LEPROSY CONTROL AND THE IMPLEMENTATION OF MULTIPLE DRUG THERAPY: TO WHAT EXTENT CAN THE OPERATIONAL STRATEGY BE SIMPLIFIED FOR PRIMARY HEALTH CARE?

1992 ◽  
Vol 63 (3) ◽  
Author(s):  
A. C. McDougall
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Drug Therapy ◽  
Multiple Drug ◽  
Operational Strategy ◽  
Primary Health ◽  
Multiple Drug Therapy ◽  
Leprosy Control

Health Worker Perceptions of the Integration of Leprosy Control Services at the Primary Health Care Level in Ibadan, Nigeria

2003 ◽  
Vol 22 (1) ◽  
pp. 111-124 ◽  
Author(s):  
Oluseyi R. Olaseinde ◽  
William R. Brieger
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Local Government ◽  
Health Worker ◽  
Health Staff ◽  
Basic Training ◽  
Front Line ◽  
Primary Health ◽  
Service Training ◽  
Leprosy Control

A goal of both the World Health Organization and the Nigerian National Tuberculosis and Leprosy Control (TBL) Program is to integrate leprosy control services into the front line primary health care service system. Traditionally, leprosy services had been handled by one local government officer with little involvement of other health staff, and this limited access and timeliness of services for leprosy patients. Even after the national TBL program was implemented, integration has not been achieved, and this study of 203 front line health workers in the five local government areas that comprise the Ibadan metropolitan area of Oyo State, Nigeria sought to determine the role of health worker knowledge, attitudes, and self-efficacy in fostering or inhibiting leprosy service integration. Leprosy knowledge scores were positively associated with years in service, having lectures on leprosy during basic training, and having attended in-service training (IST) on leprosy. Among the cadres interviewed, Environmental Health Officers (EHOs), who had traditionally managed leprosy services prior to the move for integrated services, had the highest scores. EHOs and those who had leprosy lectures during basic training also had better attitudes toward leprosy than their counterparts. Male health staff and those who had leprosy lectures during basic training also had higher attitude scores concerning integrating leprosy control services with primary care. Finally, the only factor associated with perceived self-efficacy to perform leprosy control services was cadre. Ironically, Community Health Extension workers, who have had little in the way of experience with and training in leprosy control, believed they could handle these responsibilities better than other cadres. The influence of basic and in-service training on enhancing leprosy control knowledge and attitudes is recognized and enhancement of curricula for all cadres on leprosy issues is recommended.

scholarly journals MUSCLE ADVERSE EVENTS AMONG USERS OF SIMVASTATIN IN PRIMARY HEALTH CARE: COLLABORATIVE DRUG THERAPY MANAGEMENT

2018 ◽  
Vol 11 (1) ◽  
pp. 99
Author(s):  
Marcos Francisco Pereira Lobrigatte ◽  
Glauco de Mello Nogueira ◽  
Vinícius João Navarini ◽  
Márcia Terezinha Lonardoni Crozatti ◽  
Jorge Juarez Vieira Teixeira
Keyword(s):  
Health Care ◽  
Creatine Kinase ◽  
Primary Health Care ◽  
Drug Therapy ◽  
Adverse Events ◽  
Thyroid Stimulating Hormone ◽  
Therapy Management ◽  
Drug Therapy Management ◽  
Primary Health ◽  
One Year

Collaborative drug therapy management in primary health care involves communication among the physician, pharmacist and user of simvastatin and can result in safer results regarding patient wellbeing. The aim of the study was to investigate muscle adverse events and risk factors related to simvastatin. For patients who developed muscle adverse events, collaborative drug therapy management was performed in an attempt to resolve the symptoms. A non-randomized case study was conducted at the single basic health unit in the city of Peabiru, Parana, Brazil, for a period of one year. Patients were interviewed using a structured form. To confirm muscle adverse events, the patient was referred to a physician and submitted to the suspension and return to treatment. Thyroid-stimulating hormone, creatine kinase and alanine aminotransferase exams were performed. A sample of 148 users of simvastatin was selected. Eleven patients had some type of simvastatin-associated muscle adverse event (myopathy), among whom seven had muscle symptoms (myalgia) and four had elevated creatine kinase, but were asymptomatic (asymptomatic myopathy). Collaborative drug therapy management focused on simvastatin for five patients with myalgia led to improvements in the quality of life of two patients. EVENTOS ADVERSOS MUSCULARES ENTRE USUÁRIOS DE SINVASTATINA NA ATENÇÃO PRIMÁRIA EM SAÚDE: MANEJO COLABORATIVO DE TERAPIA MEDICAMENTOSA Resumo: O manejo colaborativo de tratamento medicamentoso em atenção primária envolve a comunicação entre o médico, farmacêutico e o usuário de sinvastatina e pode levar a resultados mais seguros, favorecendo o bem-estar do paciente. O objetivo do estudo foi investigar eventos adversos musculares e fatores de risco para tais eventos, relacionados à sinvastatina. Para os pacientes que desenvolveram eventos adversos musculares, o manejo colaborativo foi realizada de forma a resolver os sintomas. Um estudo de caso não randomizado foi realizado na única unidade básica de saúde na cidade de Peabiru, Paraná, Brasil, por um período de um ano. Os pacientes foram entrevistados por meio de um formulário estruturado. Para confirmar os eventos adversos musculares, o paciente era encaminhado ao médico, sendo submetido à suspensão e retorno da sinvastatina. Foram realizadas dosagens do hormônio tireoestimulante, creatina quinase e alanina aminotransferase. Uma amostra de 148 usuários de simvastatina foi selecionada. Do grupo estudado, 11 pacientes tiveram algum tipo de evento adverso muscular (miopatia) associada à sinvastatina, entre os quais sete tiveram sintomas musculares (mialgia) e quatro apresentaram elevação da creatina quinase, mas eram assintomáticos (miopatia assintomática). O manejo colaborativo de terapia medicamentosa focada na sinvastatina para cinco pacientes com mialgia levou a melhoria na qualidade de vida de dois pacientes. Palavras-chave: Evento adverso; Manejo da terapia medicamentosa; Doença muscular; Atenção primária em saúde; Sinvastatina.

