Disertación/Tesis

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2024
Disertaciones
1
  • ARTUR FELIPE SIQUEIRA DE BRITO
  • Economic evaluation of the use of ribociclib in the treatment of locally advanced or metastatic hormone receptor-positive (HR+) and human epidermal growth factor receptor-2 negative (HER2−) breast cancer: a systematic review

  • Líder : ADEMIR EVANGELISTA DO VALE
  • MIEMBROS DE LA BANCA :
  • ADEMIR EVANGELISTA DO VALE
  • ANNA MARIA BUEHLER
  • MARCELO EIDI NITA
  • PABLO DE MOURA SANTOS
  • Data: 08-mar-2024


  • Resumen Espectáculo
  • Hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) breast cancer is the most common molecular subtype. Cyclin-dependent kinase (CDK) 4/6 inhibitors are a new class of targeted agents recommended for treatment of this subtype. Ribociclib is the representative of this class that presents more robust efficacy results considering the harsh outcome of overall survival. To investigate the cost-effectiveness of ribociclib in the treatment of patients with HR+/HER2- locally advanced or metastatic breast cancer through a systematic review of the literature. This review was conducted following Cochrane recommendations and ISPOR's CiCERO guide. The writing followed PRISMA guidelines. The searches were carried out in 8 databases. The methodology and quality of the report were assessed using the ECOBIAS checklist and the CHEERS checklist. 24 economic evaluations were included. The Markov and Partitioned Survival models, with a lifetime horizon and cycle duration of 4 weeks, were the most used. Ribociclib was considered cost-effective in 8 studies, cost-saving in 5 studies and not cost-effective in the remaining studies. Ribociclib was considered more cost-effective, and dominant compared to palbociclib. Current evidence indicates that the use of ribociclib is clinically beneficial and can be considered a cost-effective intervention for the treatment of HR+ HER2- locally advanced or metastatic breast cancer depending on the WTP in each country.

2023
Disertaciones
1
  • Sayuri Rocha Yamashita
  • A cross-sectional study in critically ill patients with COVID-19 in an intensive care unit.

  • Líder : FRANCINE JOHANSSON AZEREDO
  • MIEMBROS DE LA BANCA :
  • DIEGO GNATTA
  • ADEMIR EVANGELISTA DO VALE
  • FRANCINE JOHANSSON AZEREDO
  • GUBIO SOARES CAMPOS
  • LINDEMBERG ASSUNÇÃO COSTA
  • Data: 16-ene-2023


  • Resumen Espectáculo
  • COVID-19 is a severe acute respiratory syndrome caused by SARS-CoV-2, and in March 2020, it was considered a pandemic. In this context, a multidisciplinary group monitored and investigated clinical and laboratory findings in search of information that would add to the studies of this new virus. Along with changes in conventional infection prevention and control practices, the investigative perspective has adapted studies to the current scenario. This study aimed to describe the clinical and laboratory profile of critically ill patients affected by COVID-19 admitted to an intensive care unit (ICU) using dexamethasone. The methodology used was a cross-sectional study conducted on patients admitted to the ICU of a COVID reference hospital in the city of Salvador, Bahia. Regarding the deaths found, 55% of the patients had a diagnosis of hypertension, 44% had diabetes and/or insulin therapy, 33% had a history of cardiovascular disease (atrial fibrillation and congestive heart failure), and 22% had a history of stroke. Alterations in renal function (creatinine) had the relative risk considered significant. In addition, of the 22 patients listed, 45% (10) had blood infection or pneumonia associated with mechanical ventilation by Acinetobacter baumannii (A. baumannii) in blood cultures and/or tracheal aspirate secretion. We observed that there is a moderate correlation between length of hospital stay and infection by A. baumannii (Spearman's ρ; 0.592; p-value<0.005) and a strong correlation between the number of days on mechanical ventilation and infection by this bacterium (Spearman's ρ; 0.740; p-value <0.001). These data contribute to the etiological description of SARS-CoV-2 infections and suggest that laboratory medicine can also make a relevant contribution to scientific and health knowledge during the first outbreak of COVID-19. Hospitals that receive these patients may be vulnerable to outbreaks of multidrug-resistant organisms, such as A. baumannii . It is worth reflecting on care and operational practices in managing these patients, especially regarding isolation and restriction measures.

2
  • Erlan Canguçu Aguiar
  • Use of text messages to promote medication adherence and reduce blood pressure in hypertensive patients: the ESSENCE Study

  • Líder : MARCIO GALVAO GUIMARAES DE OLIVEIRA
  • MIEMBROS DE LA BANCA :
  • ANDRÉ OLIVEIRA BALDONI
  • Fabiane Raquel Motter
  • MARCIO GALVAO GUIMARAES DE OLIVEIRA
  • PABLO DE MOURA SANTOS
  • SOSTENES MISTRO
  • Data: 20-mar-2023


  • Resumen Espectáculo
  • Introduction: Non-communicable chronic diseases have a great impact on the health system and, among them, systemic arterial hypertension is the most prevalent, being associated with high socioeconomic costs, represented by the high rates of hospitalizations in the Unified Health System (SUS) , due to the loss of work productivity and family income. Despite its diagnosis being considered easy and the broad therapeutic arsenal available, effective blood pressure control and maintenance of the therapeutic regimen have been difficult due, among other factors, to non-adherence to treatment. Although several interventions have been developed to improve adherence to medication treatment, no high-quality evidence was found to support the use of a specific intervention. However, recently, studies have shown that sending text messages (Short Message Service - SMS) as reminders or patient engagement messages has increased adherence to the treatment of patients with chronic diseases, requiring, however, to be deepened through other designs. Objective: The ESSENCE study evaluated the effect of sending text messages with and without a reminder of the time of medication use on adherence to medication treatment and on the reduction of blood pressure in hypertensive patients. Methods: This is a randomized, cross-over, double-blind clinical trial with active control, which included hypertensive patients, aged between 30 and 69 years, monitored at a public community pharmacy. The messages were sent automatically by software and received on the participants' cell phones. Group 1 included patients who received informational text messages about antihypertensives and hypertension control for 90 days. Group 2 included patients who received informational messages associated with reminder messages at the time of each drug dose for 90 days. After a 30-day washout period, the groups were switched and received the interventions for another 90 days. Results: The 157 individuals evaluated had a mean age of 52(8.8) years and most were female (76.4%). No significant difference was found in self-reported adherence within and between groups in the pre- and post-crossover periods. For systolic and diastolic blood pressure, there was a significant reduction in the pre-crossover period, but with no difference when comparing groups. In the post-crossover period, the reduction was not significant in the intra and between groups analyses. Conclusion: Thus, it was possible to observe that there was equivalence of effect between the two interventions for the primary outcomes evaluated. The results point to the possibility of implementing messaging systems in health services.

