Pharmaceutical Care in Primary Care: an Experience with Hypertensive Patients in the North of Brazil

Abstract Background: Uncontrolled blood pressure has been associated with poor adherence to drug treatment. Objectives: To assess blood pressure control in hypertensive patients attending primary health centers after implementation of a pharmaceutical follow-up program in a city of the north of Brazil. Methods: Observational, cross sectional, descriptive study with 163 hypertensive patients attending public primary health care centers - one located on the riverside and one in the urban area of the city of Santarem, western Pará, Brazil. Adherence to the anti-hypertensive treatment was assessed using the eight-item Morisky test. Pharmacotherapy follow-up (Dader method) of patients with uncontrolled hypertension and non-adherent to anti-hypertensive treatment was performed. Results of the normality test showed that the data did not follow a normal distribution. Continuous variables were then compared using the Wilcoxon signed-rank test, and categorical variables by the likelihood ratio and the McNemar tests. Statistical significance was set at 5%. Results: Of the total sample, 94.5% were not adherent to anti-hypertensive drug therapy and 77.2% had uncontrolled hypertension. Adherence rate was higher in men than women (p=0.006). Pharmacotherapy follow-up improved blood pressure levels, particularly systolic blood pressure (p<0.001). Conclusion: An individualized pharmacotherapeutic follow-up, considering regional and cultural specificities, can contribute to the treatment of hypertensin in the primary care.

Descrição do seguimento farmacoterapêutico de pacientes com hanseníase em município hiperendêmico do estado de Mato Grosso / Pharmacotherapy follow-up of patients with leprosy in a hyperendemic city in the state of Mato Grosso

Introdução: A hanseníase é uma doença crônica, infectocontagiosa e considerada um problema de saúde pública no Brasil. O objetivo deste estudo foi descrever o seguimento farmacoterapêutico de pacientes com diagnóstico de hanseníase. Métodos: Estudo descritivo, com pacientes com hanseníase multibacilar do município de Rondonópolis, Mato Grosso. O seguimento farmacoterapêutico foi realizado a partir de uma versão adaptada do Método Dáder. Para análise de dados aplicou-se a estatística descritiva e o teste Qui-quadrado de Pearson.Resultados: Uma frequência de 95,6% dos participantes apresentou problemas relacionados aos medicamentos, 59,1% apresentaram 3 ou mais problemas, os mais frequentes foram administração errada do medicamento e interação medicamento/nutriente. A inefetividade não quantitativa foi o resultado negativo associado ao medicamento mais evidenciado. Os indivíduos acompanhados em um serviço especializado apresentaram menor número de problemas relacionados aos medicamentos quando comparados àqueles da Estratégia Saúde da Família (p = 0,027).Conclusão: A maioria dos pacientes acompanhados apresentou problemas relacionados ao uso de medicamentos. O método Dáder possibilitou realizar o seguimento farmacoterapêutico de indivíduos com hanseníase.

Introduction: Leprosy is a chronic, infectious, and contagious disease considered a public health problem in Brazil. The objective of this study was to describe the pharmacotherapy follow-up of patients diagnosed with leprosy. Methods: We conducted a descriptive study of patients with multibacillary leprosy in the city of Rondonópolis, state of Mato Grosso, Brazil. Pharmacotherapy follow-up was conducted based on an adapted version of the Dáder method. Data were analyzed using descriptive statistics and Pearson's chi-square test. Results: Drug-related problems (DRP) were reported in 95.6% of patients, among whom 59.1% had 3 or more problems DRPs. The most common DRPs were incorrect drug administration and drug-nutrient interaction. Nonquantitative ineffectiveness was the most common drug-related negative outcome. Patients monitored in a leprosy treatment center had fewer DRPs than those monitored by a Family Health Strategy team (p = 0.027). Conclusion: Most patients had DRPs. The Dáder method allowed pharmacotherapy follow-up of patients with leprosy.