Abstract:
:Background Rheumatoid arthritis is a chronic, autoimmune disease in which treatment has evolved with a variety of therapeutic classes. Biological disease-modifying antirheumatic drugs have improved therapy; however, the continued long-term use of these drugs with sustained safety and efficacy remains a challenge. ObjectiveThe objective of this study was to analyze time of use and reasons for discontinuation of biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis.SettingIt is as part of REAL (Rheumatoid Arthritis in Real Life), a multicenter project that evaluated Brazilian patients with rheumatoid arthritis in a real-life setting. Eleven referral centers for the treatment in the public network participated in the study.MethodsWe conducted a cross-sectional analysis of data collected in the REAL study from August to October 2015 study. The patients were submitted to clinical evaluation and analysis of medical records.Results1125 patients were included (89.5% women; median age: 56.6 years; and disease time: 12.8 years). A total of 406 (36.09%) participants were on a biological disease-modifying antirheumatic drugs. Infliximab was the drug with the longest time of use (12 years). Most (64.4%) drug suspension episodes were due to inefficacy. Adalimumab and certolizumab had a greater number of suspensions due to primary inefficacy, while discontinuations for abatacept were due more to secondary inefficacy. Infliximab had fewer suspensions due to primary inefficacy and golimumab had fewer episodes of secondary inefficacy. Regarding side effects, infliximab was suspended a greater number of times because of clinical and laboratory side effects. Abatacept and adalimumab had fewer suspensions due to clinical side effects, and certolizumab, rituximab and tocilizumab had fewer laboratory adverse effects. Conclusion Among the biological disease-modifying antirheumatic drugs being used for long periods, infliximab had greater time of use. Most drug suspensions (64%) were due to primary or secondary inefficacy. Number of discontinuations due to clinical and laboratory adverse effects for each drug was analyzed, and these data should be confirmed by other real-life studies. Knowledge of what is happening in real life is essential to health professionals, who need to be aware of the most common adverse effects and to health managers, who aim for greater cost-effectiveness in the choice of medications.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Gomides APM,de Albuquerque CP,Santos ABV,Bértolo MB,Júnior PL,Giorgi RDN,Radominski SC,Resende Guimarães MFB,Bonfiglioli KR,de Fátima Lobato da Cunha Sauma M,Pereira IA,Brenol CV,da Mota LMH,Pinheiro GDRCdoi
10.1007/s11096-020-01171-5subject
Has Abstractpub_date
2020-10-21 00:00:00eissn
2210-7703issn
2210-7711pii
10.1007/s11096-020-01171-5pub_type
杂志文章abstract:UNLABELLED:Background Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the controversy and consensus. ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0360-z
更新日期:2016-10-01 00:00:00
abstract::Background Several clinical pharmacy activities are common to UK hospitals. It is not clear whether these are provided at similar levels, and whether they take similar amounts of time to carry out. Objective To quantify and compare clinical pharmacist ward activities between different UK hospitals. Setting Seven acute...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,多中心研究
doi:10.1007/s11096-016-0386-2
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:There has been little research which specifically examines medicine use among South Asian (SA) and Middle Eastern (ME) groups, although evidence suggests that medicine-related needs may be poorly met for these groups. OBJECTIVE:To describe medicine-related problems (MRPs) experienced by SA and ME patients f...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0103-6
更新日期:2015-08-01 00:00:00
abstract::Background Tyrosine kinase inhibitors have been demonstrated to improve the survival of patients with chronic myeloid leukaemia. However, medication adherence is vital for patients on chronic treatment. Objective The objective of the current study was to evaluate response to treatment, adherence by patients to tyrosin...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01070-9
更新日期:2020-06-11 00:00:00
abstract::Pharmacovigilance is an essential part of the post-marketing surveillance of new biologicals. It not only requires a substantial investment of the marketing authorization holder but also of the clinical field to provide accurate safety information. Hence, does pharmacovigilance delivers value for money? This important...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0695-8
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Communication between hospital and community pharmacists when a patient is discharged from hospital can improve the accuracy of medication reconciliation, thus preventing unintentional changes and ensuring continuity of supply. It allows problems to be resolved before a patient requires a further supply of m...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9813-9
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Improper disposal of medications potentially poses a significant environmental risk and storage of expired and unused medications in households provides an increased risk of accidental childhood poisonings. OBJECTIVE:The objective of this study was to investigate the storage and disposal habits of medicatio...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9652-0
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Complete control of emesis during chemotherapy remains to be achieved. This could be improved by increasing adherence to medicines and recommendations. OBJECTIVE:The aim of this study was to analyse the effects of pharmaceutical care on the incidence of delayed chemotherapy-induced nausea and vomiting (CINV...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-9915-z
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of pharmacotherapy follow-up (PF) on metabolic control and clinical outcomes in type 2 diabetic patients. SETTING:Six community pharmacies (4 intervention and 2 control) in the Curitiba metropolitan region (Brazil). MAIN OUTCOME MEASURE:Glycosylated Haemoglobin A1 (HbA1) and fasting ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9493-2
更新日期:2011-04-01 00:00:00
abstract::Background Gram negative pathogens are increasingly resistant to commonly used first line antibiotics and colistin is in most cases the only medicine available. There is very limited information available comparing the effectiveness and costs of low versus high dose colistin with studies showing efficacy with both dos...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0713-x
更新日期:2018-10-01 00:00:00
abstract::Background While dispensing prescribed medicines, pharmacists frequently encounter technical and clinical problems that require a pharmaceutical intervention. Objective To describe the pharmaceutical interventions performed by community pharmacists while dispensing prescribed medicines and to investigate, in-depth, th...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0595-y
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:In end-of-life care, symptoms of discomfort are mainly managed by drug therapy, the guidelines for which are mainly based on expert opinions. A few papers have inventoried drug prescriptions in palliative care settings, but none has reported the frequency of use in combination with doses and route of adminis...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0094-3
