Uso crônico de anticoagulante oral: implicações para o controle de níveis adequados

Esmerio, Francieli Giachini; Souza, Emiliane Nogueira de; Leiria, Tiago Luiz Luz; Lunelli, Rosana Pinheiro; Moraes, Maria Antonieta

doi:10.1590/s0066-782x2009001100017

Cited by 28 publications

(36 citation statements)

References 15 publications

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“…There are gaps between what is provided to the patients and what they really learn about it [27,28]. Many difficulties involved in the parental knowledge about the risks their sick children are running are associated with the doubts they have no opportunities to remove and the difficulties in assimilating explanations through technical words.…”

Section: Discussionmentioning

confidence: 99%

Conhecimento dos pais sobre profilaxia de endocardite infecciosa em crianças portadoras de cardiopatias congênitas

Haag¹,

Casonato²,

Varela³

et al. 2011

Rev Bras Cir Cardiovasc

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Introduction:The guidelines to prophylaxis of infectious endocarditis changed, but many congenital heart diseases continue to be considered as high risk for the development of the disease.Objective: To evaluate the knowledge of parents or guardians of children and adolescents with congenital heart disease seen at a referral center in Rio Grande do Sul, Brazil on infective endocarditis and its prevention.Methods: Cross-sectional study with 90 patients with congenital heart defects in regular outpatient treatment. The parents' knowledge was assessed using a specific questionnaire and other data were obtained through medical records.Results: The median age of patients was 5.6 years (3 months -14 years), being 57,7% males. The median follow-up time in service was 3.49 years (1.20-7.38). The years of formal schooling of the parents had a mean of 7.67 ± 3.25 years. According to the score previously established, the knowledge of the interviewed parents was considered satisfactory in 37.7%, regular in 33.3% and unsatisfying in 28,8%. There was significant correlation between the index of parentsḱ nowledge and monitoring of children at service (r=0.584; P=0.796). There was no correlation between parentsé ducation and knowledge of them (r=0.028; P=0.796). Conclusion:The parents' knowledge about endocarditis and its prevention was inadequate, requiring greater attention to the orientations passed in consultations.Descriptors: Primary Prevention. Endocarditis. Knowledge. Resumo

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Section: Discussionmentioning

confidence: 99%

Conhecimento dos pais sobre profilaxia de endocardite infecciosa em crianças portadoras de cardiopatias congênitas

Haag¹,

Casonato²,

Varela³

et al. 2011

Rev Bras Cir Cardiovasc

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“…1,2 However, it demands rigorous clinical and laboratory monitoring and assessments by a multidisciplinary team. 3 Patients must regularly monitor blood coagulation levels with prothrombin time (PT) test results, which are expressed by the International Normalized Ratio (INR) 4 and must be kept within the established therapeutic range to reduce the risk of thromboembolic or hemorrhagic complications. 4 In primary health care (PHC), oral anticoagulants (OACs), and warfarin in particular, are among the classes of medications most associated with fatal medication errors, which are very often caused by inadequate laboratory monitoring, significant drug interactions, gaps in the technical knowledge of the professionals involved, and insufficient patient guidance.…”

Section: Introductionmentioning

confidence: 99%

“…5 In Brazil, studies of patient knowledge or adherence to oral anticoagulation treatment have focused on patients treated at specialist clinics. 3,4,[6][7][8] In this context, the present study was conducted with patients on oral anticoagulation treatment with warfarin who were not being seen at a specialist clinic, but were being treated by the PHC network in the town of Ijuí, RS, Brazil. The objectives were to determine users' level of knowledge about warfarin prescriptions, the level of information about treatment precautions provided to these users by the healthcare team, and their adherence to treatment with warfarin.…”

Section: Introductionmentioning

confidence: 99%

Nível de informação e adesão à terapia de anticoagulação oral com varfarina em pacientes acompanhados em ambulatório de atenção primária à saúde

2018

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Background: Oral anticoagulation therapy with warfarin is widely used around the world and its safety and efficacy are well-established. Nevertheless, anticoagulants are among the drug classes most associated with fatal medication errors in primary health care. Objective: To investigate patient knowledge, the level of information provided, and medication adherence in patients treated with warfarin at a primary health care service. Method: A cross-sectional study of a prospective cohort of 60 patients on warfarin treatment in the town of Ijuí, Rio Grande do Sul, Brazil. A questionnaire was administered to test patients' knowledge about their prescriptions and the level of information provided by the health team. The 8-item Morisky Medication Adherence Scale (MMAS-8) and International Normalized Ratio (INR) were used to verify adherence to treatment. Results: The results were expressed in absolute and relative values and prevalence ratios were calculated, with respective 95% confidence intervals. It was found that 83.3% of the participants had been given insufficient information by the health team, 50% did not know how to use the medication correctly, 86.7% were not adherent to the treatment according to MMAS-8 and 63.3% were outside of the correct INR range. Conclusion: In this study, we observed a need to improve the quality of information provided to users and to develop strategies to improve adherence to treatment, to ensure the safety of patients treated with warfarin in primary health care services.

