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- 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.
- Colorectal cancer prevention: strategies for promoting literacyPublication . Espírito-Santo, Margarida; Gomes, Tânia; Nascimento, TâniaBackground Colorectal cancer (CRC) is the most frequent and deadly cancer in Portugal, prevention and early detection with screening are key factors for decreasing the incidence of CRC and improving survival rates. CRC screenings allow the detection of benign situations and their remotion, preventing the development of a malignant condition. Thus, this study aimed to identify strategies that could promote CRC literacy in order to also increase the number of screenings. Methods A systematic review (SR) was performed using PICOS methodology to define study goals and then PRISMA methodology to collect data for the review, including intervention studies published from 2010. Results A final number of 11 articles were included in this SR, which used several strategies to promote literacy. These studies included patients mostly within the age range of 50–75 years. The different strategies identified contained delivering pamphlets, seminars, using technological solutions, among others. All of these educational strategies led to the breaking down of some barriers that might exist about screening and bowel preparation, which conduced to an increase in adherence to CRC screening. Since most of the studies were performed in populations presenting low health literacy or belonging to ethnic minorities, strategies such as verbal information sessions showed better results. Conclusions Several strategies seems to be effective, since the results of different interventions have translated into increased CCR literacy and also the number of screenings. Portuguese pharmacy professionals, given easy access and user confidence can contribute directly, as a future perspective, in the education of patients with CCR.
- Tea tree oil: properties and the therapeutic approach to acne—a reviewPublication . Nascimento, Tânia; Gomes, Diana; Simões, Ricardo; Miguel, MariaAcne vulgaris is an inflammatory dermatological pathology that affects mostly young people. However, it can also appear in adulthood, mainly in women. It has a high psychosocial impact, not only at the time of active lesions but also due to the consequences of lesions such as scarring and hyperpigmentation. Several factors are involved in the physiopathology of acne and the constant search for active ingredients is a reality, namely phytotherapeutic ingredients. Tea tree oil is an essential oil extracted from Melaleuca alternifolia (Maiden & Betch) Cheel with known antibacterial, anti-inflammatory, and antioxidant properties, making it a candidate for the treatment of acne. This review aims to describe the various properties of tea tree oil that make it a possible ingredient to use in the treatment of acne and to present several human studies that have evaluated the efficacy and safety of using tea tree oil in the treatment of acne. It can be concluded that tea tree oil has good antibacterial, anti-inflammatory, and antioxidant properties that result in a decrease in the number of inflammatory lesions, mainly papules, and pustules. However, given the diversity of study designs, it is not possible to draw concrete conclusions on the efficacy and safety of this oil in the treatment of acne.
- Diabetes self-care and disease knowledgePublication . Espírito-Santo, Margarida; Nascimento, Tânia; Gomes, EuricoDiabetes mellitus (DM), presenting as a chronic metabolic pathology, is multifactorial and factors such as self-care can positively contribute to the glycemic control. Allied with patient’s behaviour, the knowledge about this disease may empower patient´s to achieve appropriate disease management including treatment adherence and avoidance of complications.
- Self-medication habits during the COVID-19 pandemicPublication . Espírito-Santo, Margarida; Campos, Erica; Nascimento, TâniaBackground Self-medication is a common practice worldwide. During COVID-19 pandemic, the constant fear of going outside and to use health services may have had an impact in the number of visits to Community Pharmacies. This research aimed to study self-medication habits of the Portuguese population during the current pandemic, more specifically, to understand which non-prescription drugs and food supplements were taken and the situations that conduced to the use of self-medication. Methods An online structured survey was conducted, with data obtained anonymously and included 170 participants (≥18 years). Data were processed using SPSS v26. Results Participants in this study were mainly female (81.2%), with a mean age of 38.01 ± 1.16 years old and most (84.7%) over 12 years of schooling. Answers allowed to verify that the current pandemic didn’t affect that much the frequency of visits to Pharmacy and the situations where people used self-medication were mainly minor, such as headaches (54.1%) and muscle pains (26.5%). The medications used more often were analgesics (60.0%) and anti-inflammatory (40.0%). However, many people indicated that they didńt seek for more information about medicines (49.4%) and/or supplements (7.6%) used during this period. In general, people visited the Pharmacy with a similar frequency and purpose as the previous year. Conclusions Despite all the changes, the current pandemic has not negatively affected the practice of self-medication. The role of Pharmacy professionals in the rational use of the drugs, particularly those used in self medicated situations is essential, especially when the population shows low health literacy regarding the use of medicines.
- 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.