3
  • Felipe Feistauer Gomes
  • EFFECTIVENESS AND SAFETY OF INDUCTION WITH ANTHRACYCLINE AND CYTARABINE IN PATIENTS WITH ACUTE MYELOID LEUKEMIA: RESTROSPECTIVE STUDY IN A PUBLIC CENTER IN SALVADOR/BAHIA

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • GENARIO OLIVEIRA SANTOS JUNIOR
  • LINDEMBERG ASSUNÇÃO COSTA
  • MARCIO GALVAO GUIMARAES DE OLIVEIRA
  • MARCO AURELIO SALVINO DE ARAUJO
  • Data: 28-abr-2023


  • Resumen Espectáculo
  • Acute myeloid leukemia (AML) is a heterogeneous aggressive leukemia with poor prognosis. The standard remission induction regimen for medically eligible patients with AML consists of a backbone of cytarabine & an anthracycline (“7+3” therapy).     Brazil is a large country with striking differences in in climate, ethnic heterogeneity and socioeconomic factors. This study assessed effectiveness (Eligible to the Next Treatment-ENT CR and suficient performance status to the next treatment, PFS and OS) and security (Early Mortality) of cytarabine and anthracycline (“7 + 3”regimen) in a public health center in Salvador, Brazil. Subgroups analyzed were about FTL3 and NPM1 mutations, leukocytes (>10,000 or <10,000), platelets (>20,000 or <20,000), and transplanted or non-transplanted. It was a retrospective analysis of all the cases of non-promyelocytic AML diagnosed between 2018 and 2022 in the University Hospital Professor Edgar Santos of Federal University of Bahia, after being approved by the Ethics Committee of the hospital. Kaplan-Meier methods were used to determine the median of the time to OS and PFS. A total of 45 patients were analyzed. Median age at diagnosis was 43 years (range, 16-69 years) with 62% females. There were 17.8% and 13.3% patients with FLT3-ITD and NPM1 mutations, respectively. Only 14 patients had karyotype test (85% with normal karyotype). Regarding effectiveness, 52% of patients were eligible for the next therapy after complete remission (consolidation or stem cell transplantation). Refractory patients were 20%. Early (4 weeks) mortality was 28%. The median of PFS and OS were 3.6 and 8.2 months respectively. Patients with FLT3 mutation, platelet < 20.000 and leukocytes < 10.000 had poor outcomes. In AML patients after stem cell transplantation, PFS and OS were, respectively 20 and 43 months. Average waiting time for start induction therapy was 12 days. The outcomes were consistent with the literature, adjusted for the population in question. Even with access to diagnostic tests (not common in Brazilian’s health public centers), patients did not have access to targeted therapies, with the 7+3 regimen being the only treatment for fit patients. To achieve complete remission followed consolidation/transplantation is still the BEST scenarios in AML eligible patients, but the improvement of access to diagnostic and treatment is still an unmet need.

4
  • Dulce Brás Impene Combo
  • EVALUATION OF SIMPLIFIED ANTIRETROVIRAL TREATMENT IN A UNIVERSITY HOSPITAL OF SALVADOR, BAHIA

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • Michael Ruberson Ribeiro da Silva
  • CARLOS ROBERTO BRITES ALVES
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • PABLO DE MOURA SANTOS
  • Data: 04-may-2023


  • Resumen Espectáculo
  • Introduction: Antiretroviral treatment and adherence to therapy have been the most effective intervention in controlling disease progression, although the human immunodeficiency virus (HIV) remains an important global public health problem. Recent studies have shown that dual therapy improves adherence and clinical outcomes and can potentially decrease toxicity and costs associated with treatment. Objective: To evaluate the virological outcomes of simplified antiretroviral regimens prescribed in a University Hospital in the State of Bahia, Brazil. Methods: This is a retrospective observational cohort conducted at the Magalhães Neto Outpatient Clinic, linked to Professor Edgard Santos University Hospital of the Federal University of Bahia (UFBA). Data were collected from January 2017 to August 2022. We included patients older than 18 years, who had already been submitted to antiretroviral therapeutic regimens in the past, without distinction of sex, and with simplified ART. Data were analyzed using the statistical software JAMOVI, version 2.2.5. Descriptive analyses were performed using frequency tables for categorical variables and median and interquartile range for continuous variables. To analyze the individual association of each qualitative independent variable with the dependent variable, Pearson's chi-square test (significance level of 5%) was used. For the joint association between the independent variables and the dependent variable, the data were analyzed by adjusting a binomial logistic regression model. Results and discussion: We analyzed 244 patients of which 65.2% were male, the median age was 58 years (IQR 50-65), evidencing an aging of PLHIV. Virological suppression corresponded to 98% of the patients, with a median time of 60.50 weeks (IQR 29.25-160.25) and a median of CD4 cells cel/mm3 of 675.00 (IQR 478.50-925.25), moreover, 89.7% of the patients prescribed the DTG+3TC regimen had no history of previous therapeutic failure, while 47.5% of the patients submitted to other therapeutic regimens had already had a history of failure. In addition, 88.1% of the patients did not change simplified regimens, which evidences an effectiveness and therapeutic optimization. Conclusion: The results corroborate the literature, demonstrating a good virological response in simplified regimens, and being a safe and effective alternative even in patients with a history of previous therapeutic failure.

