Medicines are the most used health technology in Long-Term Care. The prevalence of potentially in... more Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a modified RAND/UCLA Appropriateness Method, 13 long-term care and hospital pharmacists assessed as ‘appropriate’, ‘uncertain’, or ‘inappropriate’ a collection of commonly used prescribing-assessment tools as to its suitability in assisting pharmacy practice in institutional long-term care settings. A qualitative analysis of written or transcribed comments of participants was pursued to identify relevant characteristics of prescribing-assessment tools and potential hinders in their use. From 24 different tools, pharmacists classified 9 as ‘appropriate’ for pharmacy practice targeted to long-term care patients, while 3 were classified as ‘inappropriate’. The tools feature most appreciate...
To investigate pharmacists’ interventions and impact at institutional Long-Term Care (LTC) settin... more To investigate pharmacists’ interventions and impact at institutional Long-Term Care (LTC) settings, particularly the therapeutic outcomes in elderly populations. LTC pharmacists deliver a comprehensive set of activities, especially in clinical pharmacy (e.g. medication review, deprescribing) and education, addressing elderly populations under LTC and their therapeutic needs. Pharmacists’ expertise in medicines optimisation is a useful resource in improving healthcare towards institutionalised LTC patients, often a geriatric population. Long-Term Care (LTC) systems have experienced recent developments driven by changes in healthcare and demography (e.g. population ageing). As well, pharmacists are changing from traditional roles to more patient-oriented services. The present study aimed to identify and assess pharmacists’ and/or pharmacy-based interventions in institutional LTC settings, also mapping relevant medications. The review was undertaken in general accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using three main literature databases (PubMed, Scopus, and Web of Knowledge). A set of 16 keywords, divided into three domains (professional, type of care and type of setting), were combined into search equations. Selected studies were assessed through the Quality Assessment Tool for Quantitative Studies. Twenty-six studies met the inclusion criteria, out of 794 initial hits. Most studies (12) described pharmacist/pharmacy-driven interventions assessing Medication Management Reviews' impact in different endpoints or outcomes. Other studies (3) assessed pharmacists’ interventions on specific medication groups. Good Administration Practices, new pharmaceutical care models, antibiotic stewardship programs, and studies assessing other pharmacists’ interventions, such as pharmacy-managed informatics and education, were addressed by 11 other papers. Six studies were classified as Strong after quality assessment. LTC is a clinically complex type of care benefiting from interdisciplinary work. Despite the overall lower quality of the identified studies, pharmacists perform in a wide array of LTC areas. The broad implementation of pharmaceutical activities in institutional LTC settings opens opportunities to optimise medicines’ use.
OBJECTIVE: To evaluate the elderly persons' functionality, based on the International Classif... more OBJECTIVE: To evaluate the elderly persons' functionality, based on the International Classification of Functionality. METHODS: a cross-sectional, descriptive study; a stratified random sample of 903 elderly persons; a confidence level of 95%; and a margin of error of 2.5%. Questionnaire based on the International Classification of Functionality; data was collected based on structured interviews undertaken by health professionals in the health centers in the Alentejo region of Portugal. RESULTS: 30.7% of the elderly persons stated that they were illiterate, and 22.9% lived alone. Feeding/dietary (18.7%), housing (19.2%) and health needs (26.0%) were not met. Orientation functions were maintained in 83.4%; 58% of the elderly persons referred to pain so intense that it required care; 73.3% of the elderly persons did not have functional dentition. Levels of performance were superior to 80% in the participation activities: washing oneself (82.6%), toileting (92.2%), dressing, eating...
Background The correct medication use by community dwelling elders is essential for the preservat... more Background The correct medication use by community dwelling elders is essential for the preservation of their health and quality of life. In Portugal, there are validated tools to assess the activities of daily living abilities. However, there is none specifically built to assess the medication management ability. A tool’s validation allowing the assessment of the Portuguese elder’s functional ability to manage their own medication represents an essential step, in order to devise effective policies aiming the promotion of independence, health and autonomy for the longest possible period, through the implementation of support measures in this field (1-3). The high inability rates revealed as age advances reflects a high risk for the elders health. According to WHO data (2004), about 46% of the individuals with 60 years and over, presents some degree of inability, being the more frequently causes of this inability vision and hearing loss, dementia and osteoarthritis. All can be related with a decreasing ability to manage their own medication (non-intentional process) (4-6). The evaluation of the elder’s functional ability to manage their own medication through the application of a validated tool can be an important way to identify potential inabilities and needs of the elders in primary healthcare centers and plan policy strategies to increase their performance, self-care skills and successful aging. Objective The aim of this project is to assess the functional ability of the Portuguese elderly population to manage their own medication through the application of a specific and validated tool
Medicines are the most used health technology in Long-Term Care. The prevalence of potentially in... more Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a modified RAND/UCLA Appropriateness Method, 13 long-term care and hospital pharmacists assessed as ‘appropriate’, ‘uncertain’, or ‘inappropriate’ a collection of commonly used prescribing-assessment tools as to its suitability in assisting pharmacy practice in institutional long-term care settings. A qualitative analysis of written or transcribed comments of participants was pursued to identify relevant characteristics of prescribing-assessment tools and potential hinders in their use. From 24 different tools, pharmacists classified 9 as ‘appropriate’ for pharmacy practice targeted to long-term care patients, while 3 were classified as ‘inappropriate’. The tools feature most appreciate...
