ABSTRACT
RESUMEN Introducción: la adherencia terapéutica es un problema multifactorial que ha generado el interés de muchos investigadores a nivel mundial. Objetivo: determinar la adherencia al tratamiento antihipertensivo en pacientes adultos mayores y los factores asociados a la no adherencia. Materiales y métodos: se realizó un estudio descriptivo longitudinal en pacientes adultos mayores hipertensos, pertenecientes al Policlínico Comunitario Sur, del municipio Morón, en la provincia de Ciego de Ávila. La adherencia al tratamiento fue evaluada por el cuestionario Martín-Bayarre-Grau y el nivel de conocimiento de la enfermedad por el Test de Batalla. Se identificaron las causas asociadas a los problemas de adherencia en dichos pacientes. Resultados: Predominó la no adherencia al tratamiento antihipertensivo en un 62 %. La adherencia parcial se constató en un 22 %. Los problemas de adherencia prevalecieron en las féminas de 60-69 años de edad. Se detectaron múltiples causas inherentes al paciente, como el olvido (48,4 %), la no disponibilidad de medicamentos (25,8 %) y el alivio de los síntomas (16,1 %). Entre otras causas se detectó el bajo nivel de conocimiento de la enfermedad y la presencia de comorbilidades. Conclusiones: se evidenció un predominio de adherencia al tratamiento antihipertensivo de los adultos mayores. Sus causas fundamentales fueron el olvido de ingerir el medicamento, la no disponibilidad de medicamentos, la falta de conocimientos sobre la enfermedad y la presencia de comorbilidades (AU).
ABSTRACT Introduction: therapeutic adherence is a multifactorial problem that has generated the interest of many researchers worldwide. Objective: to determine adherence to antihypertensive therapy in older adult patients and the factors associated with no adherence. Materials and methods: a longitudinal descriptive study was carried out in hypertensive elderly patients belonging to the South Community Polyclinic, in the municipality of Moron, in the province of Ciego de Avila. The adherence to treatment was evaluated by the Martín-Bayarre-Grau questionnaire and the level of knowledge of the disease by the Batalla test. The causes associated with adherence problems in these patients were identified. Results: non-adherence to antihypertensive therapy predominated in 62%. Partial adherence was found to be 22%. Adherence problems prevailed in women aged 60-69 years. Multiple causes related with the patient were detected, such as forgetfulness (48.4%), non-availability of medicines (25.8%) and relief of symptoms (16.1%). Among other causes, the low level of knowledge on the disease and the presence of comorbidities were detected. Conclusions: a predominance of adherence to antihypertensive treatment in older adults was evidenced. Its main causes were the forgetfulness of taking the medicine, the non-availability of medicines, the lack of knowledge about the disease and the presence of comorbidities (AU).
Subject(s)
Humans , Male , Female , Aged , Pulmonary Arterial Hypertension/drug therapy , Risk Factors , Patient Compliance , Treatment Adherence and Compliance , Pulmonary Arterial Hypertension/diagnosis , Pulmonary Arterial Hypertension/mortality , Pulmonary Arterial Hypertension/epidemiologyABSTRACT
Introducción: El impacto de la prescripción inapropiada de fármacos en el anciano ha llevado al desarrollo de métodos para su reducción en varias partes del mundo. Objetivo: Diseñar y validar los criterios de medicación potencialmente inapropiada en el anciano, adaptados al entorno sociosanitario de Cuba. Métodos: Se realizó una investigación cualitativa, en la cual los criterios fueron validados por medio de la metodología Delphi, por un comité de expertos (especialistas en medicina geriátrica y clínica de diferentes zonas geográficas del país), y se les calculó la consistencia interna mediante el coeficiente alfa de Cronbach. Resultados: Los criterios quedaron estructurados en tres listas: 1) medicación potencialmente inapropiada, medicamento indicado no prescripto, cuando no existe contraindicación para su uso; 2) medicación potencialmente inapropiada independiente del diagnóstico o la condición clínica; 3) medicación potencialmente inapropiada dependiente del diagnóstico o la condición clínica. Conclusiones: Se demostró la validez del contenido y la adecuada consistencia interna de los criterios diseñados para la identificación de medicación potencialmente inapropiada en el anciano.
Introduction: The impact of inappropriate prescription of medication in the elderly has led to the development of methods for its reduction in several parts of the world. Objective: To design and validate the medication approaches potentially inappropriate in the elderly, adapted to the socio-sanitary environment of Cuba. Methods: A qualitative investigation was carried out, in which the approaches were validated by means of the Delphi methodology, by an experts committee (specialists in geriatrics medicine and clinic from different geographical areas of the country), and the internal consistency was calculated by means of the alpha coefficient of Cronbach. Results: The approaches were structured in three lists: 1) potentially inappropriate medication, advised medication non prescribed, when contraindication doesn't exist for its use; 2) medication potentially inappropriate, independent from the diagnosis or clinical condition; 3) potentially inappropriate medication, depending on the diagnosis or clinical condition. Conclusions: The validity of the content and the appropriate internal consistency of the designed approaches for the medication identification potentially inappropriate in the elderly were demonstrated.