5
  • EVERTON CESAR FIAES SOUZA
  • Evaluation of denials of PCDT medication requests for the treatment of chronic kidney disease in the State of Bahia

  • Líder : ADEMIR EVANGELISTA DO VALE
  • MIEMBROS DE LA BANCA :
  • ADEMIR EVANGELISTA DO VALE
  • CHARLESTON RIBEIRO PINTO
  • LINDEMBERG ASSUNÇÃO COSTA
  • PABLO DE MOURA SANTOS
  • Data: 09-jun-2023


  • Resumen Espectáculo
  • The Specialized Component was conceived in 2009 as a strategy within the scope of the National Pharmaceutical Assistance Policy (PNAF) to guarantee sustainable access to medicines for the treatment of a significant number of diseases and illnesses. This Component contains high-tech medications, making it an important drug dispensing strategy for the population. The CEAF Pharmacy located at the Ana Nery Hospital, corresponds to one of these outpatient medication dispensing units, for patients with kidney disease, who receive treatment monthly through the Clinical Protocols and Therapeutic Guidelines (PCDT). This study aimed to identify and describe the challenges of dispensing medications for patients with chronic kidney disease in the specialized component of pharmaceutical care. The study evaluated all patients in the period from January to December / 2019, corresponding to 5,402 patients, residing in 273 municipalities in the State of Bahia. Regarding demographic data, 3038 patients (56.24%) were male and 2364 (43.76%) female, with a mean age of 54 ± 17 years. Of the patients studied, 4681 (86.65%) were able to register and withdraw their medications, while 721 (13.35%) were unsuccessful in approving the inclusion of medications. These drugs rejected, alfaepoetina represented 46.49% (457), followed by ferric hydroxide sucrate 24.62% (242). Tacrolimus and cyclosporine were the two most widely used immunosuppressants in the state, representing 48.97% and 18.89%, respectively. Of the rejections made during the year, 81.99% (806) were associated with clinical parameters in the evaluation of medical examinations and / or prescribed dose, followed by 18.01% (177), performed with administrative problems, such as absence of documents and / or incorrect completion of LME. Of the rejected clinical parameters, we observed that 79.45% of the rejections were related to the absence of clinical parameters required by the Clinical Protocol and Therapeutic Guidelines, followed by 2.44% (24) with the wrong prescribed dose, 0.20% and 0.10 % (1) with allergy to the prescribed medication. Among the rejections related to clinical parameters in the alfaepoetin dispensation, 37.64% (172) of the exams presented hemoglobin dosage above the value determined by the PCDT, followed by 22.98% (105) of the transferrin saturation result. We observed in the study, that 21.02% (37) of the patients presented hemoglobin dosage between 10 g / dl and 11 g / dl, not receiving the medication because it does not comply with the recommended by the PCDT. 36.93% (65) had hemoglobin levels between 11 g / dl and 12 g / dl and 42.05% (74) above 12.1 g / dl. The study concluded that the clinical parameters presented in the results of the medical exams, represented the main challenge in the dispensing of the component&#39;s medications, more prevalent in the requests for Alphafapoetin and Ferric Hydroxide Saccharate. The pharmacist played an important role in the evaluation of these requests, avoiding the improper use of medications, facts evidenced in the hemoglobin and transferrin saturation levels presented by the rejected patients, and the use of these medications in these circumstances would increase the risk of death.

6
  • PRISCILA MOREIRA LAUTON
  • Adherence to treatment with infliximab in patients with immune-mediated inflammatory diseases treated at an infusion center of a university hospital in Salvador, Brazil

  • Líder : PABLO DE MOURA SANTOS
  • MIEMBROS DE LA BANCA :
  • GENARIO OLIVEIRA SANTOS JUNIOR
  • GENOILE OLIVEIRA SANTANA SILVA
  • LINDEMBERG ASSUNÇÃO COSTA
  • Michael Ruberson Ribeiro da Silva
  • PABLO DE MOURA SANTOS
  • Data: 06-dic-2023


  • Resumen Espectáculo
  • Infliximab therapy is effective in controlling symptoms and attaining clinical remission of immune-mediated inflammatory diseases; however, treatment adherence is essential to achieve the therapeutic objective. This study aimed to determine the rate of adherence to infliximab treatment in patients treated at an infusion center at a university hospital. Method: This ambispective cohort study included patients treated at the HUPES infusion center of our university hospital between March 2022 and February 2023. Sociodemographic, clinical, and pharmacotherapeutic data were collected from patients through interviews and medical record reviews using a structured form. The adherence rate was defined as the proportion of days covered in a year. Patients who achieved an adherence rate >80% were considered adherent. Results: The treatment adherence rate was 91.04%. Individuals with inflammatory bowel diseases had a 39.1% higher risk of non-adherence to treatment compared with other patients. Most patients achieved remission or control of the underlying disease activity and had good functional capacities and quality-of-life indices. The main reason for absence on the scheduled date was difficulty traveling to the infusion center.Conclusions: Despite the reported difficulties, treatment adherence was observed to be high. As the study was conducted in a reference unit with multidisciplinary care and continuous monitoring for treatment effectiveness, safety, and adherence, welcoming and good communication between professionals and patients may have contributed to the high adherence rate.

2022
Disertaciones
1
  • CAROLINE ROCHA SANTANA
  • Application of point-of-care testing in community pharmacy

  • Líder : SOSTENES MISTRO
  • MIEMBROS DE LA BANCA :
  • DANIELLE SOUTO DE MEDEIROS
  • JOSE ANDRADE LOUZADO
  • MARCIO GALVAO GUIMARAES DE OLIVEIRA
  • MATHEUS LOPES CORTES
  • Data: 03-jun-2022


  • Resumen Espectáculo
  •  

    Background: The negative impact of type 2 diabetes mellitus is notably more significant when the diagnosis is delayed cause early identification makes it possible to take measures to reduce clinical complications and the speed of disease progression. Thus, applying point-of-care glycated hemoglobin testing in community pharmacies can be a strategy for detecting undiagnosed type 2 diabetes mellitus. Pharmacists are accessible to users and professionals who can perform the tests and interpret their results. Aim: To evaluate the use of use of point-of-care glycated hemoglobin testing to detect new cases of diabetes mellitus in a public community pharmacy.  Method: This cross-sectional study included individuals without a previous diagnosis of diabetes mellitus who met the criteria for screening according to the Brazilian Diabetes Society, identified during health fair attendance at a public community pharmacy. Results: One hundred and eight users met the inclusion criteria. The mean age of the patients was 54.4 (± 15.4) years, ranging from 22 to 80 years. Eighty (74.1%) participants had glycated hemoglobin levels over the standard threshold, of which 58 (72.5%) were in the pre-diabetes range, and 22 (27.5%) had glycated hemoglobin levels > 6.4%, corresponding to a new diagnosis of type 2 diabetes mellitus. Conclusion: Screening by clinical pharmacists in a Brazilian public community pharmacy made it possible to identify individuals with glycated hemoglobin alterations that corresponded to the pre-diabetes state or a new diagnosis of type 2 diabetes mellitus. The experience was successful and the use of point-of-care glycated hemoglobin testing helped pharmacists to carry out immediate interventions as self-care guidelines and referral of individuals for investigation of diabetes mellitus in an appropriate medical service.