Clinical Impact of a Comprehensive Medication Management Service in Primary Health Care

2019 ◽  
pp. 089719001986630
Author(s):  
Bruna Damázio Santos ◽  
Mariana Martins Gonzaga do Nascimento ◽  
Grazielli Cristina Batista de Oliveira ◽  
Yone de Almeida Nascimento ◽  
Juliana Vaz de Melo Mambrini ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Drug Therapy ◽  
Care Setting ◽  
Medication Management ◽  
Clinical Impact ◽  
Initial Assessment ◽  
Management Service ◽  
Primary Health ◽  
Multiple Variables

Objective:To evaluate the clinical impact of a comprehensive medication management (CMM) service in a Brazilian primary health-care setting.Methods:A quasi-experimental study has been carried out between July 2014 and November 2016 with patients who received the service in the primary care setting of a Brazilian city (n = 1057). Factors associated with drug therapy problems (DTP) detection in the initial assessment were evaluated by performing univariate and multivariate analyzes. To evaluate the impact of the CMM service, a linear regression model was constructed from the difference between the initial and final values of the clinical and laboratory parameters adjusted by multiple variables.Results:A total of 1642 DTPs was identified, the most prevalent one being “nonadherence” (31.9%) and the “need for additional drug therapy” (22.9%). The use of 5 or more medications and the presence of 3 or more diseases were positively associated with the identification of 3 or more DTPs during the initial assessment. Even after multiple adjustments, a statistically significant reduction has been observed in the values of glycated hemoglobin, systolic blood pressure, low-density cholesterol, and total cholesterol.Conclusion:The CMM service contributed to the resolution of DTP and showed positive clinical impact in primary health care in the studied setting.

scholarly journals Potential drug therapy problems: identification and associated factors among Primary Health Care users

2021 ◽  
Vol 10 (9) ◽  
pp. e23710917417
Author(s):  
Flávia Cristina Moura Gualberto ◽  
Aline Angélica de Souza Valentin ◽  
Djenane Ramalho de Oliveira ◽  
Mariana Martins Gonzaga do Nascimento ◽  
Edna Afonso Reis
Keyword(s):  
Health Care ◽  
Big Data ◽  
Primary Health Care ◽  
Drug Therapy ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Primary Health Care System ◽  
Cross Sectional ◽  
Unified Health System ◽  
Primary Health

Cardiovascular diseases (CVD) and diabetes mellitus (DM) are chronic non-communicable diseases with high prevalence. Several factors contribute to its lack of control, especially those related to pharmacotherapy, often leading to problems related to the use of medication (DTP). Objective: To identify potential DTPs for the treatment of CVD and DM, as well as associated factors, using big data from users of the Unified Health System (SUS) in a municipality. Methods: A cross-sectional study was carried out based on big data of patients for whom at least one medication was dispensed in SUS pharmacies in the primary healthcare network in April 2019 (n = 4,800). Potential DTPs involving the treatment of CVD or DM were identified based on data on medications dispensed, demographic and clinical characteristics. To classify these potential PRMs, the Pharmacotherapy Workup method was used. Logistic regression analyzes were performed to identify factors associated with identifying at least one potential MRP. Results: The results showed that 25% of the population had at least one potential DTP, with a total of 1,914 potential PRMs being identified. In the multivariate model, age group was statistically associated with the identification of at least one potential DTP. Conclusions: This study allows tracing the frequency of important potential DTPs and associated factors, pointing out some priorities that must be addressed by the public primary health care system, supporting the planning of the implementation of drug therapy management services aimed at the studied population.

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