Redução do índice de complexidade da medicação em lar de idosos

Objectivo: este estudo centrava-se na avaliação da eficácia da intervenção de um farmacêutico na Redução do Grau de Complexidade da Medicação num Lar de Idosos. Métodos: tratou-se de um estudo randomizado controlado. A instituição que serviu para a recolha de dados foi o Lar da Santa Casa da Misericórdia das Alcáçovas, localidade que pertence ao concelho de Viana do Alentejo, Distrito de Évora. Foram usados como amostra, os utentes institucionalizados (n=86), que por randomização foram divididos em grupo de intervenção e de controlo respectivamente. Em Março 2007, o Índice Çomplexidade da Medicação (MRCI), foi usado para estabelecer a linha de partida (baseline). Ocorreu uma sessão informativa com o médico acerca da importância e dos efeitos provocados pelo MRCI obtido. A fase de Intervenção teve início em Maio de 2007, e consistiu em reportar ao médico o MRCI para cada utente, o valor médio do MRCI para o Lar e algumas recomendações para o poder reduzir. Noventa dias após a intervenção, o MRCI voltou a ser avaliado para todos os utentes. Resultados: a média de idades para os 86 utentes era de 83,9 anos, com 66,3o/o de mulheres. Na linha de partida, os utentes usavam 7,8 medicamentos e apresentavam um MRCI de 22,9 (95% Cl 20,1: 25,7). Durante a fase de intervenção, 2 utentes do grupo de intervenção e 5 utentes do grupo de controlo faleceram. Após a intervenção, o número de medicamentos reduziu no grupo de intervenção (p = 0,035), mas não no grupo de controlo (p =0,079). O MACI do grupo de intervenção reduziu de 22,2 para 16,8 (p =0,015); enquanto o MRCI do grupo de controlo reduziu apenas de 23,6 para 20,0 (p =0,091). As três secções do MRCI reduziram significativamente no grupo de intervenção, mas nenhum deles reduziu no grupo de controlo. Conclusão: a intervenção de um farmacêutico pode contribuir para reduzir a complexidade da medicação nos idosos, com uma ligeira redução no número de medicamentos a tomar pelos utentes e sem focalizar a intervenção num aspecto específico do regime terapêutico. ABSTRACT; Methods: Randomized controlled study. Patients (n= 86) institutionalized in nursing home to Santa Casa da Misericórdia das Alcáçovas, Viana do Alentejo, Évora. The patients were randomly assigned to intervention and control groups. ln Mars 2007, Medication Regimen Complexity Index (MRCI) was used to establish a baseline... An informative session with the physician about the importance and effects of regime complexity occurred. lntervention started in May 2007, and consisted in reporting to the physician the complexity of each patient medication regime, with references to the average complexity and some recommendations to reduce it. Ninety days after the intervention, MRCI were evaluated in all the patients. Results: average age of the 86 patients was 83,9 years, with 66,3°/o of females. At the baseline, patients were using 7, 8 medicines, and presented a MRCI = 22,9 (95%CI 20,1 : 25,7). During the intervention phase, 2 intervention patients and 5 control patients dead. After the intervention, the number of medicines reduced in intervention group (p=0,035), but not in the control group (p = 0,079).1ntervention MRCI reduced from 22,2 to 16,8 (p =0,015), while control MRCI reduced only from 23,6 to 20,0 (p =0,091). The three section of the MRCI significantly reduced in the intervention, but none of them in the control group. Conclusions: clinical pharmacist interventions can contribute to reducing the medication regime complexity in elderly, with a slight reduction of the number of medicines taken by the patient, and without focusing the intervention in one specific aspect of the medication regime.

First reproductive and productive results on “Ribatejano pig”

The present trail aimed to study the effect of crossbreeding between Alentejano (AL) and Bísaro (BI) swine breeds (“Ribatejano pig”) on some reproductive and productive traits. Nine AL gilts and sows and six BI gilts were crossed with BI and AL boars, respectively. Mating and farrowing dates, prolificacy and litter size at 28d were registered for all sows. The pregnancy length of AL sows was shorter (111±0.4d vs 113.7±0.5d; p=0.002) than the observed on BI females. The BI gilts presented higher prolificacy rate than AL on both total born (11.0±1.0 vs 6.7±0.8; P=0.004) and born alive piglets (10.0±1.0 vs 6.7±0.8; p=0.026). The mortality rate was similar in both genotypes (p=0.255) being on average 12%, therefore at 28d after farrowing the litter size remained higher in BI sows (8.5±0.8 vs 6.1±0.6; p= 0.032). A subset of each genotype (4 gilts) was supervised during farrowing and lactation (until 28d) and piglets were weighed at birth, 24h and 28d of live. Farrowing length was not significantly different (p=0.253) between genotypes, averaging 97±22 min. When compared to ALBI (AL x BI) piglets, the BIAL (BI x AL) piglets were heavier at birth (1402±46g vs 1209±36g; p=0.002). Colostrum intake of piglets per kg of birth weight on the first 24h of life was similar between genotypes (p=0.735) being 289±15g for ALBI and 281±19g for BIAL piglets. The growth rate of piglets from birth to 28d and piglet weight at 28d was not different between genotypes (p=0.161 and p=0.091) averaging 195±6g and 6761±181g, respectively. Litter weight at 28d tended (P=0.06) to be higher on ALBI litters (56.6±4.0kg) than BIAL litters (43.2±4.0kg). This results obtained within the frame of Treasure project* are, at our knowledge, the first data of these crossbred piglets and could be used in future as reference for further studies and also for farmers that may try these cross on a commercial basis.