2
  • Andreia Dias Teixeira
  • ESTIMATED FINANCIAL SAVINGS WITH PHARMACEUTICAL CARE OFFER: AN ASSESSMENT BASED ON A THEORETICAL MODEL

  • Líder : JUCENI PEREIRA DE LIMA DAVID
  • MIEMBROS DE LA BANCA :
  • JUCENI PEREIRA DE LIMA DAVID
  • ADEMIR EVANGELISTA DO VALE
  • PABLO DE MOURA SANTOS
  • DIOGO PILGER
  • Data: 21-jun-2022


  • Resumen Espectáculo
  • Objective: To estimate, through a theoretical model, the occurrence of new drug prescriptions due to failure in the previous treatment, estimating the monetary costs of these new prescriptions, and to demonstrate, from the result, the importance of offering Pharmaceutical Care. Method: This is an analytical, transversal and quantitative intervention study, with semi-structured interviews, carried out with a panel of pharmacists and doctors, linked to the Unified Health System, in a municipality of 295,000 inhabitants, who estimated, through the use of of a theoretical model of probability pathway the occurrence of a new medical prescription due to therapeutic failure in a previous prescription, where there was no Pharmaceutical Care. Then, according to the average obtained by the expert panel, the final costs were obtained by adding the conditionals: the cost of a new prescription was added to the cost of a new medical consultation, also added to the previous prescription that caused the treatment failure, and the respective medical consultation that gave rise to this prescription. In the end, the cost result obtained was reduced by 10% to reflect the rate of new prescriptions never filled, even when treatment fails. Results: As estimated by the expert panel, 41.73±19.34 patients out of every 100 outpatients who do not receive Pharmaceutical Care experience therapeutic failure. The associated costs were entered, resulting in an expense of BRL R$8.823.260,16±1.706.418,51. Then, when decreasing by 10%, we arrive at an estimated cost of R$ R$7.940.934,14±1.535.776,66, with the occurrence of a new prescription due to failure in previous treatment in 2019, in the SUS outpatient services of the municipality in the year 2019. Conclusion: It is concluded that the offer of Pharmaceutical Care, with the availability of pharmaceutical services in outpatient clinics in the SUS, does not represent an increase in expenses, but an economy to the public coffers. Pharmaceutical Care should be used as a priority tool for public policies on access to medication, thus being able to reduce drug-related morbidity and mortality and consequently the financial cost in health.

3
  • Mariana Santos Melo
  • Drug utilization study on antibiotics use in the lower airway respiratory infections in pediatric patients at a tertiary hospital in northeastern Brazil.

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • LINDEMBERG ASSUNÇÃO COSTA
  • NEY CRISTIAN AMARAL BOA SORTE
  • RAND RANDALL MARTINS
  • Data: 15-dic-2022


  • Resumen Espectáculo
  • Introduction: Although medical advances have allowed important diagnostic progress in the etiological differentiation of viral and bacterial infections, the rational use of antimicrobials remains a challenge. In pediatrics, antibiotics are the drugs most prescribed for the treatment of respiratory infections that are mostly viral. This raises the risk of microbial resistance, mortality, onset of adverse events and in turn leads to an increased hospitalization time and additional health costs. The diagnosis of profile antibiotic uses at heath institutions allows the understanding of drug therapy, which is fundamental for the development of protocols to support health professionals to improve clinical decision-making. Objective: To idenfify the profile of antibiotic use for the treatment of lower tract respiratory diseases (pneumonia and acute bronchiolitis) and to characterize the clinical, laboratory and radiological factors associated with their prescription in the treatment of acute bronchiolitis in pediatric patients admitted to wards of a large hospital in the Northeast of Brazil.  Methods: This is an observational, single-center, drug utilization study (DUS). It was based on evaluation of medical prescriptions on electronic medical records in pediatric wards from January 2018 to July 2019 according to pre-defined selection criteria. Results: A total of 257 children in the course of bronchiolitis (102) and and pneumonia (155) were included. Among them 32,29% (83) had comorbidities and (%) mentioned previous use of continuous medication. This study identified high rates of antibiotic use, even in patients with bronchiolitis. It was associated a statistically significant difference in length of stay among patients who used antibiotic therapy, whereas in mortality there was no difference. The factors that motivated the use of antibiotics were, mainly, previous continuous use of medication, presence of previous comorbidities, respiratory distress and leukocytosis. Conclusion: The high frequency of antibiotic use in children with respiratory infections is worrisome, especially in acute bronchiolitis. At the same time that increases in hospital stay no change in the mortality outcome occurred. The factors associated with these behaviors reflect the inappropriate use of antimicrobials, insecurity on prescription and poor adherence to scientific evidence. This contributes to additional healthcare costs, more adverse drug events and microbial resistance.

