Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático

Detalhes bibliográficos
Ano de defesa: 2024
Autor(a) principal: Alencar, Taiana de
Orientador(a): Santos Júnior, Genival Araujo dos lattes
Banca de defesa: Oliveira Filho, Alfredo Dias de lattes, Severi, Juliana Aparecida lattes, Silva, Rafaella de Oliveira Santos lattes
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal do Espírito Santo
Mestrado em Assistência Farmacêutica
Programa de Pós-Graduação: Programa de Pós-Graduação em Assistência Farmacêutica
Departamento: Centro de Ciências Exatas, Naturais e da Saúde
País: BR
Palavras-chave em Português:
Área do conhecimento CNPq:
Link de acesso: http://repositorio.ufes.br/handle/10/18052
Resumo: Introduction: Arterial hypertension (AH) is a chronic health condition that may require changes in lifestyle and the use of medication. However, this use is not without risks. In this context, the Pharmacotherapeutic Follow-up Service (FHS) has emerged as a strategy capable of improving the health outcomes of people with AH. However, there are few high-research studies on this subject. Objective: To assess the impact of FAS on the health outcomes of patients with AH in the health care network in the municipality of Alegre/ES. Method: This is an experimental single-blind randomized controlled clinical trial. People with hypertension who met the eligibility criteria (over 18 years of age, with self-reported hypertension, taking medication for hypertension for at least 6 months) were randomized in a 1:1 ratio to the intervention and control groups. They received FAS and usual care, respectively, for a period of 12 months. The study was conducted in the Health Care Network of the municipality of Alegre, Espírito Santo, Brazil, from January 2022 to November 2023. In both groups, primary outcomes (blood pressure and quality of life) and secondary outcomes (knowledge about hypertension, anthropometric profile and clinical examinations) were assessed at three points in time, six months apart. Ethical considerations were observed (CAAE registration number 13586319.6.0000.8151 | Opinion no. 4.732.878). Results: 128 patients were allocated to the intervention group (64) and the control group (64). Statistically significant differences were observed in the intra-group analysis in the intervention group, including SBP (∆ = -9.47 mmHg, p = 0.014), Total Cholesterol (∆ = -18.93 mg/dL, p = 0.001), LDL (∆ = -15.70 mg/dL, p < 0.001), non-HDL cholesterol (∆ = -19.76 mg/dL, p < 0.001) and cardiovascular risk (∆ = -1.82 points, p < 0.001). There was an increase in the score for knowledge about hypertension (∆ = 1.39 points, p < 0.001), an improvement in quality of life in the mental state subdimension (∆ = -2.76 points, p = 0.020) and somatic manifestations (∆ = -1.5 points, p = 0.012). In the control group, it was possible to observe an increase in the score for knowledge about hypertension (∆ = 1.52 points, p = 0.001) and an improvement in the VAS of the EQ5D (∆ = 10.33 points, p = 0.067). In addition, almost all the patients were satisfied or very satisfied with the service provided by the pharmacists. Conclusion: The results show a promising positive impact of FAS on clinical and humanistic parameters, as well as a reduction in cardiovascular risk for negative events over the next ten years. This study was registered with The Brazilian Clinical Trials Registry (ReBEC) under registration number: RBR-4c53f3m.
