Desde a sua descoberta, no início da década de 80, o HIV/aids, constituiu-se como uma doença que ultrapassa os limites da dimensão biomédica, apresentando diversos desafios à sociedade. No Brasil, estima-se que aproximadamente 734 mil pessoas vivem com HIV/aids. Foram desenvolvidas diferentes classes de drogas antirretrovirais para seu tratamento; as quais são eficazes para o controle parcial da replicação viral. Sem a descoberta da cura, é imprescindível que as pessoas vivendo com HIV/aids sigam as recomendações da equipe de saúde, aderindo ao tratamento proposto; aumentando sua qualidade de vida, bem como contribuindo para a diminuição da transmissão do vírus. Durante o tratamento, algumas dificuldades podem surgir, determinando momentos de maior ou menor adesão ao mesmo e os profissionais de saúde, dentre eles, os farmacêuticos, devem estar atentos a estes momentos. Este estudo transversal teve como objetivo analisar a retirada do TARV nos últimos 24 meses e investigar os possíveis fatores que levam a retirada desta medicação de forma irregular na Unidade Especial de Tratamento de Doenças Infecciosas (UETDI) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo. Participaram 250 pessoas que vivem com HIV/aids que retiram a medicação na Farmácia do local do estudo. Os participantes foram separados em dois grupos: Grupo em Atraso e Grupo Controle segundo seus históricos de dispensação da TARV nos vinte e quatro meses anteriores a realização das entrevistas. Predominaram participantes do sexo masculino (57,6%), com mais de 40 anos (76%), brancos (51,6%), com baixa escolaridade (48,4%), sem parceiro fixo (52,4%), residentes em Ribeirão Preto (63,6%). Todas as variáveis foram relacionadas em um estudo univariado e aquelas com um valor de \"p\" igual ou menor que 0,2 foram selecionadas para análise multivariada. As associações entre variáveis selecionadas e a retirada irregular comparada com a retirada regular, foi estimada pela estimativa com intervalo de confiança de 95%. As variáveis que mostraram associação com a retirada da TARV em atraso foram: fazer uso de outro medicamento além da TARV, apresentar resultado de exame de carga viral como detectável, ter, no início do período analisado, contagem de linfócitos T CD4 menor que 200 células /mm3 e ter baixa adesão como resultado do Teste de Morisky- Green / Since its discovery in the early 80s, HIV / AIDS was established as a disease that pushes the boundaries of biomedical dimension, presenting many challenges to the society. In Brazil, there are almost 734,000 people carrying HIV / AIDS. Different classes of antiretroviral drugs were developed for their treatment, which are effective in partial control of viral replication. Yet incurable disease it is essential that people living with HIV / AIDS follow the recommendations of the health care agents, adhering to the proposed treatment, increasing their quality of life, and contributing to the reduction of transmission of the virus. During treatment, some difficulties may arise, determining moments of greater or lesser adherence, and pharmacists among other health professionals, should be aware of these moments. This cross-sectional study aimed to analyze the withdrawal of ART in the last 24 months, and investigate the possible factors that lead the medication withdrawal erratically on Special Treatment of Infectious Diseases Unit (UETDI) of the Clinics Hospital - School of Medicine of Ribeirao Preto, University of São Paulo. Two hundred and fifty people living with HIV / AIDS got medication in the study site pharmacy. Participants were divided into two groups: Group Control and Group Delay, according to their historical dispensing of ART in twenty-four months prior to the interviews; predominant male participants (57.6%) with more than 40 years (76%), white (51.6%), with low education (48.4%), with no steady partner (52.4%), residents in Ribeirão Preto (63.6%). All variables related in a univariate analysis, and those with a value of \"p\" equal to or smaller than 0.2 were selected for multivariate analysis. The associations between selected variables, and the irregular removal compared to regular withdrawal were estimated with 95% confidence interval. The variables that were associated with the withdrawal of ART arrears, and making use of another drug in addition to HAART, presented results of viral load test as detectable, having the beginning of period analyzed, CD4 lymphocyte count less than 200 cells / mm3, and have low compliance as a result of Morisky- Green test.