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Replacement therapy in haemophilia plays an important role in the effective management of this rare bleeding disorder and requires a high level of knowledge and practical skills. OBJECTIVE:To evaluate and to compare the knowledge and skills about the medicines and their management among people with haemophi...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,多中心研究
doi:10.1007/s11096-015-0207-z
更新日期:2016-02-01 00:00:00
abstract::Background Medication reconciliation (MedRec) at discharge is a cumbersome but necessary process to reduce the risk of medication errors at transitions of care. The main barriers to implementing such a process are the large number of professionals involved and a lack of collaboration among caregivers. Objective This s...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0292-7
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Unsafe storage of unused medications at home leads to an increased risk of toxicity, accidental childhood poisoning or risk for suicide, whereas an improper disposal of unwanted/expired medications from household raises concern about environmental pollution. OBJECTIVE:The aim of the study was to characteriz...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-0048-1
更新日期:2015-02-01 00:00:00
abstract::Setting Fifteen community pharmacies in the UK. Objective Proof of concept study to test the use of community pharmacies for active case finding of patients with coeliac disease. Methods Customers accessing over-the counter and prescription medicines indicated in the treatment of possible symptoms of coeliac disease o...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0368-4
更新日期:2016-10-01 00:00:00
abstract::Background The drug-related problem classification system of the Pharmaceutical Care Network Europe (PCNE) is well established and continuously updated. A translated version of the drug-related problem classification system can facilitate research and implementation of clinical pharmacy services in the corresponding c...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01150-w
更新日期:2020-10-06 00:00:00
abstract:BACKGROUND:Medication errors are a potential major threat to patient's health, and allergic reactions occurring in patients with known allergies are an important preventable form of adverse drug event. The use of penicillin antibiotics in patients who are allergic to penicillin, in particular, is a major concern. AIM:...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9708-1
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Granulocyte colony-stimulating factor administration is an important component of supportive therapy in chemotherapy-induced leukopenia. Although patient response to granulocyte colony-stimulating factor administration is known to vary, the factors responsible for poor response have not been identified. OBJ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9703-6
更新日期:2013-02-01 00:00:00
abstract::Background The efficacy and safety of direct oral anticoagulants is well established in patients with atrial fibrillation. However, data on their use in the oldest old patients (≥ 85 years), who have the highest risk of bleeding, is scarce. Objective The aim of this study was to evaluate the safety of direct oral anti...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01008-1
更新日期:2020-04-01 00:00:00
abstract::Background Population-based studies investigating indications for antidepressant prescribing mostly rely on diagnoses from general practitioners. However, diagnostic codes might be incomplete and drugs may be prescribed 'off-label' for indications not investigated in clinical trials. Objective We aimed to study indica...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0371-9
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To examine the prescribing pattern of antihypertensive drugs in outpatients with hypertension in a general hospital in central China and identify whether the pattern of prescribing is appropriate and in accordance with national and international guidelines for pharmacotherapy of hypertension. SETTING:The in...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-010-9476-8
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Responsible self-medication is an integral part of the health system that consists of community pharmacists counseling patients on treating minor illness using non-prescription medications. Systems for properly managing information can assist disease identification and clinical decision-making. OBJECTIVE:To...
journal_title:International journal of clinical pharmacy
pub_type: 共识发展会议,杂志文章
doi:10.1007/s11096-015-0223-z
更新日期:2016-02-01 00:00:00
abstract::Practice-based networks can serve as effective mechanisms for the development of the profession of pharmacists, on the one hand by supporting student internships and on the other hand by collection of research data and implementation of research outcomes among public health practice settings. This paper presents the c...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-014-9954-5
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:The variability in the clinical response to clopidogrel treatment has been attributed to genetic factors, but the specific genes and other risk factors remain unclear. OBJECTIVE:To investigate the incidence of high on-treatment platelet reactivity in coronary heart disease patients following clopidogrel the...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-019-00953-w
更新日期:2020-02-01 00:00:00
abstract:: ...
journal_title:International journal of clinical pharmacy
pub_type:
doi:10.1007/s11096-018-0759-9
更新日期:2019-02-01 00:00:00
abstract:UNLABELLED:Sequential antimicrobial therapy is an important part of antimicrobial stewardship and intends to improve the timeliness of switch to oral antimicrobials. The aim of this study was to assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials. SETTING:The study was...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-010-9475-9
更新日期:2011-04-01 00:00:00
abstract::Background Best practice guidelines recommend regular evaluation of antipsychotics in managing behaviours for dementia patients with a view to de-prescribing, given its significant mortality and adverse outcomes (Reus et al. in Am J Psychiatry 173(5):543-546, 2016, Deprescribing Guidelines and Algorithms in https://de...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01135-9
更新日期:2020-09-10 00:00:00
abstract::Applying the WHO definition of pharmacovigilance, the International Society of Pharmacovigilance, (ISoP) is concerned with all aspects of medicine safety. The safety of patients exposed to medicines depends on a wide variety of factors, where the understanding of each factor is associated with its own professional com...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0708-7
更新日期:2018-08-01 00:00:00
abstract::Background Despite the importance placed on the concept of the multidisciplinary team in relation to intermediate care (IC), little is known about community pharmacists' (CPs) involvement. Objective To determine CPs' awareness of and involvement with IC services, perceptions of the transfer of patients' medication inf...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0377-3
更新日期:2016-12-01 00:00:00