scholarly journals Quimioterapia adjuvante para o tratamento do câncer de ovário e o cuidado farmacêutico: uma revisão integrativa

2021 ◽  
Vol 10 (16) ◽  
pp. e497101620638
Author(s):  
Fabiola do Socorro Barros Mendes ◽  
Maria Fâni Dolabela
Keyword(s):  
Pharmaceutical Care ◽  
Care Protocol ◽  
Cáncer De Ovario

Este estudo teve como objetivo analisar os tratamentos quimioterápicos adjuvantes que vêm sendo adotados para o tratamento do câncer de ovário. Bem como, propor estratégias que podem ser adotadas para o cuidado farmacêutico a este paciente. Inicialmente, foi buscado os artigos na plataforma Capes, sendo incluídos artigos revisados por pares, publicados entre 2016 a 2021 e utilizado os seguintes termos: “pharmaceutical care protocol and câncer ovary and chemotherapy adjuvante”. Foram encontrados 125 artigos e procedeu a leitura dos títulos e resumos, sendo que somente 10 artigos tiveram relação com o tema do trabalho e 7 trabalhos foram incluídos no estudo. Estes artigos, os pacientes faziam a quimioterapia convencional associado a bevacizumabe, indol-3-carbinol, epigalocatequina-3-galato, pegfilgrastin e/ou filgrastin, vígil, lisado de tumor oxidado autólogo (OC-DC) e vacina de dez peptídeos (PEP-DC), everolimo e letrozol. Os estudos demonstraram respectivamente: aumento da sobrevida livre de doença, porém é necessário mais estudos devido algumas controversas; ausência de toxicidade que exigisse alteração no regime de terapia padrão; que ao pacientes com maior pontuação de AIVD tem maior probabilidade de completar 4 ciclos de quimioterapia e menos probabilidade de apresentar toxicidade de grau 3 ou superior;  melhora da resposta imune; a segurança, bem como alteração na sobrevida;  uma taxa de PFS promissora, sendo que 47% teve 12 semanas e toxicidade leve. Também, o desenvolvimento de formulação Nanopartículas de Paclitaxel-LDE (lipídeos não proteicos- PTX-LDE) levou uma melhora na resposta para o câncer de ovário. O papel do farmacêutico na equipe multiprofissional é muito importante, pois envolve o acompanhamento clínico do paciente, a prevenção de agravos a saúde da equipe devido a exposição aos quimioterápicos, a manipulação dos fármacos e detecção dos problemas relacionados aos medicamentos. Em síntese, ainda são escassos os estudos que visem a busca de alternativas terapêuticas mais eficazes para o tratamento do câncer de ovário.

When Does Pharmaceutical Care Impact Health Outcomes? A Comparison of Community Pharmacy—Based Studies of Pharmaceutical Care for Patients with Asthma

2005 ◽  
Vol 39 (4) ◽  
pp. 625-631 ◽  
Author(s):  
William M McLean ◽  
Linda D MacKeigan
Keyword(s):  
Health Outcomes ◽  
Pharmaceutical Care ◽  
Self Management ◽  
Positive Outcomes ◽  
Uncontrolled Asthma ◽  
Practice Model ◽  
Disease States ◽  
Care Protocol ◽  
Study Results ◽  
Computer Reminders

BACKGROUND: Pharmaceutical care (PC) as a philosophy of care and practice model is now >14 years old. It is important to determine whether PC influences health outcomes. Such outcomes are best studied in specific disease states where variables are minimized and specific outcomes have been established. We analyzed 4 multi-site controlled studies that evaluated PC in community pharmacies for patients with asthma. Study results varied widely. OBJECTIVE: To understand factors contributing to positive outcomes from PC for asthma. METHODS: The 4 studies were compared on the basis of 10 aspects of their research design, as well as 10 elements of PC. Dr. McLean conducted the initial analysis, and his assessments were confirmed by Dr. MacKeigan. RESULTS: Important differences were found in the type of pharmacy where PC was delivered (chain vs independent), how pharmacies were selected (required vs volunteered), patient selection (on asthma medication vs uncontrolled disease), pharmacist training (4-h workshop vs certification over several weeks), the nature of PC protocol (computer reminders vs detailed care protocol), rigor of the protocol (intervention vs requirement to reach self-management), and the level of pharmacist adherence to the PC protocol (<50% vs 90%). Differences were also found in study design. CONCLUSIONS: More favorable PC outcomes were associated with use of all elements of PC, independent pharmacies, pharmacist certification, a detailed PC protocol, targeting patients with uncontrolled asthma, and a practice system facilitating PC.

scholarly journals The BC Community Pharmacy Asthma Study: A Study of Clinical, Economic and Holistic Outcomes Influenced by an Asthma Care Protocol Provided by Specially Trained Community Pharmacists in British Columbia

