participants were recruited (68% women and 32% men). Adherence to the MD was low (11%). Only 10% of the participants had vitamin K intake below the adequate intake. Adherence to the MD was positively correlated with vitamin K intake (r = 0.463; p < 0.001) and age (r = 0.223; p < 0.001). Our findings underscore the importance of promoting adherence to the MD for optimal vitamin K intake, and future research should focus on developing effective interventions to promote this dietary pattern, particularly among younger individuals and men.
- 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.
- Nutritional and Pharmacological Therapy Adherence in Type-2 Diabetes Patients in a Mediterranean RegionPublication . Pinto, Ezequiel; Braz, Nidia; Gomes, Eurico; Nascimento, TâniaIntroduction: Type 2 diabetes patients do not value nutritional therapy in the same level as they value other types of interventions. In this study, we analysed the value that T2DM patients place on nutritional and pharmacological therapy and identified perceived barriers to nutritional therapy adherence. Methods: a non-random sample of 62 patients receiving health care in a Diabetes Clinic in the municipality of Faro, in the Portuguese region of the Algarve, was interviewed with a semi-structured protocol regarding sociodemographic characteristics, lifestyle, physical activity, and dietary habits. Additional data were collected from the patient’s clinical files and by conducting anthropometric assessment using standard methods. Results: patients show a poor dietary intake, and most are overweight (36%; n=22) or obese (53%; n=33). Physical activity is considered less important than dietary intake and pharmacologic treatment (F=19.6; p<0.001). Adherence to a Mediterranean diet is high (66%; n=41), and patients with a higher adherence to the Mediterranean diet consider their diet as having an higher quality (rSpearman=0.371; p=0.032). Value placed in dietary intake as a treatment for the disease is high, but patients seem to have a trouble in complying with the recommendations and to sustain the compliance they achieved. Conclusions: Patients should be empowered to improve their self-care. Proper, tailored interventions should be developed and implemented.
- Potentially inappropriate medication: a pilot study in institutionalized older adultsPublication . Andrade, Amanda de Oliveira; Nascimento, Tânia; Cabrita, Catarina; Leitao, Helena; Pinto, EzequielInstitutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles, and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ± 7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population.
- Viver bem com mais idade - projeto multidisciplinar na área da alimentação, medicação e psicologiaPublication . Meireles, Manuela; Mateus, Maria; Correia, Maria Marta; Pinto, Ezequiel; Espírito-Santo, Margarida; Braz, Nidia; Pais, Sandra; Nascimento, Tânia; Gonçalves, GabrielaA interação social, atividade física e a alimentação são cruciais para a qualidade de vida. No envelhecimento, há que adaptar atitudes e relações sociais. Com o avanço da idade surgem patologias crónicas e consequentemente a polimedicação, assumindo os cuidados com os medicamentos uma maior relevância. O objetivo é dinamizar formação de proximidade, em áreas urbanas e rurais do Algarve, de modo a melhorar a qualidade de vida da população com mais idade. Metodologia A formação consiste em sessões de 2,5h dinamizadas por formadores especializados em: alimentação, farmácia e psicologia, que abordam a importância da alimentação saudável, dos cuidados com a medicação e da gestão psicológica, de forma a manter bem-estar físico e psíquico, para dar mais vida aos anos. O contacto com as autarquias, universidades sénior e instituições de apoio sénior da região do Algarve conduziu à calendarização das ações de acordo com o interesse manifestado, em diferentes áreas da região algarvia entre setembro 2018 e dezembro de 2019. Resultados Este projeto atingiu idosos alunos de universidades sénior, membros de grupos desportivos, e frequentadores de atividades comunitárias, em áreas urbanas e também a grupos de áreas rurais. A participação e aceitação foi bastante positiva. Com as 5 sessões realizadas atingiram-se 80 formandos e há 4 novas sessões previstas em diferentes concelhos (Fig.1). Conclusão Este projeto permitiu uma maior compreensão das realidades vividas pela população idosa da região algarvia, urbana e rural, ao mesmo tempo que contribuiu para a promoção de estratégias adequadas para um envelhecimento saudável e ativo.