A importância do profissional farmacêutico na adesão farmacoterapêutica de pacientes idosos

Luiz da Silva Maia Neto, David Pablo Cavalcanti da Fonseca, Ana Tamires Alves dos Santos, Ericka Inocêncio de Santana, Anna Lígia de Castro Figueiredo, Vanessa Silva de Almeida, Caio César da Silva Guedes

Resumo


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R E S U M O

 

O público de maior idade, comumente vivenciam quadros em que devem lhe dar com comorbidades relacionadas às alterações fisiológicas e funcionamento irregular do organismo, uma vez que com o envelhecimento o mesmo não se comporte com o melhor vigor que durante a juventude. Deste modo, esses pacientes sofrem de doenças comumente associadas à idade, bem como hipertensão, Diabetes mellitus, problemas cardíacos, distúrbios cerebrais, limitações físicas e outros problemas de saúde. Associado a esses problemas, o paciente idoso realiza uma determinada farmacoterapia, no qual com a falta de acompanhamento e orientações necessárias, ocorre a descontinuidade do da farmacoterapia, promovendo o agravo de comorbidades e o desenvolvimento de outras patologias oportunistas e/ou consequentes. Sendo assim, com o intuito de promover a qualidade na farmacoterapia e implantar medidas favoráveis, que vise garantir a efetividade e realização correta do tratamento, o profissional farmacêutico atua como elemento chave visando orientar, acompanhar, instruir, qualificar e promover saúde através da atenção farmacêutica através de medidas que facilite a adesão ao tratamento medicamentoso desses pacientes. O farmacêutico possui habilidades fundamentais, no qual durante o acompanhamento farmacoterapêutico pode realizar alterações farmacológicas que favorecem melhor adesão à terapia, sugerindo formas farmacêuticas, ajuste de doses e redução de administrações ao longo do dia, favorecendo melhor adesão ao tratamento. Sendo assim, o auxílio do farmacêutico é fundamental tornando possível a promoção à saúde mediante o acompanhamento realizado, no qual favorece a aceitabilidade e adesão farmacoterapêutica entre o paciente idoso e o medicamento.  

 

Palavras-Chaves: Adesão à medicação. Atenção farmacêutica. Efetividade. Idoso. Tratamento farmacológico.

 

The importance of the pharmaceutical professional in the pharmacotherapeutic adherence of elderly patients

 

A B S T R A C T

 

The elderly public, commonly experience situations in which they must deal with comorbidities related to physiological changes and irregular functioning of the organism, since with aging it does not behave with the best vigor that during youth. Thus, these patients suffer from diseases commonly associated with age, as well as hypertension, diabetes mellitus, heart problems, emotional disturbances, physical limitations and other health problems. Associated with these problems, the elderly patient undergoes a certain pharmacotherapy, in which, with the lack of follow-up and necessary guidelines, the pharmacotherapy is discontinued, promoting the aggravation of comorbidities and the development of other opportunistic and/or consequential pathologies. Therefore, in order to promote quality in pharmacotherapy and implement promising measures, which aim to guarantee the approval and correct implementation of the treatment, the pharmaceutical professional acts as a key element in order to guide, monitor, instruct, qualify and promote through health care through measures that facilitate adherence to drug treatment for these patients. The pharmacist has fundamental skills, in which, during pharmacotherapeutic follow-up, he can make pharmacological changes that favor better adherence to therapy, suggesting pharmaceutical forms, adjusting doses and reducing administrations throughout the day, favoring better adherence to treatment. Therefore, the help of the pharmacist is essential, making it possible to promote health through the monitoring carried out, which favors the acceptability and pharmacotherapeutic adherence between the elderly patient and the medication.

 

Keywords: Medication adherence. Pharmaceutical attention. Effectiveness. Elderly. Pharmacological treatment.


Palavras-chave


Adesão à medicação. Atenção farmacêutica. Efetividade. Idoso. Tratamento farmacológico

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Referências


CONTI, A. A. Historical evolution of the concept of health in Western medicine. Acta Biomed, v. 89, n. 3, p. 352-354, 2018.

LEONARDI, F. The Definition of Health: Towards New Perspectives. International Journal of Health Services, v. 48, n. 4, p. 735-748, 2018.

