Mestrado em Ciências Farmacêuticas

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Navegando Mestrado em Ciências Farmacêuticas por Autor "Ayres, Lorena Rocha"

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    Estudo de utilização de medicamentos em pacientes com doença de Parkinson
    (Universidade Federal do Espírito Santo, 2019-02-22) Colatto, Luana Laura; Ayres, Lorena Rocha; Guimarães do Bem, Daniela Amorim Melgaço; Baldoni, André de Oliveira; Andrade, Tadeu Uggere de
    Aging is leading to an increasing incidence of chronic degenerative illnesses such as Parkinson’s disease. In addition, the elderly population is characterized by the concomitant presence of one or more chronic conditions that bring with it the challenge of polypharmacy, and with it the complexity of therapeutic regimens. Potentially inappropriate medications, which can cause severe adverse effects when given to the elderly, may interfere with the success of pharmacotherapy in these patients. Together with all these factors, depression and sociodemographic characteristics may influence adherence to pharmacological treatment. In this context, we identified the prevalence in the use of potentially inappropriate medications, according to the Beers criteria 2015 and, also, we evaluated the adherence to the drug treatment, both in patients with Parkinson’s disease. It is a cross-sectional study, developed in patients diagnosed with Parkinson’s disease and who are part of the Chronic Management Program of Unimed-Vitória. We evaluated the older adults with 60 years or more included in the digital Healthmap® platform in the year 2017. Data were collected using questionnaires (structured interview questionnaire, Hoehn and Yahr Scale, Morisky-Green Test, Brief Medication Questionnaire, MedTake) and through the digital Healthmap® platform. The association between the use of potentially inappropriate medications and the independent variables was analyzed by univariate logistic regression with their respective confidence intervals of 95%. For the multiple model, the variables that presented p < 0.20 were selected. The association between adherence and the independent variables was analyzed using Fisher's exact test. The prevalence of 83.3% was verified in the use of potentially inappropriate medications. In the multiple logistic regression model, the associated variables to use were female (p = 0.03), receive seven or more home visits (p = 0.03), some anatomical therapeutic chemical classification – code M: musculo-skeletal system (p = 0.04) and code A: alimentary tract and metabolism (p = 0.005), and the use of psychotropic medication (p = 0.03). Consulting with four or more different medical specialties was considered as a protection factor for the use of potentially inappropriate medications. The results found in the assessment of adherence ranged from 0.0% to 76.1%, considering total adherence to the prescribed treatment, according to the score of each questionnaire. There were no significant associations between the variables and adherence to treatment. This study demonstrated a high prevalence of potentially inappropriate medications in this population, evidencing the need to disseminate this criteria and the adoption of tools that promote the rational use of drugs and, on the other hand, a low therapeutic adherence of the patients, which corroborates the need for a multidisciplinary approach, particularly with the participation of a pharmacist, to develop strategies to facilitate understanding of the pharmacological treatment of patients with Parkinson’s disease.
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    Impacto do acompanhamento farmacoterapêutico na adesão ao tratamento e no controle metabólico e inflamatório de pacientes com Diabetes Mellitus tipo II
    (Universidade Federal do Espírito Santo, 2018-08-22) Santos, Mayara Paes; Gonçalves, Rita de Cássia Ribeiro; Guimarães do Bem, Daniela Amorim Melgaço; Baldoni, André de Oliveira; Ayres, Lorena Rocha
    The aim of this study was to evaluate the impact of pharmacotherapeutic follow-up on adherence to treatment and on metabolic and inflammatory parameters in patients with T2DM. This was a prospective interventional study, in which 60 patients diagnosed with T2DM were selected from Family Health Units in the Maruípe territory of the city Vitória-ES. Patients received pharmacotherapeutic follow-up with individual guidelines every 2 months for a period of 6 months. For the pharmacotherapeutic follow-up, an adaptation of the SOAP methodology (Subjective, Objective, Evaluation and Plan) was used, and the Morisky-Green (TMG) and MedTake (MTT) tests were used to evaluate adherence and knowledge of the treatment. Clinical and anthropometric parameters were measured during pharmacotherapeutic follow-up. Biochemical parameters were investigated through tests of fasting glycemia, glycated hemoglobin, lipid profile, creatinine, gamma-GT, urea and uric acid. The inflammation evaluation was performed through the inflammatory markers: fibrinogen, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α). In addition, polymorphisms were investigated in the promoter regions of the fibrinogen (-148 C/T), IL-6 (-174 G / C) and TNF-α (-308 G/A and -238 G/A) genes. In this study, a significant increase (p <0.0001) in adherence and knowledge to the treatment after pharmacotherapeutic follow-up was found. Regarding the pharmacological treatment, patients improved (p <0.05) MTT for metformin, insulin and gliclazide, in TMG questions and in adherence to the types of treatments for T2DM, evidencing an improvement in adherence and knowlegde to the treatment. In addition, no significant changes in metabolic control, systolic and diastolic blood pressure, body mass index, weight, waist circumference, and capillary glycemia were observed. However, there was a significant increase for HDL-c levels and waistto-hip ratio (WHR). Regarding inflammatory markers, only fibrinogen significantly reduced (p = 0.0224). CRP, IL-6 and TNF-α did not suffer significant changes (p> 0.05). Polymorphism genes (SNPs) were not shown to be influential in plasma levels of fibrinogen, IL-6 and TNF-α (p> 0.05). Therefore, pharmacotherapeutic follow-up was relevant because it contributed to the improvement of adherence to treatment, knowledge about medications and levels of HDL-c and fibrinogen in patients with T2DM.