Cassyano Januário Correr

Universidade Federal do Paraná

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Roberto Pontarolo

Universidade Federal do Paraná

Fernando Fernández-Llimós

Universidade do Porto

Michel Fleith Otuki

Universidade Federal do Paraná

Astrid Wiens

Universidade Federal do Paraná

Ana Carolina Melchiors

Universidade Federal do Paraná

Inajara Rotta

Universidade Federal do Paraná

Paula Rossignoli

Universidade Federal do Paraná

Rafael Venson

University of Glasgow

Thaís Teles de Souza

Universidade Federal da Paraíba

Bruno Salgado Riveros

Microsoft (Brazil)

Cooperative Institutions

Universidade Federal do Paraná

Hospital de Clínicas Universidade Federal do Paraná

Instituto de Pesquisas Jardim Botânico do Rio de Janeiro

Universidade de São Paulo

Instituto de Ciências Farmacêuticas

University of Lisbon

Universidade Federal de Ouro Preto

Instituto de Ensino e Pesquisa Santa Casa

Pontifícia Universidade Católica do Paraná

University of Technology Sydney

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Quality indicators of pharmacists' services in community pharmacies in Paraná State, Brazil

Figshare (2022)

Edson Hipólito Júnior Gerusa Clazer Halila Possagno Wálleri Christini Torelli Reis Matheus Murmel Guimarães Laís Danciguer Guanaes

ABSTRACT Pharmacists and their pharmacies have been evolving in their roles as health promoters in Brazil. Some examples are the recent legislation reaffirming the role of Brazilian pharmacies as health institutions, rather than having only a commercial profile, giving greater clarity to pharmacists about their roles as health care providers. This evolution came with the recognition that is already seen in other developed countries, confirming the need for the pharmacist as a health promoter, and not simply a dispenser of drugs in society. This study has obtained the profile and activities of community pharmacists, as well as the quality indicators of private community pharmacies throughout the State of Paraná through the application of an online survey sent to pharmacists in the state. Out of all pharmacists surveyed, 533 were part of the final analysis, being the pharmacists to complete the survey in full. Participants were mostly female (69.4%) and were, on average, 35.2 ± 9.2 years old. Of these, 60% worked in pharmacy chains and just 37% of all pharmacist respondents were issuing the Declaration of Pharmaceutical Services. The current study showed that many pharmaceutical services are not adopted by pharmacies as these services bring no significant financial reward. Regarding the structure, the Paraná State showed that pharmacies present a good overall structure. The kind of pharmacy (chain or independent) influenced the pharmaceutical services provided and the available structure, where the independent pharmacies provide a wider range of services and have better structure. This study was able to identify the profile and behaviors of pharmacists and also the quality indicators of pharmacies in Paraná State.

10.6084/m9.figshare.20039117

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Diethylpropion and mazindol: An end to the discussion?

Revista da Associação Médica Brasileira (2017)

Rosa Camila Lucchetta Bruno Salgado Riveros Roberto Pontarolo Rosana Bento Radominski Michel Fleith Otuki

Antiobesity pharmacotherapy remains the main point of disagreement among both scientists and regulators. This is probably due to small sample sizes, high levels of heterogeneity, and low methodological quality. For many years, Brazil was one of the largest consumers of appetite suppressants worldwide, with evidence of irrational use of this drug class. Therefore, the country was the scene of a debate that divided the Brazilian Health Surveillance Agency (Anvisa - Agência Nacional de Vigilância Sanitária) and medical societies over the maintenance record of diethylpropion, mazindol and fenproporex. In this context, this commentary presents new arguments to contribute to the discussion, as well as recommendations for future studies.