To investigate pharmacists’ interventions and impact at institutional Long-Term Care (LTC) settin... more To investigate pharmacists’ interventions and impact at institutional Long-Term Care (LTC) settings, particularly the therapeutic outcomes in elderly populations. LTC pharmacists deliver a comprehensive set of activities, especially in clinical pharmacy (e.g. medication review, deprescribing) and education, addressing elderly populations under LTC and their therapeutic needs. Pharmacists’ expertise in medicines optimisation is a useful resource in improving healthcare towards institutionalised LTC patients, often a geriatric population. Long-Term Care (LTC) systems have experienced recent developments driven by changes in healthcare and demography (e.g. population ageing). As well, pharmacists are changing from traditional roles to more patient-oriented services. The present study aimed to identify and assess pharmacists’ and/or pharmacy-based interventions in institutional LTC settings, also mapping relevant medications. The review was undertaken in general accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using three main literature databases (PubMed, Scopus, and Web of Knowledge). A set of 16 keywords, divided into three domains (professional, type of care and type of setting), were combined into search equations. Selected studies were assessed through the Quality Assessment Tool for Quantitative Studies. Twenty-six studies met the inclusion criteria, out of 794 initial hits. Most studies (12) described pharmacist/pharmacy-driven interventions assessing Medication Management Reviews' impact in different endpoints or outcomes. Other studies (3) assessed pharmacists’ interventions on specific medication groups. Good Administration Practices, new pharmaceutical care models, antibiotic stewardship programs, and studies assessing other pharmacists’ interventions, such as pharmacy-managed informatics and education, were addressed by 11 other papers. Six studies were classified as Strong after quality assessment. LTC is a clinically complex type of care benefiting from interdisciplinary work. Despite the overall lower quality of the identified studies, pharmacists perform in a wide array of LTC areas. The broad implementation of pharmaceutical activities in institutional LTC settings opens opportunities to optimise medicines’ use.
OBJECTIVE: To evaluate the elderly persons' functionality, based on the International Classif... more OBJECTIVE: To evaluate the elderly persons' functionality, based on the International Classification of Functionality. METHODS: a cross-sectional, descriptive study; a stratified random sample of 903 elderly persons; a confidence level of 95%; and a margin of error of 2.5%. Questionnaire based on the International Classification of Functionality; data was collected based on structured interviews undertaken by health professionals in the health centers in the Alentejo region of Portugal. RESULTS: 30.7% of the elderly persons stated that they were illiterate, and 22.9% lived alone. Feeding/dietary (18.7%), housing (19.2%) and health needs (26.0%) were not met. Orientation functions were maintained in 83.4%; 58% of the elderly persons referred to pain so intense that it required care; 73.3% of the elderly persons did not have functional dentition. Levels of performance were superior to 80% in the participation activities: washing oneself (82.6%), toileting (92.2%), dressing, eating...
Background The correct medication use by community dwelling elders is essential for the preservat... more Background The correct medication use by community dwelling elders is essential for the preservation of their health and quality of life. In Portugal, there are validated tools to assess the activities of daily living abilities. However, there is none specifically built to assess the medication management ability. A tool’s validation allowing the assessment of the Portuguese elder’s functional ability to manage their own medication represents an essential step, in order to devise effective policies aiming the promotion of independence, health and autonomy for the longest possible period, through the implementation of support measures in this field (1-3). The high inability rates revealed as age advances reflects a high risk for the elders health. According to WHO data (2004), about 46% of the individuals with 60 years and over, presents some degree of inability, being the more frequently causes of this inability vision and hearing loss, dementia and osteoarthritis. All can be related with a decreasing ability to manage their own medication (non-intentional process) (4-6). The evaluation of the elder’s functional ability to manage their own medication through the application of a validated tool can be an important way to identify potential inabilities and needs of the elders in primary healthcare centers and plan policy strategies to increase their performance, self-care skills and successful aging. Objective The aim of this project is to assess the functional ability of the Portuguese elderly population to manage their own medication through the application of a specific and validated tool
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Papers by Manuel Lopes