2003 ◽  
Vol 10 (4) ◽  
pp. 195-202 ◽  
Author(s):  
William Mclean ◽  
Jane Gillis ◽  
Ron Waller
Keyword(s):  
British Columbia ◽  
Community Pharmacy ◽  
Pharmaceutical Care ◽  
Readiness To Change ◽  
Community Pharmacists ◽  
Indirect Costs ◽  
Cost Effective ◽  
Asthma Care ◽  
Care Protocol ◽  
Asthma Patients

OBJECTIVES: Despite advances in recent years, asthma morbidity and mortality have been noted to be on the increase in the past decade. The present study examined the failures and recommendations of past studies and introduced a new milieu for asthma care - the community pharmacy. The study incorporated a care protocol with the important ingredients of asthma education on medications, triggers, self-monitoring and an asthma plan, with pharmacists taking responsibility for outcomes, assessment of a patient's readiness to change and tailoring education to that readiness, compliance monitoring and physician consultation to achieve asthma prescribing guidelines.METHODS: Thirty-three pharmacists in British Columbia, specially trained and certified in asthma care, agreed to participate in a study in which experienced pharmacists would have asthma patients allocated to enhanced (pharmaceutical) care (EC) or usual care (UC). Pharmacists less experienced were clustered by geography and had their pharmacies randomized to two levels of care; each pharmacy then had patients randomized to EC versus control, UC versus control or EC versus UC depending on their pharmacy randomization. Six hundred thirty-one patients provided consent, of which 225 in EC or UC were analyzed for all outcomes. Patients were followed for one year.RESULTS: Compared with patients in the UC group, the results of those in the EC group were as follows: symptom scores decreased by 50%; peak flow readings increased by 11%; days off work or school were reduced by approximately 0.6 days/month; use of inhaled beta-agonists was reduced by 50%; overall quality of life improved by 19%, and the specific domains of activity limitations, symptoms and emotional function also improved; initial knowledge scores doubled; emergency room visits decreased by 75%; and medical visits decreased by 75%. A patient satisfaction survey revealed that the population was extremely pleased with their pharmacy services. Cost analysis reinforces the EC model, which is more cost effective than UC in terms of most direct and indirect costs in asthma patients.CONCLUSION: Specially trained community pharmacists in Canada, using a pharmaceutical care-based protocol, can produce impressive improvements in clinical, economic and humanistic outcome measures in asthma patients. The health care system needs to produce incentives for such care.

Potential effect of pharmaceutical care to improve outcomes in patients with chronic kidney disease-mineral bone disorder in Sulaimani dialysis centers

2020 ◽  
pp. 82-94
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pharmaceutical Care ◽  
Biochemical Parameters ◽  
Positive Impact ◽  
Potential Effect ◽  
Care Group ◽  
Mineral Bone Disorder ◽  
Bone Disorder

Objective: the present study was aimed to evaluate the role of pharmaceutical services in improving the outcome of mineral bone disorder in patients with advanced chronic kidney disease. Methodology: One hundred and twenty patients with chronic kidney disease-mineral bone disorder (CKD-MBD) screened for eligibility, seventy-six patients enrolled in the study and randomly allocated into two groups: pharmaceutical care and usual care, both groups interviewed by the pharmacist using specific questionnaire for assessing the quality of life (QoL). All the drug related problems (DRPs) including drug-drug interactions (DDIs) were recorded by the pharmacist. Blood samples were collected and utilized for analyzing the levels of vitamin D, phosphorous, calcium, albumin and parathyroid hormone at baseline and three months after. The pharmaceutical care group received all the educations about their medications and how to minimize DRPs; improve the QoL. Additionally, the pharmaceutical intervention included correcting the biochemical parameters. Results: Pharmaceutical care significantly improved patients QoL and minimized DRPs and DDIs. It was also effective in improving the biochemical parameters. Conclusion: Pharmaceutical care has a positive impact on improving the outcome of patients with CKD-MBD through attenuating DRPs, improving the biochemical parameters and the QoL.

KNOWLEDGE, ATTITUDE, AND PRACTICE OF PHARMACISTS ABOUT PHARMACEUTICAL CARE FOR DIABETES MELLITUS PATIENTS IN A PRIMARY CARE CENTER IN SAUDI ARABIA

2020 ◽  
Vol 76 (3) ◽  
Author(s):  
Maha Aldraimly ◽  
Sayed Azhar Suliman ◽  
Ahmed Ibrahim Nouri ◽  
Manahel Mohammed Alshaer ◽  
Norah Mohammed Almaghrabi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Saudi Arabia ◽  
Pharmaceutical Care ◽  
Care Center ◽  
Primary Care Center ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Neonatal Intravenous Extravasation Injuries: Evaluation of a Wound Care Protocol