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“…Diante disso, os pacientes que fazem uso dessa terapêutica necessitam um acompanhamento clínico e laboratorial rigoroso (ESMERIO et al, 2009). …”

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Acompanhamento Farmacoterapêutico De Pacientes Em Uso De Varfarina: Uma Revisão Da Literatura

Colet

Amador

Heineck³

2017

Rev. Cont. Saúde

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RESUMOIntrodução: A varfarina é um dos Anticoagulantes Orais (ACOs) mais utilizados na atenção primária à saúde. Com janela terapêutica estreita, exibe extensa variabilidade de resposta farmacológica e grande suscetibilidade de eventos adversos, como sangramentos e tromboembolismo venoso. Objetivos: realizar uma revisão da literatura sobre o acompanhamento farmacoterapêutico de pacientes ambulatoriais em uso de varfarina. Método: Trata-se de um estudo de revisão. As palavras-chave usadas para a seleção dos artigos foram: Varfarina, Acompanhamento, Farmácia Clínica, Anticoagulantes Orais. Resultados: O uso de varfarina está associado com eventos adversos, sendo mais frequentes as hemorragias, que podem ser prevenidas com monitorização da Razão Normalizada Internacional (INR). A monitorização da coagulação sanguínea é de extrema importância para controlar a eficácia e a adesão do paciente ao tratamento com o anticoagulante. Em um ambulatório multiprofissional para pacientes em tratamento com varfarina identificou-se um aumento do percentual de pacientes com INR na faixa terapêutica com o prolongamento do tempo de acompanhamento no ambulatório. Pacientes atendidos em clínicas de anticoagulação tendem a apresentar mais valores de INR na faixa terapêutica, variando de 60% a 88%. Outro resultado importante relacionado com as clínicas foi a menor frequência de INRs supraterapêuticos e maior tempo na faixa terapêutica. Além disso, o acompanhamento por farmacêutico pode resultar em menores custos de cuidados e de eventos adversos relacionados com a anticoagulação, admissões hospitalares e busca por serviços de emergência. Quando os ACOs são administrados por farmacêuticos, parece haver um tempo mais curto para estabilização da terapia e uma maior percentagem de tempo no intervalo terapêutico, bem como uma diminuição da frequência de erros de medicação, maior tempo na faixa de INR terapêutico e redução das principais interações medicamentosas. ABSTRACT Introduction: Warfarin is one of the most commonly used oral anticoagulants (OACs) in primary health care. With narrow therapeutic window, it exhibits great variability of pharmacological response, and great susceptibility of adverse events, such as bleeding and venous thromboembolism. Objectives: To carry out a review of the literature on pharmacotherapeutic follow-up of outpatients using warfarin. Method: This is a review study. The keywords used for the selection of the articles were: Warfarin, Therapeutic Monitoring, Clinical Pharmacy, Oral Anticoagulants. Results: The use of warfarin is associated with adverse events, with hemorrhages being the most frequent, which can be prevented with INR monitoring. Monitoring of blood coagulation is of paramount importance in controlling patient efficacy and adherence to anticoagulant treatment. In a multiprofessional outpatient clinic for patients receiving warfarin, an increase was observed in the percentage of patients with INR in the therapeutic range, with the prolongation of the follow-up time in the outpatient clinic. Patien...

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Uso crônico de anticoagulante oral: implicações para o controle de níveis adequados

Abstract: SummaryBackground: Inappropriate and subtherapeutic anticoagulants dosages may result in severe thromboembolic and bleeding complications. The use of this treatment requires special attention and strict clinical and laboratory follow-up.

Cited by 28 publications

References 15 publications

Conhecimento dos pais sobre profilaxia de endocardite infecciosa em crianças portadoras de cardiopatias congênitas

Conhecimento dos pais sobre profilaxia de endocardite infecciosa em crianças portadoras de cardiopatias congênitas

Nível de informação e adesão à terapia de anticoagulação oral com varfarina em pacientes acompanhados em ambulatório de atenção primária à saúde

Acompanhamento Farmacoterapêutico De Pacientes Em Uso De Varfarina: Uma Revisão Da Literatura

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