This diploma thesis deals with current pharmacotherapeutic care with a focus on activities that nurses take part in. The aim was to collect and evaluate the views and experiences of selected nurses regarding their role in pharmacotherapy team, particularly what activities they perform in such team and how their pharmacotherapy teams work in general. SWOT analysis was then used firstly to evaluate the current role of nurses and secondly to suggest a way of implementation of possible extension of nurses' competencies in pharmacotherapy. In order to collect the required data, semi-structured interviews were conducted. These were recorded, so they could be easily processed afterwards. During transcription of the interviews into written text, all the collected data was briefly analysed. The data was further analysed using the open coding method, when three main categories with specific subcategories and subcodes were identified. All the selected men and women, which were asked for cooperation, are people working as a nurse without supervision and mentoring. Based on their career history all of them were expected to have a more specific experience with the issue. The respondents were mainly nurses with long-term working experience, often working in middle or senior management. When selecting the future...

Background: Type II diabetes is a common disease worldwide and several drug treatments are available. Some of the more recently approved drugs are DPP4-inhibitors, GLP analogues and SGLT2-inhibitors. Most of the Type II diabetes drugs (T2DMD) are prescribed by primary care physicians. To ensure rational drug use it is important to follow up prescribing patterns to design strategies and interventions that can improve drug treatment, since consequences of inappropriate drug use might be poor health outcomes and increased health costs. Aim: To study differences in the prescribing pattern of T2DMD among primary healthcare centres (PHC) at a macro level in Region Uppsala. Method: A cross-sectional study based on data collected from Region Uppsala’s data register. Data consisted of individuals over 25 years of age with at least one prescription of a diabetes drug from the Anatomic Therapeutic Chemical (ATC) group A10 prescribed within the period of January 2018 to June 2020. Results: There is a moderate difference in the prescribing patterns of T2DMD among different PHCs in Region Uppsala. Overall, a larger proportion of oral antidiabetic drugs (OAD) were prescribed compared to Insulins. Most PHC prescribed a larger proportion of long acting insulins than other Insulins. Among OAD, a larger proportion of Biguanide derivative where prescribed. DPP-4 inhibitors, Sulphonylureas and SGLT2-inhibitors were prescribed to almost the same extent. Conclusion: Overall, there is a minor difference in the prescribing patterns of T2DMD among different PHCs in Region Uppsala during the study period. Lately, prescribing of DPP4-inhibitors, SGLT2-inhibitors and long acting insulins have increased. / I detta fördjupningsprojekt studerades förskrivningsmönstren av typ II diabetesläkemedel i Region Uppsala. Studieresultaten vissa skillnader i hur olika vårdcentraler i Region Uppsala förskriver typ II diabetesläkemedel. Från början var hypotesen att icke-insuliner förskrivs i större utsträckning än insuliner. Vilket visade sig stämma överens med resultaten. I studien jämförs också skillnaden mellan förskrivning av icke-insuliner som funnits längre på marknaden och de nyligen godkända (DPP4-hämmare och SGLT2-inhibitorer). Resultaten visar en tydlig ökning i förskrivning av de nya läkemedlen under studieperioden. En anledning till detta kan vara läkemedels positiva farmakologiska effekter. I studien jämförs också skillnaden i förskrivningen av de olika insuliner i Region Uppsala. Resultaten visar att långverkande insuliner förskrivs i större utsträckning i jämförelse med andra insuliner, vilket är inte enligt rekommendationslistan för förskrivning av typ II diabetesläkemedel Studieresultaten kan användas för att fortsätta följa upp och förbättra kvalitén på diabetesvården i Region Uppsala. Ytterligare studier skulle till exempel kunna utgå ifrån hela populationen med en typ 2 diabetesdiagnos för att studera utfall även för andra interventioner än läkemedel. Dessutom behövs fortfarande kunskap om det är kostnadseffektiv att fler nya typ 2 diabetesläkemedel används. Studien ger kunskap om förskrivningen av typ II diabetesläkemedel i Region Uppsala. Studien kan användas som grund för dialog om förskrivningen av typ II diabetesläkemedel i regionen, så att denna optimeras och fler individer får adekvat behandling. Detta arbete är viktigt eftersom typ II diabetes är en mycket vanlig sjukdom där prevalensen ökar.  Denna studie är en tvärsnittsstudie baserat på sekundärdata från Region Uppsalas elektroniska medicinalt register och primärdata från två enkäter skickade till sjuksköterskor och läkare som jobbar på vårdcentraler med patienter med diabetes. Studien inkluderar data från de 26 offentliga vårdcentraler som hör till förvaltningen Nära, Vård och Hälsa i region Uppsala. Förskrivningsdata baseras på recept för ett diabetesläkemedel från Anatomic Therapeutic Chemical (ATC) gruppen A10, förskrivet mellan januari 2018-juni 2020.