     

2020
Disertaciones
1
  • LUÍSA FLORÊNCIA CHONGO NAMBURETE
  •  

    EPIDEMIOLOGICAL FREQUENCY OF ADVERSE EVENTS FOLLOWING MEASLES AND RUBELLA IMMUNIZATION IN MOZAMBIQUE, 2018

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • ANTONIO CARLOS BEISL NOBLAT
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • NEY CRISTIAN AMARAL BOA SORTE
  • PABLO DE MOURA SANTOS
  • Data: 30-jun-2020


  • Resumen Espectáculo
  • OBJECTIVES: To analyze the epidemiological frequency of Post-Vaccination Adverse Events (PVAEs) of measles and rubella reported in the National Pharmacovigilance System in children from 6 months to 14 years old, in 2018 year in Mozambique. The specific objectives were: to identify the main PVAEs against measles and rubella in children from 6 months to 14 years old, notified in the National Pharmacovigilance System in Mozambique; compare the frequency of PVAEs by age, sex and geographic region (South, Center and North) of the country; classify PVAEs according to their severity; and to evaluate the association between the variables of interest (region of origin, sex of the child, professional category and age) and the type of PVAEs. METHODS: As for the approach, the research is quantitative. Secondary data from the Surveillance System of the National Directorate of Pharmacy of the Ministry of Health, in Mozambique, referring to PVAEs notifications for the year 2018 were analyzed. Data collection was retrospective, based on the notification forms of vaccinations made by the sentinel health units located in all provinces, based on the PVAEs notification criteria recommended by World Health Organization (WHO). The data were processed using the SPSS statistical package, version 20. In the analysis and interpretation of the results, descriptive statistics were used through tables and graphs. Hypothesis tests were also used to assess the association between the region of origin, the child's sex, professional category and age and the type of PVAEs. RESULTS: The results of the study showed that fever, body warming and vertigo are the most frequent manifestations. In addition, Tete province has a high number of serious adverse events (8%), followed by Gaza province (5%). The province of Niassa and Nampula have not been notified of any serious adverse events. For mild adverse events, they were most frequently highlighted in Sofala province with 41%, followed by Tete province with 30%, Gaza province with 25% and with less emphasis went to Maputo provinces (3%), followed by Inhambane province with 4% and lastly Maputo City. CONCLUSIONS: The results of this study confirm the importance of implementing an active surveillance system to improve the overall performance of the Pharmacovigilance system and the early detection of adverse events after immunization and to adequately quantify them and provide valuable information considered for the formulation of evidence-based policies. Post-vaccination adverse events are often mild.

2
  • DANIEL DE JESUS RIBEIRO
  • Effectiveness and Safety of Ranibizumab Treatment in a University Hospital

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • NEY CRISTIAN AMARAL BOA SORTE
  • PABLO DE MOURA SANTOS
  • PAULO AFONSO BATISTA DOS SANTOS
  • Data: 14-jul-2020


  • Resumen Espectáculo
  • Title: Effectiveness and safety in the treatment with ranibizumab in a University Hospital. Objectives: to evaluate the effectiveness and safety of ranibizumab in the treatment of retina deseases in a university hospital. Methodology: data from patients treated with ranibizumab were collected through interviews with participants and information obtained from medical records, the main measures of effectiveness were the variation in visual acuity (VA) and changes in central retinal thickness (CRT) . All adverse events that occurred during treatment were recorded for safety assessment. Results: a total of 103 patients were included in the study and a number of 154 treated eyes. The mean age found was 67.8 years and most patients received treatment for diabetic macular edema, followed by treatment for retinal venous occlusion. The mean variation in VA represented a loss of 0.9 letters and the mean variation in the CRT found was a reduction of 12.6 µm, indicating stability in the macular edema of the treated eyes. Conclusions: The information collected in this research demonstrated that ranibizumab had a lower degree of effectiveness in the treatment of neovascular diseases of the retina, due to little variation in visual acuity and in the thickness measurements of the central retina in the treated patients. The low number of applications of the drug and the interval between applications may be the factors that contributed significantly to the low results of effectiveness in the population studied. With regard to safety aspects, the vast majority of adverse events reported were related to the medication application procedure.

3
  • BIANCA CERQUEIRA BORGES DE OLIVEIRA
  • Evaluation of Knowledge and Conducts of Pharmacists in Drugstores of Salvador (BA)

  • Líder : JUCENI PEREIRA DE LIMA DAVID
  • MIEMBROS DE LA BANCA :
  • ADEMIR EVANGELISTA DO VALE
  • JUCENI PEREIRA DE LIMA DAVID
  • LEONARDO RE?GIS LEIRA PEREIRA
  • PABLO DE MOURA SANTOS
  • TIAGO MARQUES DOS REIS
  • Data: 20-ago-2020


  • Resumen Espectáculo
  • Before the industrialization process in Brazil, the pharmacist was responsible for research, manipulation and quality control of medicines, besides providing counseling and guidance to patients; when, however, medicines started to be produced on a large scale, the pharmacist faced function loss and distancing from patients. In the last decades, many changes have occurred in order to reorient pharmaceutical practice, from the dispensing act being better understood to the development of pharmaceutical care as model of practice. The goal of this work was to verify the knowledge and conduct of pharmacists in drugstores in the city of Salvador (Bahia) regarding dispensing and provided pharmaceutical services. Therefore, a cross-sectional and descriptive study was performed, from February to July 2019 (data collection), in which pharmacists working in drugstores in the 12 Sanitary Districts of Salvador were visited and invited to participate in this research; a questionnaire validated by Reis (2013) was applied, with adaptations made after recommendations by CEP/FAR/UFBA, containing 44 questions sectioned into general data, knowledge and conduct; and for statistical analysis, Microsoft Excel Version 16.0.12130.20390 and IBM SPSS Statistics 21 were used. Among the 321 pharmacists visited, 154 (48%) agreed to participate in the research; the participants were female (77.3%), the average age was 33.2 years, graduated with generalist curriculum (87.6%), studied in private institutions (72.4%) and assumed the position of responsible pharmacists of drugstores (65.6%), with the majority of them (69.28%) having centralized administration. The result obtained about knowledge related to medication dispensing was considered satisfactory for 40.9% of pharmacists, regular for 51.3% and unsatisfactory for only 7.8% of them; and as for the concept of pharmaceutical care, 64.9% obtained a satisfactory result. About conducts, pharmacists reported that they informed more about dosage, adverse reactions and product preservation during dispensing; 19.1% had the inadequate practice of indicating prescription drugs; 30.5% said they performed pharmaceutical care, but only 4.5% of them knew the concept, worked in a drugstore whose physical structure they considered adequate, made documentation and records, and the service was included in the SOPs manual. Concerning professional practice, 35.7% of pharmacists evaluated themselves as accomplished, 26.6% needed to improve knowledge related to the pharmaceutical area, 9.1% needed to improve compliance with legislation, 48.1% needed to improve patient orientation and pharmacotherapeutic follow-up, and 0.6% felt terrible. Finally, data obtained through this research indicate that drugstores did not have a physical structure and/or clinical services implemented in an adequate or satisfactory manner, affecting the act of dispensing medications and pharmaceutical care service, which would enable the rescue of pharmacist-patient relationship and would help to reestablish the pharmacist's social role in the community.

