Pharmaceutical care for elderly asthma patients attended at the outpatient pharmacy of João de Barros Barros Barreto, Belém, Pará

Authors

DOI:

https://doi.org/10.33448/rsd-v11i1.25503

Keywords:

Elderly; Asthma; Pharmacy; Pharmaceutical Care; Pharmaceutical interventions.

Abstract

Objective: To provide pharmaceutical care through pharmaceutical services aimed at elderly patients with asthma treated in an outpatient pharmacy. Method: Interventional, cross-sectional and prospective study, carried out from July 2019 to December 2019. During pharmaceutical consultations, pharmacotherapeutic data were collected, problems related to medications were identified and pharmaceutical services were performed through organizational and educational interventions. Results: 26 users completed the follow-up, most of them female (84.62%), residing in Belém (84.62%), high school education (46.15%), retired occupation (69.23%). More than half (53.85%) were overweight, (61.53%) did not practice physical activity. The most prevalent comorbidities were hypertension (65.41%) and dyslipidemia (42.36%). The most prevalent Drug Related Problems were poorly treated health problem (20.28%), and incorrectly administered drugs (17.39%). After the different interventions, there was an improvement in adherence to drug treatment (p<0.01), greater disease control (p<0.01), better lung function (p<0.01) and improvement in quality of life ( p<0.01). Conclusion: The practice of pharmaceutical care carried out through pharmaceutical services directly aimed at elderly patients with asthma significantly improved clinical and humanistic outcomes in

References

Aguiar, R., Lopes, A., Ornelas, C., Ferreira, R., Caiado, J., Mendes, A., et al. (2017). Terapêutica inalatória: Técnicas de inalação e dispositivos inalatórios. Rev Port Imunoalergologia. 25(1):9-26.

Almomani, B. A., Mokhemer, E., Al-Sawalha, N. A., & Momany, S. M. (2018). A novel approach of using educational pharmaceutical pictogram for improving inhaler techniques in patients with asthma. Respiratory medicine. 143, 103–108. https://doi.org/10.1016/j.rmed.2018.09.004

Amegadzie, J. E., Gorgui, J., Acheampong, L., Gamble, J. M., Farrell, J., & Gao, Z. (2021). Comparative safety and effectiveness of inhaled bronchodilators and corticosteroids for treating asthma-COPD overlap: a systematic review and meta-analysis. The Journal of asthma: official journal of the Association for the Care of Asthma. 58(3), 344–359. https://doi.org/10.1080/02770903.2019.1687716

Amorha, K. C., Onu, A. C., Anene-okeke, C. G., & Ukwe, C. V. (2018). Evaluation of drug therapy problems in asthma patients receiving care in two hospitals in south-eastern nigeria. International Journal of Pharmacy and Pharmaceutical Sciences, 10(2), 50–55. https://doi.org/10.22159/ijpps.2018v10i2.22472

Andrade, T. N. G., Silvestre, C. C., Cunha, L. C., Silva, D. T., Marques, T. C., Oliveira-Filho, A. D., & Lyra-Jr, D. P. (2015). Pharmaceutical intervention assessment in the identification and management of drug interactions in an intensive care unit. Journal of Applied Pharmaceutical Science. 5:13-8. 10.7324/JAPS.2015.50103

Anum, P. O., Anto, B. P., Forson, A. G. (2017). Structured pharmaceutical care improves the health-related quality of life of patients with asthma. J Pharm Policy Pract. 10(8):1-9. http://doi.org/10.1186/s40545-017-0097-7

Ben, A. J., Neumann, C. R., & Mengue, S. S. (2012). Teste de Morisky-Green e Brief Medication Questionnaire para avaliar adesão a medicamentos. Rev Saúde Pública. 46(2):279-89. 10.1590/S0034-89102012005000013

Brasil. (2014). Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Assistência Farmacêutica e Insumos Estratégicos. Capacitação para implantação dos serviços de clínica farmacêutica. Brasília: Ministério da Saúde. 308 p.: il. (Cuidado farmacêutico na atenção básica; caderno 2).

