Cardiovascular risk rate in hypertensive patients attended in primary health care units: the influence of pharmaceutical care

Cardiovascular complications are relevant due to their frequency and severity on the hypertension scenario. Studies refer Pharmaceutical Care (PC) as capable of decreasing cardiovascular risk rate (%CVR) on hypertensive patients. This study aimed to investigate, through a randomized clinical assay, the influence of PC service on the %CVR of hypertensive patients assisted in a health primary care unit from Fortaleza-Ceará. Two study groups were formed: i. Intervention Group (IG), which received orientation about taking medicines, actions aiming to prevent/solve medicine interactions and adverse effects and non-pharmacological interventions for 9 months and, ii. Control Group (CG), which received traditional assistance of the unit and was monitored during the same period. It was observed a statistically significant reduction on %CVR (10.76 to 7.86; p=0.04) and systolic blood pressure levels (SBP) (137.69 to 131.54; p<0.01) in the IG, while, in the CG, there was no significant alteration. 151 Drug Related Problem (DRP) were identified and it was realized 124 pharmaceutical interventions, with 89.2% of them resulting on solution/prevention of the problem. Our findings indicated that the inclusion of the PC service in the hypertensive health assistance was more effective at the %CVR and the SBP reduction in comparison to the traditional assistance offered

Erro medicamentoso em cuidados de saúde primários e secundários : dimensão, causas e estratégias de prevenção = medication errors in primary and secondary care : magnitude, causes and strategies for prevention

RESUMO - Com este artigo pretende-se dar uma panorâmica sobre a frequência e as principais causas do erro medicamentoso nos cuidados de saúde primários e hospitalares. Constitui igualmente nosso objectivo abordar, ainda que de forma sucinta, algumas das estratégias de prevenção deste tipo de evento adverso e discutir alguns aspectos da sua avaliação. Da análise da literatura, constata-se que os erros de medicação em cuidados primários e secundários são um problema comum, embora este primeiro setting esteja menos estudado. Ainda que estes erros resultem, numa minoria dos casos, em dano para os doentes, a sua consequência mais preocupante – os eventos adversos medicamentosos (EAM) evitáveis – são apesar de tudo frequentes e acarretam considerável sofrimento humano e desperdício para as organizações de saúde. As intervenções para prevenção dos erros de medicação e de EAM evitáveis podem ter como enfoque os indivíduos, os processos e os aspectos inerentes às organizações de saúde. A avaliação da sua efectividade é crucial, particularmente se a intervenção se revestir de carácter complexo e/ou envolver custos significativos. Parecem existir poucos estudos realizados em países de língua portuguesa (ou publicados em português) sobre a segurança do doente na área do medicamento. Importa fomentar a formação e a investigação nesta área e sensibilizar os profissionais de saúde para a mesma, tendo em conta a sua pertinência e o seu “peso” na dimensão epidemiológica, clínica, económica e social. ABSTRACT - This article intends to give an overview of the magnitude and main causes of medication errors in primary and secondary care. It is also our aim to briefly address strategies for prevention of medication errors and adverse drug events and to discuss some aspects of their evaluation. The literature review showed that medication errors in primary and secondary care are a common problem, although the former setting is less studied. While these errors result in harm to patients in a minority of cases, preventable adverse drug events are nevertheless frequent and cause considerable human suffering and waste to healthcare organizations. Interventions to prevent medication errors and adverse drug events can be targeted at health care professionals, care processes and organizational aspects. Evaluating their effectiveness is crucial, particularly in the case of complex and/or expensive interventions. The body of published research on medication errors and adverse drug events in Portuguese-speaking countries seems modest. Given the relevance of this topic and its epidemiological, clinical, economical and social implications it is essential to raise awareness in health professionals and to foster training and research initiatives.publishersversionpublishe