Mestrado em Assistência Farmacêutica

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    Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
    (Universidade Federal do Espírito Santo, 2024-03-15) Alencar, Taiana de; Co-orientador1; https://orcid.org/; http://lattes.cnpq.br/; Co-orientador2; https://orcid.org/; http://lattes.cnpq.br/; Santos Júnior, Genival Araujo dos ; https://orcid.org/; http://lattes.cnpq.br/; Orientador2; https://orcid.org/; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Oliveira Filho, Alfredo Dias de; dc.contributor.referee1ID; http://lattes.cnpq.br/; Severi, Juliana Aparecida; https://orcid.org/; http://lattes.cnpq.br/; Silva, Rafaella de Oliveira Santos; https://orcid.org/; http://lattes.cnpq.br/; 4º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 5º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 6º membro da banca; https://orcid.org/; http://lattes.cnpq.br/; 7º membro da banca; https://orcid.org/; http://lattes.cnpq.br/
    Introduction: Arterial hypertension (AH) is a chronic health condition that may require changes in lifestyle and the use of medication. However, this use is not without risks. In this context, the Pharmacotherapeutic Follow-up Service (FHS) has emerged as a strategy capable of improving the health outcomes of people with AH. However, there are few high-research studies on this subject. Objective: To assess the impact of FAS on the health outcomes of patients with AH in the health care network in the municipality of Alegre/ES. Method: This is an experimental single-blind randomized controlled clinical trial. People with hypertension who met the eligibility criteria (over 18 years of age, with self-reported hypertension, taking medication for hypertension for at least 6 months) were randomized in a 1:1 ratio to the intervention and control groups. They received FAS and usual care, respectively, for a period of 12 months. The study was conducted in the Health Care Network of the municipality of Alegre, Espírito Santo, Brazil, from January 2022 to November 2023. In both groups, primary outcomes (blood pressure and quality of life) and secondary outcomes (knowledge about hypertension, anthropometric profile and clinical examinations) were assessed at three points in time, six months apart. Ethical considerations were observed (CAAE registration number 13586319.6.0000.8151 | Opinion no. 4.732.878). Results: 128 patients were allocated to the intervention group (64) and the control group (64). Statistically significant differences were observed in the intra-group analysis in the intervention group, including SBP (∆ = -9.47 mmHg, p = 0.014), Total Cholesterol (∆ = -18.93 mg/dL, p = 0.001), LDL (∆ = -15.70 mg/dL, p < 0.001), non-HDL cholesterol (∆ = -19.76 mg/dL, p < 0.001) and cardiovascular risk (∆ = -1.82 points, p < 0.001). There was an increase in the score for knowledge about hypertension (∆ = 1.39 points, p < 0.001), an improvement in quality of life in the mental state subdimension (∆ = -2.76 points, p = 0.020) and somatic manifestations (∆ = -1.5 points, p = 0.012). In the control group, it was possible to observe an increase in the score for knowledge about hypertension (∆ = 1.52 points, p = 0.001) and an improvement in the VAS of the EQ5D (∆ = 10.33 points, p = 0.067). In addition, almost all the patients were satisfied or very satisfied with the service provided by the pharmacists. Conclusion: The results show a promising positive impact of FAS on clinical and humanistic parameters, as well as a reduction in cardiovascular risk for negative events over the next ten years. This study was registered with The Brazilian Clinical Trials Registry (ReBEC) under registration number: RBR-4c53f3m.
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    Implementação de serviços clínicos providos por farmacêuticos na atenção primária à saúde: uma revisão de escopo
    (Universidade Federal do Espírito Santo, 2024-02-16) Paolinelli, João Pedro Vasconcelos; Pereira, Mariana Linhares; https://orcid.org/0000-0002-3214-2789; Santos Júnior, Genival Araújo dos; https://orcid.org/0000-0002-5618-1846; http://lattes.cnpq.br/; https://orcid.org/; http://lattes.cnpq.br/; Reis, Tiago Marques dos; dc.contributor.referee1ID; http://lattes.cnpq.br/; Baldoni, André de Oliveira; https://orcid.org/; http://lattes.cnpq.br/
    Introduction: The implementation of Clinical Pharmacy Services in management and clinical practice settings is a strategic action to improve clinical, economic and humanistic outcomes in various health conditions and in different contexts. However, such services are not uniformly disseminated in health systems around the world, and when they are, they often do not complete their implementation process or are not sustained in the long term, as it is difficult to ensure the effectiveness of these services in the "real world". Thus, there is a need to comprehensively understand and characterize how the process of implementing these services takes place, especially in Primary Health Care. Objective: To map the studies on the implementation of Clinical Pharmacy Services in the context of Primary Health Care. Methods: A scoping review was developed and presented in two chapters. Chapter 01 deals with the scoping review protocol, which was written following the recommendations of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The review protocol was registered with the Open Science Framework under the number 10.17605/OSF.IO/N25EA. Chapter 2 deals with the scoping review. A search was carried out in six electronic databases, in the gray literature and in the references of the selected studies, until May 2023. Original studies describing the process of implementing Clinical Pharmacy Services in Primary Health Care were eligible. Two researchers independently screened, selected and extracted data from the selected articles. The variables collected were: author(s), country; objective(s); study design; participants; type of clinical pharmacy service; use of models as an implementation guide; implementation phase; place of service provision; implementation outcomes. The data was presented in descriptive form. Results: The protocol was developed and submitted to a scientific journal. For the scoping review, 97 studies were included, the majority 85.6% (n=83) carried out in developed countries. There was a strong focus on qualitative and mixed-methods research, 46.4% (n=45). Only 22.7% (n=22) used theoretical models as a research guide, and the majority 96.9% (n=94) did not report the implementation phase. Comprehensive medication management 36.8% (n=35) was the most cited type of service. The most highly rated implementation outcome was feasibility 73.2% (n=71). Almost half (47.4%, n=46) evaluated clinical, economic and/or humanistic outcomes. Conclusion: This study has shown, in general terms, how Clinical Pharmacy Services are implemented in the different realities of Primary Health Care around the world. There was a need to redirect the evaluation focus of these studies towards measures that assess coverage, cost-effectiveness, as well as clinical and humanistic outcomes, in order to achieve sustainability in the future. Furthermore, future research into the implementation of these services should use conceptual models and quality reporting tools in order to have a greater chance of success at all stages of the implementation process and the ability to replicate/adapt the evidence generated.