Introduktion: Depression är en sjukdom som drabbar stor del av världens befolkning vilket skapar ett stort lidande för den enskilde och samhället. Standardbehandlingen är antidepressiva läkemedel i kombination med psykologisk behandling. Social aktivitet på recept har setts som ett komplement till standardbehandlingen för att lindra symtom och adressera grundorsaken till psykisk ohälsa. Syfte: Syftet med studien var att ge en översikt över den senaste forskningen gällande social aktivitet på recept för vuxna med depression. Metod: En strukturerad litteraturstudie har genomförts som grundar sig på 22 både kvalitativa och kvantitativa originalartiklar. Sökningen genomfördes i databaserna PubMed, Web of Science, Europe PMC och PsycINFO. Tematisk analys enligt Braun & Clark (2006) användes för att identifiera och analysera återkommande teman och mönster imaterialet. Resultat: Den tematiska analysen skapade sex teman. Flertalet studier visade att social aktivitet på recept främjade livskvalitet, minskade depression och ökade självkänslan. Samtidigt visade några studier på liten eller ingen effekt i socioekonomiskt utsatta områden. Hälso- och sjukvårdens resurser minskade liksom användandet av antidepressiva läkemedel förutom bland vuxna över 65 år. Upplevelsen var att social aktivitet på recept skapade en känsla av meningsfullhet, ökad social gemenskap och ökad kontroll över sitt psykiska välbefinnande. Slutsats: Social aktivitet på recept kan vara en lämplig behandlingsmetod och hälsofrämjande insats för vuxna med depression. Effekten av social aktivitet på recept kan skilja sig mellan olika åldersgrupper och socioekonomiska förutsättningar, vilket är viktigt att betänka under implementeringsfasen. En förutsättning för remiss till social aktivitet på recept är att individen söker hjälp för sina besvär. / Introduction: Depression affects a large part of the world's population, which creates great suffering for the individual and the society. The standard treatment is antidepressants combined with psychological treatment. Social prescribing has been seen as a complement to the standard treatment for symptom relief and to address the root cause of mental illness. Aim: The aim of the study was to provide an overview of the latest research regarding social prescribing for adults with depression. Methods: A structured literature review was carried out based on 22 qualitative and quantitative original articles. The articles have been found in the databases PubMed, Web of Science, Europe PMC and PsycINFO. Thematic analysis according to Braun & Clark (2006) was used to identify and analyze recurrent themes and patterns in the material. Results: The thematic analysis resulted in six themes. Several studies showed that social prescribing improved quality of life, reduced depression, and increased self-esteem. Meanwhile, some studies showed small to no effect in socio-economically vulnerable areas. Health care resources and the use of antidepressants decreased, except among adults over 65. The experience was that social prescribing created a sense of meaning, increased social belonging and increased control over one's psychological well-being. Conclusion: Social prescribing may be an appropriate treatment method and health promotion intervention for adults with depression. The effect of social prescribing can differ between age groups and socioeconomic standard, which is important to consider during the implementation phase. A qualification for referral to social prescribing is that the individual seeks help for their problems.

