Papers by Afonso M Cavaco
Brazilian Journal of Health Review, Jul 4, 2023
Objetivo: Descrever, com análise, os resultados de um estudo piloto, no desenvolvimento de um ins... more Objetivo: Descrever, com análise, os resultados de um estudo piloto, no desenvolvimento de um instrumento sistematizado 'Formulário guia' com script, para o acompanhamento de pessoas com diabetes de alto risco, na telefarmácia. Métodos: Trata-se de um estudo transversal, descritivo, envolvendo uma população de 342 pessoas com diabetes. O instrumento foi desenvolvido através de um workshop colaborativo envolvendo pesquisadores, gestão e representantes do serviço e aperfeiçoado utilizando as diretrizes e evidências para o diabetes e seu controle. Constituiu-se em duas partes, a primeira: contendo dados sociodemográficos e clínicos. A segunda, envolveu três fases: inicial, exploração e encerramento. Aspectos éticos foram contemplados e aprovados. Resultados: A amostra foi composta, em sua maioria, de mulheres (n=253;73,9%) e, quando comparadas aos homens, apresentaram maior risco para colesterol total alto (OR = 1,755; 95% IC [1,027-3,053]; P= 0,04024), e HDL baixo (OR = 1,833, 95% IC [1,076-3,116], P = 0,0233*). As orientações mais frequentes foram a adequação do exercício físico e o cuidado com a administração dos medicamentos para diabetes. Conclusão: O instrumento 'Formulário guia' com script permitiu identificar as barreiras enfrentadas pelos pacientes, e facilitou a tomada de decisão dos farmacêuticos para intervenções no período da pandemia.
Exploratory research in clinical and social pharmacy, Dec 1, 2021
Background Prescription drug use and the consumption of substances to enhance college students... more Background Prescription drug use and the consumption of substances to enhance college students' cognitive performance, described as pharmacological cognitive enhancement (PCE), is a known phenomenon potentially impacting individuals' health. University and college students are two specific subpopulations noted to use PCE (up to 17%, on average). To our knowledge, no data have been published on the use of PCE drugs among university students at a national level in Portugal and the factors that might be associated with this usage. Objective The main objective was to estimate the prevalence of PCE use by Portuguese university students and to identify the PCE substances commonly used by university students, i.e., those classified as prescription drugs and other legal and nonprescribed substances, including food supplements. Methods The study followed a cross-sectional exploratory, descriptive design and pursued a convenience sample of students from Portuguese public and private universities (22 higher education institutions). Results From a sample of 745 university students, 32% indicated the use of prescribed and nonprescribed substances. The most consumed substances were food supplements with CNS stimulants being the most frequent prescription-only drugs but not necessarily accessed through a medical prescription. A significant statistical association was found between substance consumption and the field of study. Health science students reported more food supplements and drug intake, allegedly under prescribed regimens, compared to humanities and exact sciences students. The study discusses the need to better understand the competitive societies that produce and support young students' outputs and the perceived ‘need’ for performance-enhancing substances. Conclusions One-third of the university students aimed to improve their performance by pharmacological cognitive enhancement, with a preference for food supplements dispensed in pharmacies. PCE substance consumption in higher education is thus non-negligible. The study suggests the need to improve regulations on potential inequalities in academic rankings and success and an observant attitude concerning implications that negatively affect health in the long run.
