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Fibromialgia: abordagem terapêutica integrada
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| 2.74 MB | Adobe PDF |
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Abstract(s)
A fibromialgia é caraterizada como uma síndrome de dor musculoesquelética generalizada, crónica e difusa, sem alterações biológicas que o justifiquem. Esta condição apresenta uma prevalência mundial de 2,7%, e em Portugal estima-se que 1,7% da população tenha diagnóstico de fibromialgia.
Os mecanismos fisiopatológicos exatos subjacentes à fibromialgia ainda são desconhecidos, assim como a sua causa é idiopática. Pelo que não há um tratamento standard e que cure; apenas se procura atenuar a sintomatologia que se evidencia em cada doente. Importa assim, abordar as classes terapêuticas que podem ser consideradas num doente, após diagnóstico de fibromialgia, e quais os graus de recomendação que as guidelines terapêuticas lhes associam.
O farmacêutico, enquanto especialista do medicamento, e frequentemente enquanto profissional de saúde que mais contacta com os doentes, pode ter um papel relevante perante doentes com fibromialgia. Nomeadamente, na promoção da adesão à terapêutica, monitorização da mesma e desmistificação de crenças.
Deste modo, o principal objetivo desta dissertação consistiu em fazer uma atualização terapêutica na fibromialgia, com recurso a uma pesquisa bibliográfica, e por outro lado, um estudo de caso visando complementar e/ou fornecer outra perspetiva ao tema.
O estudo de caso traduziu-se, essencialmente, na descrição de três casos clínicos recolhidos em farmácia comunitária, e sua respetiva interpretação assente na bibliografia consultada na componente teórica desta dissertação.
Concluiu-se que ao nível da literatura, e com base nas principais guidelines terapêuticas abordadas, a maioria dos fármacos não tem níveis de evidência elevados e graus de recomendação fortes, sobretudo na Europa, em que não existem fármacos aprovados com indicação terapêutica na fibromialgia. Com o estudo de caso, foi também possível concluir que na prática, a terapêutica é muito empírica e por vezes, com fraca adesão por parte dos doentes.
Fibromyalgia is characterized by a generalized, chronic and diffuse musculoskeletal pain syndrome with no biological changes to justify it. This condition has a worldwide prevalence of 2,7%, and in Portugal it is estimated that 1,7% of the population has a diagnosis of fibromyalgia. The exact pathophysiological mechanisms underlying fibromyalgia are still unknown, and its cause is idiopathic. Therefore, there is no standard treatment to cure it, only to alleviate the symptoms that each patient evinces. It is thus, important to address the therapeutic classes that can be considered in a patient after a diagnosis of fibromyalgia, and what recommendation degrees are associated with the therapeutic guidelines. The pharmacist, as a medicine specialist and often as a healthcare professional who has the most contact with patients, can play an important role in patients with fibromyalgia. In particular, in promoting adherence to therapy, monitoring it, and demystifying beliefs. As such, the main objective of this dissertation was to carry out a therapeutic update on fibromyalgia, using bibliographical research, as well as a case study aiming at complementing and/or providing a different perspective to the subject. The case study consisted in the description of three clinical cases collected in a community pharmacy, and their respective interpretation based on the bibliography used in the theoretical component of this dissertation. It was concluded that in terms of literature, and based on the main therapeutic guidelines addressed, most drugs don’t show high levels of evidence and strong degrees of recommendation, especially in Europe, where there are no approved drugs with therapeutic indication for fibromyalgia. With the case study, it was also possible to conclude that in practice, the therapy is very empirical, showing poor adherence by patients.
Fibromyalgia is characterized by a generalized, chronic and diffuse musculoskeletal pain syndrome with no biological changes to justify it. This condition has a worldwide prevalence of 2,7%, and in Portugal it is estimated that 1,7% of the population has a diagnosis of fibromyalgia. The exact pathophysiological mechanisms underlying fibromyalgia are still unknown, and its cause is idiopathic. Therefore, there is no standard treatment to cure it, only to alleviate the symptoms that each patient evinces. It is thus, important to address the therapeutic classes that can be considered in a patient after a diagnosis of fibromyalgia, and what recommendation degrees are associated with the therapeutic guidelines. The pharmacist, as a medicine specialist and often as a healthcare professional who has the most contact with patients, can play an important role in patients with fibromyalgia. In particular, in promoting adherence to therapy, monitoring it, and demystifying beliefs. As such, the main objective of this dissertation was to carry out a therapeutic update on fibromyalgia, using bibliographical research, as well as a case study aiming at complementing and/or providing a different perspective to the subject. The case study consisted in the description of three clinical cases collected in a community pharmacy, and their respective interpretation based on the bibliography used in the theoretical component of this dissertation. It was concluded that in terms of literature, and based on the main therapeutic guidelines addressed, most drugs don’t show high levels of evidence and strong degrees of recommendation, especially in Europe, where there are no approved drugs with therapeutic indication for fibromyalgia. With the case study, it was also possible to conclude that in practice, the therapy is very empirical, showing poor adherence by patients.
Description
Keywords
Fibromialgia Terapêuticas Guidelines terapêuticas Papel do Farmacêutico.