HOLVAST, F.; VOSHAAR, R. C. O.; WOUTERS, H.; HEK, K.; SCHELLEVIS, F.; BURGER, H.; VERHAAK, P. F. M. Non-adherence to antidepressants among older patients with depression: a longitudinal cohort study in primary care. Family Practice. v. 36, n.1, p. 12-20, 2018.

LORD, S. R.; DELBAERE, K.; STURNIEKS, D. L. Aging. Handbook of Clinical Neurology, v. 159, p. 157-171, 2018.

CORNELISSEN, G.; OTSUKA, K. Chronobiology of Aging: A Mini- Review. Gerontology, v. 63, n. 2, p. 118-128, 2017.

BOWL, M. R.; DAWSON, S. J. Age- Related Hearing Loss. Cold Spring Harb perspect Med. v. 9, n.8, p. 1-15, 2019.

PERES, H. A.; PEREIRA, L. R. L.; MARTINEZ, E. Z.; VIANA, C. M.; FOSS-FREITAS, M. C. Heart failure is associeted with non-adherence to pharmacotherapy in elderly with type 2 diabetes mellitus in public health system Brazilians. Clinical Research & Reviews, v. 13, n. 2, p. 939-946, 2019.

THIEM, U. Listenbasierte Ansätze in der Arzneimitteltherapie bei älteren und geriatrischen Patienten. Zeitschift für Gerontologie und Geriatrie, v. 51, n. 4, p. 394-398, 2018.

CALDERÓN-LARRAÑAGA, A.; MARENGONI, ALESSANDRA, A. Multimorbidity and functional impairment: bidirectional interplay, synergistic effects and common pathways. Journal of Internal medicine, v. 285, n. 3, p. 255-271, 2019.

RICHTER, J.; SCHÖNFELD, M. S.; LANGEBRAKE, C.; BERGELT, C.; KRISTON, L.; OLOTU, C.; KIEFMANN, R. Pharmaceutical management of elderly high-risk patients in perioperative settings (PHAROS): protocol of a pilot sequential intervention study. BMJ Open, v. 10, n. 11, p. 1-9, 2020.

KOMAGAMINE, J.; SUGAWARA, K.; KAMINAGA, M.; TATSUMI, S. Study protocol for a single- centre, prospective, non-blinded, randomised, 12-month, parallel-group superiority study to compare the efficacy of pharmacist intervention versus usual care for elderly patients hospitalised in orthopaedic wards. BMJ Open, v. 8, n. 7, p. 1-9, 2018.

RANKIN, A.; CADOGAN, C. A.; PATTERSON, S. M.; CARDWELL, C. R.; BRADLEY, M. C.; RYAN, C.; HUGHES, C. Interventions to improve the appropriate use of polypharmacy for older people (Review). Cochrane Database of Systematic Reviews, v. 9, p. 1-185, 2018.

BUTTERWORTH, J. E.; HAYS, R.; MCDONAGH, S. T. J.; RICHARDS, S. H.; BOWER, P.; CAMPBELL, J. Interventions for involving older patients with multi- morbidity in decision-making during primary care consultations (Review). Cochrane Database of Systematic Reviews, v. 10, p. 1-74, 2019.

CROSS, A. J.; ELLIOTT, R. A.; PETRIE, K.; KURUVILLA, L.; GEORGE, J. Interventions for improving medication-taking ability and adherence in older adults prescribed multiple medications (REVIEW). Cochrane Database of Systematic Reviews, v. 5, p. 1-225, 2020.

KINDSTEDT, J.; SVAHN, S.; SJÖLANDER, M.; GLADER, EL.; LÖVHEIM, H.; GUSTAFSSON, M. Investigating the effect of clinical pharmacist intervention in transitions of care on drug related hospital readmissions among the elderly: study protocol for a randomised controlled trial. BMJ Open, v. 10, n. 4, p. 1-8, 2020.

DALVI, V.; MEKOTH, N. Patient non- adherence: an interpretative phenomenological analysis. International Journal of Health care Quality Assurance, v. 30, n. 3, p. 274-284, 2017.

KRISKO, A.; RADMAN, M. Protein damage, ageing and age-related diseases. OPEN BIOLOGY, v. 9, n.3, p. 1-12, 2019.

LUO, J.; MILLS, K.; CESSIE, S. I.; NOORDAM, R.; HEEMST, D. V. Ageing, Age-related Diseases and Oxidative Stress: What to do Next. Ageing Research Reviews, v. 57, 2020.