Brasil. Conselho Nacional de Saúde. (2012) Resolução nº 466 de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Brasília. Distrito Federal. Ministério da Saúde (saude.gov.br)

Brasil. Conselho Nacional de Saúde. (2016). Resolução nº 510, de 07 de abril de 2016. Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais cujos procedimentos metodológicos envolvam a utilização de dados diretamente obtidos com os participantes ou de informações identificáveis ou que possam acarretar riscos maiores o que os existentes na vida cotidiana. Brasília. Distrito Federal. Nova resolução (510/2016) de Ética na Pesquisa | ANPEd

Brasil. (2013). Ministério da Saúde. Protocolos Clínicos e Diretrizes Terapêuticas. 2. Segunda ed. 1-596p. Protocolos_Clinicos_e_Diretrizes_Terapeuticas_Volume_2.PDF (tre-rs.jus.br)

Brasil. (2014). Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Assistência Farmacêutica e Insumos Estratégicos. Serviços farmacêuticos na atenção básica à saúde. Brasília: Ministério da Saúde. 108p. il. – (Cuidado farmacêutico na atenção básica; Caderno 1). Cuidado farmacêutico na atenção básica. Caderno 1: Serviços farmacêuticos na atenção básica à saúde (saude.gov.br)

Cardoso, T. A., Roncada, C., Silva, E., Pinto, L. A., Jones, M. H., Stein, R. T., & Pitrez, P. M. (2017). The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system. Jornal brasileiro de pneumologia: publicação oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 43(3):163–168. https://doi.org/10.1590/S1806-37562016000000352

Cavalcante, D., Oliveira, D., Antunes, M., & Carnelozzi, A. (2018). Análise da qualidade de vida em idosas praticantes de dança. Revista Interdisciplinar de Promoção da Saúde. 1(1):23-31. 10.17058/rips.v1i1.11944

Chipps, B., Taylor, B., Bayer, V., Shaikh, A., Mosnaim, G., Trevor, J., et al. (2020). Relative efficacy, and safety of inhaled corticosteroids in asthma patients: systematic review and network meta-analysis. Ann Allergy, Asthma Immunol.;S1081-1206(20):30234-9. http://doi.org/10.1016/j.anai.2020.04.006

Costa, D. D., Pitrez, P. M., Barroso, N. F., & Roncada, C. (2019). Asthma control in the quality of life levels of asthmatic patient's caregivers : a systematic review with meta-analysis and meta-regression. J Pediatr. 95(4):401-9. https://doi.org/10.1016/j.jped.2018.10.010

Crespo-Gonzalez, C., Fernandez-Llimos, F., Rotta, I., Correr, C. J., Benrimoj, S. I., & Garcia-Cardenas, V. (2018). Characterization of pharmacists' interventions in asthma management: a systematic review. Journal Of The American Pharmacists Association. 58(2):210-219. 10.1016/j.japh.2017.12.009.

Dalcin, P. D. T. R., Grutcki, D. M., Laporte, P. P., Lima, P. B., Menegotto, S. M., & Pereira, R. P. (2014). Fatores relacionados ao uso incorreto dos dispositivos inalatórios em utentes asmáticos. J Bras Pneumol. 40(1):13-20. https://doi.org/10.1590/S1806-37132014000100003

Dantas, S. C. C., Kheir, N., Dantas, F. F. L., Almeida, P. C. D., Silva, K. M., & Fonteles, M. M. D. F. (2019). Pharmacotherapeutic follow-up of asthmatic patients in ambulatory care service of Ceará: clinical outcomes. Revista Brasileira de Farmácia Hospitalar e Serviços de Saúde. 3(3): 11-17. View of Pharmacotherapeutic follow-up of asthmatic patients in ambulatory care service of Ceará: clinical outcomes (rbfhss.org.br)

Dokbua, S., Dilokthornsakul, P., Chaiyakunapruk, N., Saini, B., Krass, I., & Dhippayom, T. (2018). Effects of an Asthma Self-Management Support Service Provided by Community Pharmacists: a systematic review and meta-analysis. Journal Of Managed Care & Specialty Pharmacy. 24(11):1184-1196. 10.18553/jmcp.2018.24.11.1184.

Farias, T. F., Aguiar, K. S., Rotta, I., Belletti, K. M. S., & Carlotto, J. (2016). Implementing a clinical pharmacy service in hematology. Einstein (São Paulo). 14(3):384-390. 10.1590/s1679-45082016ao3667.

