ANÁLISE DA CAPACIDADE FUNCIONAL DOS IDOSOS DE PORTO ALEGRE E SUA ASSOCIAÇÃO COM AUTOPERCEPÇÃO DE SAÚDE

resumo Introdução: A complexidade que abrange o processo do envelhecimento e a saúde do idoso envolve o aumento da prevalência de doenças crônicas degenerativas em idades avançadas. Tais doenças acometem o idoso e interferem na sua capacidade funcional. Objetivo: Este estudo tem como objetivo analisar a relação entre a necessidade de auxílio para a realização de atividades de vida diárias entre os idosos de Porto Alegre e a sua autopercepção de saúde frente às doenças crônicas degenerativas. Metodologia: Trata-se de um estudo retrospectivo, com base em dados do estudo Multidimensional do Idoso de Porte Alegre, de 2005, realizado pelo Instituto de Geriatria e Gerontologia (IGG) da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Os dados foram analisados e as suas frequências foram comparadas entre a variável dependente necessidade de auxílio e as variáveis independentes: sexo, idade, autopercepção de saúde e doenças crônicas degenerativas, através do teste Qui-quadrado. Resultados: Os resultados mostraram diferença significativa para a necessidade de auxílio na realização das atividades diárias em relação ao sexo com p=0,002. Quando comparada a faixa etária e as demais variáveis foi observado resultado estatisticamente significativo para atividades de casa (p<0,001), ingestão de medicamentos (p=0,010), higiene pessoal (p<0,001) e para movimentar-se (p= 0,004). Observou-se também que conforme o avanço da idade a necessidade de auxílio aumentou, sendo que após os 80 anos tal necessidade tornou-se mais importante. No que se refere à autopercepção de saúde, foram observados resultados significativos em relação às atividades de casa, tomar remédio, higiene e movimentar-se com p<0,001, exceto para alimentação. Quando comparados o diabetes, doenças cardíacas e isquemias cerebrais com as variáveis do estudo, os dados foram significativos (p<0,001) para quase todas as variáveis de necessidade de auxílio com exceção da higiene e alimentação em relação à diabetes, atividades de casa em relação à isquemia cerebral e higiene e alimentação em relação aos problemas cardíacos. Com relação à autopercepção de saúde, os dados foram significativos (p<0,001) para a necessidade de auxílio para atividades de casa, tomar remédio, higiene pessoal e movimentar-se. Conclusão: Tais dados demonstram a importância da capacidade funcional do idoso como preditor do seu estado de saúde, pois quando a sua necessidade de auxílio aumenta, piora a autopercepção de saúde e o seu estado real de saúde. palavras-chave: Capacidade Funcional. Envelhecimento. Saúde do Idoso. Doenças Crônicas. Autopercepção de Saúde.   abstract Introduction: The complexity that covers the process of ageing and elderly health involves increasing prevalence of chronic degenerative diseases in advanced ages. Such diseases that happen to the elderly interfere with their functional capacity. Objective: The aim of this study is to examine the relationship between the need for aid for daily life activities between the elderly of Porto Alegre and their self perception of health to chronic degenerative diseases. Methodology: It is a retrospective study based on data from the Porto Alegre Elderly Multidimensional study of 2005. The data were analyzed and their frequencies were compared among the perception of health variables, the need for aid and chronic degenerative diseases by the Chi square test. Results: The results show significant difference to the need of assistance in carrying out daily activities for sex (p=0.002), different age groups (p< 0.001), ingestion of medicines (p=0.010), personal hygiene (p<0.001) and for movements (p= 0.004). Chronic diseases, diabetes, heart disease and brain’s ischemia were significant data for almost all variables of aid needs. About health self perception were significant data (p<0.001)) to the need for aid for activities, take medicine, personal hygiene and movements. Conclusion: Such data demonstrate the importance of elderly functional capacity as a predictor of their state of health and the need for increasing aid, making their self perception health and their actual state worse. Keywords Elderly. Chronic Disease. Health Self perception. Healthcare Needs. Elderly Health

Assessment of used medications and drug-drug interactions among chronic renal failure patients

AIMS: To describe the drugs most frequently used by patients in hemodialysis and to identify potential drug-drug interactions. METHODS: Cross-sectional study conducted in a hospital hemodialysis unit. Each combination of drugs prescription was analyzed in Micromedex©2014 Truven Health Analytics (Michigan, United States), to identify potential drug-drug interactions and classify them according to severity. RESULTS: Sixty-five patients were included. The mean age was 59.1±14.7 years and 50.8% were women. The occurrence of polypharmacy was 87.7%, with average of 6.3±3.1 medications/patient, the most frequent being calcium carbonate (n=55, 84.6%) and erythropoietin (n=47, 72.3%). The prevalence of potential drug-drug interactions was 56.9%, with median of one interaction per patient, and most were classified as moderate (49.1%) being the most frequent atenolol/calcium carbonate (n=9, 8.0%) and iron/calcium carbonate (n=9, 8.0%). The presence and number of potential moderate or important drug-drug interactions were significantly associated with the number of drugs used by the patient (P<0.001). CONCLUSIONS: The prevalence of potential drug-drug interactions was high and closely linked to the number of drugs used by each patient. The population with chronic kidney disease requires the use of various drugs, therefore the careful selection of therapeutic alternatives through pharmaceutical assistance is important for effective, rational and safe use of medicines

Pharmaceutical services in a Mexican pain relief and palliative care institute.

Neither the purchase nor the distribution of pharmaceuticals in hospitals and community pharmacies in Mexico is under the care of pharmacists. Some are under control of physicians. This report presents the results of the implementation of somef pharmaceutical services for the Jalisco Pain Relief, and Palliative Care Institute (Palia Institute), under the direction of the Secretary of Health, Government of Jalisco. The services implemented were drug distribution system, Drug Information Service, Pharmacovigilance Program , and home pharmacotherapy follow-up pilot program for patients with advanced illness, with the ultimate using the appropriate medication. The drug distribution system included dispensing of opioid pain medications, antidepressants, anticonvulsants, NSAIDs, anxiolytic drugs, steroid drugs, laxatives, and anti-emetics. The frequently used drugs were morphine sulfate (62%), amitriptyline (6.4%), and dextropropoxyphene (5.8%). The Drug Information Service answered 114 consultations, mainly asked by a physician (71%) concerned with adverse drug reactions and contraindications (21%). The pharmacovigilance program identified 146 suspected adverse drug reactions and classified them reasonably as possible (27%), probable (69%), and certain (4%). These were attributed mainly to pregabalin and tramadol. The home pharmacotherapy follow-up pilot program cared patients with different cancer diagnoses and drug-related problems (DRP), which were identified and classified (according to second Granada Consensus) for pharmaceutical intervention as DRP 1 (5%), DRP 2 (10%), DRP 3 (14%), DRP 4 (19%), DRP 5 (24%), or DRP 6 (28%). This report provides information concerning the accurate use of medication and, above all, an opportunity for Mexican pharmacists to become an part of health teams seeking to resolve drug-related problems