Use of biochemical markers in type II diabetes as parameters of monitoring the patients pharmacotherapeutic follow-up: an approach in pharmaceutical care

A prÃtica da AtenÃÃo FarmacÃutica (AF) individualizada no Diabetes, com a monitorizaÃÃo dos parÃmetros bioquÃmicos, faz-se necessÃria, uma vez que proporciona os melhores resultados clÃnicos e resulta em maior qualidade de vida para os pacientes. Objetivo: Analisar, atravÃs de um plano em AtenÃÃo FarmacÃutica para pacientes com Diabetes mellitus tipo II, os problemas relacionados com os medicamentos, bem como a viabilizaÃÃo do uso de marcadores bioquÃmicos de disfunÃÃo endotelial como parÃmetros de monitorizaÃÃo no acompanhamento farmacoterapÃutico. MÃtodos: O estudo foi realizado com um grupo de pacientes diabÃticos atendidos no Centro de Pesquisas em Diabetes e DoenÃas EndocrinometabÃlicas no perÃodo de junho de 2006 a junho de 2007. A pesquisa contou com a participaÃÃo efetiva de 58 pacientes. O Acompanhamento FarmacoterapÃutico (AFT) realizou-se atravÃs de visitas dos pacientes ao centro, ao todo sete, quando eram entrevistados, orientados dentro do plano desenvolvido para o serviÃo de AtenÃÃo FarmacÃutica e tinham exames laboratoriais colhidos, entre esses os marcadores da disfunÃÃo endotelial, como colesterol total (CT), triglicÃrides (TG), hemoglobina glicada (HbA1c), glicose de jejum (GJ) e colesterÃis LDL e HDL. Resultados: Observou-se o predomÃnio do sexo feminino (58,4%) sobre o masculino (41,58 %). A hipertensÃo esteve associada em 54,4% dos pacientes diabÃticos. Uma porcentagem significativa dos pacientes era sedentÃria (64%) e possuÃa diagnÃstico de diabetes hà menos de 10 anos (84,2%). Os parÃmetros laboratoriais dos pacientes GJ, CT, LDL-C e HbA1c melhoraram apÃs seis meses da AF. Aproximadamente 96,70% dos pacientes apresentaram dislipidemia no inÃcio da AF, sendo que esse valor diminuiu para 64,29% apÃs trÃs meses e aumentou para 81,04% apÃs seis meses. A porcentagem dos pacientes com dislipidemia classificada por HDL baixo caiu de 96,70%, no inÃcio da AF, para 92,60% apÃs 3 meses de AF. ConclusÃo: A prÃtica da AtenÃÃo FarmacÃutica firmou-se eficiente na melhoria da qualidade de vida dos pacientes diabÃticos, atravÃs da identificaÃÃo e resoluÃÃo de problemas relacionados a medicamentos (PRM), bem como de orientaÃÃes sobre qualidade de vida e uso racional dos fÃrmacos, agindo, assim, na prevenÃÃo de complicaÃÃes tardias da doenÃa.Individualized Pharmaceutical Care (PC) practice in Diabetes, monitoring biochemical parameters, is a very important activity once that it provides better clinical and it helps to improve the diabetic patientsâ health quality. Objective: The aim of this work was to present and to analyze, through a Pharmaceutical Care (PC) plan for patients with Diabetes Mellitus type 2, the drug related problems (DRP) and the implantation of endhotelial dysfunction biochemical markers as parameters of monitor the pharmacotherapeutic follow-up. Methods: The study was carried out with a group of diabetic patients attended at Centro de Pesquisas em Diabetes e DoenÃas EndocrinometabÃlicas during the period from June-2006 to June-2007. The research was developed with 101 patients and counted on the effective participation of 58 patients until its conclusion. The patients had participated of 7 visits to the center, where they had been interviewed, they had carried out laboratorial determinations and they had received the orientation from the developed plan for the pharmaceutical attention service. Results: It was observed the feminine gender predominance (58.4%) when compared to the masculine (41.58%). Arterial hypertension was associated in 54.4% of diabetic patients. A significant percentage of the patients (64%) was sedentary and presented diagnostic of diabetes since less than 10 years (84.2%). The general state of the patientsâ condition while analyzing parameters GJ, CT, LDL-C and HbA1c had improved after 6 months of PC. 96.70% of the patients had presented dyslipidemia in the beginning of PC and this value had decreased to 64.29% 3 months after, increasing again to 81,04% after 6 months. The percentage of the patients with dyslipidemia classified for low HDL in the beginning of PC was 96,70%, and this number had decreased to 92.6% after 3 months of PC plan. Conclusion: PC practice was firmed as an efficient instrument in patientâs adhesion to the therapeutic plan, as well as in the improvement of the diabetic individuals life quality, also helping the prevention of some complications like those ones related to cardiovascular conditions