Treatment of patients with neuropathic pain and provision of drug information by clinical pharmacists

Abstract Patient's satisfaction with healthcare services has an influence on pain management, which can be improved by patient education. Therefore, this study was aimed at identifying primary care health service opportunities in the treatment of neuropathic pain and assessing patients' satisfaction with the provision of drug information by clinical pharmacists. This was a cross- sectional, prospective study conducted at a pain unit during March-May 2017. Patients aged >18 years; diagnosed with neuropathic pain; and who used amitriptyline, gabapentin, pregabalin, or duloxetine were included. They were verbally informed about drug treatment by a clinical pharmacist, and their satisfaction was evaluated after 1 month. In all, 90 patients were included. The median duration for which the patients experienced pain until hospital admission was 3.6 years; furthermore, this duration was longer among women (p < 0.05). However, the median time to seeking advice from doctors was 3 months. The patients (15.6%) were less likely to admit pain unit initially and 46.7% had visited different units before being admitted to a pain unit. More than 95% of the patients indicated that they had received information from a pharmacist at a clinic and were satisfied with the provision of information (median duration, 8.5 min). Thus, the involvement of pharmacists in multidisciplinary pain management may help improve health- related outcomes at hospitals and/or in community care settings

Appropriate knowledge of the indications for medications in use among older individuals assisted in the Jornada Científica dos Acadêmicos de Farmácia-Bioquímica

This study aimed to identify variables associated with the appropriate recall of indications and the drug classes that represented the most unmatching medications (i.e., when the individual who used it had not reported any illness that matched its indications). Community-dwelling individuals aged ≥60 years using ≥1 medication, from Santa Cruz da Esperança-SP, Brazil, were home-interviewed. Logistic regression models were used to evaluate the association between the appropriate recall of the indications for all medications in use and the following: gender, age, education, individual income, living arrangement, self-perceived health, and medication number, administration, payment, and identification. Medications whose indications were inappropriately recalled were classified as matching or unmatching. One hundred seventeen individuals used an average of 5.1 (standard deviation, 3.3) medications. Sixty-one (52.1%) appropriately recalled all indications. The appropriate recall of all indications was negatively associated with the number of medications in use (e.g., individuals taking 5-6 medications were 25 times less likely to appropriately recall all indications than those taking 1-2). Antithrombotic, acid-related disorder and psychoanaleptic classes showed greater frequencies of unmatching than matching medications. Therefore, counseling the elderly about drug indications should focus on those using ≥3 medications and/or antithrombotic, acid-related disorder, and psychoanaleptic agents.

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.

RESUMO O objetivo foi descrever e avaliar um modelo de serviço de dispensação de medicamentos desenvolvido e implantado em uma Farmácia Comunitária no Brasil. Trata-se de restudo descritivo, observacional e quase-experimental, realizado no período de 21 de janeiro a 20 de abril de 2013. A descrição e avaliação do modelo foi realizada segundo os parâmetros: estrutura, processo e resultado.Os aspectos descritos e avaliados foram: 1. Estrutura: perfil dos pacientes, perfil profissiográfico dos farmacêuticos, estrutura física, material de informação; 2. Processo: problemas relacionados ao medicamento detectados, intervenções farmacêuticas realizadas, resultados das intervenções farmacêuticas; 3. Resultado: conhecimento do pacientes sobre os medicamentos utilizados. A dispensação proporcionou melhora do conhecimento do paciente sobre os medicamentos (p < 0,05), que demonstrou-se associada à complexidade da farmacoterapia (p < 0,05). Foram identificados majoritariamente problemas relacionados à falta de condições do paciente em utilizar o medicamento (52,94%). As intervenções farmacêuticas foram realizadas predominantemente junto ao paciente (86,27%) através do fornecimento de informações verbais (95,4%) e escritas (68,2%) e, em sua maioria, o problema que originou a intervenção foi totalmente resolvido (62,75%).O serviço foi capaz de identificar e resolver os problemas relacionados ao medicamento e contribuiu para a melhoria do conhecimento dos pacientes relativo aos medicamentos utilizados.