4
  • DANILO REIS GOMES
  • Direct costs involved in renal support therapies in adult patients admitted to the intensive care unit.

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • DIMITRI GUSMAO FLORES
  • PABLO DE MOURA SANTOS
  • ANTONIO CARLOS BEISL NOBLAT
  • Data: 25-ago-2020


  • Resumen Espectáculo
  • Health costs are very high. This growth scenario is observed both in the world and in Brazil. Health innovations cause a range of inclusions of new technologies that add costs to services, patients and / or society. These costs impact on several processes in the health management system, so understanding them is essential to assist in decision making in order to subsidize the allocation of resources. It is known that health services have a major challenge in cost management, especially in hospital institutions that concentrate flows which require high technological resources and that are proportionally linked to high values. Within these institutions are the intensive care units, some typical areas with complex therapies that require highly specialized teams and high investment processes. One of these therapies is renal support, which is frequent in inpatient units. These therapies need for equipment, supplies and specific staff to perform. This study aims to identify the direct costs involved in renal support therapies performed in adult patients admitted to an intensive care unit. The research is a study of measurement and valuation of direct costs. The study is observational and descriptive. The direct costs involved in renal support therapies used in adult patients admitted to an intensive care unit of a hospital in the city of Salvador / Bahia will be measured and analyzed. The study showed that 16.6% of patients admitted to the hospital's intensive care units underwent some type of renal support therapy. Three types of renal support therapy are performed in the ICUs, namely: Acute Hemodialysis (SLEED), Peritoneal Dialysis (PD) and Continuous Veno-Venous Hemodialysis (CVV). It was found that SLEED dialysis is the most common with total expense generated by direct costs in this therapy of R$ 111.0526, followed by Continuous Veno-Venous Hemodialysis with a total value of R$ 4,345.8688 and ending Dialysis peritoneal with a total value of R$ 224.4419. In the ICUs of the institution under study in 2019, 1000 SLEED therapy procedures were performed, which added up, in direct costs, R$ 111,052.60. Regarding peritoneal dialysis, there were 39 procedures in the year, with a total of R$ 8,753.23 and, finally, the most expensive, the CVV with 954 procedures, totaling R$ 4,140,815.97. The study concluded that the direct costs involved with renal support therapies performed in ICUs can be classified into medical materials and solutions for performing dialysis. In intermittent dialysis therapies (SLEED and PD), medical supplies are the ones that present the largest portion of the direct costs involved in therapies, unlike continuous dialysis (CVV) whose solutions necessary for performing dialysis represent 64.7% of direct costs. It is important to highlight that this study measured and valued only the direct costs, being necessary to obtain the total costs of renal support therapies to identify the indirect costs.

5
  • BRUNA LARANJEIRA ALVES
  • Emergency contraception: consumption, profile of emergency contraceptive users and performance of the pharmacist in accessing the morning-after pill among women in Salvador/Bahia

  • Líder : JUCENI PEREIRA DE LIMA DAVID
  • MIEMBROS DE LA BANCA :
  • ADEMIR EVANGELISTA DO VALE
  • DENISE BUENO
  • JUCENI PEREIRA DE LIMA DAVID
  • LEONARDO RE?GIS LEIRA PEREIRA
  • PABLO DE MOURA SANTOS
  • Data: 26-ago-2020


  • Resumen Espectáculo
  • Objectives: To know the profile of emergency contraceptive users and the performance of the pharmacist in accessing the morning-after pill among women in Salvador/Bahia. Methods: An observational, descriptive and cross-sectional study was conducted with women and pharmacists in the municipality of Salvador/BA, between November 2018 and September 2019. To achieve the objectives, an online semi-structured questionnaire was applied, through the Google Forms® Platform, with women between 15-49 years of age, residents of Salvador/BA, who have already declared the use of emergency contraceptives. And to collect the pharmacist’s performance profile, a face-to-face questionnaire was applied with Pharmacists working in Pharmacies and Drugstores in Salvador. Results: 216 women participated in the study, 51% were aged 23-29, 87% were single, 76% had completed or ongoing higher education, and 74% had family income between 2-5 minimum wages. Unprotected sexual intercourse was the most cited reason (60%) for using the morning-after pill, and all women purchased the drug from the private company. Among these, 39% of the participants reported irregular periods after the use of the morning-after pill. Only 17% of women reported being satisfied with the guidance they received at the time of purchasing the morning-after pill, and 43% were never served by a pharmacist when purchasing the medicine. As for pharmacists, 64% adequately consider inhibition of ovulation as the mechanism of action of the morning-after pill. Among pharmacists, 90% agree that the drug brings harmful effects to women’s reproductive health, 67% said they always guide consumers of emergency contraception, and 40% has already indicated its use. Conclusion: More than half of the participants in this study are single and have completed or ongoing higher education. Unprotected sexual intercourse was the most commonly cited reason for emergency contraceptive use, and irregularity in menstruation was the most common undesirable effect. In addition, there is a low rate of satisfaction among women with the guidance received by pharmacists. Most of them, in turn, know at least one mechanism of action of the morning-after pill and report providing guidance to women who purchase emergency contraception.

2019
Disertaciones
1
  • ELIANE DEBORTOLI DE CARVALHO
  • FAMILY PARTICIPATION IN ADHERING TREATMENT WITH ANTIPSYCOTICS IN AMBULATORY PATIENTS WITH SCHIZOPHRENIA.