No / The United Kingdom is considered to be the world leader in nurse prescribing, no other country having the same extended non-medical prescribing rights. Arguably, this growth has outpaced research to evaluate the benefits, particularly in areas of clinical practice where patients have complex co-morbid conditions such as palliative care. This is the first study of non-medical prescribing in palliative care in almost a decade. AIM: To explore the current position of nurse prescribing in palliative care and establish the impact on practice of the 2012 legislative changes. DESIGN: An online survey circulated during May and June 2013. PARTICIPANTS: Nurse members (n = 37) of a regional cancer network palliative care group (61% response rate). RESULTS: While this survey found non-medical prescribers have embraced the 2012 legislative changes and prescribe a wide range of drugs for cancer pain, we also identified scope to improve the transition from qualified to active non-medical prescriber by reducing the time interval between the two. CONCLUSION: To maximise the economic and clinical benefit of non-medical prescribing, the delay between qualifying as a prescriber and becoming an active prescriber needs to be reduced. Nurses who may be considering training to be a non-medical prescriber may be encouraged by the provision of adequate study leave and support to cover clinical work. Further research should explore the patients' perspective of non-medical prescribing.

The exponential growth in medical pharmaceuticals and related clinical trials have created a need to better understand the decision-making factors in the processes for developing hospital medication formularies. The purpose of the study was to identify, rank, and compare major factors impacting hospital formulary decision-making among three prescriber groups serving on a hospital's pharmacy and therapeutics (P&T) committee. Prescribers were selected from the University of Texas, MD Anderson Cancer Center which is a large, multi-facility, academic oncology hospital. Specifically, the prescriber groups studied were comprised of physicians, midlevel providers, and pharmacists. A self-administered online survey was disseminated to participants. Seven major hospital formulary decision-making factors were identified in the scientific literature. Study participants were asked to respond to questions about each of the hospital formulary decision-making factors and to rank the various formulary decision-making factors from the factor deemed most important to the factor deemed least important. There are five major conclusions drawn from the study including three similarities and two significant differences among the prescriber groups and factors. Similarities include: (1) the factor "pharmacy staff's evaluation of medical evidence including formulary recommendations" was ranked highest for all three prescriber groups; (2) "evaluation of medications by expert physicians" was ranked second for physicians and midlevel providers while pharmacists ranked it third; and (3) the factor, "financial impact of the treatment to the patient" was fifth in terms of hospital formulary decision-making statement and ranking by all three prescriber groups. Two significant differences include: (1) for the hospital-formulary decision making statement, "I consider the number of patients affected by adding, removing, or modifying a drug on the formulary when making hospital medication formulary decisions," midlevel providers considered this factor of significantly greater importance than did physicians; and (2) for the ranked hospital formulary decision-making factor, "financial impact of treatment to the institution," pharmacists ranked this factor significantly higher than did physicians. This study contributes to a greater understanding of the three prescriber groups serving on a P&T committee. Also, the study contributes to the body of literature regarding decision-making processes in medicine and specifically factors impacting hospital formulary decision-making. Furthermore, this study has the potential to impact the operational guidelines for the P&T committee at the University of Texas, MD Anderson Cancer Center as well as other hospitals.

