Management and prevention of problems related to oncology drugs are particularly important due to the excessive cost, high toxicity, and narrow therapeutic index of the antineoplastic drugs, in addition to the patients' state of health. Therefore, the presence of the pharmacist as a member of the multidisciplinary team is essential to contribute to patient safety. In this work, the interventions performed were identified, quantified, and classified to characterize the work of the clinical oncology pharmacist. This is a prospective and quantitative study, conducted over a period of six months in the outpatient oncology and chemotherapy clinic of the University Hospital of the University of Campinas, Brazil. A total of 3526 medical prescriptions were evaluated for the 780 patients seen and, among these prescriptions, 220 (6.24%) contained errors, representing 6.24% of the total number. The most common error was dose-related with 79 (22.83%) cases of overdosing. Wrong-patient medication error was the least reported (0.29%). Thirty drugs were involved in the pharmaceutical interventions, Carboplatin and Ondansetron being the most frequent. Thirteen types of potential errors were evaluated according to the method proposed by Cardinal and Fernandes. Two (15.38%) included interventions of indication, contraindication, and therapeutic efficacy of a drug. Five of them (38.46%) are related to the treatment regimen, and two (15.38%) were related to prevention of potential adverse events. Four interventions (30.77%) concerned technical interventions in injectable drugs such as dilution, compatibility, and administration time. Of the 346 interventions performed, 1 (0.29%) was classified as potentially lethal, 114 as serious (32.95%), 140 as significant (40.46%), and 91 as minor (26.30%).
Introduction Capecitabine is an oral anticancer drug which can cause some adverse reactions and the great challenge for its use is to ensure the medication adherence. The aim of this study was to analyze adverse reactions and adherence to capecitabine in patients with gastrointestinal cancer. Methods A prospective study was performed in a tertiary teaching hospital in Brazil. Outpatients undergoing capecitabine treatment for colorectal or gastric cancer were followed for three cycles of treatment. Patient demographic and clinical characteristics data were collected. Adverse reactions were analyzed using Common Terminology Criteria for Adverse Events (CTCAE) v.4. Adherence to capecitabine were evaluated using Morisky-Green and MedTake tests. Statistical analysis was conducted using Chi‐square, Fisher's exact and McNemer tests. Results One hundred and four patients were enrolled in this study, with a mean age was 58.5 ± 10.9 years; 51.0% were men and 51.0% Caucasian. Nausea and diarrhea were the most frequently reported adverse reactions (82.7% and 62.5%, respectively), followed by vomiting (54.8%), fatigue (54.8%), and hand-foot syndrome (53.9%). Nausea and diarrhea were also the most severe adverse reactions. Most patients were adherent to capecitabine in all cycles of treatment using the Morisky-Green test. Adherence increased significantly between cycle 1 and cycle 2 by MedTake test (p < 0.001). Some demographic and clinical characteristics were associated with adverse reactions (e.g., age and nausea, gender and nausea and vomiting) and capecitabine adherence (e.g., marital status and educational level) as well as some adverse reactions were associated with capecitabine adherence (hand-foot syndrome and nausea). Conclusions Clinical oncology pharmacists must provide patient information on the correct use of capecitabine, manage adverse reactions, and monitor adherence to treatment. Strategies to prevent non-adherence to capecitabine must be adopted to ensure the success of pharmacotherapy.
Resumo O objetivo principal desta pesquisa é identificar como a sustentabilidade tem sido introduzida e tratada na produção recente de habitação de interesse social a partir do Programa Minha Casa Minha Vida (PMCMV), criado em 2009 e que têm reorientado suas ações em relação à sustentabilidade recentemente. A motivação da pesquisa se dá pelo interesse em torno da qualidade socioambiental urbana e seus reflexos na vida das pessoas. Neste sentido, são necessários estudos e engajamento teórico para a aplicação de critérios mais consistentes de sustentabilidade nas habitações sociais, buscando soluções mais eficazes e eficientes a fim de minimizar os impactos ambientais, socioculturais e econômicos.
Resumo O objetivo deste estudo foi avaliar a adesão, a qualidade de vida e o conhecimento da doença dos pacientes oncológicos em tratamento com antineoplásicos orais, demonstrando a importância da atenção farmacêutica nos cuidados desses indivíduos. Trata-se de um estudo transversal em que pacientes oncológicos ambulatoriais (n=49) que estavam em tratamento com antineoplásicos orais foram entrevistados e avaliados em relação à adesão à terapia antineoplásica oral (Testes de Morisky-Green e MedTake), qualidade de vida (FACT-G) e em relação ao nível de informação recebida (EORTC QLQ-INFO 25). Cada paciente recebeu orientações farmacêuticas e um panfleto informativo ao final da entrevista.
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