Ferreira, A. S., & Soler, O. (2020). Strengthening patient safety strategies: an integrative review as to drug safety processes. Research, Society and Development, 9(12), e129129564. https://doi.org/10.33448/rsd-v9i12.9564

Flecka, M. P. A., Chachamovicha, E. & Trentini, C. M. (2003). Projeto WHOQOL-OLD: método e resultados de grupos focais no Brasil. Rev Saúde Pública. 37(6):793-799. 16-AO3728WHOQOI.p65 (scielo.br)

Fuller, J. M., Saini, B., Bosnic-anticevich, S., Garcia, V., Benrimoj, S. I., & Armour, C. (2017). Testing evidence routine practice : Using an implementation framework to embed a clinically proven asthma service in Australian community pharmacy. Res Soc Adm Pharm.;13(5):989-96. http://dx.doi.org/10.1016/j.sapharm.2017.05.019

Garcia-Cardenas, V., Armour, C., Benrimoj, S. I., Martinez-Martinez, F., Rotta, I., Fernandez-Llimos, F. (2015). Pharmacists' interventions on clinical asthma outcomes: a systematic review. European Respiratory Journal. 47(4):1134-1143. 10.1183/13993003.01497-2015.

Global Initiative for Asthma. (2019). Global Strategy for Asthma Management and Prevention. https://ginasthma.org/gina-patient-guide-you-can-control-your-asthma

Ahmad, A., Mast, M. R., Nijpels, G., Elders, P. J., Dekker, J. M., & Hugtenburg, J. G. (2014). Identification of drug-related problems of elderly patients discharged from hospital. Patient preference and adherence. 8:155-165. https://doi.org/10.2147/PPA.S48357

Instituto Brasileiro de Geografia e Estatística (IBGE). (2013). Pesquisa Nacional de Saúde: percepção do estado de saúde, estilos de vida e doenças crônicas - Brasil, Grandes Regiões e Unidades da Federação Rio de Janeiro: IBGE; 2014.

Instituto Brasileiro de Geografia e Estatística (IBGE). (2019). Pesquisa de orçamentos familiares 2017-2018: primeiros resultados/Coordenação de Trabalho e Rendimento. IBGE. 69p.

Janežič, A., Locatelli, I., & Kos, M. (2020). Inhalation technique and asthma outcomes with different corticosteroid-containing inhaler devices. The Journal of asthma : official journal of the Association for the Care of Asthma, 57(6):654–662. https://doi.org/10.1080/02770903.2019.1591442

Kovačević, M., Ćulafić, M., Jovanović, M., Vučićević, K., Kovačević, S. V., & Miljković, B. (2018). Impact of community pharmacists' interventions on asthma self-management care. Research in social & administrative pharmacy: RSAP. 14(6):603–611. https://doi.org/10.1016/j.sapharm.2017.07.007

Leite, M., Ponte, E. V., Petroni, J., Júnior, A. D. O., Pizzichini, E., & Cruz, A. A. (2008). Avaliação do Questionário de Controle da Asma validado para uso no Brasil. J Bras Pneumol. 34(10):756-63. http://doi.org/10.1590/S1806-3713200800100000

Linneberg, A., & Gonzalez-Quintela, A. (2016). The Unsolved Relationship of Alcohol and Asthma. International archives of allergy and immunology. 171(3-4);155–157. https://doi.org/10.1159/000454809

Lopes, I. C. C., Costa, J. L. B., Dias, J. B., Fialho, J. D. O., Pereira, B. C., & Garib, J. R. (2013). Obesity, abdominal circumference and control of asthma symptomatology. Revista Médica de Minas Gerais. 23(1):21-26. 10.5935/2238-3182.20130004

Manfrin, A., Tinelli, M., Thomas, T., & Krska, J. (2017). A cluster randomised control trial to evaluate the effectiveness and cost-effectiveness of the Italian medicines use review (I-MUR) for asthma patients. Bmc Health Services Research. 17(1):1-13. /10.1186/s12913-017-2245-9.