BMJ Open, Nov 1, 2022
Objectives The study aimed to determine how eHealth was adopted in pharmaceutical care (PC), the ... more Objectives The study aimed to determine how eHealth was adopted in pharmaceutical care (PC), the outcome reported and the contextual factors. Design Systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources Literature was searched in six databases including PubMed, Scopus, Medline, Web of Science, Science Direct and China National Knowledge Infrastructure. Eligibility criteria Studies which reported the usage experiences of eHealth in any aspects of PC by pharmacists during the COVID-19 pandemic, written in English or Chinese, and published in peer-reviewed journals between December 2019 and March 2022 were included. Opinion articles, conference abstracts, correspondence, letters and editorials were excluded. Data extraction and synthesis The literature search was completed on 15 April 2022. Two researchers independently conducted the literature search and extracted the data into an Excel table informed by the logic model with the key components of goals, input, activities, output and contextual factors. Results Forty-three studies were included in this review. During the COVID-19 pandemic, hospital pharmacists, community pharmacists and specialist pharmacists in 17 countries continued to educate, consult, monitor and manage the patients and the general public via phone calls, videoconferences, mobile applications, social media, websites and/or enhanced interoperability of electronic medical records. Assuring the continuity of pharmacy care, reduced need for hospital visits, and improved work accuracy and efficiency were the benefits of eHealth mostly reported. Contextual factors affecting the adoption of eHealth were multifaceted, prompting supporting actions at the levels of government, hospital/pharmacy, pharmacists and patients. Conclusion This study revealed the wide adoption of eHealth in PC during the pandemic and the emerging evidence for its importance. Proper adoption of eHealth will help reshape the mode of pharmacy services to ensure continuity, quality and efficiency of care amid the challenges of the pandemic. PROSPERO registration number CRD42022299812.
Advances in healthcare information systems and administration book series, May 19, 2023
Instrumentos para avaliação de habilidades de comunicação no cuidado em ... Araújo DCSA, et al.
Medicine brand names should be correctly read, because confusions with these names may lead to se... more Medicine brand names should be correctly read, because confusions with these names may lead to serious medication errors. Objectives: to evaluate if aspects of the spelling of medicine names negatively influence the way they are read aloud. Methods: a pronunciation task was conducted where participants had to read aloud medicine brand names. The names were classified in three groups: names comprising letters that are not used in Portuguese native vocabulary, names deviating from the Portuguese orthographic rules, and names following Portuguese spelling. The effect of name length was also investigated. Two groups of participants were tested: thirty non-biomedical university students (younger and more educated), and thirty-seven pharmacy customers (older and less educated). Results: names with non-native letters (both groups of participants) and names with non-native patterns (students group only) yielded significantly more errors than the names with native shapes. Longer names showed more pronunciation errors than shorter names. Less educated, older subjects made significantly more errors than more educated, younger participants. Conclusion: some medicine brand names may need to be adapted or modified before commercialization in order to prevent potential errors in the use of medicines.
Artigo disponível em português e inglês em: www.scielo.br/rsp Escrito em português de Portugal. A... more Artigo disponível em português e inglês em: www.scielo.br/rsp Escrito em português de Portugal. Avaliação da legibilidade de folhetos informativos e literacia em saúde Evaluation of health literacy and the readability of information leafl ets RESUMO OBJETIVO: O bom uso dos folhetos informativos dos medicamentos depende, entre outros fatores, da sua legibilidade e da literacia do utilizador, respectivamente a clareza em identifi car letras, palavras e frases impressas e a capacidade em compreender e usar essa informação. O objetivo do estudo foi identifi car a possível relação entre uma medida de literacia funcional em saúde e a legibilidade de um folheto de um medicamento anti-infl amatório não-esteróide, esta última avaliada pela diretriz Europeia específi ca. Numa amostra de 53 participantes, recrutados no ano de 2010 numa farmácia da região de Lisboa (Portugal) e que apresentavam literacia variável, não se encontrou relação entre o nível de literacia e os vários parâmetros de apreciação da qualidade e legibilidade de um folheto informativo.
Interface, 2020
Instrumentos para avaliação de habilidades de comunicação no cuidado em ... Araújo DCSA, et al.
