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      Intervenciones Farmaceuticas en pacientes con Diabetes Mellitus Tipo 2 Translated title: Pharmaceutical interventions in patients with Type 2 Diabetes Mellitus

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          Abstract

          Resumen Introducción: La Atención Farmacêutica es la provision responsable de la farmacoterapia con el propósito de alcanzar resultados concretos que mejoren la calidad de vida de los pacientes. Objetivo: Evaluar el impacto de las intervenciones farmacéuticas en pacientes con Diabetes Mellitus Tipo 2. Metodologia: Ensayo Clínico Aleatorizado, con medición de variables antes y después. No probabilísti-co. De conveniencia. Participaron 32 pacientes del grupo intervenido y 32 en grupo control. Se realizaron entrevistas mensuales en un periodo de intervención farmacéutica de 6 meses (desde octubre 2011 hasta junio 2012). Se registraron solo 3 abandonos. Resultados: La edad de los pacientes fue 55,6±10,6 anos. Los pacientes del grupo intervenido mejoraron la glicemia en 34%, donde 24 pacientes tenian el valor (< 130 mg/dL); la hemoglobina glicosilada mejoró 1,9%, donde 15 pacientes lograron los parámetros deseados (< 6,5%). La calidad de vida del grupo inter-venido aumentó de (56,3 a 71,3 %) y fue medido con el cuestionario SF-36. En el grupo intervenido se encontraron 80 problemas relacionados con medicamentos, en 27 pacientes, se resolvieron 59; al final del estudio 12 pacientes resolvieron todos los problemas relacionados con medicamentos; se realizaron 254 intervenciones farmacêuticas, el nivel de conocimiento de los pacientes sobre la enfermedad mejoró en 41%, el conocimiento sobre sus medicamentos mejoró en 53%. Conclusión: Las intervenciones farmacêuticas mejoraron los parámetros clínicos de glicemia, hemoglobina glicosilada, optimizaron el uso de medicamentos, disminuyeron los problemas relacionados con medicamentos, mejoraron la calidad de vida de los pacientes.

          Translated abstract

          Abstract Introduction: Pharmaceutical Care is the responsible provision of the pharmacotherapy with the purpose of achieving concrete results in order to improve the quality of life of the patients. Objective: To evaluate the impact of pharmaceutical intervention on patients with Type 2 Diabetes Mellitus. Methodology: Random Clinical Assay with measurement of variables before and after. Non probabilistic. At convenience. Participating population was composed of 32 patients at the intervention group and 32 at the control group. Monthly interviews were performed in a period of pharmaceutical intervention of 6 months (from October 2011 to June 2012). In this period they were recorded only 3 dropouts. Results: The patients’ age was 55.6 ± 10.6 years. Patients in the intervention group improved glycaemia in 34%, where 24 patients had the value (< 130 mg / dL); the glycosylated hemoglobin improved 1.9%, where 15 patients achieved the desired parameters (< 6.5%). The quality of life of the intervention group increased from (56.3 to 71.3%) and was measured with the SF-36 questionnaire. In the intervened group, 80 drug-related problems were found; in 27 patients, 59 were resolved; at the end of the study 12 patients resolved all drug-related problems; 254 pharmaceutical interventions were performed, the level of patient knowledge about the disease improved by 41%, knowledge about their medications improved by 53%. Conclusion: Pharmaceutical interventions improved the clinical parameters of glycemia, glycosylated hemoglobin, optimized drug use, decreased drug-related problems, and improved the quality of life of patients.

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          Most cited references32

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          Drug-related problems: their structure and function.

          In order to better focus the role of the pharmacist on patient need and patient outcome, a means of categorizing drug-related problems (DRPs) is presented. A DRP exists when a patient experiences or is likely to experience either a disease or symptom having an actual or suspected relationship with drug therapy. Eight different categories of DRPs are described and examples of each category are offered. This categorization serves a number of functions, such as: (1) to illustrate how adverse drug reactions form but one category of extant DRPs, (2) to make tangible the pharmacist's role for the future, (3) to serve as a focus for developing a systematic process whereby the pharmacist contributes significantly to the overall positive outcome of patients, (4) to bring to pharmacy practice a vocabulary consistent with that of other healthcare professionals, and (5) to aid in the development of standards of practice for pharmacists.
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            Sensitivity of patient outcomes to pharmacist interventions. Part I: systematic review and meta-analysis in diabetes management.

            Pharmacists participate in managing diabetes therapy. Despite many reviews, few have quantified the impact of pharmacists' interventions. To identify outcomes sensitive to pharmacists' interventions and quantify their impact through critical literature review. All original research describing the impact of pharmacists' interventions in the management of diabetic pharmacotherapy was sought in International Pharmaceutical Abstracts, MEDLINE, Embase, Cochrane Register, and Cumulative Index to Nursing & Allied Health Literature from inception through 2006. Two independent reviewers identified articles, compared results, and settled differences through consensus. The Downs-Black scale was used to assess quality. Data included intervention type, patient numbers, demographics, study characteristics, instruments used, data compared, and outcomes reported. A random-effects meta-analysis combined amenable results. Of 302 articles identified, 108 involved pharmacists' interventions; 36 addressed diabetes (14 medical clinics, 11 community pharmacies, 7 ambulatory care clinics, 4 hospital wards, 1 physician's office, 1 prison, and 3 in both medical clinics and community pharmacies; 1 did not describe its practice site). Research designs included randomized (n = 18) and nonrandomized (n = 9) controlled trials, pre- and postobservational cohorts (n = 2), retrospective cohort study (n = 1), chart reviews (n = 5), and database study (n = 1). Diabetes education (69%) and medication management (61%) were the most frequently used interventions. Mean +/- SD quality was 62 +/- 11% (fair). Fifty-one (69%) study results were sensitive. Meta-analysis of data from 2247 patients in 16 studies found a significant reduction in hemoglobin A1C (A1C) levels in the pharmacists' intervention group (1.00 +/- 0.28%; p < 0.001) but not in controls (0.28 +/- 0.29%; p = 0.335). Pharmacists' interventions further reduced A1C values 0.62 +/- 0.29% (p = 0.03) over controls. A1C is sensitive to pharmacists' interventions. Several potentially sensitive outcomes were identified, but too few studies were available for quantitative summaries. More research is needed.
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              Drug-Related Morbidity and Mortality: Updating the Cost-of-Illness Model

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                Author and article information

                Journal
                ars
                Ars Pharmaceutica (Internet)
                Ars Pharm
                Universidad de Granada (Granada, Granada, Spain )
                2340-9894
                March 2017
                : 58
                : 1
                : 21-28
                Affiliations
                [1] Asunción orgnameUniversidad Nacional de Asunción orgdiv1Facultad de Ciências Químicas Paraguay
                [2] Araraquara São Paulo orgnameUniversidade Estadual Paulista orgdiv1Faculdade de Ciências Farmacêuticas orgdiv2Departamento de Fármacos e Medicamentos Brazil
                Article
                S2340-98942017000100003 S2340-9894(17)05800100003
                10.30827/ars.v58i1.5917
                a59ab9c0-f2cc-4543-8239-b2b9d2dd8394

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 15 March 2017
                : 12 January 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 8
                Product

                SciELO Spain

                Categories
                Artículos Originales

                Diabetes Mellitus Tipo 2,Atención Farmacéutica,Intervención Farmacéutica,Type 2 Diabetes Mellitus,Pharmaceutical Care,Pharmaceutical Intervention

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