Browsing by Author "Costa, Filipa A."
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- Anticoagulants utilization in Portugal: are there inequalities?Publication . Costa, Filipa A.; Teixeira, Inês; Vilão, Sérgio; Antoniou, Sotiris
- Community pharmacist-led medication review procedures across Europe: characterization, implementation and remunerationPublication . LeilaImfeld-Isenegger, Tamara; Soares, Inês Branco; Makovec, Urska Nabergoj; Horvat, Nejc; Van Mil, Foppe; Costa, Filipa A.; Hersberger, Kurt E.Background: Pharmaceutical Care Network Europe (PCNE) proposed a definition and classification system (type 1, 2a, 2b, 3) for medication review in 2016. However, to date, a description of the implementation and remuneration of such procedures across Europe is lacking. Objective: The aim of this study was to describe the medication review procedures and the level of implementation and remuneration in community pharmacies across Europe. Methods: An online survey was developed to characterize medication review procedures (PCNE classification), level of implementation (considering regional or national) and remuneration by a third party. This survey was sent to a purposive sample of three individuals per country, with a working background in community pharmacy, pharmacy practice research, or health policy to ensure reliable data. Data triangulation was used and consensus sought between the responses. Results: Data were received from 34 out of 44 targeted European countries (November 2016–October 2017) [response rate = 77%]. Overall, 55.9% of the countries provided at least one type of medication review as an implemented service or project. Type 1 medication review (based on the medication history) was provided in 13 countries, type 2a (medication history + patient interview) in 14, type 2b (medication history + clinical data) in two, and type 3 medication review (medication history + patient interview + clinical data) in four countries. Ten of the mentioned services or projects were remunerated by a third-party. Conclusion: Substantial heterogeneity was observed across Europe in various aspects, including the procedures, implementation level and remuneration obtained. Type 1 and 2a medication review services seem to be more feasible to implement in the community pharmacy than type 2b and 3. A large number of medication review projects were ongoing in community pharmacies, which suggests that new medication review services could become implemented in the coming years.
- Contribution of different patient information sources to create the best possible medication historyPublication . Oliveira, Joelizy; Cabral, Ana Cristina; Lavrador, Marta; Costa, Filipa A.; Almeida, Filipe Félix; Macedo, António; Saraiva, Carlos; Castel-Branco, Margarida; Caramona, Margarida; Fernandez-Llimos, Fernando; Figueiredo, Isabel VitóriaIntroduction: Obtaining the best possible medication history is the crucial step in medication reconciliation. Our aim was to evaluate the potential contributions of the main data sources available – patient/caregiver, hospital medical records, and shared electronic health records – to obtain an accurate ‘best possible medication history’. Material and Methods: An observational cross-sectional study was conducted. Adult patients taking at least one medicine were included. Patient interview was performed upon admission and this information was reconciled with hospital medical records and shared electronic health records, assessed retrospectively. Concordance between sources was assessed. In the shared electronic health records, information was collected for four time-periods: the preceding three, six, nine and 12-months. The proportion of omitted data between time-periods was analysed. Results: A total of 148 patients were admitted, with a mean age of 54.6 ± 16.3 years. A total of 1639 medicines were retrieved. Only 29% were collected simultaneously in the three sources of information, 40% were only obtained in shared electronic health records and only 5% were obtained exclusively from patients. The total number of medicines gathered in shared electronic health records considering the different time frames were 778 (three-months), 1397 (six-months), 1748 (nine-months), and 1933 (12-months). Discussion: The use of shared electronic health records provides data that were omitted in the other data sources available and retrieving the information at six months is the most efficient procedure to establish the basis of the best possible medication history. Conclusion: Shared electronic health records should be the preferred source of information to supplement the patient or caregiver interview in order to increase the accuracy of best possible medication history of the patient, particularly if collected within the prior six months.
- Determinants of self-medication with NSAIDs in a Portuguese community pharmacyPublication . Nunes, Ana P.; Costa, Isabel M.; Costa, Filipa A."Background: Non-steroid anti-inflammatory drugs (NSAIDs) are a widely used therapeutic group in the world, and particularly in the Portuguese population. Objective: To compare NSAID’s use by prescription and self-medication acquisition and to determine the pattern of indication of NSAIDs, their usage profile and possible implications for patients’ safety. Methods: A cross-sectional design was used where individuals presenting at a community pharmacy requesting NSAIDs during the study period (one month) were invited to answer a face-to-face interview where socio-demographic characteristics, the indication pattern and previous experience of side effects were assessed. A follow-up interview was performed one week later to assess the incidence of adverse effects. The study was ethically approved. Results: A sample of 130 NSAIDs users was recruited, comprising mostly women (n=87; 66.9%), actively employed (n=77; 59.2%) and presenting a mean age of 49.5 years old (SD=20.49). An equal proportion of individuals acquired NSAIDs by self-medication and with medical prescription (n=65; 50%). Over 4/5 of patients (n=57; 87.7%) acquiring NSAIDs without a prescription were self-medicated by their own initiative, and only 10.8% (n=7) had been advised by the pharmacist. The most commonly acquired active substances were ibuprofen and diclofenac. Self-medicated users more frequently resorted to topical NSAIDs following short term treatments. The major underlying condition motivating NSAIDs sought were musculoskeletal disorders (45.0%), regardless of the regimen. An important proportion of prevalent users of NSAIDs reported previous experience of adverse effects (11.3%). One week after initiating NSAID therapy, a small proportion of patients reported incidence of adverse effects. Conclusion: Self-medication with NSAIDs is sought for numerous medical conditions. Reported adverse effects (prevalent and incident) confirm the need for a more rational use of NSAIDs and ongoing pharmacovigilance."