id UFES_0e1d4d8d0c4fd4e8c5cd6ecabceaaed7
oai_identifier_str oai:repositorio.ufes.br:10/18052
network_acronym_str UFES
network_name_str Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
repository_id_str
spelling Santos Júnior, Genival Araujo dos https://orcid.org/0000-0002-5618-1846http://lattes.cnpq.br/5917097187533724Alencar, Taiana dehttps://orcid.org/0009-0006-1916-9633http://lattes.cnpq.br/7190658443957873Oliveira Filho, Alfredo Dias dehttps://orcid.org/0000-0003-3192-8285http://lattes.cnpq.br/2692375096980574Severi, Juliana Aparecidahttps://orcid.org/0000-0001-7516-2395http://lattes.cnpq.br/4265400222421660 Silva, Rafaella de Oliveira Santoshttps://orcid.org/http://lattes.cnpq.br/40085964652438422024-10-25T00:40:25Z2024-10-25T00:40:25Z2024-03-15Introduction: Arterial hypertension (AH) is a chronic health condition that may require changes in lifestyle and the use of medication. However, this use is not without risks. In this context, the Pharmacotherapeutic Follow-up Service (FHS) has emerged as a strategy capable of improving the health outcomes of people with AH. However, there are few high-research studies on this subject. Objective: To assess the impact of FAS on the health outcomes of patients with AH in the health care network in the municipality of Alegre/ES. Method: This is an experimental single-blind randomized controlled clinical trial. People with hypertension who met the eligibility criteria (over 18 years of age, with self-reported hypertension, taking medication for hypertension for at least 6 months) were randomized in a 1:1 ratio to the intervention and control groups. They received FAS and usual care, respectively, for a period of 12 months. The study was conducted in the Health Care Network of the municipality of Alegre, Espírito Santo, Brazil, from January 2022 to November 2023. In both groups, primary outcomes (blood pressure and quality of life) and secondary outcomes (knowledge about hypertension, anthropometric profile and clinical examinations) were assessed at three points in time, six months apart. Ethical considerations were observed (CAAE registration number 13586319.6.0000.8151 | Opinion no. 4.732.878). Results: 128 patients were allocated to the intervention group (64) and the control group (64). Statistically significant differences were observed in the intra-group analysis in the intervention group, including SBP (∆ = -9.47 mmHg, p = 0.014), Total Cholesterol (∆ = -18.93 mg/dL, p = 0.001), LDL (∆ = -15.70 mg/dL, p < 0.001), non-HDL cholesterol (∆ = -19.76 mg/dL, p < 0.001) and cardiovascular risk (∆ = -1.82 points, p < 0.001). There was an increase in the score for knowledge about hypertension (∆ = 1.39 points, p < 0.001), an improvement in quality of life in the mental state subdimension (∆ = -2.76 points, p = 0.020) and somatic manifestations (∆ = -1.5 points, p = 0.012). In the control group, it was possible to observe an increase in the score for knowledge about hypertension (∆ = 1.52 points, p = 0.001) and an improvement in the VAS of the EQ5D (∆ = 10.33 points, p = 0.067). In addition, almost all the patients were satisfied or very satisfied with the service provided by the pharmacists. Conclusion: The results show a promising positive impact of FAS on clinical and humanistic parameters, as well as a reduction in cardiovascular risk for negative events over the next ten years. This study was registered with The Brazilian Clinical Trials Registry (ReBEC) under registration number: RBR-4c53f3m.Introdução: A hipertensão arterial (HA) é uma condição de saúde crônica que pode necessitar de alterações no modo de vida e no uso de medicamentos. No entanto, esse uso não está isento de riscos. Nesse contexto, emerge o Serviço de Acompanhamento Farmacoterapêutico (SAF) como uma estratégia capaz de aprimorar os resultados em saúde de pessoas com HA. Contudo, existem poucos estudos de alta evidência sobre essa temática. Objetivo: Avaliar o impacto de um SAF nos desfechos em saúde de pacientes com HA da rede de atenção à saúde do município de Alegre/ES. Método: Este é um estudo experimental de ensaio clínico randomizado controlado simples-cego. Realizado com pessoas com HA que atenderam aos critérios de elegibilidade (maiores de 18 anos, com HA autorreferida, em uso de medicamento para HA há pelo menos 6 meses) foram randomizadas aleatoriamente na proporção 1:1 para grupo intervenção e controle. Esses receberam o SAF e os cuidados usuais, respectivamente, durante o período de 12 meses. O estudo foi conduzido na Rede de Atenção à Saúde do munícipio de Alegre, Espírito Santo, Brasil, de janeiro de 2022 a novembro de 2023. Em ambos os grupos foram avaliados os desfechos primários (pressão arterial e qualidade de vida) e secundários (conhecimento sobre HA, perfil antropométrico e exames clínicos) em três momentos com seis meses de intervalo entre eles. Este ensaio clínico foi submetido ao Comitê de Ética e Pesquisa em Seres Humanos (número de registro