REA, I. M.; GIBSON, D. S.; MCGILLIGAN, V.; MCNERLAN, S. E.; ALEXANDER, H. D.; ROSS, O. A. Age and Age-Related Diseases: Role of Inflammation Triggers and Cytokines. Frontiers in immunology, v.9, n. 586, p. 1-28, 2018.

WOOLLEY, C.; THOMPSON, C.; HAKENDORF, P.; HORWOOD, C. THE EFFECT OF AGE UPON THE INTERRELATIONSHIP OF BMI AND INPATIENT HEALTH OUTCOMES. The journal of nutrition, health & aging, v. 23, n. 6, p. 558-563, 2019.

NOALE, M.; LIMONGI, F.; MAGGI, S. Epidemiology of Cardiovascular Diseases in the Elderly. Frailty and Cardiovascular Diseases, v. 1216, p. 29-38, 2020.

HEIDARI, F.; AFSHARI, M.; MOOSAZA DEH. M. Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis. Rheumatology International, v. 37, n. 9, p. 1527-1539, 2017.

ÇAKAN, F. Ö. Yaşlilarda hipertansiyon. Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir, v. 45, n. 5, p. 29-31, 2017.

World Health Organization, Improving hypertension control in 3 million people. WHO, 2019. Acesso em 30 de março 2020 disponível em: https://apps.who.int/iris/handle/10665/336019.

FINGERET, M.; MARQUES-VIDAL, P.; VOLLENWEIDER. P. Incidence of type 2 diabetes, hypertension, and dyslipidemia in metabolically healthy obese and non- obese. Nutrition, metabolism & cardiovascular diseases, v. 28, n. 10, p. 1036-1044, 2018.

World Health Organization, Insulin and associated devices: access for everybody. WHO, 2020. Acesso em 30 de março 2020 disponível em: https://www.who.int/publications/i/item/insulin-and-associated-devices-access-for-everybody-who-stakeholder-workshop-21-and-23-25-september-2020.

REISS, A. B.; GLASS, A. D.; WISNIEWSKI, T.; WOLOZIN, B.; GOMOLIN, I. H.; PINKHASOV, A.; LEON, J. D.; STECKER, M. M.; Alzheimer’s disease: many failed trials, so Where do we go from here?. Journal of Investigative medicine, v.68, n. 6, p. 1135-1140, 2020.

LOPEZ, O. L.; KULLER, L. H. Epidemiology of aging and associated cognitive disorders: Prevalence and incidence of Alzheimer’s disease and other dementias. Handbook of clinical neurology, v. 167, p. 139-148, 2019.

VEITCH, D. P.; WEINER, M. W.; AISEN, P. S.; BECKETT, L. A.; CAIRNS, N. J.; GREEN, R. C.; HARVEY, D.; JACK-JÚNIOR, C. R.; JAGUST, W.; MORRIS, J. C.; PETERSEN, R. C.; SAYKIN, A. J.; SHAW, L. M.; TOGA, A. W.; TROJANOWSKI, J. Q. Understanding disease progression and improving Alzheimer’s disease clinical trials: Recent highlights from the Alzheimer’s disease Neuroimaging Initiative. Alzheimer’s & Dementia- The Journal of The Alzheimer’s Association, v. 15, n. 1, 2018.

PERKOWSKA-PTASINSKA, A. DEBORSKA-MATERKOWSKA, D.; DURLIK, M. The current management of kidney disease in the elderly. Minverva Medica, v. 109, n. 1, p. 41-52, 2018.

FULOP, T.; LARBI, A.; KHALIL, A.; COHEN, A. A.; WITKOWSKI, J. M. Are we III Because we Age?. Frontiers in Physiology, v. 10, n. 1508, p. 1-12, 2019.

HÖCHEL, J. Does Everything Get Slower with Age? Pharmacokinetics in the Elderly. Drug Research, v. 69, p. 57-58, 2019.

DALVI, V.; MEKOTH, N. Regimen Difficulty and medication Non- Adherence and the Interaction Effects of Gender and Age. Hospital Topics, v. 96, n. 2, p. 35-41, 2018.