Chapter 1 reviews better-known factorization theorems of a square matrix. For example, a square matrix over a field can be expressed as a product of two symmetric matrices; thus square matrices over real numbers can be factorized into two diagonalizable matrices. Factorizing matrices over complex num hers into Hermitian matrices is discussed. The chapter concludes with theorems that enable one to prescribe the eigenvalues of the factors of a square matrix, with some degree of freedom. Chapter 2 proves that a square matrix over arbitrary fields (with one exception) can be expressed as a product of two diagona lizab le matrices. The next two chapters consider decomposition of singular matrices into Idempotent matrices, and of nonsingutar matrices into Involutions. Chapter 5 studies factorization of a comp 1 ex matrix into Positive-( semi )definite matrices, emphasizing the least number of such factors required / Mathematical Sciences / M.Sc. (MATHEMATICS)

Chapter 1 reviews better-known factorization theorems of a square matrix. For example, a square matrix over a field can be expressed as a product of two symmetric matrices; thus square matrices over real numbers can be factorized into two diagonalizable matrices. Factorizing matrices over complex numbers into Hermitian matrices is discussed. The chapter concludes with theorems that enable one to prescribe the eigenvalues of the factors of a square matrix, with some degree of freedom. Chapter 2 proves that a square matrix over arbitrary fields (with one exception) can be expressed as a product of two diagonalizable matrices. The next two chapters consider decomposition of singular matrices into Idempotent matrices, and of nonsingular matrices into Involutions. Chapter 5 studies factorization of a complex matrix into Positive-(semi)definite matrices, emphasizing the least number of such factors required. / Mathematical Sciences / M. Sc. (Mathematics)

Introdução. Desde a promulgação da Constituição Federal de 1988 no Brasil, que consolida a saúde como um direito social, a ser garantido de forma integral e universal pelo Estado brasileiro, os cidadãos passaram a reivindicar este direito em juízo, acionando legitimamente o Estado para a garantia de suas pretensões sanitárias. E, neste sentido, o número de ações que demandam medicamentos vem crescendo de forma exponencial no Brasil, impactando diretamente a política pública de saúde, e suscitando debates sobre a segurança sanitária dos medicamentos dispensados em juízo. Objetivo. Evidenciar de que forma as questões técnicas e políticas que envolvem o direito social à assistência farmacêutica vem sendo debatidas dentro de processos judiciais que tem por objeto a solicitação de medicamentos em face do Estado. Isto para que se possa relacionar estes resultados aos atuais debates sobre o papel do Poder Judiciário em face da garantia do direito à saúde, e seu impacto perante a política pública de saúde. E, também, aos atuais debates político-sanitários sobre a prescrição médica, e sua importância para o exercício do direito em foco. Método. A metodologia de pesquisa revestiu-se em duas etapas distintas. A primeira etapa consistiu na análise de processos judiciais que versavam sobre a demanda de medicamentos em face do Estado, provenientes de quatro Tribunais Estaduais do país, em primeira instância: São Paulo, Minas Gerais, Rio Grande do Sul e Rio de Janeiro. Os processos foram analisados através do uso da Metodologia Qualiquantitativa do Discurso Coletivo. A segunda etapa consistiu na pesquisa de artigos científicos, nas principais bases de dados de periódicos científicos de saúde pública, que tivessem relação com a pergunta de pesquisa: Como hoje estrutura-se a discussão político-sanitária em torno da prescrição médica? Resultados. Pela análise dos processos judiciais, evidencia-se que as demandas que envolvem pedidos de medicamento em juízo vêm sendo deferidas pelos juízes, prioritariamente, com base nas prescrições médicas individuais e com base na leitura pura do ordenamento jurídico, sem considerar as dimensões técnicas e políticas que envolvem o direito à assistência farmacêutica. A análise dos artigos científicos nos demonstra a vasta discussão técnica acerca da prescrição médica e suas implicações sanitárias, e aponta a necessidade de contraditar esses documentos e investir em educação e informação médicas, em prol da segurança sanitária dos pacientes-cidadãos. Conclusão. O direito à saúde é um direito complexo, que requer, para a sua adequada proteção e garantia, que ultrapassemos o paradigma positivista, com sua leitura exclusivamente normativa e dogmática, em prol de um novo paradigma que permita maior penetração de questões e saberes técnicos e políticos no âmbito do direito. Tanto judicial quanto extrajudicialmente precisam ser criados caminhos de proteção à saúde, que abriguem todos os profissionais jurídicos, políticos e técnicos envolvidos na temática, rumo à construção interdisciplinar do direito à saúde e da cidadania