International Journal of Clinical Pharmacy, Jul 13, 2018
Authorea (Authorea), Apr 21, 2023
Aim. To investigate the impact of pharmacists' presence in long-term care facilities (LTCFs) on m... more Aim. To investigate the impact of pharmacists' presence in long-term care facilities (LTCFs) on medication usage. Methods. The study followed a retrospective cohort design, with a sample of patients aged [?] 65 years old admitted to 3 LTCFs over 30 months. Data on age, gender, type of stay, presence/absence of pharmacist and medication at admission and discharge were obtained for study patients. Variations in the number of medicines (NoM), anticholinergic burden (ACB), and potentially inappropriate medication (PIMs), at admission and discharge, were assessed as outcome variables. Anticholinergic burden and PIMs were identified using the Anticholinergic Cognitive Burden scale and the EU(7)-PIM List, respectively. One-sample t-tests were applied to compare outcome variables' mean values at admission and discharge. A 4-way ANOVA was employed to test the association between background and outcome variables. Partial Eta squared (η2) was used to measure the effect size. Results. The 3 LTCFs assisted 1643 patients during the study period, of which 1366 were included in data analysis. Only one LTCF had pharmacy services. All outcome variables showed a statistically significant increase at discharge compared with admission. Pharmacist's presence was statistically significant at improving the NoM (p<0.001) and ACB score (p<0.001), while no statistically significant value was reached on PIMs (p = 0.642). Small effect size values were reached for pharmacist impact on the NoM and ACB score (η2 = 0.021, η2 = 0.011, respectively). Conclusion. The present findings suggest that pharmacists' presence positively impacts the use of medications implicated in adverse health outcomes in LTC patients.
Counseling is an important part of pharmaceutical care to influence patient behavior and adherenc... more Counseling is an important part of pharmaceutical care to influence patient behavior and adherence. The concepts described in this chapter are a proposal of counseling skills in pharmaceutical care. More than assuring expected medication outcomes, adequate counseling requires communication and relational abilities as tools to provide the best patient care possible. Counseling aims to set a permanent cooperation with patients, thus favoring patient empowerment, self-caring abilities, medication adherence and improved health-related behaviors.
Journal of toxicology and environmental health, Jul 18, 2019
Methylmercury (MeHg) is a contaminant present in fish which exerts a severe impact on health pred... more Methylmercury (MeHg) is a contaminant present in fish which exerts a severe impact on health predominantly exhibiting neurotoxicity that might irreversibly affect fetal neurodevelopment. Fish consumption in Portugal is the third highest in the world, particularly high in regions with fishing tradition such as the Madeira Archipelago. Therefore, this study aimed at assessing the risk of exposure to MeHg in a population of pregnant women residing in Madeira. Blood samples from pregnant women (533) and umbilical cord (194) were collected from volunteer participants collected at primary health services in Madeira (Portugal) and analyzed for total mercury (HgT) level. A food-frequency questionnaire was used to estimate exposure and indices of risk while HgT in blood were correlated with estimated exposure. Analysis of HgT levels in blood indicated that 30% of pregnant women surpassed the maximum safe level of 10 µg/L recommended by the WHO, which was derived from the consumption of predatory fish, rich in MeHg. In addition, HgT levels in cord blood were 1.3 fold higher than in maternal blood, indicating the high risk of exposure to MeHg in this population. It is thus important to provide nutritional advice concerning fish consumption as a food choice in order to reduce fetal exposure and potential neurologic damage.
Frontiers in Pharmacology, Jun 21, 2019
Introduction: Improving adherence to antidiabetic medication is crucial, resulting in improved he... more Introduction: Improving adherence to antidiabetic medication is crucial, resulting in improved health outcomes, cost reduction, and minimization of waste. A lack of underlying theory in existing interventions may explain the limited success in sustaining behavior change. This paper describes the development of a theory and evidence-based complex intervention to improve adherence to oral antidiabetics in older people via a software prototype with an anthropomorphic virtual assistant. Methods: The Behavior Change Wheel (BCW) was used to develop a theoretical understanding of the change process, corresponding to the first phase of the Medical Research Council Framework for developing and evaluating complex interventions. At the BCW core is a model of human behavior (COM-B), which posits that human behavior (B) results from the interaction between capabilities (C), opportunities (O), and motivation (M). Literature-derived medication adherence determinants were mapped onto COMB components. Then, intervention functions (IFs) were selected employing the APEASE criteria. Finally, standardized behavior change techniques (BCTs) were