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Abstract(s)
Introdução: As doenças cardiovasculares constituem a principal causa de morte prematura a nível Nacional e Europeu, destacando-se a hipertensão arterial (HTA) como um dos mais importantes factores de risco modificáveis. Apesar da evolução substancial no conhecimento, tratamento e controlo da HTA, constata-se uma elevada prevalência de HTA não controlada. A renovação da prescrição médica constitui um dos principais motivos de consulta em cuidados de saúde primários. No entanto, uma parte substancial é feita sem contacto médico-doente e as repercussões desta prática no controlo da HTA permanecem por estudar.
Objectivo: Avaliar o efeito da renovação da prescrição sem consulta médica (RPSCM) de antihipertensores (aHT) no controlo da HTA e validar a hipótese de que a RPSCM está associada a um menor controlo da HTA.
Métodos: Realizou-se um estudo observacional transversal, no Centro de Saúde e numa Farmácia da Covilhã. Numa amostra de 213 doentes com diagnóstico de HTA e terapêutica antihipertensora há mais de um ano, foi comparado o controlo da HTA no grupo que renovou a prescrição de aHT com consulta médica e no grupo que renovou a prescrição de aHT sem consulta médica (tendo a última consulta ocorrido há mais de 6 meses).
Resultados: No grupo RPSCM mais de 75% dos doentes apresentaram HTA não controlada. A RPSCM de aHT aumenta significativamente o risco de HTA não controlada (OR=3.89, IC 95% 1.73-8.74), após ajustamento para as variáveis idade e número de medicamentos.
Conclusão: A RPSCM de aHT está associada a um menor controlo da HTA. É necessário desenvolver um procedimento regulamentado de RPSCM em Portugal, que permita maior controlo clínico do número e intervalos de prescrições repetidas. A cooperação médico-farmacêutico pode revelar-se útil na monitorização dos resultados terapêuticos da RPSCM.
Introduction: Cardiovascular disease is the leading cause of premature death both at a National and European level; hypertension being one of the most important modifiable risk factors. Despite substantial progress in knowledge, treatment and control of hypertension, there is still a high prevalence of uncontrolled hypertension. The repeat prescribing is one of the main reasons for consultation in primary care. However, a substantial part is done without the doctor-patient contact (RPSCM) and the repercussions of this practice in the control of hypertension remain to be studied. Objective: To evaluate the effect of repeat prescribing of antihypertensive drugs without consultation in the control of hypertension and validate the hypothesis that RPSCM is associated with less hypertension control. Methods: An observational transversal study was conducted in the Health Center and one pharmacy in Covilhã. A sample of 213 patients diagnosed with hypertension and using antihypertensive drugs for over one year was studied. The control of hypertension was compared between two groups: the RPCCM group (repeat prescribing with consultation) and the RPSCM group (repeat prescribing without consultation). Results: In the RPSCM group over 75% of patients had uncontrolled hypertension with a blood pressure of ≥ 140 mmHg systolic and 90 mmHg diastolic. The RPSCM significantly increases the risk of uncontrolled hypertension (OR = 3.89, systolic and 95% CI 1.73-8.74) after adjusting to age and number of medication. Conclusion: The RPSCM of antihypertensive drugs is associated to less control of hypertension. In order to improve the frequency and intervals of repeated prescriptions, it is necessary to develop a protocol to guide RPSCM in Portugal. The doctor-pharmacist cooperation may be useful in monitoring the therapeutic results of RPSCM.
Introduction: Cardiovascular disease is the leading cause of premature death both at a National and European level; hypertension being one of the most important modifiable risk factors. Despite substantial progress in knowledge, treatment and control of hypertension, there is still a high prevalence of uncontrolled hypertension. The repeat prescribing is one of the main reasons for consultation in primary care. However, a substantial part is done without the doctor-patient contact (RPSCM) and the repercussions of this practice in the control of hypertension remain to be studied. Objective: To evaluate the effect of repeat prescribing of antihypertensive drugs without consultation in the control of hypertension and validate the hypothesis that RPSCM is associated with less hypertension control. Methods: An observational transversal study was conducted in the Health Center and one pharmacy in Covilhã. A sample of 213 patients diagnosed with hypertension and using antihypertensive drugs for over one year was studied. The control of hypertension was compared between two groups: the RPCCM group (repeat prescribing with consultation) and the RPSCM group (repeat prescribing without consultation). Results: In the RPSCM group over 75% of patients had uncontrolled hypertension with a blood pressure of ≥ 140 mmHg systolic and 90 mmHg diastolic. The RPSCM significantly increases the risk of uncontrolled hypertension (OR = 3.89, systolic and 95% CI 1.73-8.74) after adjusting to age and number of medication. Conclusion: The RPSCM of antihypertensive drugs is associated to less control of hypertension. In order to improve the frequency and intervals of repeated prescriptions, it is necessary to develop a protocol to guide RPSCM in Portugal. The doctor-pharmacist cooperation may be useful in monitoring the therapeutic results of RPSCM.
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Keywords
Doença cardiovascular Hipertensão arterial Hipertensão arterial - Antihipertensores - Prescrição médica Pressão arterial - Controlo
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Universidade da Beira Interior