Analysis of care in patiens at risk for arterial hypertension in pharmacy I. Author: Stanislav Gregor1 Tutor: Josef Malý1 Consultant: Stanislav Havlíček2 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové 2 Czech Chamber of Pharmacists, Prague Introduction: Arterial hypertension represents a serious health problem. Despite of the fact that great attention is paid to an early diagnosis and therapy of arterial hypertension, it remains compensated insufficiently in a number of patients. Objectives: The aim of the thesis was to analyse the possibilities of pharmaceutical care provided to patients who are at risk of arterial hypertension. Methodology: Blood pressure was measured from the beginning of October till December 2012 in a public pharmacy in Moravská Třebová. The blood pressure was measured by a pharmacist by means of a validated and calibrated tonometer. Other data were collected from a directed interview with the pharmacy client. The data were evaluated in Microsoft Excel 2007 and processed by means of the frequency analysis. A retrospective analysis of drug problems was further performed in patients who have been using pharmacotherapy or food supplements. Results: The data were obtained from 196 pharmacy clients (31 % of men and...

Analysis of care in patients at risk for arterial hypertension in pharmacy II. Author: Kateřina Panáčková Tutor: PharmDr. Josef Malý, Ph.D.1 Consultant: PharmDr. Stanislav Havlíček2 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové 2 Pharmacy Luna, Plzeň Introduction: Arterial hypertension is one of the most common illnesses in the Czech Republic. Not only this should be the reason for proper health education and early detection of clients endangered by this illness. Objectives: The objective of the thesis was to perform and evaluate consultancy activities in a pharmacy focusing on clients with a risk of arterial hypertension or with already diagnosed arterial hypertension. Methodology: Collection of data took place in a public pharmacy in Česká Lípa between 1 May 2013 and 27 June 2014. Measuring of blood pressure was a part of controlled interview with clients of the pharmacy. Following data was recorded into a form: social-demographic characteristics of the respondend, his/her attitude towards measuring blood pressure in the pharmacy, incidence of risk factors of arterial hypertension, respectively atherosclerosis and other illnesses in the anamnesis, medication including nutrition supplements, results of own measurings and proposed...

Analysis of blood pressure measurement in Czech pharmacies I. Author: Jakub Prouza Tutor: Josef Malý1 1 Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Králové Introduction: Arterial hypertension is one of the most serious health problems of today and its therapy must be approached comprehensively. In addition to medical care, to the improvement of the health status of the patient significantly contribute properly implemented pharmaceutical care and blood pressure measurement in pharmacy. Objectives: The aim of the thesis was to describe and analyse conditions of blood pressure measurement in a sample of Czech pharmacies. Methods: Data were collected via questionnaire survey in 2012 and 2013 in three districts. The survey was conducted using two questionnaires, which were filled at pharmacies with possible help of trained interviewer. The first questionnaire was completed by the authorized employee representative of the pharmacy and included questions characterizing the pharmacy. Furthermore the question whether they provided blood pressure measurement in the pharmacy. If they did, further questions were on the frequency of measurement, instrumentation and space equipment in pharmacy. The second questionnaire was completed by the pharmacy...

Drug interactions of drugs used in thyroid diseases Author: Veronika Teťáková1 Tutor: PharmDr. Josef Malý, Ph.D.1 1 Department of Social and Clinical Pharmacy, Charles University, Faculty of Pharmacy in Hradec Králové Introduction and objectives: Drug interactions are considered to be a significant aspect of pharmacotherapy that can lead to the potentiation of toxicity and side effects of drugs. However, their identification and adequate management of the use of drug combinations hampers a number of obstacles. The aim of this thesis was to summary information about the drug interactions of drugs used in thyroid diseases (levothyroxine, propylthiouracil, thiamazole) and to formulate articles describing the management of interactions in a clinical practice including information for the dispensation of these drugs. To compare the information presented in each database and to determine the degree of conformity between these sources. Methodology: Based on the use of numerous information sources (Micromedex, UpToDate, SPC, Stockley's Drug Interactions) lists of drug interactions of drugs used in thyroid disaeses were established. Information about these interactions were completed by findings from other sources (PubMed®, scientific reports, Google Scholar). The information presented in each of these...

Title of diploma thesis: Analysis of individual counselling in pharmacy I Author: Tereza Brandejská Tutor: PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Jana Šolínová Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and objective: Individual consultations are a relatively new and developing service provided for patients in community pharmacies within the pharmaceutical care. The aim of this paper was to analyse professional individual consultations in community pharmacy in period of 2009-2019. Methodology: Professional individual consultations were provided in the form of a discreet dialogue between a pharmacist and patient in a consulting room of a basic pharmacy with two dispensing places. Pharmacy is located in a municipality of up to 5000 inhabitants, where no other pharmacy is available. The content of every consultation was recorded into a consultation form, while its extent corresponded with the focus of the given consultation. Patient's medical history was obtained during the consultation: demographic data, personal history data, lifestyle, use of medicines and food supplements including dosage information. The data was transferred into an electronic form with the use of web application containing a structured template....