NIENKE, B.; ALEXANDER, K. S.; SEI, J. L.; IRENA, S. C.; JOHN, B. W.; KENNETH, E. C. Difficulty Managing Medications and Finances in Older Adults: A 10 year Cohort Study. Journal of The American Geriatrics Society, v. 65, n. 7, 1455-1461, 2017.

DRUMMOND, E. D.; SIMÕES, T. C.; ANDRADE, F. B. Avaliação da não adesão à farmacoterapia de doenças crônicas e desigualdades socioeconômicas no Brasil. Revista Brasileira de Epidemiologia, v. 23, p. 1-14, 2020.

BLÖNDAL, A. B.; ALMARSDÓTTIR, A. B.; JÓNSSON, J. S.; GIZURARSON, S. Lyfjafræðileg umsjá í Heilsugæslunni í Garðabæ – greining á fjölda og eðli lyfjatengdra vandamála eldri einstaklinga. Læknablaðið, the Icelandic Medical Journal, v. 11, n. 103, p. 481-486, 2017.

YILDIRIM, A. B.; KILINÇ, A. K. Yaşli hastalarda polifarmasi ve ilaç etkileşimi. Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir, v. 45, n. 5, p. 17-21, 2017.

HILMER, S. N.; WU, H.; ZHANG, M. Biology of frailty: Implications for clinical pharmacology and drug therapy in frail older people. Mechanisms of Ageing and Development, v. 181, p. 22-28, 2019.

VAN-DER-LAN, D. M.; ELDERS, P. J. M.; BOONS, C. C. L. M.; BECKERINGH, J. J.; NIJPELS, G.; HUGTENBURG, J. G. Factors associated with antihypertensive medication non-adherence: a systematic review. Journal of Human Hypertension, v. 31, n. 11, p. 687-694, 2017.

PARK, H. Y.; SEO, S. A.; YOO, H.; LEE, K. Medication adherence and beliefs about medication in elderly patients living alone with chronic diseases. Dovepress, v. 12, p. 175-181, 2018.

BURNIER, M.; WUERZNER, G. Hypertension and Drug Adherence in the Elderly. Frontiers in Cardiovascular Medicine, v. 7, n. 49, 2020.

VICENTE-SÁNCHEZ, S.; OLMOS-JIMÉNEZ, R.; RAMÍREZ-ROID, C.; GARCÍA-SÁNCHEZ, M. J.; VALDERREY-PULIDO, M.; RUBIA-NIETO, A. DL. Treatment adherence in patients more than 65 years who experience Early readmissions. Farmacia Hospitalaria, v. 42, n. 4, p. 147-151, 2018.

CHRISTIAN, C.; BORDEN, B. A.; DANAHEY, K.; YEO, KT. J.; VAN-WIJK, X. M. R.; RATAIN, M. J.; O’DONNELL, P. H. Pharmacogenomic-Based Decision-Support to Predict Adherence to Medications. Clinical Pharmacology & Therapeutics, v. 108, n. 2, p. 368-376, 2020.

ULLEY, J.; HARROP, D.; ALI, A.; ALTON, S.; DAVIS, S. F. Deprescribing interventions and their impact on medication adherence in community-dwelling older adults with polypharmacy: a systematic review. BMC Geriatrics, v. 19, n. 14, 2019.

DOHERTY, A. J.; BOLAND, P.; REED, J.; CLEGG, A. J.; STEPHANI, AM. WILLIAMS, N. H.; SHAW, B.; HEDGECOE, L.; HILL, R.; WALKER, L. Barriers and facilitators to deprescribing in primary care: a systematic review. BJGP Open, v. 4, n. 3, 2020.

KIM, GG.; CHAE, DH.; PARK, MS.; YOO, SH. Factors influencing 1-year medication adherence of Korean ischemic Stroke Survivors. International Journal of Behavioral Medicine, v. 27, p. 225-234, 2020.

ERSTAD, B. L. The Conscience of a Pharmacist. American Journal of Pharmaceutical Education, v. 83, n. 2, p. 133-135, 2019.

JOMAA, I.; ODISHO, M.; CHEUNG, J. M. Y.; WONG, K.; ELLIS, J. G.; SMYTH, T.; SAINI, B. Pharmacist’s perceptions and communication of risk for alertness impairing medications. Research in Social & Administrative Pharmacy, v. 14, n. 1, p. 34-45, 2018.

