Publications by authors named "Marcus Fernando da Silva Praxedes"

13 Publications

  • Page 1 of 1

Prescribing potentially inappropriate medications for the elderly according to Beers Criteria: systematic review.

Cien Saude Colet 2021 Aug 3;26(8):3209-3219. Epub 2020 Jun 3.

Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Av. Carlos Amaral 1015, Cajueiro. 44574-490 Santo Antônio de Jesus BA Brasil.

The study aimed to perform a systematic review to identify and evaluate the prevalence of potentially inappropriate medicines (PIM) prescriptions for the elderly, according to Beers Criteria, in hospitalized elderly individuals aged 65 years or older. Five databases consulted: VHL; Cochrane Library; CINAHL; MEDLINE and Web of Science. Nineteen articles identified, selected based on eligibility criteria. The mean age was 78.2 years and the most used criterion for the identification of PIM for the elderly was Beers 2015 (57.9%). A total of 221,879 elderly received a prescription for PIM, the mean prevalence was 65.0%, for the gastrointestinal system (15.3%) and proton-pump inhibitors (27.7%) highlighted as the main class of medicine prescribed. It concluded that the Beers Criteria have made it possible to identify the high prevalence in the prescription of PIM. The results of this review may help in the decision making of health professionals, to avoid the administration of PIM and to propose best practices to ensure the safety of the elderly hospitalized.
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http://dx.doi.org/10.1590/1413-81232021268.05672020DOI Listing
August 2021

Self-report instruments for assessing adherence to warfarin therapy: a systematic review.

Eur J Clin Pharmacol 2021 Jul 22. Epub 2021 Jul 22.

Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil.

Background: The assessment of adherence to warfarin therapy is useful in clinical practice due to its wide variability in dose-response and risks of complications. The aim of this study was to investigate validated instruments used to assess adherence to warfarin therapy.

Methods: Information was collected from the MEDLINE (PubMed), LILACS, EMBASE, and Cochrane Library databases. Search strategies were applied for each database, with no time limit or language restriction. Inclusion criteria consisted of study participants of ≥ 18 years of age, from both sexes, on chronic anticoagulation with warfarin for any indication and the use of validated instruments to assess adherence to warfarin therapy. Exclusion criteria consisted of duplicate articles, narrative or systematic reviews, and meta-analyses, as well as case reports/series and experimental studies involving animals. Two independent reviewers performed the following steps: evaluation of titles/abstracts, selection of studies after full reading, data extraction, and evaluation of potential bias. Discrepancies were resolved by a third reviewer.

Results: Overall, 19 articles were selected for this systematic review, including 17 cross-sectional studies, one cohort study, and one quasi-experimental study, published from 2009 to 2019. The validated instruments identified in this review were Morisky Medication Adherence Scale (MMAS), the eight-item Morisky Medication Adherence Scale (MMAS-8), Measurement of Treatment Adherence (MTA), and Brief Medication Questionnaire (BMQ). Only MMAS-8 was tested for reliability, using the internal consistency assessment, with Cronbach's α range 0.56-0.71.

Conclusions: This review highlighted a gap in knowledge regarding the scarcity of validated instruments to assess adherence to warfarin therapy. Limitations were found in instruments that comprised the assessment of the isolated use of medication and the lack of analysis of other relevant therapeutic aspects. Future studies are needed to develop and validate more comprehensive instruments in an attempt to assess adherence to warfarin therapy.

Prospero: Registration number CRD42019128324.
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http://dx.doi.org/10.1007/s00228-021-03168-zDOI Listing
July 2021

Effectiveness and usability of mobile health applications to medication adherence for heart failure: a systematic review protocol.

JBI Evid Synth 2021 Jun 1. Epub 2021 Jun 1.

Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, Brazil Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Objective: This review will assess the effectiveness and usability of mobile health applications to improve medication adherence in patients with heart failure.

Introduction: Inadequate medication adherence by heart failure patients is a major cause of negative clinical outcomes, high rates of hospital readmissions, and death, thus increasing the costs to patients and the health care system. Several studies have shown that the use of mobile health applications improves self-care by heart failure patients, including medication adherence. Therefore, gathering evidence on these studies will help researchers and clinicians understand the impact of such interventions on patient care.

Inclusion Criteria: Eligible studies will evaluate medication adherence and include participants aged ≥18 years diagnosed with heart failure who are using app-based (software) interventions. Experimental and observational studies will be included. We will exclude studies with interventions that used mobile applications without functionality to assist the user in organizing and taking their medications.

Methods: Articles published to the present day, without restrictions of language, will be selected from Embase, MEDLINE, LILACS, Scopus, Web of Science, CINAHL, and Cochrane Library. Two independent reviewers will perform article screening, assessment of methodological quality, and data extraction using JBI assessment and extraction instruments. Discrepancies will be solved by consensus and a third reviewer will be consulted if necessary. A narrative synthesis of findings will be presented, and statistical analysis will be used only when appropriate.