     

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • AMANDA CRISTINA GALVAO OLIVEIRA DE ALMEIDA
  • CRISTIANA MERCURI DE ALMEIDA BASTOS
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • Data: 29-mar-2019


  • Resumen Espectáculo
  • Introduction: Schizophrenia is a chronic disease that causes the disorganization of thought or consciousness. The success of drug therapy is compromised because many patients with schizophrenia do not adhere to treatment. Non-adherence to antipsychotic medication is associated with worse prognosis. Recent guidelines on the treatment of this disorder recommend that knowledge of the disease and its treatment, in addition to other strategies such as psychosocial interventions centered on the person, should be provided to these individuals (and / or their families) in order to adherence to drug treatment. Objective: To analyze the participation of the family of individuals with schizophrenia in the process of adherence to drug treatment in an outpatient clinic of a hospital in the city of Salvador-BA. Method: The study was elaborated using the qualitative method, with descriptive analytical character. Participants were 05 pairs (relatives and patients diagnosed with schizophrenia according to the International Classification of Diseases (ICD-10)) over 18 years of age. Fieldwork was carried out from July to September 2018. Final considerations: The study indicates partial adherence, since the patients were unaware of the drug treatment prescribed by him, on the other hand demonstrates the family as an agent facilitator of the adhesion process for being an incentive for self-care, accompanying the therapeutic itinerary and medication administration. a chronic mental disorder and its drug treatment requires support from the family The promotion of adherence through family participation requires recognition and intervention on a set of difficulties, sufferings and limitations addressed in the present study.

2018
Disertaciones
1
  • YARA OLIVEIRA MOREIRA
  • CLINICAL AND EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH SECONDARY HYPERPARATIREOIDISM CCOMPANIED IN ONE REFERENCE AMBULATORY OF SALVADOR (BA, BRAZIL).

  • Líder : JUCENI PEREIRA DE LIMA DAVID
  • MIEMBROS DE LA BANCA :
  • ADEMIR EVANGELISTA DO VALE
  • JUCENI PEREIRA DE LIMA DAVID
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • Data: 13-sep-2018


  • Resumen Espectáculo
  • Introduction: Secondary hyperparathyroidism (HPT) is one of the common complications in dialysis patients. It is an important morbidity and mortality factor in patients with chronic kidney disease and its progression is controllable through early diagnosis and effective therapy. Objective: To describe the clinical and epidemiological profile of patients with HPT in a reference outpatient clinic in Mineral and Bone Disorder (MBD). Method: A descriptive observational epidemiological study with a retrospective cross - sectional design of dialysis patients, over 18 years of age, of both sexes and with PTH above 300pg / ml, who were conducted to first care in MBD reference outpatient clinic in the State of Bahia from January 1, 2013 to December 31, 2014. Results: Of the 182 medical records evaluated, it was verified that 58.24% of the individuals were male; the median age was 46 (± 12 years) years; 28% had systemic arterial hypertension as the cause of chronic kidney disease; the median dialysis time was 84.79 (± 52.16) months; 60.77% underwent dialysis in Salvador and 50.55% were asymptomatic. Sevelamer hydrochloride was the medicine most used by the patients, representing 75.82% of prevalence. Hyperphosphatemia was verified in 54.6% of the population; 75.29% had equal and/or above 300U/L alkaline phosphatase (AF) values and 90.66% had parathyroid hormone (PTH) above 600 pg/mL. Conclusion: A population with severe HPTS has been evidenced and therefore it is necessary to promote the continued education of physicians, better disclosure of clinical protocols and availability and delivery flows of new therapies.

2
  • BRUNO ANDRADE AMARAL
  •  

    DEVELOPMENT AND VALIDATION OF QUALITY INDICATORS OF THE TREATMENT OF RHEUMATOID ARTHRITIS IN BRAZIL.

  • Líder : ADEMIR EVANGELISTA DO VALE
  • MIEMBROS DE LA BANCA :
  • ADEMIR EVANGELISTA DO VALE
  • MARCIO GALVAO GUIMARAES DE OLIVEIRA
  • PABLO DE MOURA SANTOS
  • SONIA CRISTINA LIMA CHAVES
  • VALDERÍLIO FEIJÓ AZEVEDO
  • Data: 22-oct-2018


  • Resumen Espectáculo
  • Rheumatoid arthritis (RA) is a chronic, autoimmune, inflammatory, and systemic condition of unknown etiology. The maintenance of RA under control requires a specific treatment with difficult clinical management, being imperative the rationalization of the use of the technologies and the qualification of the assistance given to the patients. The objective of this study was to develop and validate the content of quality indicators for the treatment of RA in Brazil, based on the recommendations of the Clinical Protocol and Therapeutic Guidelines (PCDT). This is a methodological research, carried out in two phases, development and validation, with rheumatologists. The quality indicators were developed based on PCDT for AR in Brazil, and validated using the Delphi method. The data analysis included the calculation of the mean scores assigned to each indicator and the confidence interval was 95%. 28 indicators were created, with the first phase of the validation (1st round) consensus in 33% (9/27) of the quality indicators. At the end, 61% (17/28) of the quality indicators were validated. It can be concluded that the Delphi consensus technique showed agreement among the participants and is an important tool in the validation and development process of indicators for RA, therefore, it should be a widespread information among health professionals.

3
  • JULIANA FERREIRA FERNANDES MACHADO
  • Factors that influence the notification of medication errors and near misses in a University Hospital.

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • JORGE ALBERTO BERNSTEIN IRIART
  • JUCENI PEREIRA DE LIMA DAVID
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • Data: 04-dic-2018


  • Resumen Espectáculo
  • OBJECTIVES: To describe the factors that stimulate or impede the reporting of near misses and medication errors by health professionals in a University hospital. The specific objectives were: to understand which factors are stimuli and which act as barriers to reporting medication errors and near misses, to identify strategies to overcome barriers to reporting, and to explore the knowledge of Hospital reporting systems. METHODS: This is a qualitative study. Data collection was conducted through semi-structured interviews with doctors, pharmacists and nurses directly related to patient care in the Hospital's nursing wards. A topic guide was developed for conducting the interviews. Interview audio was recorded electronically, and all interviews were transcribed in full. The saturation criterion was used to determine the finalization of the data collection. For inclusion in this study, professionals needed to have a minimum of six months of professional work in the institution. As exclusion criteria, professionals could not perform their activities at the Pharmacovigilance Center, at the Medicines Information Center or at the institution's surgical ward. A thematic content analysis was performed from the transcripts. RESULTS: Fifteen in-depth interviews were conducted involving 6 nurses, 5 doctors and 4 pharmacists. Factors perceived as incentive were grouped into four themes: related to the professionals, related to the patients, related to the type, nature and consequences of the error and organizational factors. The barriers to reporting were grouped into five themes: related to the professionals, related to the type, nature and consequences of the error, related to the reporting system, factors related to the work or time needed to make the report, and organizational factors. Strategies to overcome barriers to reporting were addressed to: changes in the reporting system, conduct of education and training, and organizational aspects. Some proposals have revealed a transfer of responsibility for the report. CONCLUSIONS: This study allowed us to understand the perception of doctors, nurses and pharmacists about the barriers and stimuli to the reports and to demonstrate knowledge about the current report systems. The proposed strategies can be useful to guide the adoption of improvements in the institution, aiming at the development of a culture of error reporting and patient safety. They also demonstrate what is needed for each professional's role in the effectiveness of the report system.

