Papers by Divaldo Lyra Jr.
Journal of Clinical Pharmacy and Therapeutics, 2019
The Nursing Working Group of the International Society of Pediatric Oncology developed baseline s... more The Nursing Working Group of the International Society of Pediatric Oncology developed baseline standards for pediatric oncology nursing care in low-and middle-income countries. The standards represent the foundational support required to provide quality nursing care and address barriers such as inadequate staffing, lack of support, limited access to education, and unsafe nursing environments. The purpose of the current study was to develop and validate an instrument to accurately measure the standards. Content validity was assessed by a panel of expert pediatric oncology nurses from all geographical regions of the World Health Organization. The experts were informed about the study's purpose and provided the publications used to develop the instrument. The experts rated how well each criterion measured the corresponding standard by using a 4-point scale. A content validity index (CVI) was computed by using the percentage of total standards given a score of 3 or 4 by the experts. A CVI of .98 was obtained from the panel's evaluation. A CVI of more than .80 is recommended for a newly developed instrument. On the basis of the panel's recommendations, minor modifications were made to the instrument. We developed and validated the content of an instrument to accurately measure baseline standards for pediatric oncology nursing care. This instrument will aid future research on the effect of nursing standards on clinical outcomes, including mortality and abandonment of treatment, with the potential to influence health policy decisions and improve nursing support in low-and middle-income countries.
Pharmacy Practice, 2018
Objective. To measure undergraduate pharmacy and medical students' collaborative attitudes regard... more Objective. To measure undergraduate pharmacy and medical students' collaborative attitudes regarding Pharmacist-Physician collaboration. Methods. A cross-sectional descriptive study was conducted from September 2016 to February 2017 in Northeast Brazil. Pharmacy and medical students from the first and the last year of courses were invited to complete Portuguese version of Scale of Attitudes Toward Pharmacist-Physician Collaboration (SATP 2 C). Descriptive and comparative analyses were performed using IBM SPSS (22 version). Differences were considered significant when p<0.05. Results. Three hundred seventy students completed the SATP 2 C. Overall, the students had positive attitudes towards physicianpharmacist collaboration. There was no significant correlation between age and score (p=0.79). Women showed a more positive collaborative attitude than men (53.1, SD=6.8 vs. 55.1, SD=6.3). Pharmacy students had a higher score than medical students (57.5, SD=4.7, vs. 51.1, SD=6.4). The first-year medical students had a higher score than last-year medical students (52.3, SD=6.0 vs. 49.5, SD=6.6; p<0.007). There was no significant difference in the attitudes between the first and last year pharmacy students (p<0.007). Conclusions. Pharmacy and medical students showed positive attitudes towards physician-pharmacist collaboration. However, pharmacy students presented more collaborative attitudes than medical ones. Additionally, the first-year medical students had more collaborative attitudes than last-year medical students. Studies should be conducted to provide recommendations to improve interprofessional education efforts to further enhance the positive attitudes toward physician-pharmacist collaboration.
PloS one, 2016
To assess the effect of pharmacist interventions on glycemic control in type 2 diabetic patients ... more To assess the effect of pharmacist interventions on glycemic control in type 2 diabetic patients and to examine factors that could explain the variation across studies. A comprehensive literature search was performed in PubMed, Scopus, and LILACS databases for randomized controlled trials (RCTs) published up to July 2015. The search strategy included the use of MeSH terms or text words related to pharmacist interventions, type 2 diabetes, and randomized controlled trials. RCTs published in English, Portuguese, or Spanish that evaluated the effect of pharmacist intervention on glycemic control in type 2 diabetic outpatients were included. Two independent authors executed study selection, data extraction, and risk of bias assessment. Mean differences in glycosylated hemoglobin (HbA1c) were estimated using random-effect models, and heterogeneity was evaluated by subgroup and meta-regression analyses. The literature search yielded 963 records of potential interest, of which 30 were incl...