sanitária no Brasil / Introduction. Since the enactment of the 1988 Federal Constitution in Brazil, that consolidates health as a social right, the citizens began to demand this right in court, lawfully driving the state to guarantee their health claims. And, in this sense, the number of actions that require medicines is growing exponentially in Brazil, which impact directly the public health policy, and stimulate discussions about the safety of drugs dispensed by the courts. Objective. Show how the technical and political issues, involving the social right to pharmaceutical assistance has been debated in legal proceedings whose objective is the solicitation of drugs against the State. This to be able to relate these findings to the current debates about the role of the judiciary, in view of the guaranteed of right to health and its impact on the public health policy. And, also, to the current political debates about health prescription, and its importance for the right in focus. Method. The research methodology is coated in two stages. The first step was the analysis of court cases that focused the drug demand against the State, from Four State Courts in Brazil: Sao Paulo, Minas Gerais, Rio Grande do Sul and Rio de Janeiro. The processes were analyzed through the use of qualitativequantitative methodology of collective discourse. The second step consisted in the search of scientific articles in major databases of scientific journals of public health, that were related to the following research question: How today\'s discussion is structured around the political health context of the medical prescription? Results. The analysis of court proceedings, results clear that the demands that involve medication in court have been deferred by the judges, primarily, based on the individual medical prescriptions, and based on the pure reading of the legal system, without considering the technical and political dimensions that involve the right to pharmaceutical assistance. The analysis of scientific articles shows us the extensive technical discussion about the prescription and its health implications, and highlights the need to contradict these documents, and invest in education and medical information, towards the safety of patients-citizens. Conclusion. The right to health is a complex right, which requires for its adequate protection and security, that we move beyond the positivist paradigm, with its exclusively normative reading and dogmatic rules, towards a new paradigm which allows greater penetration of issues and political and technical knowledge within the law. Both judicial and extrajudicial ways need to be created to protect health, involving all legal, politicians and technicians professionals involved in the matter, toward interdisciplinary construction of the right to health and health citizenship in Brazil

Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2018-08-08T13:48:43Z No. of bitstreams: 1 Fabiane Raquel Motter_.pdf: 88399023 bytes, checksum: 3b609e9bf1fb7252cd2973a8db6869be (MD5) / Made available in DSpace on 2018-08-08T13:48:43Z (GMT). No. of bitstreams: 1 Fabiane Raquel Motter_.pdf: 88399023 bytes, checksum: 3b609e9bf1fb7252cd2973a8db6869be (MD5) Previous issue date: 2018-03-20 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / UNISINOS - Universidade do Vale do Rio dos Sinos / O uso de Medicamentos Potencialmente Inapropriados (MPIs) em idosos pode comprometer a efetividade ou a segurança da farmacoterapia e têm se destacado como importante desafio para saúde pública, visto que está associado a elevados índices de morbidade e mortalidade. Pesquisas nacionais que investigaram esse tema revelam que as prevalências de uso de MPIs variam de 28,0% a 82,6%; contudo, esses estudos utilizaram listas de MPIs validadas na América do Norte e Europa, uma vez que o primeiro consenso brasileiro sobre MPIs foi publicado somente no final de 2016. Segundo os autores, a lista desenvolvida apresenta algumas lacunas no conhecimento, uma vez que foi baseada em critérios publicados até 2012 e, portanto, não inclui as versões mais atualizadas publicadas em 2015, bem como não incorpora possíveis alternativas terapêuticas para os medicamentos que compõem a lista. Dessa forma, este estudo teve como objetivo estabelecer critérios explícitos para avaliação de MPIs prescritos aos idosos no Brasil e suas respetivas alternativas terapêuticas. O projeto englobou duas etapas complementares: 1- Elaboração da lista de critérios explícitos para avaliação de medicamentos inapropriados para idosos a partir de revisão sistemática já realizada; 2- Validação da proposta por consenso de especialistas utilizando técnica Delphi; A primeira etapa, elaboração da lista preliminar de MPIs, foi baseada em um estudo de revisão sistemática das listas publicadas entre janeiro/1991 e abril/2017.Realizou-se também uma análise qualitativa das listas com o objetivo de verificar a aplicabilidade destas ao mercado brasileiro em termos de disponibilidade e frequência de