2017
Disertaciones
1
  • JANE MEIRE MAGALHÃES CARNEIRO
  • TRIPLE THERAPY EVALUATION FOR HEPATITIS C TREATMENT CHRONICLE USING BOCEPREVIR AND TELAPREVIR.

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • ISABELA HEINECK
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MARENI ROCHA FARIA
  • RAYMUNDO PARANA FERREIRA FILHO
  • Data: 29-jul-2017


  • Resumen Espectáculo
  • Chronic hepatitis C has a low prevalence in Brazil, but affects 2.3 million people, accounting for 75% of deaths from viral hepatitis. The protease inhibitors (PI), boceprevir (BOC) and telaprevir (TVR), were authorized for use in Brazil because of a better effectiveness compared to standard therapy – peginterferon alfa + ribavirin, but with the higher frequency of adverse events observed. The objective this study is evaluate the sustained virologic response and adverse effects associated to the triple therapy in patients that were going through this treatment in reference service in Salvador / Bahia. A retrospective and descriptive observational study was out sing information from patients assisted in a reference service public hospital who used some of the PI were selected. The data were collected from the medical records using a semi-structured questionnaire and performed descriptive analysis. Most of the patients had already gone through previous treatments, with relapse. The RVS by intention to treat was 44.9% with TVR and 40% with BOC. The occurrence of adverse event motivated the interruption of the therapy of 13.2% patients when used TVR and of 7.5% in the use of BOC. The occurrence of a suspected serious adverse reaction related to the treatment was associated with the female sex, age 60 years old or more, another pathology, another medication use, previous drug allergy and previous alcoholism. The results suggest lower effectiveness than those presented in the incorporation studies and poor safety. In this way an alert is made to use better analysis procedures in the incorporation of new technologies.

2
  • GABRIELLA FERNANDES MAGALHAES
  • Derug conciliation in hospital patients university.

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • ADRIANA LOPES LATADO BRAGA
  • IVONETE BATISTA DE ARAÚJO
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MÁRIO BORGES ROSA
  • Data: 22-ago-2017


  • Resumen Espectáculo
  • Introduction: Medication reconciliation is among the strategies to improve patient safety, since it ensures the necessary prescribed drugs during the care transition processes. An accurate medical history in medical records is important when patients are admitted to hospitals, since this record can prevent failures such as discontinuing medications required by patients. Objective: to evaluate the effectiveness of medication reconciliation in the identification of medication errors on admission of patients at a university hospital and whether medication records are duly completed in the medical records of these reconciled patients. Methods: A reconciled list was created among the prescribed drugs on admission and those used on hospital preadmission; then, records of the reconciled patients were evaluated with a view to identifying records of the patients' usual medicines performed on admission and discharge from hospital. Data were analyzed through descriptive statistics. Results: 107 patients were included and 226 discrepancies were found in 92 patients; of these, 46 (21.4%) were unintended in 34 (31.8%) patients. Among the unintended discrepancies, the omission of medication had the highest occurrence (65.2%) and twenty-seven drugs were involved with unintended discrepancies, of which 13 (48.1%) are considered potentially dangerous drugs. Of the 107 patients, 102 had their admission records and discharge summaries evaluated. Seventy-five (73.5%) had medical admission records with pre-admission medications and only 51 (50%) had discharge records. No single admission record was considered complete. When evaluating whether information about drugs prescribed on admission was complete, we observed that, of the 373 drugs, 301 had a recorded dose. Only 11 discharge summaries had complete drug registration records with all items. Conclusion: The medication reconciliation was effective in detecting medication errors, since a large number of unintentional discrepancies were identified. Failures in drug registration have been identified which may be related to the unintended discrepancy rates detected. These failures may hinder the drug reconciliation process.

3
  • ALINE CRISTINA BARROS LUZ AMARAL
  • Evaluation of possible medication prescription omissions according to the START criteria in a hospital in the Northeast of Brazil.

  • Líder : LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MIEMBROS DE LA BANCA :
  • LUCIA DE ARAUJO COSTA BEISL NOBLAT
  • MARCIO GALVAO GUIMARAES DE OLIVEIRA
  • MÁRIO BORGES ROSA
  • Data: 06-oct-2017


  • Resumen Espectáculo
  • Potentially inappropriate prescribing for elderly individuals has become a global concern, although few researchers have analyzed potential prescribing omissions for this population. Objective: This study aimed to compare the frequency of potential prescribing omissions for elderly patients at their admission to and discharge from a university hospital in northeast Brazil, using the validated and adapted Brazilian START criteria. Methods: This cross-sectional study examined data from patients who were ≥ 60 years old when they were admitted for > 24 h to a northeastern Brazil teaching hospital during June–December 2016. Results: Data from 227 patients were included. The mean patient age was 71 ± 8.23 years. The patients included 131 women (57.7%), and 176 patients (77.5%) presented with a Charlson Comorbidity Index of ≥ 3. Based on the START criteria, the frequency of potential prescribing omissions was 44.1% (100/227) at the admission and decreased to 39.6% (90/227) at the discharge. The most common potential omissions at the admission were beta-blockers in cases of stable chronic angina, and angiotensin converting enzyme inhibitors or angiotensin receptor blockers in cases of diabetic nephropathy or renal dysfunction. Conclusion: The prevalence of potential prescribing omissions among elderly patients remained relatively high at their discharge from a northeastern Brazilian university hospital. The START criteria could be a useful tool to optimize the clinical management of the elderly.

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