Subject(s)
Aged , Inappropriate Prescribing/prevention & control , Pharmacovigilance , Peer Review , CubaABSTRACT
ABSTRACT Incorporating methodological tools that allow uniform and standardized development from the clinical pharmacy services to the Pharmaceutical Care practice, is nowadays a necessity. Considering the importance of pharmaceutical care provision to elderly patients, this manuscript introduces the design and content validation of a standard operating procedure to provide pharmacotherapy follow-up to the elderly in nursing homes in Cuba. The procedure was designed based on a deep analysis of documents relative to experiences focused on holistic care to elderly patients, criteria for the identification and assessment of potentially inappropriate prescriptions and the relationship between functional geriatric evaluation and the use of drugs. The content validation was conducted by a panel of experts, using the Delphi methodology, through two working sessions. In addition, we used Likert-type scale to evaluate the procedure by experts, in line with the indicators described. In general, the criteria issued by the experts were very appropriate and allowed us to modify, add or keep several elements of the instrument for the final version. The findings demonstrated that the instrument can be used at any level of health care.
Subject(s)
Aged/statistics & numerical data , Drug Therapy/statistics & numerical data , Projects , /statistics & numerical data , Aged , Methods , Delphi Technique , Outcome Assessment, Health Care , Delivery of Health Care/standardsABSTRACT
OBJETIVO: identificar los problemas asociados al uso de digoxina en pacientes ancianos. MÉTODOS: se seleccionaron los pacientes a partir de los certificados médicos, por digoxina, archivados en las farmacias, y luego de dar su consentimiento de participación se realizaron sucesivas entrevistas. Se tuvo en cuenta enfermedad para la que fue indicado el medicamento, individualización de la prescripción, dosis empleada e intervalo de dosificación prescrito. Se valoró además las prescripciones potencialmente inapropiadas, según criterios de Beers. RESULTADOS: en el 100 % de los pacientes se detectó algún problema asociado al empleo de la digoxina. Entre los problemas detectados estuvieron: interacciones medicamentosas (100 %), probable uso para tratar enfermedades no indicadas (82 %), empleo de dosis superiores a las indicadas (62 %) y uso de intervalo de dosificación irregular (47 %). Entre los fármacos interactuante se detectaron 58 prescripciones potencialmente inapropiadas para el paciente anciano, las cuales representaron el 26,6 % del total de prescripciones. CONCLUSIONES: se detectó alta incidencia de problemas asociados al uso de digoxina en el paciente anciano, por lo que se hace necesario realizar un trabajo conjunto "médico-farmacéutico-paciente" en aras de ganar en calidad de la prescripción y uso de la digoxina en el adulto mayor.
OBJECTIVE: to identify the problems related to the use of digoxin in elderly patients. METHODS: the selection of patients was based on the medical certificates for the use of digoxin, which were filed in the drugstores, and on the patient's consent to be involved in interviews. The research took into account the disease for which digoxin was prescribed as treatment, the individualization of prescription, the prescribed dosage and dosing intervals, in addition to the assessment of potentially inappropriate prescriptions according to Beers criteria. RESULTS: all the participating patients presented with some problems related to the use of digoxin. The most common were drug interactions (100 %), likely use to treat nonprescribed diseases (82 %), use of a dose higher than the recommended one (62 %) and irregular dosing interval (47 %). Among drug interactions were 58 potentially inappropriate prescriptions for elderly patients, which accounted for 26.6 % of total prescriptions. CONCLUSIONS: there was a high incidence rate of problems associated with the use of digoxin in the elderly, so it is necessary to work together, meaning the physician, the pharmacist and the patient, in order to increase prescribing quality for the use of digoxin in the elderly.
Subject(s)
Humans , Aged , Digoxin/therapeutic use , Drug-Related Side Effects and Adverse Reactions , Inappropriate Prescribing/adverse effects , AgedABSTRACT
Teniendo en cuenta la necesidad de un currículo que garantice una formación universitaria universal, contextual, flexible y comprometida con la realidad social y profesional, en el presente trabajo se diseñó el perfil profesional que caracterizará al egresado de la Licenciatura en Ciencias Farmacéuticas de la Universidad de Oriente, Cuba. Se utilizó para ello el Modelo de Actuación Profesional; se precisó el problema profesional, el objeto de la profesión y el objetivo profesional, y sobre la base del sentido articulador entre estas configuraciones se definieron los campos, esferas y modos de actuación, dejando explícito, además, los objetivos educativos e instructivos que se aspiran alcanzar
Taking into account the need of a curriculum assuring universal, contextual and flexible university formation that is committed to the social and professional realities of the country, the present paper designed the professional profile of the Pharmaceutical Sciences graduate in the University of Oriente, Cuba. To this end, the Professional Performance Model was used; the professional problem, the object of the profession and the professional objectives were defined. On the basis of the articulation of these configurations, the various fields, spheres and modes of performance were established, thus clearly stating the educational and learning objectives that are expected to be attained