CAAE 13586319.6.0000.8151 | Parecer nº 4.732.878) e também foi registrado no The Brazilian Clinical Trials Registry (ReBEC) sob número de registro: RBR-4c53f3m. As análises estatísticas foram realizadas utilizando o software Jamovi 2.2.5. Resultados: 128 pacientes foram alocados no grupo intervenção (64) e no grupo controle (64). Foram observadas diferenças estatisticamente significativas na análise intragrupo no grupo intervenção, incluindo PAS (∆ = -9,47 mmHg, p = 0,014), Colesterol Total (∆ = -18,93 mg/dL, p = 0,001), LDL (∆ = -15,70 mg/dL, p < 0,001), colesterol não HDL (∆ = -19,76 mg/dL, p < 0,001) e risco cardiovascular (∆ = -1,82 pontos, p < 0,001). Aumento na pontuação de conhecimento sobre hipertensão (∆ = 1,39 pontos, p < 0,001), melhora da qualidade de vida na subdimensão de estado mental (∆ = -2,76 pontos, p = 0,020) e manifestações somáticas (∆ = -1,5 pontos, p = 0,012) também foi observado no grupo intervenção. No grupo controle foi possível observar um aumento na pontuação de conhecimento sobre hipertensão (∆ = 1,52 pontos, p = 0,001) e uma melhora na Escala Visual Analógica do European Quality of Life 5 dimensions (EQ-5D-3L) (∆ = 10,33 pontos, p = 0,067). Além disso, quase todos os pacientes manifestaram estar satisfeitos ou muito satisfeitos com o serviço prestado pelas farmacêuticas. Conclusão: Os resultados demonstram de maneira promissora o impacto positivo do SAF nos parâmetros clínicos e humanísticos, bem como uma redução no risco cardiovascular para eventos negativos nos próximos dez anosFundação de Amparo à Pesquisa e Inovação do Espírito Santo (Fapes)Texthttp://repositorio.ufes.br/handle/10/18052porptUniversidade Federal do Espírito SantoMestrado em Assistência FarmacêuticaPrograma de Pós-Graduação em Assistência FarmacêuticaUFESBRCentro de Ciências Exatas, Naturais e da Saúdehttps://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessFarmáciaHipertensãoFarmacêuticosAssistência FarmacêuticaEnsaio clínicoHypertensionPharmacistsPharmaceutical servicesClinical trialAvaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmáticoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)instname:Universidade Federal do Espírito Santo (UFES)instacron:UFEStaiana_alencar@hotmail.comLICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufes.br/bitstreams/1c3fbdf2-e88c-4b4c-8e3a-fab6fb1f8eab/download8a4605be74aa9ea9d79846c1fba20a33MD52ORIGINALTaianadeAlencar-2024-dissertacao.pdfTaianadeAlencar-2024-dissertacao.pdfapplication/pdf4875256http://repositorio.ufes.br/bitstreams/64a755f1-dc0d-4121-800d-6bebbe29f340/downloade723265e254aece19c4eb1837cde2949MD5110/180522025-06-09 17:29:26.669https://creativecommons.org/licenses/by-nc-nd/4.0/open accessoai:repositorio.ufes.br:10/18052http://repositorio.ufes.brRepositório InstitucionalPUBhttp://repositorio.ufes.br/oai/requestriufes@ufes.bropendoar:21082025-06-09T17:29:26Repositório Institucional da Universidade Federal do Espírito Santo (riUfes) - Universidade Federal do Espírito Santo (UFES)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
dc.title.none.fl_str_mv Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
title Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
spellingShingle Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
Alencar, Taiana de
Farmácia
Hipertensão
Farmacêuticos
Assistência Farmacêutica
Ensaio clínico
Hypertension
Pharmacists
Pharmaceutical services
Clinical trial
title_short Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
title_full Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
title_fullStr Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
title_full_unstemmed Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
title_sort Avaliação do impacto do acompanhamento farmacoterapêutico a pessoas com hipertensão arterial em um município sul-capixaba : ensaio clínico pragmático
author Alencar, Taiana de
author_facet Alencar, Taiana de
author_role author
dc.contributor.authorID.none.fl_str_mv https://orcid.org/0009-0006-1916-9633
dc.contributor.authorLattes.none.fl_str_mv http://lattes.cnpq.br/7190658443957873
dc.contributor.advisor1.fl_str_mv Santos Júnior, Genival Araujo dos
dc.contributor.advisor1ID.fl_str_mv https://orcid.org/0000-0002-5618-1846
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/5917097187533724
dc.contributor.author.fl_str_mv Alencar, Taiana de
dc.contributor.referee1.fl_str_mv Oliveira Filho, Alfredo Dias de
dc.contributor.referee1ID.fl_str_mv https://orcid.org/0000-0003-3192-8285
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/2692375096980574
dc.contributor.referee2.fl_str_mv Severi, Juliana Aparecida
dc.contributor.referee2ID.fl_str_mv https://orcid.org/0000-0001-7516-2395
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/4265400222421660
dc.contributor.referee3.fl_str_mv Silva, Rafaella de Oliveira Santos
dc.contributor.referee3ID.fl_str_mv https://orcid.org/
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/4008596465243842
