Estudos têm demonstrado que algumas das complicações da Hipertensão Arterial e da Diabetes mellitus poderiam ser evitadas com os serviços de atenção básica e mudança de atitude do paciente. Com vistas à diminuição dos problemas associados à farmacoterapia, o Hiperdia aparece como ferramenta estratégica. Ainda assim, os problemas de adesão acontecem.O objetivo do estudo foi verificar o grau de adesão à farmacoterapia e conhecimento dos pacientes portadores de Hipertensão e Diabetes mellitus tipo 2 atendidos em uma Unidade Básica de Saúde em Aracaju, SE. Pacientes com hipertensão e diabetes mellitus apresentaram o mesmo índice (79%) de acertos e por isso foram classificados, segundo teste de Batalla, como cumpridores do tratamento medicamentoso. Outro aspecto importante para o entendimento dos fatores que associam o baixo grau de adesão foia análise do teste de Morisky e Green. De acordo com o teste, apenas 15% dos pacientes foram classificados como aderentes ao tratamento medicamentoso. Resultados mais expressivos foram de pacientes que apresentaram baixo grau de adesão, com perfil semelhante ao de ambas as intencionalidades. Como os fatores educacionais estão envolvidos, torna-se necessário que estratégias educativas adequadas a estes grupos sejam realizadas, visando o esclarecimento sobre Hipertensão Arterial e Diabetes mellitus.

The teaching model based on objective, measurable, and linear knowledge no longer seems to be the most appropriate, given the new responsibilities of pharmacists, who should focus their practices on patient care. The objective of the present study was to analyze students' perception about preparedness to pharmacy practice and to patient-centered care, and identify experiential training barriers Two discussion groups were formed with 12 and 13 individuals to present their perceptions about teaching and learning for pharmaceutical care. The analysis followed the methodology of Bardin. The analysis of the answers indicates that there is a significant gap in the training of pharmacists, with a strong emphasis on theoretical issues and less focus on knowledge acquisition and interpersonal communication, generating poor professional training and relationship barriers. In general, students do not feel prepared to deal with patients. These students identify the lack of infrastructure, such as the lack of a pharmacy and underutilization of the hospital, deficiencies in the curriculum such as the lack of key subjects, lack of clinical practice, and lack of preparation of some teachers, with an excess of classes following the lecture format. These factors influence the teaching and learning of clinical and communication skills, which undermine the pharmacists' ability to carry out clinical interventions, as well as affect the pharmaceutical-patient and pharmaceutical-physician relationship. These results suggest that for the pharmacists' clinical training it is necessary to rethink whether the infrastructure, the curriculum, and the teaching method are adequate for the development of skills and competences.

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BACKGROUND The clinical activities developed by pharmacists in a hospital environment can improve health outcomes and generate savings for hospitals. However, to determine whether pharmaceutical interventions are cost effective, it is essential to define a method according to which cost-effectiveness is intended to be measured. In addition, the quality of economic assessments and the amount of information present in systematic reviews in the literature make it difficult to analyze the effects of this intervention. OBJECTIVE This paper aims to provide an overview of systematic reviews on the pharmacoeconomic impact of the performance of pharmaceutical care in hospitals. METHODS A systematic search of the Cochrane Library databases, PubMed or MEDLINE, LILACS, Scopus, Web of Science, Google Scholar, and Open Thesis will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search will involve the use of keywords determined using the Medical Subject Headings database to define the search terms and include the following terms: “pharmacoeconomics,” “pharmaceutical care,” and “hospital.” The study designs to be included will be systematic reviews of good quality. Studies will be included that address pharmacoeconomics; studies that evaluated pharmaceutical care in hospitals; and studies published in Portuguese, English, or Spanish. The primary outcome sought in the systematic reviews will be the cost ratio in monetary units and the outcomes in monetary or natural units. The secondary economic outcomes considered will be determined based on factors associated with the drugs and translated into benefit, efficacy, or utility. RESULTS It is intended to start this overview in January 2023. Thus far, only previous searches have been carried out to contextualize the theme and build the protocol. CONCLUSIONS This overview will determine the pharmacoeconomic impact of pharmaceutical care interventions in the hospital environment. In addition, this study will point out which clinical outcomes in natural units are impacted by the performance of pharmaceutical care and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work. CLINICALTRIAL PROSPERO CRD42019140665; https://tinyurl.com/bddwnz43