Systematic Review Registration Number: PROSPERO CRD42020147816.
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http://dx.doi.org/10.11124/JBIES-20-00399DOI Listing
June 2021

Sex-influence on the time in therapeutic range (TTR) during oral anticoagulation with coumarin derivatives: Systematic review and meta-analysis.

Br J Clin Pharmacol 2021 May 11. Epub 2021 May 11.

Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.

Aims: We sought to investigate the association between sex and oral anticoagulation control employing coumarin derivatives.

Methods: Electronic sources were MEDLINE, Biblioteca Virtual em Saúde (BVS), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Cochrane Central and Web of Science. Inclusion criteria were: observational and experimental studies; age ≥18 years; both sexes; treatment with any coumarin derivative for ≥3 months; any indication of long-term use; quality of oral anticoagulation measured by time in therapeutic range (TTR). The meta-analysis was developed with odds ratios (OR) for binary variables and mean differences (MD) for continuous variables, using random-effects models (DerSimonian and Laird) with 95% confidence intervals (CI).

Results: Overall, 22 articles were selected, comprising 16 cohort studies, four cross-sectional studies and two clinical trials. The number of participants ranged from 110 to 104 505 (183 612; women: 45%). The main indication of oral anticoagulation was atrial fibrillation. Most studies reported the use of warfarin. In the meta-analysis, 15 studies were analysed using TTR as a binary variable (OR = 0.87; 95% CI = 0.78, 0.96; z = -2.75; P = .006.; I  = 67%) and seven studies as a continuous variable (MD = -2.97; 95% CI = -4.80, -1.14; z = -3.19; P = .0014; I  = 75%). The pooled estimates indicated that women were associated with lower TTR than men.

Conclusions: Our findings revealed an association between female sex and worse oral anticoagulation control. Further studies are needed with primary design to investigate sex-related factors influencing oral anticoagulation control with coumarin derivatives. Innovative strategies focused on women's health may be useful to improve patient-centred care.
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http://dx.doi.org/10.1111/bcp.14892DOI Listing
May 2021

Influence of sex-based differences on oral anticoagulation control in patients taking coumarin derivatives: a systematic review protocol.

JBI Evid Synth 2021 02;19(2):477-483

Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Objective: This review will aim to assess the influence of sex-based differences on oral anticoagulation control in patients taking coumarin derivatives.

Introduction: Coumarin derivatives, such as warfarin, have a narrow therapeutic index, requiring frequent monitoring to achieve adequate anticoagulation control, which can be assessed by the time in therapeutic range. Differences in the quality of oral anticoagulation control between men and women have been reported, although the current evidence is controversial. A systematic review on this topic would provide results that could be incorporated into clinical practice to enhance oral anticoagulation control and treatment outcomes.

Inclusion Criteria: Observational and experimental studies were assessed for eligibility, with participants aged ≥18 years of either sex taking oral anticoagulation or other coumarin derivatives for ≥3 months, for any indication of chronic use, who had oral anticoagulation control evaluated by time in therapeutic range.

Methods: Electronic databases to be searched include MEDLINE, BVS, CINAHL, Embase, Cochrane CENTRAL, and Web of Science. Two reviewers will independently perform title/abstract selection and screening, and then full text retrieval and screening of articles that meet the inclusion criteria. The evaluation of methodological quality and data extraction will also be performed by two independent reviewers. Data will be synthesized in tables and then the compiled results will be meta-analyzed. In the presence of subgroup differences, meta-regression methods will be used to investigate the effects of categorical or continuous covariates. If statistical pooling is not possible, a narrative synthesis will be presented.

Systematic Review Registration Number: PROSPERO (CRD42019128329).
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http://dx.doi.org/10.11124/JBIES-20-00168DOI Listing
February 2021

Acute kidney injury biomarkers in the critically ill.

Clin Chim Acta 2020 Sep 12;508:170-178. Epub 2020 May 12.

Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil; Faculdade de Medicina da Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil; Hospital das Clínicas da Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 110, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil. Electronic address:

Acute kidney injury (AKI) is a highly common complication in intensive care units (ICUs). Novel biomarkers might accelerate the detection and management of AKI. We performed a systematic review aiming to evaluate the performance of biomarkers for early AKI diagnosis in ICUs. MEDLINE, BVS, CINAHL, COCHRANE and EMBASE were searched for studies (2006-2019) on the use of biomarkers for AKI diagnosis. Preselected biomarkers were cystatin C, chitinase-3-like protein-1 (UCHI3L1), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1) and interferon-gamma-inducible protein 10 (IP-10/CXCL-10), measured in plasma or urine. Eleven articles with total of 2,289 patients were included. The most cited biomarker was NGAL (n = 7 studies; 63.6%). Biomarkers with the highest sensitivity (se) and specificity (sp) were urinary heat shock protein (HSP-72) (se = 100%; sp = 90%) and urinary IL-18 (se = 92%; sp = 100%). All biomarkers' performance was influenced by the presence of comorbidities or AKI etiology. Although some biomarkers showed good performance, there was no externally validated biomarker for early AKI diagnosis. Thus, from this review, we did not indicate a novel biomarker to be promptly used in clinical practice. Prospective studies with a large number of patients are needed to expand knowledge in this field. PROSPERO registration number CRD42016037325.
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http://dx.doi.org/10.1016/j.cca.2020.05.024DOI Listing
September 2020

Assessment of patient knowledge on warfarin: An item response theory approach.

J Clin Pharm Ther 2020 Aug 27;45(4):698-706. Epub 2020 Apr 27.

Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

What Is Known And Objective: There are no instruments to assess the patient's knowledge of oral anticoagulation with warfarin, in which the performance of the items has been evaluated through the item response theory. To evaluate psychometric properties of the Brazilian version of the Oral Anticoagulation Knowledge Test, using the item response theory.

Methods: This methodological study was developed in an anticoagulation clinic of a university hospital with a sample of 201 patients treated with warfarin. The item response theory was used to evaluate questions regarding psychometric properties and the performance of the Brazilian version of the Oral Anticoagulation Knowledge Test items. The unidimensionality hypothesis was analysed by decomposing the polychoric correlation and the Cronbach's alpha coefficient. An item characteristic curve of the 20 items of the instrument was made to identify the discrimination power of each item of the performance scale.

Results And Discussion: Correlations were positive and statistically significant among the 20 items, with a Cronbach's alpha coefficient of 0.82. The difficulty parameter ranged from -4.14 to 0.42. The discrimination parameter ranged from 0.41 to 1.89. The items regarding drug-drug/drug-food interactions were able to differentiate knowledge about oral anticoagulation with greater accuracy.

What Is New And Conclusion: This study is the first that uses this methodology to evaluate the knowledge on oral anticoagulation therapy with warfarin. The evaluation using item response theory showed that the Brazilian version of the Oral Anticoagulation Knowledge Test is suitable for assessing the patient's knowledge of oral anticoagulation with warfarin. Thus, our findings confirmed the utility of this instrument and provided an essential point of reference for the structuring of health education activities that ensure the individualization of educational interventions in patients on warfarin.
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http://dx.doi.org/10.1111/jcpt.13147DOI Listing
August 2020

Adverse reactions to meglumine antimoniate in Brazilian inpatients with visceral leishmaniases: A case series.

J Clin Pharm Ther 2020 Jun 2;45(3):573-576. Epub 2019 Dec 2.

Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

What Is Known And Objectives: Adverse drug reactions (ADR) related to the treatment of visceral leishmaniasis (VL) can cause severe clinical complications. We report a case series of ADR in hospitalized VL patients on meglumine antimoniate (MA).

Case Description: Seven cases of patients taking MA had at least one objective evidence for suspected ADR, including electrocardiographic, laboratory or clinical alteration.

What Is New And Conclusion: Meglumine antimoniate is highly toxic. Adherence to treatment guidelines is important. Pharmacists working in multidisciplinary teams may contribute to early detection and management of MA therapy-related ADR.
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http://dx.doi.org/10.1111/jcpt.13089DOI Listing
June 2020

Instruments for the assessment of patient adherence to oral anticoagulation with warfarin protocol for a systematic review.

Medicine (Baltimore) 2019 Oct;98(42):e17323

Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte.

Background: Non-adherence can be highlighted as one of the main contributors to the occurrence of adverse events in patients treated with warfarin. The usefulness of self-reporting measures of drug adherence could be improved by following psychometric properties in the development of the measurement scales. Thus, we aimed to describe the protocol of a systematic literature review designed to investigate and describe validated instruments used to assess adherence to warfarin therapy.

Methods: We will perform a systematic review will include observational and experimental studies involving the use of validated instruments to assess adherence to warfarin therapy. Dimensions of adherence raised by the selected studies will be extracted to be compared. We will systematically search electronic databases including MEDLINE, LILACS, EMBASE, and Cochrane Library using a comprehensive strategy from inception to June 31, 2019. Two reviewers will revise the literature independently using a standardized form and assess the potential bias. After the comparison of results, discrepancies will be solved after the analysis of a third reviewer.

Result: The development of the present systematic will help to summarize and evaluate the validated instruments that have been previously published to assess adherence to warfarin therapy.

Conclusion: This review will substantiate the discussion of relevant topics that should be assessed while providing care to patients taking warfarin. This knowledge will enable a comprehensive approach for healthcare professionals to improve treatment outcomes and the design of future investigations.

