CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / The high prevalence of poorly controlled asthma and the associated high morbimortality have been shown to be related mainly to under-diagnosis and inadequate treatment of this condition. This present significant cost adding further burden on the healthcare budget The consequences of poorly controlled asthma are repeated clinic visits repeated emergency room admissions and repeated hospital admissions In extreme but numerous occasions asthma attacks resulting from poor management lead to deaths Therefore it had been stated that a key component of many asthma management guidelines is the recommendation for patient education and regular medical review These (patient education and regular medication/medical reviews) are primary areas for the pharmacist to make an impact Objective To describe and to analyze the influence of a Pharmaceutical Care (PC) service in the clinical and humanistic outcomes through the pharmacotherapeutic follow-up (PF) of a group of asthmatic patients attending an ambulatory care facility by hospital referral in the State of the Cearà Methods Thirty patients participated of this longitudinal prospective and descriptive study in the period from August 2006 to May 2007 Instruments used to collect information from patients were an asthma-specific quality of life questionnaire (The Brazilian version of the Asthma Quality of Life Questionnaire AQLQ) daily records of symptoms of the asthma and a questionnaire to assess satisfaction with Pharmaceutical Care services The PF and the classification of drug related problems (DPR) followed Cipolle et al criteria (2004) and adopted a systematic PWDT (Pharmacistâs Work up of Drug Therapy) approach in identifying and resolving DPR Results The majority of patients were females (80%) 10% completed primary school level only mean age was 46  x 11 9 30% were on married social pension and with income of two minimum salaries Patients used an average of two inhaled medications (corticosteroids and bronchodilator) /day and more than 50% of patients did not use their inhaler medication devices correctly Sixty four DPR were identified, of which 31 25% were related to poor compliance with drug therapy After the provision of Pharmaceutical Care and through following a PWDT strategy 66 6% of the patients did not report nocturnal symptoms of asthma and did not have to use short-acting bronchodilator for asthma symptoms By the conclusion of the study a significant improvement (p< 0 05) was observed in the four domains of the AQLQ In the questionnaire assessing satisfaction with the Pharmaceutical Care services a superior index of 95% was observed in all its domains Conclusion The improvement seen in all aspect of the outcomes measured including clinical and humanistic outcomes after the provision of PC has provided evidence for the role of the pharmacist in asthma management using a structured approach to educate the patient about the pharmacotherapy regimen address compliance issues and making drug therapy interventions that lead to rationalizing therapy and minimizing DPR

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà / The podologic complications liked to Diabetes mellitus (DM) constitute a serious problem faced by the health system. Its treatment has a high social and economic cost. The pharmacist can contribute to the improvement of the quality of the proposed pharmacotherapy through the use of methodologies for the implementation and divulgation of Pharmnaceutical Care in hospital settings as well. The present study aims to carry out the Drug Therapy Follow-up, of inpatients with diabetc foot, at Dr. Waldemar de AlcÃntara General Hospital, through DÃder Pharmaceutical Care Methodology, by observing descriptive aspects of the adjustment and feasibility. Thus, a Drug Therapy Follow-up of 53 patients was carried out from November 2003 to March 2004, according to the steps suggested in the methodology (service offer, first interview, diagnostic, study phase, evaluation phase, intervention outcomes phase, new diagnostic, with appropriate adjustments to local needs. Drug-Related Problems (DRP) were classified according to the second Consensus of Granada(2002). Data set up analysis were executed using computer programs, mainly Access and SPSS. The methodological adjustments involved the structure of the Drug Therapy Follow-up