This paper details collaboration in elective global health Advanced Pharmacy Practice Experiences (APPEs) between six schools of pharmacy, four in the United States (U.S.) and two in Uganda. This collaboration was initiated to build capacity within Uganda to advance pharmacy practice by strengthening pharmaceutical care education and research, and to provide benefits in the global and public health education and research for U.S. students and each partner University. Makerere University and Mbarara University of Science and Technology in Uganda sought out collaborations to improve pharmacy education in Uganda and alleviate shortages in faculty they have experienced in expanding pharmacy training. In response to this need, Wilkes University, Binghamton University, the University of Minnesota, and East Tennessee State University developed faculty-led APPEs to help model and teach the principles of clinical pharmaceutical care. These faculty-led APPEs occur in various Ugandan locations throughout the year and incorporate Ugandan and U.S. students as co-learners. Ugandan and U.S. faculty act as co-facilitators of didactic, experiential, and research learning experiences. APPE activities include modeling the provision of pharmaceutical care, interprofessional patient care on inpatient wards, joint didactic lectures and case presentations, skills laboratory sessions, and research components. Developed to serve the needs of both the U.S. and Ugandan partners, the elective global health APPEs to Uganda have grown to be sustainable, mutually beneficial collaborations between the six schools of pharmacy and the Ugandan partners. Formal and informal communications between all of the entities involved have helped support continuity of these programs. We recommend such initiatives to other countries and institutions desiring to improve training for pharmaceutical care to advance pharmacy practice.

The impact of the pharmacist in elderly patient healthcare management is developing. In our study, the interventions made by community pharmacists in the RESPECT study (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) were analysed and evaluated. In our study, the study sample was chosen according to specific criteria. The outcomes of these pharmacist interventions were measured by a clinical panel which scored and categorised each intervention into one of five categories. The study also investigated the percentage of interventions implemented or not implemented by GPs. In our study, initially 398 patients and of these 52 were excluded because their files did not contain the entry criteria information, leaving 346 patients who were identified with a mean (SD) of 8.9 (3.3) pharmaceutical care plans which contained mean (SD) 8.2(7.2) pharmaceutical care issues. Of these 43% were males and 57% were females with a mean (SD) age of 81(3.7) years. There were many missing data about drugs prescribed due to poor documentation by community pharmacists in the RESPECT study particularly at post study period (T5). The mean (SD) for all drugs prescribed was 35.9 (12.38) for each patient and for the whole study period including the post period (T5). In our study a total of 2879 individual pharmaceutical care issues were identified. A clinical panel judged that 43% of the interventions prevented harm, 31% improved the efficacy of management, 3% were detrimental to the patient¿s management plan, 12% only provided information and there was insufficient information to make a decision on the remaining 11%. For the classifications prevented harm to the patient and improve efficacy of management, the panel gave a score of 7 or more to 264 and 103 respectively which were classed as potential prevented hospital admissions. The outcome of 1628 could not be determined from the data and the pharmacist did not intervene on 361 occasions. Of the remaining 890 (30.9%) GPs accepted 715 and did not accept 175. The cost effectiveness of providing pharmaceutical care to older people by community pharmacists could be estimated (£620,000) by calculating reduction in expenditure of hospital admissions. In addition, there would be the possibility of reduced pressure on other NHS resources such as availability of hospital beds. The involvement of a clinical pharmacist in elderly patient health care, within the setting of a community pharmacy, provided positive healthcare outcomes and therefore should be encouraged in line with the new white paper for England "Building on strengths-delivering the future" (2008). The study emphasises the importance of revising the nature and period of postgraduate training for community pharmacists who are going to provide pharmaceutical care for elderly patients. This raises the possibility of specialised competency based postgraduate training for community pharmacists with a special interest in the care of older people (PhwSI). This would enable community pharmacists practising as generalists to become advanced practitioners in the specialist clinical area of older people and ensure a consistent level of service for elderly patients in line with government expectations.