prescrição. Dessa forma, selecionaram-se três listas de MPIs: Beers 2015, STOPP 2015, European Union (7) PIM list. Ao final desse processo, obteve-se 153 critérios distribuídos em sete instrumentos: Dor e Inflamação, Sistema Cardiovascular, Sistema Endócrino, Geniturinário, Sistema Respiratório, Sistema Nervoso Central, sendo os dois primeiros já validados por meio da técnica Delphi modificada. Considerou-se validados os itens para os quais o limite inferior do IC 95% foi superior ou igual a 4,0. O consenso sobre MPIs - Dor e inflamação foi constituído duas rodadas. Um grupo de nove especialistas atingiu consenso sobre 98 (63,2%) das 155 questões apresentadas: 31/34 preocupações independente do diagnóstico, 4/4 preocupações quanto à dose, 4/4 preocupações quanto a duração do tratamento, 19/20 preocupações quanto ao uso em condições específicas, 12/23 considerações especiais de uso e 28/68 alternativas terapêuticas. No consenso sobre MPIs -Sistema Cardiovascular, um grupo de sete especialista atingiu consenso sobre 84 das 257 questões apresentadas: 20/25 preocupações independente do diagnóstico, 4/4 preocupações quanto à dose, 37/57 preocupações quanto ao uso em condições específicas, 20/105 considerações especiais de uso e 3/66 alternativas terapêuticas. Embora a validação de listas de MPIs a partir da opinião de especialistas seja um processo complexo, a listas desenvolvidas poderão ampliar o conhecimento sobre MPIs no país, uma vez que são baseadas em consensos recentes. Desse modo, esta pesquisa possibilitará um melhor entendimento da magnitude do uso de MPIs no Brasil, e poderá contribuir para o desenvolvimento de estratégias e intervenções mais eficazes para a redução dos problemas relacionados ao uso de medicamentos em idosos no país. / The use of potentially inappropriate medications (PIMs) for older patients is a public health problem because it can compromise the effectiveness or safety of pharmacotherapy and is responsible for high rates of morbidity and mortality in this age group. Brazilian studies that investigated PIMs show that the prevalence of PIM use ranges from 28.0% to 82.6%. However, these studies used PIM lists developed in other countries in North America and Europe. The first Brazilian consensus on PIMs was published in 2016. Limitations reported by the authors included that the PIM list was based on previous versions of Beers (2012) and STOPP (2008), therefore, it did not include the most up-to-date versions published in 2015, and did not incorporate therapeutic alternatives. The aim of the present study is to develop and validate explicit criteria for the evaluation of PIMs prescribed to older patients in Brazil and their respective therapeutic alternatives. The development of this project comprises of two steps: 1- Elaboration of the preliminary PIM list for older patients based on a systematic literature review; 2 - Validation of the preliminary PIM list with the consensus of experts using modified Delphi technique; The elaboration of the preliminary list of MPIs was based on a systematic review of PIM lists published between January 1991 and April 2017. A qualitative analysis of the PIM lists was performed with the objective of verifying their applicability to the Brazilian market. This way, three lists of PIMs were selected: Beers’ 2015, STOPP 2015, and European Union (7) PIM. Thus, we obtained 153 explicit criteria distributed across seven instruments: PIMs–Pain and Inflammation, PIMs–Cardiovascular System, PIMs–Endocrine System, PIMs–Genitourinary, PIMs–Respiratory System, and PIMs–Central Nervous System. The first two were already validated using the modified Delphi technique. The items for which the lower limit of the 95% confidence interval (CI) was greater than or equal to 4.0 were considered to have been validated. The consensus on PIMs–Pain and Inflammation was formed by two rounds. A group of nine experts reached consensus on 98 (63.2%) of the 155 items. A consensus was reached for 31/34 concerns regardless of diagnosis, 4/4 dose concerns, 4/4 concerns about the duration of treatment, 19/20 concerns about use under specific conditions, 12/23 special considerations of use, and 28/68 therapeutic alternatives. In the consensus on PIMs–Cardiovascular System, a group of seven experts reached consensus on 84 of the 257 questions. A consensus was reached for 20/25 concerns independent of diagnosis, 4/4 concerns regarding dose, 37/57 concerns regarding use under specific conditions, 20/105 special considerations of use and 3/66 therapeutic alternatives. Although the development and validation of PIM lists based on expert opinion is a long and complex process, the development of PIM list based on recent consensuses will expand the knowledge about the PIMs in Brazil. Thus, this research will improve the understanding of the magnitude of PIM use in this country, and may contribute to the development of more effective strategies and interventions to reduce drug-related problems among older Brazilian patients.

