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Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte

The high prevalence of chronic diseases and use of multiple medications identified in Primary Health Care (PHC) suggest the need for the implementation of Comprehensive Medication Management (CMM) services. This study aimed to evaluate the clinical results of CMM services in a Brazilian PHC setting....

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Autores principales: Neves, Carina de Morais, do Nascimento, Mariana Martins Gonzaga, Silva, Daniela Álvares Machado, Ramalho-de-Oliveira, Djenane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631671/
https://www.ncbi.nlm.nih.gov/pubmed/31212741
http://dx.doi.org/10.3390/pharmacy7020058
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author Neves, Carina de Morais
do Nascimento, Mariana Martins Gonzaga
Silva, Daniela Álvares Machado
Ramalho-de-Oliveira, Djenane
author_facet Neves, Carina de Morais
do Nascimento, Mariana Martins Gonzaga
Silva, Daniela Álvares Machado
Ramalho-de-Oliveira, Djenane
author_sort Neves, Carina de Morais
collection PubMed
description The high prevalence of chronic diseases and use of multiple medications identified in Primary Health Care (PHC) suggest the need for the implementation of Comprehensive Medication Management (CMM) services. This study aimed to evaluate the clinical results of CMM services in a Brazilian PHC setting. A quasi-experimental study was performed with patients followed-up for two years (n = 90). Factors associated with the detection of four drug therapy problems (DTP) or more in the initial assessment were evaluated (univariate and multivariate analyses), as well as the clinical impact observed in laboratory parameters (HbA1c, Blood Pressure, LDL- and HDL-covariance analysis). A predominance of women (61.1%), a mean age of 65.5 years, and a prevalence of polypharmacy (87.8%)—use of five or more drugs—were observed. A total of 441 DTP was identified, 252 required interventions with the prescriber, 67.9% of which were accepted and 59.6% were solved. The main DTP were ‘non-adherence’ (28.1%), ‘need for additional drug therapy’ (21.8%), and ‘low dose’ (19.5%). Hypertension was positively associated with the identification of four DTP or more. A statistically significant reduction was detected in all assessed laboratory parameters (p < 0.05). CMM services contributed to the resolution of DTP and improved clinical outcomes.
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spelling pubmed-66316712019-08-19 Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte Neves, Carina de Morais do Nascimento, Mariana Martins Gonzaga Silva, Daniela Álvares Machado Ramalho-de-Oliveira, Djenane Pharmacy (Basel) Article The high prevalence of chronic diseases and use of multiple medications identified in Primary Health Care (PHC) suggest the need for the implementation of Comprehensive Medication Management (CMM) services. This study aimed to evaluate the clinical results of CMM services in a Brazilian PHC setting. A quasi-experimental study was performed with patients followed-up for two years (n = 90). Factors associated with the detection of four drug therapy problems (DTP) or more in the initial assessment were evaluated (univariate and multivariate analyses), as well as the clinical impact observed in laboratory parameters (HbA1c, Blood Pressure, LDL- and HDL-covariance analysis). A predominance of women (61.1%), a mean age of 65.5 years, and a prevalence of polypharmacy (87.8%)—use of five or more drugs—were observed. A total of 441 DTP was identified, 252 required interventions with the prescriber, 67.9% of which were accepted and 59.6% were solved. The main DTP were ‘non-adherence’ (28.1%), ‘need for additional drug therapy’ (21.8%), and ‘low dose’ (19.5%). Hypertension was positively associated with the identification of four DTP or more. A statistically significant reduction was detected in all assessed laboratory parameters (p < 0.05). CMM services contributed to the resolution of DTP and improved clinical outcomes. MDPI 2019-06-12 /pmc/articles/PMC6631671/ /pubmed/31212741 http://dx.doi.org/10.3390/pharmacy7020058 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Neves, Carina de Morais
do Nascimento, Mariana Martins Gonzaga
Silva, Daniela Álvares Machado
Ramalho-de-Oliveira, Djenane
Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte
title Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte
title_full Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte
title_fullStr Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte
title_full_unstemmed Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte
title_short Clinical Results of Comprehensive Medication Management Services in Primary Care in Belo Horizonte
title_sort clinical results of comprehensive medication management services in primary care in belo horizonte
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631671/
https://www.ncbi.nlm.nih.gov/pubmed/31212741
http://dx.doi.org/10.3390/pharmacy7020058
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