2006 ◽  
Vol 25 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Doris Sawatzky-Dickson ◽  
Karen Bodnaryk
Keyword(s):  
Wound Healing ◽  
Birth Weight ◽  
Wound Infection ◽  
Gestational Age ◽  
Wound Care ◽  
Systemic Infection ◽  
Coagulase Negative Staphylococcus ◽  
Evidence Based ◽  
Infection Rates ◽  
Care Protocol

Purpose:To evaluate an evidence-based wound protocol for intravenous extravasation injuries in neonates.Sample:Nine newborns with intravenous extravasation injuries. Birth weight: 582–4,404 gm, gestational age: 24–40 weeks.Results:Five wounds were colonized with coagulase-negative Staphylococcus species, two with diphtheroids, three with Enterococcus. There was no evidence of wound infection or systemic infection. Rates of wound healing ranged from one to six weeks.

scholarly journals Homeopathy for Covid-19 in Primary Care: A structured summary of a study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ubiratan Cardinalli Adler ◽  
Maristela Schiabel Adler ◽  
Livia Mitchiguian Hotta ◽  
Ana Elisa Madureira Padula ◽  
Amarilys de Toledo Cesar ◽  
...  
Keyword(s):  
Primary Care ◽  
Alternative Hypothesis ◽  
University Hospital ◽  
List Type ◽  
Study Medication ◽  
Link Type ◽  
Care Protocol ◽  
Full Protocol ◽  
Isolation Period

Abstract Objectives To investigate the effectiveness and safety of homeopathic medicine Natrum muriaticum (LM2) for mild cases of COVID-19 in Primary Health Care. Trial design A randomized, two-armed (1:1), parallel, placebo-controlled, double-blind, clinical trial is being performed to test the following hypotheses: H0: homeopathic medicines = placebo (null hypothesis) vs. H1: homeopathic medicines ≠ placebo (alternative hypothesis) for mild cases of COVID-19 in Primary Care. Participants Setting: Primary Care of São Carlos – São Paulo – Brazil. One hundred participants aged 18 years or older, with Influenza-like symptoms and a positive RT-PCR for SARS-CoV-2. Willingness to give informed consent and to comply with the study procedures is also required. Exclusion criterium: severe acute respiratory syndrome. Intervention and comparator Homeopathy: 1 globule of Natrum muriaticum LM2 diluted in 20 mL of alcohol 30% and dispensed in a 30 ml bottle. Placebo: 20 mL of alcohol 30% dispensed in a 30 ml bottle. Posology: one drop taken orally every 4 hours (6 doses/day) while there is fever, cough, tiredness, or pain (headache, sore throat, muscle aches, chest pain, etc.) followed by one drop every 6 hours (4 doses/day) until the fourteenth day of use. The bottle of study medication should be submitted to 10 vigorous shakes (succussions) before each dose. Posology may be changed by telemedicine, with no break in blinding. Study medication should be maintained during home isolation. According to the Primary Care protocol, the home isolation period lasts until the 10th day after the appearance of the first symptom, or up to 72 hours without symptoms. Main outcomes The primary endpoint will be time to recovery, defined as the number of days elapsed before all COVID-19 Influenza-like symptoms are recorded as mild or absent during home isolation period. Secondary measures are recovery time for each COVID-19 symptom; score of the scale created for the study (COVID-Simile Scale); medicines used during follow-up; number of days of follow-up; number of visits to emergency services; number of hospitalizations; other symptoms and Adverse Events during home isolation period. Randomisation The study Statistician generated a block randomization list, using a 1:1 ratio of the two groups (denoted as A and B) and a web-based tool (http://www.random.org/lists). Blinding (masking) The clinical investigators, the statistician, the Primary Care teams, the study collaborators, and the participants will remain blinded from the identity of the two treatment groups until the end of the study. Numbers to be randomised (sample size) One hundred participants are planned to be randomized (1:1) to placebo (50) or homeopathy (50). Trial Status Protocol version/date May 21, 2020. Recruitment is ongoing. First participant was recruited/included on June 29,2020. Due to recruitment adaptations to Primary Care changes, the authors anticipate the trial will finish recruiting on April 10, 2021. Trial registration COVID-Simile Study was registered at the University Hospital Medical Information Network (UMIN - https://www.umin.ac.jp/ctr/index.htm) on June 1st, 2020, and the trial start date was June 15, 2020. Unique ID: UMIN000040602. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

scholarly journals Nurses' responsibilities and tasks in pharmaceutical care: A scoping review

Nursing Open ◽  
2021 ◽  
Author(s):  
Elyne De Baetselier ◽  
Tinne Dilles ◽  
Hilde Feyen ◽  
Filip Haegdorens ◽  
Laura Mortelmans ◽  
...  
Keyword(s):  
Pharmaceutical Care ◽  
Scoping Review
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