record card, of the HENPA Method of codification of the non-conformities of the pharmacotherapy cicle, of the scales for the measurement of the disease perception of the caregiver and the patient, and also of the domiciliary pharmacotherapy used and the necessary forms for communications and outcomes record, and the instruments used for the follow-up. Most patients were from Fortaleza, with average age of 66 yaers, and low schooling. Hospitalization average time was 19 days. When amputation was necessary for more than half of the diabetes follwed-up. The evaluation of the degree of perception of caregiver the patients with relation to DM and its correlations showed they have little knowledge of the various aspects. A statiscally significant relation was observed (p<0,05) between the level of knowledge of the DM complications and treatment. 57,2 DRP/patien (atotal of 3030 DRP), of whom 75% were potencial. The most displayed DRP class was regular insulin. The most suggested pharmaceutical interventions were related to drug administration and prescrition, respectively, base don internal written communication. The adoption of Pharmaceutical Care, through the application of DÃder methodology contextualized an important strategy for the rational use of drugs and the revival of pharmacistâs social role. / As complicaÃÃes podolÃgicas (pà diabÃtico) associadas ao Diabetes mellitus (DM) constituem grave problema enfrentado pelo sistema de saÃde. Seu tratamento tem elevado custo social e econÃmico. O farmacÃutico pode contribuir na melhoria da qualidade da farmacoterapia proposta com utilizaÃÃo de metodologias para implantaÃÃo e difusÃo da AtenÃÃo FarmacÃutica tambÃm no ambiente hospitalar. O presente estudo objetivou realizar o Seguimento FarmacoterapÃutico(SFT) dos pacientes internados com pà diabÃtico, no Hospital Geral Dr. Waldemar AlcÃntara, atravÃs da Metodologia DÃder de AtenÃÃo FarmacÃutica, observando aspectos descritivos, de adequaÃÃo e operacionalizaÃÃo. Para tanto, foi feito o SFT de 53 pacientes no perÃodo de novembro de 2003 a marÃo de 2004, seguindo as etapas preconizadas na metodologia (oferta do serviÃo, primeira entrevista, estado da situaÃÃo, fase de estudo, fase de avaliaÃÃo, fase de intervenÃÃo, resultados da fase de intervenÃÃo e novo estado da situaÃÃo) com adequaÃÃes apropriadas para as necessidades locais. Os Problemas Relacionados aos Medicamentos (PRM) foram classificados de acordo com o 2 Consenso de Granada (2002). A organizaÃÃo e anÃlise dos dados foram feitas utilizando alguns pacotes computacionais, destacando utilizando alguns pacotes computacionais, destacando o Accessà e SPSSÂ, respectivamente. As adaptaÃÃes metodolÃgicas envolveram a estruturaÃÃo da Ficha de Seguimento FarmacÃutico, do MÃtodo HENPA de codificaÃÃo das nÃo conformidades do ciclo famacoterapÃutico,de escalas para mensuraÃÃo da percepÃÃo do cuidador e paciente sobre a doenÃa e para esse Ãltimo, tambÃm sobre a farmacoterapia utilizada domiciliarmente e formulÃrios necessÃrios para comunicaÃÃo e registros dos achados, bem como foram adequados instrumentos para o acompanhamento. O delineamento do perfil dos pacientes demonstrou que os mesmos tinham idade mÃdia em torno de 66 anos, com baixo grau de escolaridade, sendo a maioria proveniente de Fortaleza. O tempo mÃdio de internaÃÃo foi cerca de 19 dias, em que a amputaÃÃo foi necessÃria para mais da metade dos diabÃticos acompanhados. A avaliaÃÃo do grau de percepÃÃo dos cuidadores e pacientes quanto ao DM e suas interfaces evidenciou ser incipiente o conhecimento dos mesmos sobre esses aspectos. Observou-se uma relaÃÃo significante estatisticamente (p<0,05) entre o grau de conhecimento sobre as complicaÃÃes da DM e seu tratamento. Encontrou-se 57,2 PRM/paciente (total de 3030 PRM), dos quais 75% foram potenciais. A classe de PRM mais evidenciada foi a de necessidade (59,4%), destacando o PRM1(1756 observaÃÃes). O medicamento mais envolvido foi a insulina regular. As intervenÃÃes farmacÃuticas mais sugeridas foram as relativas aos erros de administraÃÃo e de prescriÃÃo, respectivamente, utilizando em maior proporÃÃo a comunidade interna escrita. A adoÃÃo da AtenÃÃo FarmacÃutica, atravÃs da aplicaÃÃo da Metodologia DÃder contextualizada a cada cenÃrio hospitalar especÃfico, constitui uma estratÃgia importante para o uso racional de medicamentos e a retomada do papel social do farmacÃutico.