Conselho Federal de Farmácia. Resolução – RDC nº 585 de 29 de abril de 2013. Regulamenta as atribuições clínicas do farmacêutico e dá outras providências. CFF. Acesso em 1 de abril de 2021. Disponível em: https://www.cff.org.br.

KINSEY, J. D.; NYKAMP, D. Dangers of Nonprescription Medicines: Educating and Counseling Older Adults. The Consultant Pharmacist – Clinical Note, v. 32, n. 5, p. 269-280, 2017.

MELO, D. O.; CASTRO, L. L. C. Pharmacist’s contribution to the promotion of access and rational use of essential medicines in SUS. Ciência & Saúde Coletiva, v. 22, n. 1, p. 235-244, 2017.

PETRELLI, F.; TIFFI, F.; SCURI, S.; NGUYEN, C. T. T.; GRAPPSONNI, I. The pharmacist’s role in health information, vaccination and health promotion. Annali di igiene: medicina preventive e di comunita, v. 31, n. 4, p. 309-315, 2019.

MEDHAT, M.; SABRY, N.; ASHOUSH, N. Knowledge, attitude and practice of community pharmacists towards nutrition counseling. International Journal of Clinical Pharmacy, v. 42, p. 1456-1468, 2020.

KHAN, N.; MCGARRY, K.; NAQVI, A. A.; IQBAL, M. S.; HAIDER, Z. Pharmacist’s viewpoint towards their professional role in healthcare system: a survey of hospital settings of Pakistan. BMC Health Services Research, v. 20, n. 610, 2020.

BAUMGARTNER, A. D.; CLARK, C. M.; LAVALLEY, S. A.; MONTE, S. V.; WAHLER-JR, R. G.; SINGH, R. Interventions to deprescribe potentially inappropriate medications in the elderly: Lost in translation?. Journal Clinical Pharmacy and Therapeutics, v. 45, n. 3, p. 453-461, 2020.

COLLADO-BORREL, R.; ESCUDERO-VILAPLANA, V.; RIBED, A.; JIMÉNEZ, R. R.; PEINADO, I. I.; HERRANZ-ALONSO, A.; SANJURJO-SÁEZ, M. Novel mobile application for direct communication between pharmacists and patients treated with oral antineoplastic agents. American Journal of Health-System Pharmacy, v. 77, n. 17, p. 1393-1402, 2020.

KARAMPATAKIS, G. D.; PATEL, N.; STRETCH, G.; RYAN, K. Patients’ experiences of pharmacists in general practice: an exploratory qualitative study. BMC Family Practice, v. 48, p. 1-11, 2021.

CHEVALIER, B. A.M.; WATSON, B. M.; BARRAS, M. A.; COTTRELL, W. N. Hospital pharmacist’ and patients’ views about what constitutes effective communication between pharmacists and patients. International journal of Pharmacy practice, v. 26, n. 5, p. 450-457, 2018.

NOGUEIRA, N.; OTUYAMA, L. J.; ROCHA, P. A.; PINTO, V. B. Pharmaceutical care-based interventions in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials. Einstein, v. 18, p. 1-14, 2020.

ANOOPKUMAR-DUKIE, S.; MEY, A.; HALL, S.; BERNAITIS, N.; DAVEY, A. K.; PLUMMER, D. Non-Prescription Medicines may Contribute to Non-Adherence to prescription Medicines in People in Living with Chronic Health Conditions. THE INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, v. 74, n. 6, 2020.

BALA, S. S.; CHEN, T. F.; NISHTALA, P. S. Reducing Potentially Inappropriate Medications in Older Adults: A Way Forward. CANADION JOURNAL ON AGING, v. 38, n. 4, p. 419-433, 2019.

SUTHERLAND, J. J.; MORRISON, R. D.; MCNAUGHTON, C. D.; DALY, T. M.; MILNE, S. B.; DANIELS, J. S.; RYAN, T. P. Assessment of Patient Medication Adherence, Medical Record Accuracy, and Medication Blood Concentrations for Prescription and Over-the- Counter Medications. JAMA Network Open, v. 1, n. 7, p. 1-10, 2018.

EARL, T. R.; KATAPODIS, N. D.; SCHNEIDERMAN, S. R.; SHOEMAKER-HUNT, S. J. Using Deprescribing Practices and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults. JOURNAL OF PATIENT SAFETY, v. 16, n. 3, p. s23-s35, 2020.


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