Quality of life perception of type 1 diabetic patients treated with insulin analogs and receiving medication review with follow-up in a public health care service from Ponta Grossa-PR, Brazil

ABSTRACT Glycemic control in patients with diabetes mellitus type 1 (DM1) reduces the risk of complications but requires a rigorous health care routine. Thus, diabetes education is central to increasing treatment compliance and self-care practices. This study aimed to evaluate the quality of life (QoL) and glycemic control of DM1 patients being treated with insulin analogs and receiving medication review with follow-up. This was a transversal study that included 110 patients registered at the 3rd Health Regional of Ponta Grossa-PR, aged ≥ 18 years, and receiving pharmaceutical care for at least 1 year. The Diabetes Quality of Life Measure (DQOL)-Brazil was used to evaluate QoL. The data were statistically analyzed using SPSS version 17.0 with 95% confidence levels. Of the 110 patients, 58.2% were women. The average age was 33.7 years (±10.5), and the average glycated hemoglobin (HbA1c) value was 8% (±1.4). The mean total DQOL-Brazil score was 2.11 (95% confidence interval, 2.02 - 2.21). All DQOL-Brazil scores were lower in patients with HbA1c ≤ 8%, indicating a better QoL. Good glycemic control, thus, appears to have a positive influence on the QoL, and pharmaceutical interventions are able to contribute to the achievement of therapeutic targets

Medication dispensing as an opportunity for patient counseling and approach to drug-related problems

ABSTRACT The objective was to describe and evaluate a model of drug dispensing developed and implemented in a community pharmacy in Brazil. This was a descriptive, observational, quasi-experimental study performed in the period between 21 January 2013 and 20 April 2013. The model was evaluated and described in terms of three parameters: structure, process and outcome. The description and assessment of each parameter was performed as follows: (I) Structure: profile of patients, pharmacist's professional profile, physical facility, informational material; (II) Process: drug-related problems, pharmaceutical interventions performed, results of pharmaceutical interventions; (III) Outcome: patient knowledge of medications. Dispensing service improved patient knowledge of medications (p < 0.05), which was associated with pharmacotherapy complexity (p < 0.05). The main problems identified were related to lack of patient knowledge regarding their medication (52.9%). Pharmaceutical interventions were mostly performed directly to the patients (86.3%) by verbal (95.4%) and written (68.2%) information, and most of the problems were completely solved (62.7%). The medicine dispensing model was able to identify and solve drug-related problems and promote an improvement in patient knowledge about medication

Reestruturação metropolitana e emergência de centralidades: novos fluxos pendulares e a configuração espacial da Região Metropolitana de Porto Alegre / Metropolitan restructuring and the emergence of centralities: New commuting flows and the spatial configuration of the Metropolitan Region of Porto Alegre

RESUMO O texto discute os processos de desconcentração das atividades produtivas da Região Metropolitana de Porto Alegre (RMPA), buscando investigar variáveis implicadas na emergência de novas centralidades e suas interações com os deslocamentos moradia-trabalho. Adota-se uma análise multivariável relacionando processos de conurbação e dados censitários de comutação às propriedades morfológicas da configuração espacial, descritas pela metodologia da Sintaxe Espacial. Através da Sintaxe Espacial, principal metodologia utilizada, identificam- se tendências de potenciais de movimentos e probabilidade de fluxos na rede metropolitana. Verificou-se na pesquisa: (i) intensidade e sentido de movimentos pendulares; (ii) hierarquias de acessibilidade relativa/ integração do sistema espacial; (iii) hierarquias de centralidade na rede de circulação/rotas com maior probabilidade de fluxo. Presume-se que há relação entre a desconcentração de atividades econômicas, as mudanças nos padrões de acessibilidade relativa regional, a emergência de centralidades funcionais e o sentido de fluxos pendulares metropolitanos ABSTRACT The article discusses the process of deconcentration of productive activities in the Metropolitan Region of Porto Alegre (Brazil) in order to investigate variables implicated in the emergence of new centralities and their interactions with commutation (home-work displacements). By adopting a multivariate analysis, conurbation processes and commutation census data were related to the morphological properties of the spatial configuration, described by the Spatial Syntax methodology. Through Spatial Syntax, which is the main methodology used, trends of movement potentials and probability of flows in the metropolitan network are identified. The following was verified: (i) intensity and direction of commutation flows; (ii) hierarchies of relative accessibility/integration of the system; (iii) centrality hierarchies in the network/routes with higher probability of flow. It is assumed that there is a relation between the deconcentration of economic activities, changes in regional accessibility patterns, the emergence of functional centralities, density and direction of metropolitan commuting flows