Marchioro, J., Gazzotti, M. R., Nascimento, O. A., Montealegre, F., Fish, J., & Jardim, J. R. (2014). Level of asthma control and its relationship with medication use in asthma patients in Brazil. J Bras Pneumol. 40(5):487-494. 10.1590%2FS1806-37132014000500004

Menegat, K. L., Borges, R. L., Senhorelo, M. C. C. M. P., & Catro, P. F. S. (2020). Do health graduates know how to teach the technique of using inhalation devices? Brazilian J Dev. 6(4):19901-12. http://doi.org/10.34117/bjdv6n4-239

Minayo, M. C. S.; & Costa, A. P. (2018). Fundamentos Teóricos das Técnicas de Investigação Qualitativa. Revista Lusófona de Educação, 40:139-153. ISSN 1645-7250

Muniz, E. C. S., Goulart, F. C., Lazarini, C. A., & Marin, M. J. S. (2017). Analysis of medication use by elderly persons with supplemental health insurance zplans. Revista Brasileira de Geriatria e Gerontologia. 20(3):374-386. 10.1590/1981-22562017020.160111

Nastaravicius, A., & Ramanauskiene, K. (2018). Role of a Community Pharmacy Service in Care of Bronchial Asthma Patients in Lithuania. Can Respir J. 2018:1-7. http://doi.org/10.1155/2018/6060581

Nastaravičius, A., & Ramanauskienė, K. (2018). Role of a Community Pharmacy Service in Care of Bronchial Asthma Patients in Lithuania. Canadian Respiratory Journal. 2018:1-7. 10.1155/2018/6060581.

Nathan, R. A., Sorkness, C. A., Kosinski, M., Schatz, M., Li, J. T., Marcus, P., Murray, J. J., & Pendergraft, T. B. (2004). Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 113:59–65. 10.1016 / j.jaci.2003.09.008.

National Institutes Of Health. (2018). National Heart, Lung and Blood Institute. Global Initiative for Asthma: Global strategy for Asthma Management and Prevention. Washington: NIH. Global Initiative for Asthma - Global Initiative for Asthma - GINA (ginasthma.org)

Boulet, L. P., Reddel, H. K., Bateman, E., Pedersen, S., FitzGerald, J. M., & O'Byrne, P. M. (2019). The Global Initiative for Asthma (GINA): 25 years later. The European respiratory journal. 54(2), 1900598. https://doi.org/10.1183/13993003.00598-2019

Oliveira, P. D., Menezes, A. M. B., Bertoldi, A. D., Wehrmeister, F. C., & Macedo, S. E. C. (2014). Avaliação da técnica de utilização de dispositivos inalatórios no tratamento de doenças respiratórias no sul do Brasil: estudo de base populacional*. J Bras Pneumol. 40(5):513-20. http://doi.org/10.1590/S1806-37132014000500007

Oliveira, T. C., Vieira, H. K. S., Elmescany, S. B., Gonçalves, S. T., Santos, V. R. C., & Soler, O. (2021). Interventions applied to the prescription, use and administration of medications as strategic factors for patient safety: systematic review. Research, Society and Development, 10(17), e195101724601. https://doi.org/10.33448/rsd-v10i17.24601

Paes, M. W., Soler, O., Grisólia, A. B.A. (2020). Intervenções farmacêuticas sobre o uso de dispositivos inalatórios: o cuidado farmacêutico no controle da asma. Infarma – Ciências Farmacêuticas. 32(4):309-318. ISSN - 2318-9312 (Versão eletrônica) 10.14450/2318-9312.v32.e4.a2020.pp309-318

Peytremann-Bridevaux, I., Arditi, C., Gex, G., Bridevaux, P. O., & Burnand, B. (2015). Chronic disease management programmes for adults with asthma. The Cochrane Database of Systematic Reviews. 5:CD007988. 10.1002/14651858.cd007988.pub2.