INTRODUÇÃO: A Tuberculose (TB) e a Síndrome da Imunodeficiência Adquirida (AIDS) são, individualmente, grandes ameaças à saúde pública. As epidemias de AIDS e TB são sinérgicas e criaram uma crise de grandes proporções e desafios para o manejo clínico dos doentes, serviços de saúde e órgãos governamentais. A infecção pelo Vírus da Imunodeficiência Humana (HIV) é um dos principais fatores de risco para TB. O tratamento de pacientes com HIV ou aids e TB requer o uso concomitante de medicamentos tuberculostáticos e antirretrovirais, e as dificuldades a serem superadas incluem alto número de comprimidos, adesão aos tratamentos, interações medicamentosas com possibilidade de sobreposição de efeitos tóxicos e síndrome de reconstituição imune inflamatória. Uma forma de prevenção da TB é o Tratamento Preventivo com Isoniazida (TPI) nos pacientes com Infecção Latente por Mycobacterium tuberculosis (ILMTb), para os quais taxas de adesão de 80% ou mais são adequadas. A baixa adesão ao TPI diminui a sua efetividade. Neste cenário, avaliar a adesão ao TPI é de grande importância. O Serviço de Farmácia pode ser um instrumento altamente eficiente para realizar esta avaliação, através do acompanhamento das taxas de dispensação de isoniazida (INH) prescrita como TPI. OBJETIVO: Avaliar a taxa de adesão ao TPI em sujeitos com HIV ou aids e ILMTb, através da dispensação de INH. MÉTODO: Foram incluídos sujeitos que apresentaram prescrição do medicamento INH no período de 01/07/2008 a 30/06/2011 na farmácia do Serviço de Extensão ao Atendimento de Pacientes HIV/Aids da Divisão de Moléstias Infecciosas e Parasitárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (SEAP HIV/Aids). As informações sobre sexo, idade, acompanhamento médico, uso de antirretrovirais, doenças concomitantes, intercorrências, datas de início e término do TPI foram obtidas do prontuário e informações sobre prescrição e dispensação de INH foram obtidas do Sistema de Informações de Gerenciamento Hospitalar (SIGH). RESULTADOS: Foram incluídos na análise 161 sujeitos, 78,9% (127) do sexo masculino, com idade média de 46 anos, 84,5% (136) deles acompanhados por médicos assistentes, 92,5% (149) utilizavam drogas antirretrovirais, 77,6% (125) apresentavam doenças concomitantes e 12,4% (20) sofreram intercorrências durante o TPI. Observou-se aumento transitório de enzimas hepáticas que não justificava a suspensão do TPI. A taxa de adesão foi de 96%. A prescrição eletrônica da INH nem sempre acompanhou, temporalmente, as datas, registradas em prontuário, de início e fim do TPI. A análise de concomitância entre início e fim do TPI e a prescrição de INH foi realizada para 90% (146) dos sujeitos para os quais estas informações eram disponíveis. Para 8,7% (14) dos sujeitos a prescrição eletrônica foi posterior à data de início de TPI; para 56,2% (82) dos sujeitos a prescrição de INH ultrapassou a data de término do TPI no prontuário e para 17,1% (25) dos sujeitos a prescrição de INH foi encerrada antes do término do TPI no prontuário. Não foram observadas associações estatísticas significativas entre o desfecho e as variáveis de interesse. CONCLUSÃO: Adesão é um comportamento complexo, assim como sua avaliação. Identificamos elevada taxa de adesão ao TPI entre sujeitos que vivem com HIV/aids; a frequência de hepatotoxicidade foi baixa e, quando ocorreu, transitória. Salientamos o descompasso entre o projeto terapêutico de TPI, registrado em prontuário, e a sua concretização, através da prescrição da INH. A prescrição eletrônica é um instrumento concebido para elevar a qualidade e