chosen based on their suitability and their effectiveness on medication adherence trials. The prototype was developed for android devices; its core was implemented in Unity3D, using a female 3D virtual assistant, named Vitória. Results: Two COMB components were identified as main targets for behavior change-psychological capability and reflective motivation; these were linked with four IFs-education, persuasion, enablement, and environmental restructuring. Eleven BCTs were, in turn, linked with the IFs. An example of a BCT is "problem solving"; it requires users to pinpoint factors influencing non-adherence and subsequently offers strategies to achieve the desired behavior. BCTs were operationalized into the dialogues with Vitória and into supplementary software features. Vitória communicates with users verbally and
Journal of the American Pharmacists Association, Mar 1, 2023
Revista De Saude Publica, Oct 1, 2012
Artigo disponível em português e inglês em: www.scielo.br/rsp Escrito em português de Portugal. A... more Artigo disponível em português e inglês em: www.scielo.br/rsp Escrito em português de Portugal. Avaliação da legibilidade de folhetos informativos e literacia em saúde Evaluation of health literacy and the readability of information leafl ets RESUMO OBJETIVO: O bom uso dos folhetos informativos dos medicamentos depende, entre outros fatores, da sua legibilidade e da literacia do utilizador, respectivamente a clareza em identifi car letras, palavras e frases impressas e a capacidade em compreender e usar essa informação. O objetivo do estudo foi identifi car a possível relação entre uma medida de literacia funcional em saúde e a legibilidade de um folheto de um medicamento anti-infl amatório não-esteróide, esta última avaliada pela diretriz Europeia específi ca. Numa amostra de 53 participantes, recrutados no ano de 2010 numa farmácia da região de Lisboa (Portugal) e que apresentavam literacia variável, não se encontrou relação entre o nível de literacia e os vários parâmetros de apreciação da qualidade e legibilidade de um folheto informativo.
Springer eBooks, 2023
Learning Outcomes This chapter contributes to achieving the following learning outcomes: BC6.1 Ge... more Learning Outcomes This chapter contributes to achieving the following learning outcomes: BC6.1 Generate with the person opportunities for behaviour change. BC6.2 Assess the extent to which the person wishes and can become co-manager of his/her chronic disease. BC6.3 Demonstrate how to promote coping skills and self-efficacy to manage chronic disease's physical, emotional and social impacts in everyday life. BC6.4 Assist the person to become co-manager of his/her chronic disease in partnership with health professionals. BC7.1 Apply strategies to support the cooperative working relationship between the person and a healthcare provider. BC7.2 Demonstrate active listening of the person's concerns and difficulties in the self-management of chronic disease. BC14.1 Share information and adequate educational materials according to individual factors (e.g. knowledge gaps, health literacy level and preferences).
Antioxidants, Nov 19, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
BMC Medical Education, May 20, 2021
Background: Healthcare and other professionals are expected to support behaviour change in people... more Background: Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies. Methods: The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases.
Revista Da Associacao Medica Brasileira, 2014
Systematic review of studies that investigate the communication between patients and health profe... more Systematic review of studies that investigate the communication between patients and health professionals with the application of the RIAS methodology. Methods: Keyword Roter Interaction Analysis System was searched in the following bibliographic resources: Academic Search Complete, Current Contents, ISI Proceedings, PubMed, Elsevier, SpringerLink, Web of Science, RCAAP, Solo and the official RIAS site. Selection period: 2006 to 2011. Studies were selected using multicriteria dichotomous analysis and organized according to PRISMA. Results: Identification of 1,262 articles (455 unrepeated). 34 articles were selected for analysis, distributed by the following health professions: family medicine and general practitioners (14), pediatricians (5), nurses (4), geneticists (3), carers of patients with AIDS (2), oncologists (2), surgeons (2), anesthetists (1) and family planning specialists (1). The RIAS is scarcely used and publicized within the scope of healthcare in Portuguese speaking countries. Discussion: Main themes studied include the influence of tiredness, anxiety and professional burnout on communication and the impact of specific training actions on professional activities. The review enabled the identification of the main strengths and weaknesses of synchronous and dyadic verbal communication within the provision of healthcare. Conclusion: Scientific investigation of the communication between health professionals and patients using RIAS has produced concrete results. An improvement is expected in health outcomes through the application of the RIAS.
IGI Global eBooks, Feb 4, 2022
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Papers by Afonso M Cavaco