Pizzichini, M. M. M., Carvalho-Pinto, R. M., & Cançado, J. E. D. (2020). Recomendações para o manejo da asma da Sociedade Brasileira de Pneumologia e Tisiologia - 2020. J Bras Pneumol. 46(1): e201-307. 10.1590/1806-3713/e20190307

Power, M., Quinn, K., & Schmidt, S. (2005). Development of the WHOQOL-Old Module. Quality of Life Research. 14(10):2197–2214. 10.1007/s11136-005-7380-9

Price, D., Bosnic-Anticevich, J., Briggs, A., & Chrystyn, H. (2013). The Inhaler Error Steering Committee, et al. Inhaler competence in asthma: common errors, barriers to use and recommended solutions. Respiratory Medicine. 107: 37-46. 10.1016/j.rmed.2012.09.017

Roxo, J. P. F., Ponte, E. V., Ramos, D. C. B., Pimentel, L., Júnior, A. D. O., & Cruz, A. A. (2010). Validação do Teste de Controle da Asma em português para uso no Brasil. J Bras Pneumol. 36(2):159-66. http://doi.org/10.1590/S1806-37132010000200002

Sabzghabaee, A., Balasubramanian, R., Bhojan, C., Devarajan, V., Shanmugam, S., Varughese, J., Nair, M. S., & Velu, S. (2012). Pharmaceutical care for asthma patients: a developing countrys experience. Journal Of Research In Pharmacy Practice. 1(2):66-78. 10.4103/2279-042x.108373.

Shanmugam, S., Varughese, J. N., Nair, M. A. S., Balasubramanian, R., Velu, S., Bhojan, C., et al. (2012). Pharmaceutical care for asthma patients: A Developing Country's Experience. J Res Phamacy Pract.1(2):66-71. http://doi.org/10.4103/2279-042X.108373

Silva, A. F., Abreu, C. R. O., Barbosa, E. M. S., Raposo, N. R. B., & Chicourel, E. L. (2013). Problemas relacionados aos medicamentos em idosos fragilizados da Zona da Mata Mineira, Brasil. Revista Brasileira de Geriatria e Gerontologia. 16(4):691-704. 10.1590/s1809-98232013000400004.

Soler, O., & Barreto, J. O. M. (2019). Community-Level pharmaceutical interventions to reduce the risks of polypharmacy in the elderly: Overview of systematic reviews and economic evaluations. Frontiers in Pharmacology. 10:Article 302.https://doi.org/10.3389/fphar.2019.00302

Tavares, N. U. L., Costa, K. S., Mengue, S. S., Vieira, M. L. F. P., Malta, D. C., & Silva-Júnior, J. B. (2015). Uso de medicamentos para tratamento de doenças crônicas não transmissíveis no Brasil: resultados da pesquisa nacional de saúde, 2013. Epidemiologia e Serviços de Saúde. 24(2):315-323. 10.5123/s1679-49742015000200014.

Thiollent, M. (2011). Metodologia da pesquisa-Ação. (18a ed.), Cortez.

Todo, B. A., & Mota, P. A. (2009). Allergic respiratory diseases in the elderly. Respiratory Medicine. 103(11):1614–1622. 10.1016/j.rmed.2009.06.003.

Word Health Organization (WHO). (2019). 10 facts on asthma 2019. Asthma (who.int)

World Health Organization (WHO). (2020). Chronic respiratory diseases: asthma. https://www.who.int/news-room/q-a-detail/asthma

World Health Organization (WHO). (2015). World report on ageing and health Geneva: World report on ageing and health (who.int)

Yadav, A., & Thapa, P. (2019). Pharmacist Led Intervention on Inhalation Technique among Asthmatic Patients for Improving Quality of Life in a Private Hospital of Nepal. Pulm Med. (24):1-9. https://doi.org/10.1155/2019/8217901

Yin, R. K. (2015). Estudo de caso: planejamento e métodos. (5a ed.), Bookman. 320p.

Zambelli-Simões, L., Martins, M. C., Possari, J. C. C., Carvalho, G. B., Coelho, A. C. C., Cipriano, S. L. et al. (2015). Validação de escores de uso de dispositivos para inalação: valoração dos erros cometidos. Jornal Brasileiro de Pneumologia. 41(4):313-322. 10.1590/S1806-37132015000004435

Published

16/01/2022

How to Cite

PAES, M. W. .; GRISÓLIA, A. B. A. .; SOLER, O. Pharmaceutical care for elderly asthma patients attended at the outpatient pharmacy of João de Barros Barros Barreto, Belém, Pará. Research, Society and Development, [S. l.], v. 11, n. 1, p. e59911125503, 2022. DOI: 10.33448/rsd-v11i1.25503. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/25503. Acesso em: 19 apr. 2024.

Issue

Section

Health Sciences