PHARMACOTHERAPEUTIC FOLLOW-UP OF A PATIENT WITH MULTIMORBITIES: EXPERIENCE REPORT
DOI:
https://doi.org/10.25110/arqsaude.v27i2.2023-004Palavras-chave:
Chronic Noncommunicable Diseases, Multimorbidity, Pharmaceutical CareResumo
Chronic non-communicable diseases are growing global health problems. The objective of this study was to promote pharmaceutical care for a patient with multimorbidities in order to improve its quality of life. A pharmacotherapeutic follow-up was performed using the SOAP method, registered in the form of clinical evolution, along with laboratory tests, anthropometric measurements and application of validated instruments to assess pharmacological adherence, mental health and quality of life. The report deals with a female patient, 55 years old, obese and dyslipidemic, sedentary, hypertensive, diabetic and on the control phase of breast cancer. Self-medication with antibiotics and a proton pump inhibitor was identified. Despite the good pharmacological adherence, the patient had decompensated diabetes, accompanied by dyslipidemia without treatment and interruption of supplements. After pharmacological and non-pharmacological interventions, the patient showed a significant improvement in the reduction of anthropometric measurements and in biochemical parameters. At the end of the follow-up, pharmaceutical care proved to be fundamental in identifying the patient's health problems, contributing to obtain a more rational pharmacotherapy.
Referências
ACHTERHOF, Alexandra B. et al. Potentially inappropriate medication and attitudes of older adults towards deprescribing. PLoS One, v. 15, n. 10, p. e0240463, 2020.
APARECIDA SILVEIRA, Erika et al. Visceral obesity and its shared role in cancer and cardiovascular disease: A scoping review of the pathophysiology and pharmacological treatments. International Journal of Molecular Sciences, v. 21, n. 23, p. 9042, 2020.
BAI, Lucy et al. Body image problems in women with and without breast cancer 6–20 years after bilateral risk-reducing surgery–a prospective follow-up study. The breast, v. 44, p. 120-127, 2019.
BODAI, Balazs I.; TUSO, Phillip. Breast cancer survivorship: a comprehensive review of long-term medical issues and lifestyle recommendations. The Permanente Journal, v. 19, n. 2, p. 48, 2015.
CHUDASAMA, Yogini V. et al. Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study. PLoS medicine, v. 17, n. 9, p. e1003332, 2020.
COLSON, Abigail R. et al. Quantifying uncertainty about future antimicrobial resistance: Comparing structured expert judgment and statistical forecasting methods. PloS one, v. 14, n. 7, p. e0219190, 2019.
CORTEZ, Daniel Nogueira et al. Evaluating the effectiveness of an empowerment program for self-care in type 2 diabetes: a cluster randomized trial. BMC public health, v. 17, p. 1-10, 2017.
DE BOER, Rudolf A. et al. Common mechanistic pathways in cancer and heart failure. A scientific roadmap on behalf of the Translational Research Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European journal of heart failure, v. 22, n. 12, p. 2272-2289, 2020.
FAYFMAN, Maya; PASQUEL, Francisco J.; UMPIERREZ, Guillermo E. Management of hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Medical Clinics, v. 101, n. 3, p. 587-606, 2017.
FEREIDOUNI, Zhila; KAMELI MORANDINI, Morteza; NAJAFI KALYANI, Majid. Experiences of self-medication among people: a qualitative meta-synthesis. DARU Journal of Pharmaceutical Sciences, v. 27, p. 83-89, 2019.
GÓMEZ, Marciana Alodia et al. Promoting appropriate drug use through the application of the Spanish drug-related problem classification system in the primary care setting. Annals of Pharmacotherapy, v. 43, n. 2, p. 339-346, 2009.
HIGUERA-LLANTÉN, Sebastián et al. Extended antibiotic treatment in salmon farms select multiresistant gut bacteria with a high prevalence of antibiotic resistance genes. PLoS One, v. 13, n. 9, p. e0203641, 2018.
HUANG, Dou et al. Macrovascular complications in patients with diabetes and prediabetes. BioMed research international, v. 2017, 2017.
KADAMBI, Sindhuja; ABDALLAH, Maya; LOH, Kah Poh. Multimorbidity, function, and cognition in aging. Clinics in geriatric medicine, v. 36, n. 4, p. 569-584, 2020.
LIMA-COSTA, M. Fernanda et al. The Brazilian longitudinal study of aging (ELSI-Brazil): objectives and design. American journal of epidemiology, v. 187, n. 7, p. 1345-1353, 2018..
LIU, Jian et al. Proton pump inhibitors therapy and risk of bone diseases: An update meta-analysis. Life sciences, v. 218, p. 213-223, 2019.
MAGNUSSON, Roger S. et al. Legal capacities required for prevention and control of noncommunicable diseases. Bulletin of the World Health Organization, v. 97, n. 2, p. 108, 2019.