contributor_str_mv Santos Júnior, Genival Araujo dos
Oliveira Filho, Alfredo Dias de
Severi, Juliana Aparecida
Silva, Rafaella de Oliveira Santos
dc.subject.cnpq.fl_str_mv Farmácia
topic Farmácia
Hipertensão
Farmacêuticos
Assistência Farmacêutica
Ensaio clínico
Hypertension
Pharmacists
Pharmaceutical services
Clinical trial
dc.subject.por.fl_str_mv Hipertensão
Farmacêuticos
Assistência Farmacêutica
Ensaio clínico
Hypertension
Pharmacists
Pharmaceutical services
Clinical trial
description Introduction: Arterial hypertension (AH) is a chronic health condition that may require changes in lifestyle and the use of medication. However, this use is not without risks. In this context, the Pharmacotherapeutic Follow-up Service (FHS) has emerged as a strategy capable of improving the health outcomes of people with AH. However, there are few high-research studies on this subject. Objective: To assess the impact of FAS on the health outcomes of patients with AH in the health care network in the municipality of Alegre/ES. Method: This is an experimental single-blind randomized controlled clinical trial. People with hypertension who met the eligibility criteria (over 18 years of age, with self-reported hypertension, taking medication for hypertension for at least 6 months) were randomized in a 1:1 ratio to the intervention and control groups. They received FAS and usual care, respectively, for a period of 12 months. The study was conducted in the Health Care Network of the municipality of Alegre, Espírito Santo, Brazil, from January 2022 to November 2023. In both groups, primary outcomes (blood pressure and quality of life) and secondary outcomes (knowledge about hypertension, anthropometric profile and clinical examinations) were assessed at three points in time, six months apart. Ethical considerations were observed (CAAE registration number 13586319.6.0000.8151 | Opinion no. 4.732.878). Results: 128 patients were allocated to the intervention group (64) and the control group (64). Statistically significant differences were observed in the intra-group analysis in the intervention group, including SBP (∆ = -9.47 mmHg, p = 0.014), Total Cholesterol (∆ = -18.93 mg/dL, p = 0.001), LDL (∆ = -15.70 mg/dL, p < 0.001), non-HDL cholesterol (∆ = -19.76 mg/dL, p < 0.001) and cardiovascular risk (∆ = -1.82 points, p < 0.001). There was an increase in the score for knowledge about hypertension (∆ = 1.39 points, p < 0.001), an improvement in quality of life in the mental state subdimension (∆ = -2.76 points, p = 0.020) and somatic manifestations (∆ = -1.5 points, p = 0.012). In the control group, it was possible to observe an increase in the score for knowledge about hypertension (∆ = 1.52 points, p = 0.001) and an improvement in the VAS of the EQ5D (∆ = 10.33 points, p = 0.067). In addition, almost all the patients were satisfied or very satisfied with the service provided by the pharmacists. Conclusion: The results show a promising positive impact of FAS on clinical and humanistic parameters, as well as a reduction in cardiovascular risk for negative events over the next ten years. This study was registered with The Brazilian Clinical Trials Registry (ReBEC) under registration number: RBR-4c53f3m.
publishDate 2024
dc.date.accessioned.fl_str_mv 2024-10-25T00:40:25Z
dc.date.available.fl_str_mv 2024-10-25T00:40:25Z
dc.date.issued.fl_str_mv 2024-03-15
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://repositorio.ufes.br/handle/10/18052
url http://repositorio.ufes.br/handle/10/18052
dc.language.iso.fl_str_mv por
pt
language por
language_invalid_str_mv pt
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv Text
dc.publisher.none.fl_str_mv Universidade Federal do Espírito Santo
Mestrado em Assistência Farmacêutica
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Assistência Farmacêutica
dc.publisher.initials.fl_str_mv UFES
dc.publisher.country.fl_str_mv BR
dc.publisher.department.fl_str_mv Centro de Ciências Exatas, Naturais e da Saúde
publisher.none.fl_str_mv Universidade Federal do Espírito Santo
Mestrado em Assistência Farmacêutica
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
instname:Universidade Federal do Espírito Santo (UFES)
instacron:UFES
instname_str Universidade Federal do Espírito Santo (UFES)
instacron_str UFES
institution UFES
reponame_str Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
collection Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
bitstream.url.fl_str_mv http://repositorio.ufes.br/bitstreams/1c3fbdf2-e88c-4b4c-8e3a-fab6fb1f8eab/download
http://repositorio.ufes.br/bitstreams/64a755f1-dc0d-4121-800d-6bebbe29f340/download
bitstream.checksum.fl_str_mv 8a4605be74aa9ea9d79846c1fba20a33
e723265e254aece19c4eb1837cde2949
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Repositório Institucional da Universidade Federal do Espírito Santo (riUfes) - Universidade Federal do Espírito Santo (UFES)
repository.mail.fl_str_mv riufes@ufes.br
_version_ 1856037474032156672