Redução do risco cardiovascular em pacientes com critérios para síndrome metabólica: Modelo de cuidados farmacêuticos com parceria pública e privada, Vitória-ES

• Ano de defesa: 2013
• Autor(a) principal: Dias, Renaa Aubin
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Doutorado em Ciências Fisiológicas; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Ciências Fisiológicas
• Palavras-chave em Português: Metabolic Syndrome; Pharmaceutical Care; Pharmacotherapy Follow-up; Risk of Coronary Events; Síndrome Metabólica; Atenção Farmacêutica; Seguimento Farmacoterapêutico; Risco Cardiovascular.; Fisiologia; 612
• Link de acesso: http://repositorio.ufes.br/handle/10/8059

Introduction: Metabolic syndrome (MS) characterized by central obesity, dyslipidemia, hyperglycemia and hypertension is considered a worldwide epidemic which is associated with increased risk of cornonary events (RCE). The Pharmaceutical Care (PC) in the MS could improve adherence to treatment of this clinical condition, seeking positive clinical outcomes and cardiovascular risk reduction. Objective: To evaluate the impact of PC and cardiovascular risk through a program implemented in private community pharmacy in partnership with staff of the Health Unit (HU) with Pharmacotherapeutic follow-up (PF) of patients at least 2 MS components changed. The patients did regular monitoring at the HU of San Antonio, Vitoria-ES for more than five years. Methods: 56 patients were selected for the study. After selection the 1st interview was conducted and PF consists of 10 individual meetings with the pharmacist at the pharmacy and 4 collective meetings (CM) in HU. Along the SFAR were performed biochemical, anthropometric and blood pressure (BP) measurements with evaluation of the results by NCEP-ATP III and IDF. After each CM the RCE was calculated. The negative outcomes associated with medication (NOM) were identified and resolved according to pharmaceutical interventions. The Satisfaction Questionnaire with the Pharmacy Services was applied in all patients to the end of the study. At the beginning and end of the study was applied questionnaire of quality of life WHOQOL-BREF. Results: The Mean age was 61.7 ± 11.5 years and the adherence to the program of PC was 89.3%. It was increased control of the comorbidities (p <0.05) blood pressure, HDL, triglycerides and glucose, 84% of patients had control one or more risk factors, reducing the number of components changed when compared to the beginning of the study, according to NCEPATPIII. There were differences (p <0.05) in parameters systolic pressure, diastolic pressure, triglycerides, total cholesterol, HDL-C, LDL-C and glucose, which reached values recommended by the NCEP-ATPIII and SBH. 80.2% of the NOM identified were resolved. There was a better classification of patients to RCE, with risk reduction in 56% (n = 28) of patients and was not observed worsening or increased risk (McNemar, p-value = 0.001), demonstrating that the improvement and control of blood pressure and lipid profile had a significant impact on RCE reduction. The average level of satisfaction by patients relating to pharmaceutical care service performed in our study was 4.55 ± 0.06. Regarding the quality of life questionnaire WHOQOL-BREF, there was increase the mean of domain psychological, personal relations and the environment. The number of patients satisfied with the health increased, i.e., there was a positive perception of the increase quality of life for patients in these domains. Conclusion: Pharmaceutical Care in community pharmacy in partnership with the private public health service determines positive clinical results, with better control of cardiovascular co-morbidities that make up the SM, resulting in reduced risk of coronary events in ten years.