International Journal of Environmental Research and Public Health

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12 pages, 366 KiB

Open AccessArticle

Professionals’ and Patients’ Perspectives on Criteria for Referring Hypertensive Patients to Comprehensive Medication Management Services in Public Primary Health Care

by Maria do Carmo Vilas Boas Sousa, Elizabeth do Nascimento, Simone de Araújo Medina Mendonça and Clarice Chemello

Int. J. Environ. Res. Public Health 2023, 20(7), 5233; https://doi.org/10.3390/ijerph20075233 - 23 Mar 2023

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Abstract

Patient prioritization in comprehensive medication management services allows coordinating care and guiding patients according to their clinical profile and their medication use. The aim of the study is to identify and describe factors that indicate the need for comprehensive medication management services among [...] Read more.

Patient prioritization in comprehensive medication management services allows coordinating care and guiding patients according to their clinical profile and their medication use. The aim of the study is to identify and describe factors that indicate the need for comprehensive medication management services among primary care hypertension patients within a public health system from the perspective of patients, pharmacists, nurses and physicians. A qualitative study was carried out with interviews with nurses, pharmacists and physicians (n = 20), and two focus groups with hypertensive patients (n = 12) at primary health care facilities and a public outdoor fitness area between January and February 2019 in Brazil. All interviews were transcribed and analyzed using the Atlas.ti^® software. The data analysis revealed the following factors indicative of the need to refer hypertension patients to a pharmacist: lifestyle habits, comorbidities, health care utilization and medication use. The issues identified and the information obtained from the qualitative research and compared with literature studies reviewed allowed defining dimensions that should be considered as an aid in the selection of uncontrolled hypertensive patients for comprehensive medication management services. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

11 pages, 816 KiB

Open AccessArticle

The Medication Experience of TB/HIV Coinfected Patients: Qualitative Study

by Natália Helena de Resende, Ursula Carolina de Morais Martins, Djenane Ramalho-de-Oliveira, Dirce Inês da Silva, Silvana Spíndola de Miranda, Adriano Max Moreira Reis, Wânia da Silva Carvalho and Simone de Araújo Medina Mendonça

Int. J. Environ. Res. Public Health 2022, 19(22), 15153; https://doi.org/10.3390/ijerph192215153 - 17 Nov 2022

Cited by 1 | Viewed by 1642

Abstract

Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pharmacotherapy and the stigma related to both diseases are complex. The patients’ subjective experiences with diseases and medications are of utmost importance in pharmaceutical care practice. This study aimed to understand the subjective medication [...] Read more.

Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pharmacotherapy and the stigma related to both diseases are complex. The patients’ subjective experiences with diseases and medications are of utmost importance in pharmaceutical care practice. This study aimed to understand the subjective medication experience of TB and HIV/AIDS coinfected patients. The study was based on descriptive research of a qualitative and quantitative nature using data collected during pharmaceutical care appointments and from medical records from September 2015 to December 2016 at a tertiary infectious diseases referral hospital in Southeastern Brazil. Data from 81 patients were analyzed. Regarding patient subjective medication experience, the following responses to the quantitative questionnaire were most frequent: preference for a route of administration (12.4%) and for non-pharmacological therapy (50.6%); concerns about price (11.1%) and adverse effects (18.5%); and association of a worsening of their health status with a change in medication dosage (23.5%). In the thematic analysis, adversity and socially constructed aspects were more prominent. Resolvability, associated with the patient’s understanding of relief from signs and symptoms and health recovery, was observed; however, feelings of ambivalence permeated the other aspects, hence leading to treatment abandonment. The evaluation of patient medication experience can be a path to understanding and intervening in the phenomenon of treatment abandonment among TB and HIV/AIDS coinfected individuals. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

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9 pages, 368 KiB

Open AccessArticle

Implementation and Effectiveness of a Pharmacotherapeutic Follow-Up Service for People with Tuberculosis in Primary Healthcare

by Célio Rezende Lara-Júnior, Ana Emília de Oliveira Ahouagi, Isabela Vaz Leite Pinto, Debora Gontijo Braga, Thiago Rabelo Andrade, Djenane Ramalho-de-Oliveira and Mariana Martins Gonzaga do Nascimento

Int. J. Environ. Res. Public Health 2022, 19(21), 14552; https://doi.org/10.3390/ijerph192114552 - 6 Nov 2022

Cited by 3 | Viewed by 1555

Abstract

Tuberculosis (TB) is a disease of great relevance, responsible for 1.5 million deaths worldwide. Therefore, actions to control TB are necessary, and pharmacists may play an important role, especially in primary healthcare (PHC), where the diagnosis and management of this infection occurs. In [...] Read more.