African journal of pharmacy and pharmacology
In the elderly population, increased predisposition to chronic diseases and consequent use of var... more In the elderly population, increased predisposition to chronic diseases and consequent use of various medications increases the chances of using a potentially inappropriate drug therapy. The purpose of this review was to analyze research that uses tools to study potentially inappropriate drug therapy through the strengthening the reporting of observational studies in epidemiology (STROBE) initiative. A systematic review was undertaken between February and March, 2013. The studies were selected from different combinations of the Medicine's controlled vocabulary thesaurus (MESH) terms-" aged, " " elderly, " " inappropriate prescribing, " and " drug utilization " in English, Spanish and Portuguese, in the Literatura Latino-Americana e do Caribe em Ciências da Saúde, PubMed, Scopus, and Web of Science databases. The papers that satisfied the inclusion criteria for data extraction were examined regarding the following variables: country, sample...
PLOS ONE, 2015
Background In recent years, pharmacists have been involved in expanded patient care responsibilit... more Background In recent years, pharmacists have been involved in expanded patient care responsibilities, for example patient counseling in self-medication, medication review and pharmaceutical care, which require graduates to develop the necessary competences. Consequently, reorientation of pharmacy education has become necessary. As such, active learning strategies have been introduced into classrooms to increase problem-solving and critical thinking skills of students. The objective of this study was to evaluate the performance and perceptions of competency of students in a new pharmaceutical care course that uses active learning methodologies. Methods This pharmaceutical care course was conducted in the first semester of 2014, in the Federal University of Sergipe. In the pharmaceutical care course, active learning methods were used, consisting of dialogic classroom expository, simulation and case studies. Student learning was evaluated using classroom tests and instruments that evaluated the perception of competency in pharmaceutical care practice. Furthermore, students' satisfaction with the course was evaluated. Results Thirty-three students completed the four evaluations used in the course (i.e., a discursive written exam, seminars, OSCE, and virtual patient); 25 were female (75.75%), and the median age was 23.43 (SD 2.82) years. The overall mean of student scores, in all evaluation methods was 7.97 (SD 0.59) on a scale of 0 to 10 points, and student performance on the virtual patient method was statistically superior to other methods. With respect to the perception of competency in pharmaceutical care practice, a comparison of pre-and post-test scores revealed statistically significant improvement for all evaluated competences. At the PLOS ONE |
Patient Preference and Adherence, 2014
Objective: To assess the understanding and cultural acceptability of the United States Pharmacope... more Objective: To assess the understanding and cultural acceptability of the United States Pharmacopeia Dispensing Information (USP-DI) in a group of elderly Brazilians. Methods: The study participants were individuals between 60 and 90 years old, of both sexes, with different levels of education and income. Fifteen of 81 pictograms from the USP-DI were presented to the elderly subjects, individually, without subtitles and in random order, so that the participants' understanding of the pictograms could be evaluated. Results: The study included 116 participants. Only one of the selected pictograms reached the comprehension criterion established by the International Organization for Standardization 3864. With regard to the relationship between understanding and sociodemographic characteristics, age, wage income, and level of education were all found to be significantly associated with participants' understanding of some of the pictograms. Conclusion: Most of the USP-DI pictograms evaluated were not well understood by the elderly Brazilians. This finding indicates that such pictograms need to be culturally adapted for the Brazilian context if they are to serve their purpose effectively in this country.
Therapeutics and clinical risk management, 2007
To evaluate the impact of a Pharmaceutical Care service in the identification and resolution of d... more To evaluate the impact of a Pharmaceutical Care service in the identification and resolution of drug-related problems (DRPs) and in quality of life (QoL) of a group of elderly outpatients with chronic health conditions. 30 outpatients (aged 60-75-years old) were followed between August 2003 and July 2004 at a primary health care unit in Ribeirão Preto (SP), Brazil. Patients were scheduled monthly to meet with the researcher, who provided Pharmaceutical Care service (the intervention). Through Pharmaceutical Care, the pharmacist worked with the patient and other care providers to improve outcomes of drug therapy through focused education, care planning, and monitoring. Intervention outcomes were the number of DRPs prevented or resolved, and the impact on QoL. The Short Form-36 health survey was used to measure changes in QoL. The mean age of patients was 66 ± 5 years, 21 of whom had low literacy. During the study, 92 DRP were identified, 3.0 ± 1.5 problems per patient. By the end of ...
