Glycemic control and associated factors in patients with type 1 diabetes mellitus in primary care in Southeastern Brazil

Abstract Diabetes is a self-managed condition with knowledge, attitudes and practices that can influence the overall treatment and outcomes delay the complications of diabetes. However, the few reported studies published point out that: low education level, poor adherence to pharmacotherapy and diet recommendations, infrequent monitoring of blood glucose, and insulin dosage regimen are associated with higher hemoglobin levels. This study aimed to assess the knowledge, adherence medication, and complexity of pharmacotherapy in T1DM patients in Brazil. A cross-sectional study was conducted involving 156 T1DM patients who were attending in primary care. Logistic regression analyses were conducted to assess the variables associated with glycemic control. The overall assessments of T1DM patients for the glycemic control were bad (121, 77.6%). However, T1DM patients with high MedTake Test (OR=2.4, CI=1.1-5.7) and Morisky-Green Test (OR= 2.5, CI=1.1-6.1), and in the use of dosage insulin (>40 units, OR=0.3, CI=0.1-0.7) and postprandial glucose (100-125mg/dl, OR=3.8, CI=1.1-14.6) had better glycemic control compared to uncontrolled patients. Glycemic control in Brazilians adults with T1DM is low. We suggested the screening patients with low MedTake and Morisky-Green Tests, increasing patient knowledge as part of a complex intervention that may lead to substantially improved treatment outcomes in primary care

Hipertensão Arterial Resistente: uma oportunidade para o farmacêutico desenvolver o cuidado farmacêutico / Resistant Hypertension: an opportunity for the pharmaceutical develop pharmaceutical care

A hipertensão arterial resistente (HAR) ocorre quando há falta de controle da pressão arterial com o uso de ≥3 fármacos anti-hipertensivos distintos, em doses máximas, e toleradas após a exclusão da hipertensão secundária. O Cuidado Farmacêutico (CF) permite a interação do farmacêutico com o paciente, reduzindo os problemas referentes à farmacoterapia e agravamentos devido ao acompanhamento farmacoterapêutico. Neste contexto, o objetivo desta revisão é discutir a farmacoterapia e interações medicamentosas em pacientes com HAR e propor medidas para aumentar a adesão ao tratamento. Os métodos de busca para o estudo foram obtidos em livros e bases de dados eletrônicas como Science Direct, PubMed e SciELO. O CF melhorou o controle da pressão arterial, a adesão ao tratamento e a qualidade de vida dos pacientes com HAR. Apesar de a farmacoterapia estar bem estabelecida, o CF, somado às medidas não farmacológicas, e o uso dos pictogramas podem ser usados para ajudar no controle da HAR.

Resistant hypertension (RH) occurs when there is lack of blood pressure control with the use of ≥3 antihypertensive of different classes after exclusion of secondary hypertension. Pharmaceutical Care (PC) allows pharmacist interaction with the patient and reduces problems related to pharmacotherapy due to pharmacotherapeutic follow-up. In this context, this review aims to discuss pharmacotherapy and drug interaction in patients with RH proposing measures to increase adherence to treatment. Methods of the search for the study were obtained from books and electronic databases such as Science Direct, PubMed and SciELO. PC improved blood pressure control, adherence to treatment and quality of life of patients with RH. Although pharmacotherapy is well established, the AF adds the non-pharmacological measures and the use of pictograms can be used to help in the control of HAR.