Tuberculosis (TB) is a disease of great relevance, responsible for 1.5 million deaths worldwide. Therefore, actions to control TB are necessary, and pharmacists may play an important role, especially in primary healthcare (PHC), where the diagnosis and management of this infection occurs. In a large Brazilian city, pharmacotherapeutic follow-up in PHC has been offered by pharmacists to people with TB since 2018. The objective of this study was to evaluate the implementation and effectiveness of this service though a longitudinal type 1 effectiveness–implementation hybrid study. Data were collected from January 2018 to February 2020 in the pharmaceutical services system. The service indicators were described and effectiveness was evaluated using Poisson regression analysis to compare the incidence of cure among patients using and not using the service. The service was performed in 148 PHC units by 82 pharmacists. Of the total of 1076 treatments, 721 were followed up by pharmacists, and TB was cured more frequently in these cases (90.4% attended vs. 73.5% unattended). The adjusted hazard ratio of cure among patients enrolled in the pharmacotherapeutic follow-up service was 2.71 (2.04–3.61; p < 0.001). Pharmacotherapeutic follow-up for people with TB significantly increased the incidence of cure and should be encouraged. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

12 pages, 676 KiB

Open AccessArticle

The Lived Experience of Patients Utilizing Second-Generation Direct-Acting Antiviral for Treatment of Chronic Hepatitis C Virus Infection: A Phenomenological Analysis

by Yone de Almeida Nascimento, Luciana Diniz Silva and Djenane Ramalho de Oliveira

Int. J. Environ. Res. Public Health 2022, 19(19), 12540; https://doi.org/10.3390/ijerph191912540 - 1 Oct 2022

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Abstract

Hepatitis C is a global public health problem, and the aim of this study was to understand the experiences of patients with hepatitis C using second-generation antivirals. In-depth interviews were conducted with ten outpatients, cognitively capable of reporting their experience, followed up at [...] Read more.

Hepatitis C is a global public health problem, and the aim of this study was to understand the experiences of patients with hepatitis C using second-generation antivirals. In-depth interviews were conducted with ten outpatients, cognitively capable of reporting their experience, followed up at a university clinic. Field diaries kept during the interviews were also used. The researchers carried out a thematic analysis to identify the ways in which individuals experienced their medication; then, these ways were reorganized to encompass the essential structures of the experience. The patients experienced the use of DAAs as providing resolution and it was permeated by: the experience of time—stagnant time, waiting for medication and the cure; the experience of spaces, understood as necessary and imposed spaces; the experience of relationships with others, personified by the support provided by healthcare professionals; the experience of sexuality, when patients developed several coping strategies to deal with the challenges imposed by the treatment. To conclude, increasing the knowledge about the patients’ experiences can contribute to improve the healthcare model for hepatitis C, since several patients have severe hepatic impairment, and the eradication of the virus is only one of the stages of patients’ treatments. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

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9 pages, 756 KiB

Open AccessArticle

Assessment of Pharmaceutical Services for Smoking Cessation: An Effectiveness–Implementation Hybrid Study

by Maria Eduarda Pinheiro Laborne-e-Valle, Ana Emília de Oliveira Ahouagi, Debora Gontijo Braga, Isabela Vaz Leite Pinto, Célio Rezende Lara-Júnior, Sabrina Gonçalves Ferreira, Paula de Fátima Fernandes Blunk, Adriano Max Moreira Reis, Edna Afonso Reis, Djenane Ramalho-de-Oliveira and Mariana Martins Gonzaga do Nascimento

Int. J. Environ. Res. Public Health 2022, 19(19), 12305; https://doi.org/10.3390/ijerph191912305 - 28 Sep 2022

Cited by 1 | Viewed by 1425

Abstract

Smoking is the main preventable cause of illness and early death worldwide. Thus, it is better to promote smoking cessation than to treat tobacco-related diseases. The objective of this study was to assess the implementation and effectiveness of smoking cessation pharmaceutical services offered [...] Read more.

Smoking is the main preventable cause of illness and early death worldwide. Thus, it is better to promote smoking cessation than to treat tobacco-related diseases. The objective of this study was to assess the implementation and effectiveness of smoking cessation pharmaceutical services offered in primary health care (PHC) in a large Brazilian city through a type 1 effectiveness–implementation hybrid study. The services were offered through individual or group approaches (Jan/2018–Dec/2019). The service indicators were described and the incidence of cessation in the services was evaluated. Factors associated with cessation were assessed by Poisson regression analysis. The services were offered in most PHC centers (61.2%) and by most pharmacists (81.3%). In total, 170 individual (9.7%) and 1591 group (90.3%) approaches occurred, leading to cessation in 39.4% (n = 67) and 44.8% (n = 712) of these, respectively. The use of nicotine plus antidepressants (RR = 1.30; 95%CI = 1.08–1.57; p = 0.006) and the number of sessions with pharmacists (RR = 1.21; 95%CI = 1.19–1.23; p < 0.001) were positively associated with cessation; a very high level of dependence was negatively associated (RR = 0.77; 95%CI = 0.67–0.89; p = 0.001). The smoking cessation services were effective and should be encouraged. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

