Pilot-project of implantation of pharmaceutical care close to the program of bipolar mood disorder of the Hospital of Clinics of Porto Alegre

Abstract

The Bipolar Mood Disorder is characterized by the alternation of depressive crises with episodes of mania or euphoria, having these patients 15 to 35 times more chances of suicide, as compared with people without this disorder. The pharmacotherapy is fundamental for this disease, aiming to decrease the frequency of episodes and disease severity. In these patients, the polypharmacy has recently increased and one of the main difficulties is the adherence to treatment. The objective of this study was to contribute for the improvement of bipolar patients health conditions, developing their respective pharmacotherapeutic follow-up. Twenty eight adult bipolar patients who were participants of a specialized clinic within a tertiary hospital in Porto Alegre have been randomly selected, and the Dader Method of pharmacotherapeutic follow-up has been applied. The more common clinical comorbidities were: hypertension (50%), obesity (46.43%), and hypothyroidism (36.29%). The bipolar patients are more susceptible to clinical comorbidities, and many of them could be due to pharmacotherapy. Only 1.43% of patients presented Drug Related Problems, being all of them resolved along the study. It was also observed that 32.14% of evaluated patients presented low adherence to treatment, and between these patients, 55.56% passed to have good adherence after pharmacotherapeutic follow-up. The pharmacotherapeutic follow-up is fundamental for the improvement of patient's health. New studies, with higher number of patients and longer duration, are necessary to evaluate the percentage of patients that could be beneficiary of Pharmaceutical Care.<br>O Transtorno do Humor Bipolar é caracterizando pela alternância de crises depressivas com episódios de mania ou euforia, tendo estes pacientes 15-35 vezes mais chances de suicídio em comparação com pessoas sem este transtorno. A farmacoterapia é fundamental, visando diminuir a freqüência dos episódios e a gravidade da doença. Nestes pacientes, a polifarmácia tem aumentado ultimamente e uma das maiores dificuldades é a adesão ao tratamento. O objetivo do estudo foi contribuir para a melhoria das condições de saúde de pacientes bipolares, realizando o acompanhamento farmacoterapêutico dos mesmos. Foram selecionados aleatoriamente 28 pacientes bipolares adultos, participantes de um ambulatório especializado de um hospital terciário em Porto Alegre e aplicado o Método Dáder de acompanhamento farmacoterapêutico. As co-morbidades clínicas mais comuns foram: hipertensão (50%), obesidade (46,43%) e hipotiroidismo (39,29%). Os pacientes bipolares são mais suscetíveis a co-morbidades clínicas e muitas destas podem ser devidas a farmacoterapia. Apenas 1,43% dos pacientes apresentavam Problemas Relacionados a Medicamentos, sendo todos solucionados no decorrer do estudo. Também se observou que 32,14% dos pacientes avaliados apresentavam baixa adesão ao tratamento e entre estes, 55,56% passaram a ter boa adesão após o acompanhamento farmacoterapêutico. É fundamental para a melhoria da saúde do paciente o acompa...

Assessment of the Effectiveness of Pharmacotherapy Follow-up in Patients Treated for Depression

“…Studies that have employed the Dáder Method have shown its effectiveness in several diseases, but there are no data on patients being treated for depression. [20][21][22] Due to the worldwide advancement of PC and the need to assess its effectiveness in female patients with depression, the present clinical trial sought to employ and assess the Dáder Method of PF. Our hypothesis states that the Dáder Method is effective and results in the clinical improvement of depressive and anxious symptoms.…”

“…Thus, the pharmacist would be the suitable professional to monitor patients through pharmaceutical care, working with the doctor. • It has been observed that the use of pharmacists in the mental health system is in its early stages, and few studies have been developed outside the United States with the objective of demonstrating the importance of the pharmacist on the mental health team (Razali et al, 1995;Shaw, 2000;Prats and Cebrián, 2002;Castelló, 2002;Ceresér et al, 2009). There are few randomized controlled trials, 3 of them were developed in the United States Capoccia et al, 2004;Adler et al, 2004) and 2 in the Netherlands (Brook et al, 2003, Brook et al, 2005, which do not specify the method used in pharmaceutical care.…”

“…• Pharmacotherapeutic follow-up (PF) by the Dáder Method has been used in several countries (Spain, Brazil, Colombia, Bogotá, and Portugal) to monitor the pharmacological treatment of various diseases (Chemello et al, 2011, Fontana et al, 2003Ceresér et al, 2009, Amariles et al, 2004Muñoz et al, 2006;Afonso et al, 2012). However, to date, this methodology had not been evaluated to monitor the treatment of patients with depression.…”