Background The clinical activities developed by pharmacists in a hospital environment can improve health outcomes and generate savings for hospitals. However, to determine whether pharmaceutical interventions are cost effective, it is essential to define a method according to which cost-effectiveness is intended to be measured. In addition, the quality of economic assessments and the amount of information present in systematic reviews in the literature make it difficult to analyze the effects of this intervention. Objective This paper aims to provide an overview of systematic reviews on the pharmacoeconomic impact of the performance of pharmaceutical care in hospitals. Methods A systematic search of the Cochrane Library databases, PubMed or MEDLINE, LILACS, Scopus, Web of Science, Google Scholar, and Open Thesis will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search will involve the use of keywords determined using the Medical Subject Headings database to define the search terms and include the following terms: “pharmacoeconomics,” “pharmaceutical care,” and “hospital.” The study designs to be included will be systematic reviews of good quality. Studies will be included that address pharmacoeconomics; studies that evaluated pharmaceutical care in hospitals; and studies published in Portuguese, English, or Spanish. The primary outcome sought in the systematic reviews will be the cost ratio in monetary units and the outcomes in monetary or natural units. The secondary economic outcomes considered will be determined based on factors associated with the drugs and translated into benefit, efficacy, or utility. Results It is intended to start this overview in January 2023. Thus far, only previous searches have been carried out to contextualize the theme and build the protocol. Conclusions This overview will determine the pharmacoeconomic impact of pharmaceutical care interventions in the hospital environment. In addition, this study will point out which clinical outcomes in natural units are impacted by the performance of pharmaceutical care and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work. Trial Registration PROSPERO CRD42019140665; https://tinyurl.com/bddwnz43

Introdução: No Brasil, cerca de três milhões de pessoas tem sorologia positiva para Hepatite C. Recentemente, novas terapias têm proporcionado maior efetividade, segurança e conveniência no tratamento de pacientes com hepatite C. Contudo, poucos estudos comparam as diferenças entre as farmacoterapias a partir dos benefícios dos cuidados farmacêuticos. Objetivo: Avaliar os cuidados farmacêuticos em um grupo de pacientes com hepatite C. Métodos: Foram analisados 219 prontuários médicos e farmacêuticos de pacientes atendidos em um centro de referência do Estado de Sergipe, de 2000-2015. A identificação dos problemas relacionados aos medicamentos foi realizada por meio do método Pharmacist´s Workup of Drug Therapy, sendo classificados em sete tipos e agrupados em quatro categorias (necessidade, efetividade, segurança e adesão). Os esquemas terapêuticos utilizados por pacientes em tratamento da hepatite C no Estado de Sergipe empregaram Interferon Pegilado + Ribavirina e Interferon Pegilado + Ribavirina + Inibidores de Protease (Boceprevir e/ou Telaprevir). Resultados: Ao longo do estudo foi observado o uso de 93 fármacos diferentes, sendo 1,47 a média por paciente. Os pacientes que utilizaram a terapia mais recente apresentaram maior chance de cura (70%) que os usuários da terapia habitual. Os fármacos mais utilizados foram paracetamol (17,7%) e loratadina (6,3%) quando houve necessidade de tratamento adicional. A terapia adicional foi requerida em 62,4% dos tratamentos realizados. Quanto à segurança, a média de efeitos colaterais foi de 6,7/paciente (intervalo foi de 0 a 29 sintomas clínicos), resultando em alterações de doses e interrupção da farmacoterapia (n=82). Após as intervenções farmacêuticas, 21 (9,6%) dos pacientes que apresentaram efeitos colaterais tiveram o tratamento suspenso permanentemente. A análise dos prontuários permitiu ao farmacêutico identificar que dos pacientes que tiveram o tratamento suspenso definitivamente, apenas 12 tiveram recomendação clínica. A terapia assistida em pólo aplicador pode ter sido o motivo do alto grau de adesão ao tratamento observada neste estudo. Embora mais efetivo, o tratamento atual é considerado complexo, apresentando variabilidade nos resultados dos pacientes tratados com farmacoterapias de outras gerações. Assim, o farmacêutico precisou dar maior atenção aos casos em que houve mudança de formas farmacêuticas e vias de administração, aumentando a segurança dos pacientes. Conclusão: Os dados obtidos sugerem que os cuidados farmacêuticos podem contribuir para a identificação de problemas relacionados aos medicamentos e a realização de intervenções que melhoram a segurança de pacientes com hepatite C, principalmente quando usam terapias adicionais.