Ciência & Saúde Coletiva, 2010
As bulas representam a principal fonte de informação escrita fornecida aos pacientes, especialmen... more As bulas representam a principal fonte de informação escrita fornecida aos pacientes, especialmente aos idosos. O presente trabalho visou analisar o conteúdo das bulas dos medicamentos frequentemente prescritos para idosos com hipertensão, bem como a sua adequação à regulamentação sanitária e possíveis implicações para a saúde. Foi realizado um estudo descritivo em duas etapas: etapa A, em julho de 2002, e B em julho de 2007. Em cada etapa foram analisadas 34 bulas de sete fármacos anti-hipertensivos que constam na Relação Nacional de Medicamentos Essenciais (2006). Entre as 68 bulas analisadas, a maioria não continha todas as informações exigidas pela Portaria n° 110/1997 na etapa A (89,5%) e pela RDC n°140/2003 na B (100%). Alguns itens importantes como via de administração, modo de uso e superdose não constavam em 76% das bulas analisadas. A falta dessas informações é relevante para a segurança dos pacientes. Com base nos dados obtidos, foi possível constatar o não cumprimento da...
Pharmacy World & Science, 2009
Aim of study To analyze dental prescribing errors in Aracaju, Brazil, and to suggest feasible imp... more Aim of study To analyze dental prescribing errors in Aracaju, Brazil, and to suggest feasible improvements for patient safety. Methods A descriptive study was conducted at nine Primary Health Care Units (PHCUs) in the northeast region of Brazil. A convenience sample of 300 dental prescriptions was selected during the period February-May 2007. The World Health Organization (WHO) prescribing criteria were used to measure the quality of the prescriptions. Main outcome measures All medications were prescribed by generic name; 98.3% of prescription information contained abbreviations and 26% of them were classified as having low legibility or as being illegible. The most commonly prescribed medications were diclofenac (35%), both sodium and potassium, and amoxicillin (26%). Conclusions Dental prescribing errors should be considered as a potential area for improvement in the medication management process and patient safety. We suggest that a pharmacist should be available for medication dispensing at all units and that dentists are trained continuously so that medication orders may become more legible and complete. Improving the quality of dental prescriptions will reduce the risks for medication errors and will promote the rational use of pharmacotherapy, and patient safety.
Pharmacy Practice (Internet), 2013
Background: Headache, or cephalalgia, is one of the 20 most disabling diseases in the world and a... more Background: Headache, or cephalalgia, is one of the 20 most disabling diseases in the world and affects a large portion of the world's population. People generally use over-the-counter medications to treat headaches and other minor symptoms. A pharmacist should help patients choose the most effective, safe, and convenient pharmacotherapeutic option. Objective: To assess the counselling skills of community pharmacists for headache management by using the simulated patient approach. Methods: A cross-sectional study was conducted from March 2010 to July 2010. Data were obtained from a convenience sample consisting of one pharmacist from each of the 24 participating community pharmacies. In order to evaluate the pharmacists' counselling skills, a simulated patient role played a standardized headache case requesting self-medication. The interactions of the simulated patient with the pharmacists were audiovisually recorded using a hidden micro camera, and these recordings were analysed using a validated questionnaire. Results: Of the 24 evaluated pharmacists, 19 (79.1%) were women. Information was spontaneously provided by 15 (62.5%) pharmacists. At least one question was asked by the pharmacist to assess the signs and symptoms. Most pharmacists (n=17, 70.8%) recommended sodium dipyrone, either alone or in combination with other drugs. The most discussed items in the simulation visits were contraindications (n=17, 70.8%), indications (n=10, 41.6%), and drug administration times (n=8, 33.3%). None of the pharmacists recommended any non-pharmacological therapeutic
Patient Education and Counseling, 2007
This article was published in an Elsevier journal. The attached copy is furnished to the author f... more This article was published in an Elsevier journal. The attached copy is furnished to the author for non-commercial research and education use, including for instruction at the author's institution, sharing with colleagues and providing to institution administration. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright
Revista Brasileira de Ciências Farmacêuticas, 2008
The purpose of this study was to evaluate the effect of pharmacist intervention on the prevention... more The purpose of this study was to evaluate the effect of pharmacist intervention on the prevention and solution of drug therapyproblems (DTP), Body Mass Index (BMI), and blood pressure control in elderly outpatients with hypertension. The instruments were applied to 30 elderly outpatients assisted at the pharmacy of a primary health care unit in Ribeirão Preto (SP), Brazil. The group of patients received follow-up during a period of 12 months. It was observed that Pharmaceutical Care intervention optimized the medication use; reduced symptoms caused by drug therapy and improved the elderly patients' health conditions. The Pharmaceutical Care intervention influenced the care given to elderly people as well as the achievement of positive health outcomes. After this study, the researcher gave training about practice of Pharmaceutical Care to 38 dispensing pharmacists from the Public Health-System of Ribeirão Preto. Nowadays, these pharmacists are perpetuating the practice introduced in the region.