- Evolução do serviço de administração de vacinas da gripe numa farmácia comunitáriaPublication . Aguiar, João; Faia, Tânia; Costa, Filipa A.; Silva, Patrícia C.
- Impact of pharmaceutical counseling in minor health problems in rural PortugalPublication . Coelho, Raquel B.; Costa, Filipa A."Objectives: The objectives of this study were to determine the prevalence of self-medication and to evaluate the clinical impact of pharmaceutical counseling. Methods: A cross-sectional study was used with a prospective component, the latter to evaluate the impact of pharmaceutical counseling . The study was conducted in a rural community pharmacy for 14 consecutive days in December 2012, recruiting all individuals who agreed to participate and met the eligibility criteria. During a facetoface direct interview demographic and clinical characteristics of patients were registered, followed by a pharmaceutical intervention, which consisted of evaluating the symptoms, selecting the most appropriate nonprescription medicine (NPM) available and advising the patient on pharmacologic and non-pharmacologic measures, all according to established protocols for minor health problems. When appropriate, the patient was referred to a medical appointment. One week later, the clinical outcome of such intervention was measured by asking the patients about the resolution of their minor health problems. Results: Data from 298 patients were analyzed, the majority being female (60.1%) with an average age of 44.84 years (SD=22.41). Respiratory problems were the most frequent (n=78; 26.2%) and respiratory tract medication was the most frequently indicated (n= 77; 27.8%). The observed prevalence of self-medication was 40.7%. Of the 271 patients’ beneficiaries of pharmaceutical counseling, 86.8% had their minor health problems solved after one week (ranging from 77.5% to 88.2% according to a sensibility analysis for drop-outs). Conclusions: This work is important as it demonstrates the beneficial impact of pharmaceutical counseling, a very relevant area for the pharmacist and where literature is particularly scarce."
- Know your pulse awareness campaign: involving pharmacists for greater outreachPublication . Hamedi, Nadya; Williams, Helen; Bell, Becky; Loban, Trudie; Antoniou, Antoniou; Costa, Filipa A.; International Pharmacists for Anticoagulation Care Taskforce
- PRACTISE - PhaRmAcist-led CogniTIve Services in Europe: recruitment and current statusPublication . Imfeld-Isenegger, Tamara L.; Soares, Inês Branco; Costa, Filipa A.; Makovec, Urska Nabergoj; Horvat, Nejc; Kos, Mitja; Hersberger, Kurt E.
- PRACTISE Survey-PhaRmAcist-led CogniTIve Services in Europe: first resultsPublication . Imfeld-Isenegger, Tamara L.; Costa, Filipa A.; Soares, Inês Branco; Kos, Mitja; Makovec, Urska N.; Hersberger, Kurt. E.
- Provision of pharmaceutical care by community pharmacists across Europe: Is it developing and spreading?Publication . Costa, Filipa A.; Scullin, Claire; Al-Taani, Ghaith; Hawwa, Ahmed F.; Anderson, Claire; Bezverhni, Zinaida; Binakaj, Zahida; Cordina, Maria; Foulon, Veerle; Garcia de Bikuña, Borja; Gier, Han de; Granås, Anne Gerd; Grinstova, Olga; Griese-Mammen, Nina; Grincevicius, Jonas; Grinceviciene, Svitrigaile; Kaae, Susanne; Kubiliene, Loreta; Mariño, Eduardo L.; Martins, Silvia; Modamio, Pilar; Nadin, Giancarlo; Nørgaard, Lotte Stig; Obarcanin, Emina; Tadic, Ivana; Tasic, Ljiljana; McElnay, James C.; Hersberger, Kurt E.; Westerlund, TommyRationale, Aims, and Objectives Pharmaceutical care involves patient-centred pharmacist activity to improve medicines management by patients. The implementation of this service in a comprehensive manner, however, requires considerable organisation and effort, and indeed, it is often not fully implemented in care settings. The main objective was to assess how pharmaceutical care provision within community pharmacy has evolved over time in Europe.