Thesis (M.Pharm. (Pharmacy Practice)) -- University of Limpopo, 2022 / Developing countries face huge challenges in provision of pharmaceutical care whereas some developed countries have developed and implemented measure to improve pharmaceutical care through collaborative practices. Collaborative patient care is referred to as the cooperative work or practice by healthcare professionals assuming complementary roles and sharing responsibilities for decision making and problem solving to formulate and furnish quality patient care. Pharmaceutical care is governed by the principles and philosophy of patient centred pharmacy practice, where the main responsibilities, roles or action of a pharmacist are based on patient care. Collaborative pharmaceutical care practice for outpatient requires collaborative action of a pharmacist with other healthcare practitioners. Pharmacist-medical practitioner collaborative care practice is one of the recently emerging aspects in developing countries’ hospitals such as in South Africa which can enhance patient care. Method A qualitative study using semi-structured interviews was conducted with a purposeful sample of 8 pharmacists and 9 medical practitioners at Mankweng Hospital in Limpopo province, South Africa. In the study we used audiotaped interviews that were transcribed exactly as said and analysed using thematic content analysis. Results Three main themes emerged from the study’s interview analysis, description of the current relationship and collaborative practices; the perspective of the pharmacists and medical practitioners on collaboration; the barriers affecting pharmacist-medical practitioner collaboration; and recommendations on the ways, strategy and model to improve pharmacists-medical practitioner collaboration. This highlighted that the relationship among pharmacists and medical practitioners is moderate and there a need for improvement in the relationship. The recommendations range from established xv educational and interactional platforms, improved resource supply, clarity in terms of roles and responsibilities and enhanced managerial structures and functions. Conclusion The current relationship among pharmacists and medical practitioners is moderate. There is still a need for improvement in the relationship to achieve quality collaborative practice for pharmaceutical care in outpatient.

Introducción: La atención farmacéutica mejora la adherencia del paciente al tratamiento, por lo que es necesario que el farmacéutico cuente con instrumentos para evaluarla y mejorarla mediante su intervención en el seguimiento farmacoterapéutico (SFT). Objetivos: Evaluar el impacto de la intervención farmacéutica en la mejora de la adherencia de los pacientes con virus de la inmunodefi ciencia humana (VIH) y sida, e identifi car los factores que infl uyen en ella y que pueden ser modifi cados por la intervención farmacéutica en el SFT. Métodos: Se realizó SFT durante 23 meses a 52 pacientes mayores de 18 años de edad, con tratamiento antirretroviral durante más de 3 meses, que dieron su consentimiento informado. La adherencia se evaluó con el CEAT-VIH (cuestionario para evaluar la adhesión al tratamiento antirretroviral) al inicio y al fi nal de 6 meses de SFT. Resultados: La puntuación total del CEAT-VIH (p <0,05; intervalo de confi anza del 95%), el cumplimiento del tratamiento (p <0,001) y la percepción del paciente respecto a su enfermedad y tratamiento antirretroviral (p <0,001) incrementaron signifi cativamente su valor. La educación al paciente para incrementar la adherencia al tratamiento (46%) fue la intervención farmacéutica más frecuente. Conclusiones: Se demuestra que la intervención del farmacéutico, mediante el SFT, mejora la adherencia al tratamiento antirretroviral. El farmacéutico mejoró los aspectos de cumplimiento y percepción del paciente sobre su tratamiento y enfermedad. Los farmacéuticos pueden utilizar el CEAT-VIH como instrumento para evaluar la adherencia en la práctica del SFT. / Introduction: Pharmaceutical care improves medication adherence that is why is important that the pharmacist uses instruments to evaluate and improves it through pharmaceutical intervention at pharmaceutical care. Objective: To evaluate the impact of the pharmaceutical intervention in the improvement of the medication adherence of the patients with HIV and AIDS, and to identify the factors that infl uence on medication adherence and which one could be modifi ed by the pharmaceutical intervention during pharmaceutical care. Methods: Pharmacotherapeutic follow-up was realized for 23 months to 52 patients, older than 18 years, with antiretroviral treatment for up to three months, consent informed was obtained from patients. Medication adherence was evaluated with CEAT-HIV (questionnaire to evaluate the adhesion to the antiretroviral treatment) at the beginning and at the end of the study (6 months). Results: The fi nal score from CEAT-HIV (p <0.05; 95% IC), treatment compliance (p <0.001) and patient’s beliefs to the disease and antiretroviral treatment (p <0.001) improved signifi cantly with the pharmaceutical intervention. The more frequent pharmaceutical intervention was education to the patient to increment the adherence to the treatment (46%). Conclusion: These results demonstrate that the pharmacists’ intervention through pharmacotherapeutic follow-up improves the adherence to the antiretroviral treatment. The pharmacist was able to improve aspects of compliance and patient’s beliefs about the treatment and disease. The pharmacist could utilize CEAT-VIH as an instrument to evaluate the adherence in HIV/AIDS patients.