MARKS, Lawrence B. et al. Use of normal tissue complication probability models in the clinic. International Journal of Radiation Oncology* Biology* Physics, v. 76, n. 3, p. S10-S19, 2010.
MULUGETA, Anwar et al. Obesity and depressive symptoms in mid-life: a population-based cohort study. BMC psychiatry, v. 18, n. 1, p. 1-10, 2018.
MUSCHITZ, Christian et al. Diagnosis and management of patients with diabetes and co-existing osteoporosis (Update 2019) Common guideline of the Autrian Society for Bone and Mineral Research and the Austrian Diabetes Society. Wiener Klinische Wochenschrift, v. 131, p. 174-185, 2019.
OTTANELLI, Silva. Prevention and treatment of bone fragility in cancer patient. Clinical Cases in Mineral and Bone Metabolism, v. 12, n. 2, p. 116, 2015.
PARK, Gyung-Min et al. Triglyceride glucose index is a useful marker for predicting subclinical coronary artery disease in the absence of traditional risk factors. Lipids in health and disease, v. 19, p. 1-7, 2020.
PATEL, Dhiren; TRIPLITT, Curtis; TRUJILLO, Jennifer. Appropriate titration of basal insulin in type 2 diabetes and the potential role of the pharmacist. Advances in Therapy, v. 36, p. 1031-1051, 2019.
PLOEG, Jenny et al. The complexity of caregiving for community-living older adults with multiple chronic conditions: A qualitative study. Journal of Comorbidity, v. 10, p. 2235042X20981190, 2020.
REN, Huihui et al. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiovascular diabetology, v. 19, n. 1, p. 1-8, 2020.
ROTH, Gregory A. et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, v. 392, n. 10159, p. 1736-1788, 2018.
SADEK, Ibrahim et al. Anti-HER-2 therapy following severe trastuzumab-induced cardiac toxicity. Genes & diseases, v. 4, n. 3, p. 159-162, 2017.
SCHINDEL, Theresa J.; BREAULT, Rene R.; HUGHES, Christine A. “It made a difference to me”: a comparative case study of community pharmacists’ care planning services in primary health care. Pharmacy, v. 7, n. 3, p. 90, 2019.
SHIN, Kyung-A.; KIM, Young-Joo. Usefulness of surrogate markers of body fat distribution for predicting metabolic syndrome in middle-aged and older Korean populations. Diabetes, metabolic syndrome and obesity: targets and therapy, p. 2251-2259, 2019.
SHRESTHA, Sunil; SHRESTHA, Sudip; KHANAL, Saval. Polypharmacy in elderly cancer patients: Challenges and the way clinical pharmacists can contribute in resource‐limited settings. Aging Medicine, v. 2, n. 1, p. 42-49, 2019.
STUHEC, Matej; GORENC, Katja; ZELKO, Erika. Evaluation of a collaborative care approach between general practitioners and clinical pharmacists in primary care community settings in elderly patients on polypharmacy in Slovenia: a cohort retrospective study reveals positive evidence for implementation. BMC Health Services Research, v. 19, p. 1-9, 2019.
SYAFHAN, Nadia Farhanah et al. General practitioner practice-based pharmacist input to medicines optimisation in the UK: pragmatic, multicenter, randomised, controlled trial. Journal of Pharmaceutical Policy and Practice, v. 14, p. 1-15, 2021.
TANAKA, Mizue; ITOH, Soichiro; TAKEUCHI, Yasuhiro. Effectiveness of bisphosphonate combined with activated vitamin D in patients with aromatase inhibitor-induced osteoporosis after breast cancer operation. Osteoporosis and Sarcopenia, v. 4, n. 3, p. 102-108, 2018.
UUSITUPA, Matti et al. Prevention of type 2 diabetes by lifestyle changes: a systematic review and meta-analysis. Nutrients, v. 11, n. 11, p. 2611, 2019.
WANG, Jing et al. Association between serum vitamin B6 concentration and risk of osteoporosis in the middle-aged and older people in China: a cross-sectional study. BMJ open, v. 9, n. 7, p. e028129, 2019.
WEED, Lawrence L. et al. Medical records that guide and teach. N Engl J Med, v. 278, n. 11, p. 593-600, 1968.
WORLD HEALTH ORGANIZATION (WHO) et al. Noncommunicable diseases country profiles 2018. 2018.
YAO, Song et al. Serum bone markers and risk of osteoporosis and fragility fractures in women who received endocrine therapy for breast cancer: a prospective study. Breast cancer research and treatment, v. 180, p. 187-195, 2020.
YU, Li-Yuan et al. A review of the novel application and potential adverse effects of proton pump inhibitors. Advances in Therapy, v. 34, p. 1070-1086, 2017.
ZHANG, L. et al. A multicenter study of multimorbidity in older adult inpatients in China. The journal of nutrition, health & aging, v. 24, p. 269-276, 2020.
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