Tatyana Xavier Almeida Matteucci Ferreira

Medication adherence in patients in treatment for rheumatoid arthritis and systemic lupus erythematosus in a university hospital in Brazil

Medication adherence is essential for the control of symptoms and progression of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The aim of the study was to investigate medication adherence in outpatients in treatment for RA and SLE in a university hospital in Brazil. This was a quantitative, cross-sectional analytical study. A total of 92 patients (55 RA patients and 37 SLE patients) were included in the study. A structured questionnaire for patients’ interview and a form for collecting data from medical records were used for data collection. Adherence to drug treatment was assessed by the Morisky scale questionnaire. Data storage and analysis were performed using Epi Info 3.5.4 and statistical analysis by Stata/SE 12.0. The Pearson’s chi-squared test and Fisher’s exact test were applied for statistical and bivariate analyses. For multivariate data analysis the Poisson regression and the Wald test were used. The prevalence of adherence to drug treatment was 16.4% in RA patients and 45.9% in SLE patients. The final model of the multivariate analysis demonstrated associations between medication adherence and the following covariates for both RA and SLE groups: duration of therapy for rheumatic disease at the institution greater than 15 years and presence of more than six chronic comorbidities. The parameter “acquisition of medication at the high-cost pharmacy” was differently associated with medication adherence by group, and for the SLE group, living outside the city of Goiânia was a protective factor associated with adherence. This study demonstrated a low prevalence of medication adherence in patients in treatment for RA and SLE treated at this institution. These findings will serve as a base for future studies to elucidate what factors may positively or negatively affect medication adherence in this population. In addition, multidisciplinary approaches are needed to enhance adherence to drug treatment in patients in treatment for rheumatic disease.

Medication dispensing as an opportunity for patient counseling and approach to drug-related problems

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, pharmacists 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.

ESTÁGIO CURRICULAR OBRIGATÓRIO NA FARMÁCIA ESCOLA DA FACULDADE DE FARMÁCIA DA UNIVERSIDADE FEDERAL DE GOIÁS

The Farmacia Escola of Goias Federal University (FE � UFG) is a public institution, founded in 1996, and has a main objective to develop teaching research and outreach projects, in the areas of magistral manipulation, dispenseing of medicinal products, cosmetics and related items. This offers students the adequate conditions for development of their professional profile and consolidating a role of pharmacy and healthcare facilities in the community. The training curriculum requires 128 hours, but both, the FE team and the students, perceive that probationary period is short. To some extent, this limits the acquisition of experience and obtaining greater security in carrying out activities. Another limiting factor of the training is the small number of patients who frequent the establishment. This is due to poor visibility that the pharmacy front has to the general public. In order to make known the FE, we count on the help of Social Communication Agency of the UFG, whose main task is the institutional promotion. Through this partnership outreach, activities are scheduled to be held throughout the year 2012. It is believed that through the implementation of the actions described here, along with the several outreach projects that will begin this year, we�ll be able to achieve the goal of the giving more visibility to Farmacia Escola and, accordingly, we expect a greater demand for services offered and therefore more productivity in all sectors and more learning opportunities for trainees.