agilizar a assistência; entretanto, pode expor o paciente a prescrição inadequada. Para evitá-lo devem ser adotadas medidas de segurança que, sem dificultar a prescrição, possam aprimorá-la constantemente, conforme os protocolos de tratamento disponíveis e os conhecimentos atualizados / BACKGROUND: Tuberculosis (TB) and Acquired Immunodeficiency Syndrome (AIDS) are major threats to public health. The Aids and TB epidemics are synergistic, bring great challenges for the clinical management of patients, health services and governments. Infection with Human Immunodeficiency Virus (HIV) is a major risk for TB. The treatment of coinfected patients requires antituberculosis and antiretroviral drugs administered concomitantly. These patients are defied by the high number of tablets, adherence, drugs interactions, overlapping toxicities and immune reconstitution inflammatory syndrome. The isoniazid preventive therapy (IPT) is recommended to reduce the risk of TB in HIV/aids patients with Mycobacterium tuberculosis Latent Infection (MTbLI). Adherence rates of 80% or more are adequate. Low adherence to the IPT reduces its effectiveness. Assessing adherence to the IPT is of great importance in this setting, and the withdrawal of INH from the pharmacy can be used for this purpose. OBJECTIVE: To evaluate the adherence to the IPT in subjects with HIV/Aids and MTbLI, followed at Serviço de Extensão ao Atendimento de Pacientes HIV/ Aids (SEAP HIV/Aids), an HIV/aids outpatient clinic, through the withdrawal of INH from the pharmacy. METHODS: subjects with HIV/Aids and MTbLI who had a prescription of INH for IPT from 01/07/2008 to 30/06/2011 were included. Information about sex, age, medical conditions, antiretrovirals, comorbidities, IPT period, intercurrences during the IPT and withdrawal of INH from the pharmacy were retrieved from the medical files and the system of information and hospital management (SIGH). RESULTS: 161 subjects were included in the study, 78,9% (127) of them males, with a mean age of 46 years, 84,5 % (136) of them assisted by infectologists, 92,5% ( 149) taking antiretrovirals, 77,6% (125) with comorbidities and 12,4% (20) with intercurrences during the IPT; a low and transient increase of liver enzymes that not led to discontinuation of the IPT was observed. The adherence rate was 96%. The evaluation of concordance between the periods of ITP and prescription of INH was performed for 90% (146) of subjects for whom this information was available. The electronic prescription of INH was not coincident with the period of IPT registered in medical files for most subjects. To 8,7% (14) of the subjects the electronic prescription was made after the beginning of IPT, for 56,2% (82) of the subjects the prescription of INH exceeded the date of completion of the IPT and for 17,1% (25) of the subjects the prescription of INH ended before the end of the IPT registered in medical files. No statistically significant associations between the outcome and the variables of interest were observed. CONCLUSION: Adherence is a complex behavior, as well as their evaluation. We found a high adherence rate to IPT among HIV/Aids subjects with MTbLI, with a low and transient grade of hepatotoxicity. Although the electronic prescription is an instrument designed to improve the quality of the health care, it can expose patients to inappropriate prescription. To avoid this, security measures should be adopted, in order to improve it constantly, according to the protocols of treatment available and updated knowledge, without hampering medical prescription