Registration: The systematic review is registered in the PROSPERO international prospective register of systematic review (PROSPERO# CRD42019128324).
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http://dx.doi.org/10.1097/MD.0000000000017323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824815PMC
October 2019

Cross-cultural Adaptation of the Oral Anticoagulation Knowledge Test to the Brazilian Portuguese.

Cien Saude Colet 2017 May;22(5):1615-1629

Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG). Av. Pres. Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.

Patients' knowledge about oral anticoagulant therapy may favor the achievement of therapeutic results and the prevention of adverse pharmacotherapy-related events. Brazil lacks validated instruments for assessing the patient's knowledge about treatment with warfarin. This study aimed to perform the cross-cultural adaptation of the Oral Anticoagulation Knowledge (OAK) Test instrument from English into Portuguese. This is a methodological study developed in an anticoagulation clinic of a public university hospital. The study included initial translation, synthesis of translations, back-translation, review by the experts committee and pre-testing with 30 individuals. We obtained semantic equivalence through the analysis of the referential and general meaning of each item. The conceptual equivalence of the items sought to demonstrate the relevance and acceptability of the instrument. The process of cross-cultural adaptation produced the final version of the OAK Test in Brazilian Portuguese entitled "Teste de Conhecimento sobre Anticoagulação Oral". There was a suitable semantic and conceptual equivalence between the adapted version and the original version, as well as an excellent acceptability of this instrument.
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http://dx.doi.org/10.1590/1413-81232017225.17782015DOI Listing
May 2017

Assessment of psychometric properties of the Brazilian version of the oral anticoagulation knowledge test.

Health Qual Life Outcomes 2016 Jun 24;14:96. Epub 2016 Jun 24.

Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica. Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.

Background: The aim of this study was to evaluate the psychometric properties of the Brazilian version of the Oral Anticoagulation Knowledge (OAK) Test.

Methods: This study, conducted in an anticoagulation clinic, included 201 Brazilian participants aged over 18 years, who had been using warfarin for more than two months. The reliability of the instrument was evaluated by assessing internal consistency (Kuder-Richardson coefficient) and reproducibility (test-retest reliability). The validity was evaluated by hypothesizing that there would be a positive correlation of moderate to strong intensity between the correctness levels of the OAK Test and time within therapeutic range (TTR) values, which is a measure used to evaluate the quality of oral anticoagulation.

Results: The instrument exhibited good psychometric properties. The total a Kuder-Richardson coefficient value was 0.818 and intraclass correlation coefficient was 0.967. The validity revealed a strong positive correlation between the values of the level of knowledge, as measured by the OAK Test and the TTR values (rs = 0.780).

Conclusion: The instrument proved to be a reliable and valid tool for evaluating the knowledge of Brazilian patients on oral anticoagulation therapy with warfarin. This instrument may be incorporated into the practice of health care for substantiating the structuring of educational activities to ensure the improvement of knowledge about the use of warfarin, thereby increasing the effectiveness and safety of treatment.
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http://dx.doi.org/10.1186/s12955-016-0498-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4921033PMC
June 2016

[Medication errors: analysis of what a hospital's nursing staff know].

Rev Gaucha Enferm 2011 Sep;32(3):539-45

Departamento de Enfermagem da Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brasil.

The aim of this study was to determine and discuss with the nursing staff their knowledge about what represents a medication error, the need to notify such an error and what would be necessary to put in these notifications. This is a descriptive quantitative study, carried out in a hospital, of which 72 professionals took part. Regarding the definition of medication errors, we found that 49 (68%) share the concept adopted in this study. Regarding the need of notification, 67 (93%) declared that there is such a need. As regards the content of the notification, 63 (85%) had a similar concept to the one used in this study. The need to further approach aspects related to medication errors was evident.
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http://dx.doi.org/10.1590/s1983-14472011000300015DOI Listing
September 2011

Nursing journals and medication management: identification and categorization of publications from 1987 to 2008.

Rev Lat Am Enfermagem 2009 Sep-Oct;17(5):721-9

Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil.

This study aimed to identify and categorize publications about themes related to medication administration in Brazilian nursing journals between 1987 and 2008. From a survey in the main health databases, we reviewed literature about the theme in six Brazilian journals, classifying the articles into care, teaching, research, technique, medication errors, communication and specific drugs. One hundred eight articles were identified, particularly in the Revista Latino-Americana de Enfermagem and the Revista Brasileira de Enfermagem. The author Cassiani and the category specific drugs stand out as responsible for the largest number of articles published. Efforts need to be added up with a view to a more expressive production of articles on medication administration.
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http://dx.doi.org/10.1590/s0104-11692009000500020DOI Listing
January 2010
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