Assuntos
Farmacêuticos , Assistência Farmacêutica , Atenção Primária à Saúde/métodos , Adesão à Medicação , Hipertensão/tratamento farmacológico , Assistência Individualizada de Saúde/métodos , Brasil , Centros de Saúde , Saúde da População Urbana , Tratamento Farmacológico/métodos , Hipertensão/prevenção & controleRESUMO
Abstract Background: Uncontrolled blood pressure has been associated with poor adherence to drug treatment. Objectives: To assess blood pressure control in hypertensive patients attending primary health centers after implementation of a pharmaceutical follow-up program in a city of the north of Brazil. Methods: Observational, cross sectional, descriptive study with 163 hypertensive patients attending public primary health care centers - one located on the riverside and one in the urban area of the city of Santarem, western Pará, Brazil. Adherence to the anti-hypertensive treatment was assessed using the eight-item Morisky test. Pharmacotherapy follow-up (Dader method) of patients with uncontrolled hypertension and non-adherent to anti-hypertensive treatment was performed. Results of the normality test showed that the data did not follow a normal distribution. Continuous variables were then compared using the Wilcoxon signed-rank test, and categorical variables by the likelihood ratio and the McNemar tests. Statistical significance was set at 5%. Results: Of the total sample, 94.5% were not adherent to anti-hypertensive drug therapy and 77.2% had uncontrolled hypertension. Adherence rate was higher in men than women (p=0.006). Pharmacotherapy follow-up improved blood pressure levels, particularly systolic blood pressure (p<0.001). Conclusion: An individualized pharmacotherapeutic follow-up, considering regional and cultural specificities, can contribute to the treatment of hypertensin in the primary care.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Farmacêuticos , Assistência Farmacêutica , Atenção Primária à Saúde/métodos , Adesão à Medicação , Hipertensão/tratamento farmacológico , Assistência Individualizada de Saúde/métodos , Brasil , Centros de Saúde , Saúde da População Urbana , Tratamento Farmacológico/métodos , Hipertensão/prevenção & controleRESUMO
This paper discusses the controversy between top-down, disease-focused, vertical programs, on the one hand, and activities that have been horizontally integrated into health services, on the other, using as a reference the public health initiatives developed in Mexico in the context of a recent comprehensive health care reform. The main message is that it is possible to achieve a synthesis between vertical and horizontal strategies, and also between public health and personal health care programs. Public health and personal care are the two sides of the health system coin, and both are central to a comprehensive concept of health security. Investments in epidemiological surveillance and response clearly contribute to the control of threats facing nation-states, such as pandemics and biological warfare. At the same time, investments in the protection of individuals from threats that endanger their health would also make our world a safer place.
Assuntos
Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/terapia , Assistência Individualizada de Saúde/métodos , Administração em Saúde Pública/métodos , Guerra Biológica/métodos , Humanos , México/epidemiologiaRESUMO
Contiene: Enfoques y planes, como aprendre viendo haciendo y pensando, para parender a usar el libro donde hay doctor, actividades con madres y niños, la salud en relacion conla alimentacion, la tierra y los problemas sociales, un llamado al valor y a la precaucion