REDUCTION OF CARDIOVASCULAR RISK IN PATIENTS WITH METABOLIC SYNDROME AFTER PARTICIPATION OF A PHARMACEUTICAL CARE PROGRAM IN A P

AF01

Camila Pedro Plaster (1); Danilo Travassos Melo (1); Veraci Boldt (1); Tadeu Uggere de Andrade (1); tadeu.andrade@uvv.br

(1) Department of Pharmacy. University Center of Vila Velha – UVV.

Introduction: the Metabolic Syndrome (MS) is a set of chronic diseases with metabolic origin and related with hypertension, obesity, dislipidemia and fasting hyperglycemia. These combination of factors put patients in a treatment that needs the use of a set of medicines which could determine a high degree of non-adherence to the treatment as well as the development of drug-related problems (DRP). Objective: the aim of this study was to verify whether the institution of a Pharmaceutical Care (PC) program in a Public Health Center (PHC) to MS patients would result in positive influence on their clinical profile with reduction of the cardiovascular risk. Methods: it was performed a case control study with 73 patients participants of HiperDia program from a PHC (Vila Velha-ES, Brazil) previously identified with MS. They were randomized into two groups: Control (C; n=37) and Intervention (I; n=36). The presence of MS was confirmed by clinical and laboratory evaluation according to the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATP III) and the cardiovascular risk was analyzed by the updated Score of Framingham (SF). These evaluations were performed in both groups by a pharmacist blind to the experiment before and after the follow-up program. The only intervention of the pharmacist team to the C group was an initial interview and pharmacotherapy history analysis. A team of four pharmacists developed a PC program according to Dáder methodology. DRP were identified according to the Second Consensus of Granada and categorized in DRP related to: necessity, effectiveness and safety. In I group these problems were analyzed and the best solution was proposed in accordance with the patient. The pharmacotherapy follow-up program consisted of a monthly meeting at the PHC during six month from April to September of 2007. In each meeting arterial blood pressure and capillary blood glucose, cholesterol and triglycerides were measured. Results: there were no significant differences on the initial socio-economic and clinical profile data between the groups. DRP were identified in both groups (C=123; I=129) with predominance of the DRP related to effectiveness (C=47.3%; I=45.8%). The improvement (81.5–100%) or resolution (50–90%) of the DRP in I group resulted in a improvement in almost all parameters analyzed (PAS=131±3; women waist circumference=94±2; glucose: 130±12; cholesterol=182±5; men HDL-c=47±2; women HDL-c=49±1; LDL-c=111±5; p<0.05 or 0.01) and a reduction of the SF (14.3±1.5%; p<0.01) compared with C group (PAS=141±4; women waist circumference=105±2; glucose: 173±13; cholesterol=210±4; men HDL-c=40±3; women HDL-c=41±3; LDL-c=132±4; p<0.05 or 0.01. SF=26.4±2.7%). Conclusion: the institution of a PC program in a PHC determines the reduction of the cardiovascular risk of the patients’ adherent to the program as a result of the improvement or resolution of the majority of the DRP after the pharmacist interventions (UVV).