Pharmacy Practice, 2019
Objective: To characterize the inclusion of the teaching of communication skills in the curriculu... more Objective: To characterize the inclusion of the teaching of communication skills in the curriculum of Pharmacy Schools of Federal Institutions of Higher Education. Methods: An exploratory study of documental analysis of curriculum of Pharmacy Schools was carried out. A convenience sample was selected from undergraduate pharmacy courses of Federal Institutions of Higher Education (IFES). The variables collected were related to the identification of the course, its nature (elective or mandatory), workload, semester, and program content. Results: Among the 49 undergraduate pharmacy courses of IFES, 35 (71.4%) had their curriculum available online. The teaching of communication in health was identified in 26 (74.3%) curriculum. In this study, three courses (7.2%) specifically aimed at teaching communication skills, while 39 (92.9%) had content related to this subject. Most courses (22; 52.4%) belonged to the field of Social, Behavioral, and Administrative Sciences. As for the course period, there was a concentration in the third (19%) and fourth (28.6%) years. The main content present in the curriculum was related to the principles and techniques of health communication (42.8%). Conclusions: Data obtained enabled the identification of gaps in the curricula of undergraduate courses in pharmacy concerning the inclusion of the teaching of communication skills. These results can be used to reflect the current models adopted in Brazil for the teaching of this skills, especially after the recent publication of the new curricular guidelines for undergraduate pharmacy courses.
The pharmaceutical education has been changed by incorporating of new teaching methods. In this s... more The pharmaceutical education has been changed by incorporating of new teaching methods. In this sense, assessment of students' perceptions about these teaching methods is essential for achieving the goal of providing students with the competences to pharmacy practice. Thus, the present study aimed to evaluate pharmacy students’ perceptions of a pharmaceutical care course implementing learner-centered teaching. A pharmaceutical care course, using active learning methods, was introduced at the Federal University of Sergipe. Feedback concerning the students’ experiences with the newly developed course and information about their preferences regarding the learner-centered approach were collected. The resulting data were analyzed using a quali-quantitative approach. In their evaluations of the course, most of the students (94.6%) indicated that they thought the lessons of the pharmaceutical care course had relevance for their professional/personal development. Furthermore, they indicated that the use of techniques such as role-play had helped to motivate their learning. The vast majority of the students reacted positively to the innovative course. They perceived the use of learner-centered methods as providing an appropriate environment for allowing students to demonstrate their pharmaceutical care competencies. The students’ responses also pointed to potential ways to improve the curriculum of the course.
Keywords: Active Learning, Competences, Pharmacy Students, Pharmaceutical Care, Student Perceptions.
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Papers by Divaldo Lyra Jr.
Keywords: Active Learning, Competences, Pharmacy Students, Pharmaceutical Care, Student Perceptions.
Keywords: Active Learning, Competences, Pharmacy Students, Pharmaceutical Care, Student Perceptions.