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13 pages, 1937 KiB

Open AccessArticle

Creation and Implementation of a New Sentinel Surveillance Model in Pharmacy Offices in Southern Europe

by Anna M. Jambrina, Neus Rams, Pilar Rius, Maria Perelló, Montserrat Gironès, Clara Pareja, Francisco José Pérez-Cano, Àngels Franch and Manel Rabanal

Int. J. Environ. Res. Public Health 2022, 19(14), 8600; https://doi.org/10.3390/ijerph19148600 - 14 Jul 2022

Cited by 3 | Viewed by 1565

Abstract

Traditionally, health sentinel networks have focused on the reporting of data by primary care physicians and hospitals, ignoring the role of the community pharmacist as an expert in drugs. The objective of this study was to describe a method for creating a network [...] Read more.

Traditionally, health sentinel networks have focused on the reporting of data by primary care physicians and hospitals, ignoring the role of the community pharmacist as an expert in drugs. The objective of this study was to describe a method for creating a network of sentinel pharmacies in a region of Southern Europe in order to have a pharmaceutical surveillance system that is representative of the territory to be monitored and that can respond to any events or incidents that can be followed up by the community pharmacy. The creation process was carried out in three phases: a first phase of selection through a cluster and population analysis and a final adjustment, a second phase of voluntariness and random selection, and a third phase of training and implementation of the network. A sentinel network of 75 community pharmacies has been established in Catalonia. The network monitors 2.47% of the total population with a homogeneous proportion of urban (42), rural (30), and mountain-area (3) pharmacies based on the particular characteristics of the territory. This model allows increased surveillance in the territory, objectively and representatively detects problems arising from the use of medicines, and establishes improvement strategies of public health. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

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Other

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7 pages, 291 KiB

Open AccessCommentary

Community Champions: The Crucial Contribution of an Independent Pharmacy in COVID-19 Vaccination Efforts in an Underserved Community

by Chardaé Whitner, Stacey D. Curtis, John M. Allen and Kevin J. Duane

Int. J. Environ. Res. Public Health 2023, 20(19), 6881; https://doi.org/10.3390/ijerph20196881 - 3 Oct 2023

Viewed by 1841

Abstract

Historically, pharmacists in independent community pharmacies have been pivotal in promoting community health. During the COVID-19 pandemic, they demonstrated their commitment by advocating for vaccination and providing accessible care, particularly in underserved communities. By addressing disparities, implementing strategies like mobile clinics and community [...] Read more.

Historically, pharmacists in independent community pharmacies have been pivotal in promoting community health. During the COVID-19 pandemic, they demonstrated their commitment by advocating for vaccination and providing accessible care, particularly in underserved communities. By addressing disparities, implementing strategies like mobile clinics and community outreach, and fostering trust and engagement, independent community pharmacists played a crucial role in bridging gaps in healthcare access for vulnerable populations and mitigating the impact of the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

8 pages, 808 KiB

Open AccessBrief Report

Implementation of a Pharmacy Follow-Up Program for Dispensed Opioid Medications

by Elizabeth Skoy, Oliver Frenzel, Haley Pajunen and Heidi Eukel

Int. J. Environ. Res. Public Health 2023, 20(17), 6628; https://doi.org/10.3390/ijerph20176628 - 23 Aug 2023

Viewed by 1252

Abstract

Background: There have been multiple reported pharmacy initiatives to reduce opioid misuse and accidental overdose to address our nation’s public health crisis. To date, there has not been a description in the literature of a community pharmacy follow-up initiative for dispensed opioids. Methods: [...] Read more.

Background: There have been multiple reported pharmacy initiatives to reduce opioid misuse and accidental overdose to address our nation’s public health crisis. To date, there has not been a description in the literature of a community pharmacy follow-up initiative for dispensed opioids. Methods: A follow-up program was designed and implemented in community pharmacies as part of a previously developed opioid overdose and misuse prevention program (ONE Program). Five to twelve days after the dispensing of an opioid, pharmacy technicians called the patient to follow up on opioid safety topics. Pharmacy technicians used a questionnaire to inquire about medication disposal plans, if the patient was taking the medication more than prescribed, medication side effects, and if the patient needed a pharmacist consultation. The results from that questionnaire were documented. Results: During the first 18 months of the follow-up program, 1789 phone calls were completed. Of those contacted, 40% were still using their opioid medication, and over 10% were experiencing side effects which triggered a pharmacist consult. Patients were reminded of proper medication disposal methods, and most patients (78%) desired to dispose of unused medication at the pharmacy medication disposal box. Conclusions: Follow-up phone calls post-opioid medication dispensing were shown to add value to a previously established opioid misuse and accidental overdose prevention program and allowed for the fulfillment of the Pharmacist Patient Care Process. Full article

(This article belongs to the Special Issue Pharmacy in the Frontlines of Public Health)

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