18 research outputs found
Pharmacotherapy review: a proposal to improve medication adherence among hypertensive patients
Antioxidant and anti-dermatophytic properties leaf and stem bark of Xylosma longifolium clos
Measurement complexity of adherence to medication
Dayani Galato, Fabiana Schuelter-Trevisol, Anna Paula PiovezanMaster Program in Health Sciences, University of Southern Santa Catarina (Unisul) Tubarão, Santa Catarina, BrazilAdherence to pharmacologic therapy is a major challenge for the rational use of medicines, particularly when it comes to antiretroviral drugs that require adherence to at least 95% of prescribed doses.1 Studies in this area are always important and contribute to medication adherence understanding, even though there is no reference test for measuring this. Recently, an article was published in this journal that proposes the determination of lamivudine plasma concentration to validate patient self-reported adherence to antiretroviral treatment.2 In that study, serum levels obtained after 3 hours of ingestion of the last dose of the drug were compared with patient reports that were classified into different levels of adherence, based on their recall of missed doses in the previous 7 days.It was hypothesized by the authors that the use of a biological marker for drug adherence was extremely important, given the relevance of the topic. However, we would like to draw attention to some points that may determine the success of the use of similar methods for this purpose. The formation of groups with similar anthropometric characteristics is relevant since the dose of lamivudine may have to be changed, depending, for example, on sex, weight, and age.3 Even information considered important by the authors of that study was not provided. There is a need for greater clarity on the eligibility criteria, especially with regard to the clinical stage of the disease, CD4 counts and viral load, associated diseases, and comorbidity, as well as the evaluation of kidney function and other medications used that can affect lamivudine pharmacokinetics.3View original paper by Minzi and colleague
Pharmacy practice simulations: performance of senior pharmacy students at a University in southern Brazil
Objective: A simulation process known as objective
structured clinical examination (OSCE) was applied
to assess pharmacy practice performed by senior
pharmacy students.
Methods: A cross-sectional study was conducted
based on documentary analysis of performance
evaluation records of pharmacy practice simulations
that occurred between 2005 and 2009. These
simulations were related to the process of selfmedication
and dispensing, and were performed
with the use of patients simulated. The simulations
were filmed to facilitate the evaluation process. It
presents the OSCE educational experience
performed by pharmacy trainees of the University of
Southern Santa Catarina and experienced by two
evaluators. The student general performance was
analyzed, and the criteria for pharmacy practice
assessment often identified trainees in difficulty.
Results: The results of 291 simulations showed that
students have an average yield performance of
70.0%. Several difficulties were encountered, such
as the lack of information about the
selected/prescribed treatment regimen (65.1%);
inadequate communication style (21.9%); lack of
identification of patients麓 needs (7.7%) and
inappropriate drug selection for self-medication
(5.3%).
Conclusions: These data show that there is a need
for reorientation of clinical pharmacy students
because they need to improve their communication
skills, and have a deeper knowledge of medicines
and health problems in order to properly orient their
patients.Objetivo: Se aplic贸 un proceso conocido como
examen cl铆nico estructurado objetivo (OSCE) para
evaluar la actuaci贸n en pr谩ctica farmac茅utica de
estudiantes s茅nior de farmacia.
M茅todos: Se realiz贸 un estudio transversal basado
en un an谩lisis documental de los registros de
simulaciones de farmacia pr谩ctica que ocurrieron
entre 2005 y 2009. Estas simulaciones estaban
relacionadas con el proceso de auto-medicaci贸n y
dispensaci贸n con el uso de pacientes simulados.
Las simulaciones fueron filmadas para facilitar el
proceso de evaluaci贸n. Se presentan la experiencia
educativa OSCE realizada por alumnos de la
Universidad del Sur de Santa Catarina y gestionada
por dos evaluadores. Se analiz贸 la evaluaci贸n
global de los estudiantes y los criterios de la
evaluaci贸n en pr谩ctica farmac茅utica identificados
por los alumnos por su dificultad.
Resultados: Los resultados de las 291 evaluaciones
mostraron que los estudiantes tienen una actuaci贸n
promedio del 70%. Se encontraron varias
dificultades, tales como la falta de informaci贸n
sobre el tratamiento seleccionado/prescrito
(65,1%); estilo de comunicaci贸n inadecuado
(21,9%); falta de identificaci贸n de las necesidades
del paciente (7,7%) y selecci贸n inadecuada de
medicamento para auto-medicaci贸n (5,3%).
Conclusiones: Estos datos demuestran que hay una
necesidad de re-orientaci贸n de los estudiantes de
farmacia cl铆nica porque necesitan mejorar sus
habilidades de comunicaci贸n y tengan un
conocimiento m谩s profundo de medicamentos y
problemas de salud para orientar adecuadamente a
sus pacientes
Impact of clonidine administration on delirium and related respiratory weaning after surgical correction of acute type-A aortic dissection: results of a pilot study
Factors associated with hepatitis C seropositivity in people living with HIV
OBJECTIVE: To identify risk factors associated with hepatitis C virus (HCV) seropositivity in human immunodeficiency virus (HIV)-infected patients. METHODS: A paired case-control study adjusted by age and gender was conducted. It included adults coinfected with HIV and HCV (cases) and HIV mono-infected subjects (controls) using non-probability sampling. Data were collected through interviews and review of medical records. The chi-square test was used for comparing categorical variables and the Student鈥檚 t-test or Wilcoxon (Mann-Whitney U) test for continuous variables. Confidence intervals (95%) were estimated along with crude and adjusted odds ratios using conditional logistic regression. RESULTS: A total of 165 patients were surveyed, including 55 cases and 110 controls. The mean age was 43.6 卤 8.4 years, ranging from 19 to 64 years; 70.9% were male. Independent risk factors for HIV/HCV coinfection were education (up to eight years of schooling); age at first intercourse < 15 years; having undergone tattooing; blood transfusion; and use of injecting drugs. CONCLUSIONS: Low level of education, early age at first sexual intercourse, tattooing, blood transfusions, and sharing needles and other drug injection equipment were factors that increased the risk of HIV/HCV coinfection. The results from this research can be compared with similar data from other regions to help direct preventive and educational efforts targeting people living with HIV