Mazindol

Pharmacotherapy

10.1590/1806-9282.63.03.203

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Cross-Cultural Translation into Brazilian Portuguese and Validation of the Oral Anticoagulation Knowledge Tool (AKT-Br)

Figshare (2022)

Felipe F. Mainka Vinicíus Lins Ferreira Antonio M. Mendes Gustavo Lenci Marques Cassyano Januário Correr

ABSTRACT Introduction: Oral anticoagulants are the treatment of choice for diverse types of coagulation disorders. Warfarin is widely used by the Brazilian population, possibly due to its lower cost than other oral anticoagulants. However, it has a high risk of serious adverse effects if used incorrectly. The Anticoagulation Knowledge Tool (AKT) can assess a patient’s knowledge about her/his oral anticoagulant therapy and can assist health professionals in identifying patients with difficulties in adherence. This study aimed to translate, culturally adapt, and validate the AKT into Brazilian Portuguese. Methods: After a standard forward-backward procedure to translate the AKT into Brazilian Portuguese (AKT-Br), a version of the instrument was applied in three groups (patients, pharmacists, and the general population). The reliability of the AKT-Br was tested using an internal consistency measure and test-retest. The validity of the instrument was confirmed with data from the contrasted groups. All statistical analyses were performed with RStudio. Results: The median scores obtained with the AKT-Br were 29.0, 17.0, and 7.5 for pharmacists, patients, and the general population, respectively (maximum score of 35 points). There was moderate internal consistency for the instrument and test-retest reliability was satisfactory. Analysis of variance for validity of the groups revealed a significant relationship between the total score and the evaluated groups. Conclusion: The ATK-Br is a reliable and valid tool to assess knowledge about oral anticoagulants. AKT-Br can be used in clinical practice as an auxiliary tool to improve patient care through personalised educational interventions.

Brazilian Portuguese

10.6084/m9.figshare.19996648

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A Systematic Review and Meta‐analysis of the Efficacy and Safety of Etanercept for Treating Rheumatoid Arthritis

Scandinavian Journal of Immunology (2009)

Astrid Wiens Cassyano Januário Correr Roberto Pontarolo Rafael Venson Juliana Vasconcelos Quinalha

Abstract The aim of this study was to evaluate the efficacy and safety of etanercept (ETA) for treating rheumatoid arthritis. A systematic review was performed to search for randomized clinical trials comparing subcutaneous doses of ETA at 25 mg twice a week or 50 mg weekly to a placebo group, with or without methotrexate. Studies of low quality (less than 3 points on Jadad’s scale) were excluded. The efficacy was assessed by using the criteria of the American College of Rheumatology (ACR). Safety data were evaluated based on serious adverse events, serious infections, malignancy and deaths. Withdrawals as a result of adverse events or lack of efficacy were also evaluated. Eight studies met the inclusion criteria, comprising 2385 patients. In the efficacy meta‐analysis, a greater number of ETA‐treated patients achieved the efficacy criteria within 6 months of treatment, where the relative risk (RR) was 2.94 [2.27, 3.81] for achieving ACR20, 5.28 [3.12, 8.92] for ACR50 and 4.83 [1.74, 13.47] for ACR70. After 1 year, the RR for achieving ACR20, ACR50 and ACR70 were 1.14 [1.07, 1.23], 1.36 [1.21, 1.53] and 1.56 [1.30, 1.88], respectively. This response rates were higher for ETA‐treated patients in comparison with control group patients. For safety, there were no statistically significant differences between treated patients and controls. This was also confirmed by withdrawals as a result of adverse events, which were not statistically different between the two groups. However, more patients withdrew from control groups because of a lack of efficacy as compared with ETA groups (RR = 0.48 [0.30, 0.78]).

Jadad scale

10.1111/j.1365-3083.2009.02296.x

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Prevalence of people at risk of developing type 2 diabetes mellitus and the involvement of community pharmacies in a national screening campaign: a pioneer action in Brazil

Diabetology & Metabolic Syndrome (2020)

Cassyano Januário Correr Wendel Coura‐Vital Josélia Cintya Quintão Pena Frade Renata Cristina Rezende Macedo do Nascimento Lúbia Guaima Nascimento

Abstract Background Brazil is one of top 10 countries with the highest number of people with diabetes mellitus (DM), affecting 16.8 million peoples. It is estimated that 7.7 million people (20–79 years) in the country have not yet been diagnosed, representing an under-diagnosis rate of 46.0%. Herein we aimed to screen people for high blood glucose or risk for developing type 2 DM (T2DM) through community pharmacies in Brazil. Methods A cross-sectional study was carried out in November 2018, involving 977 pharmacists from 345 municipalities in Brazil. The study evaluated people between 20 and 79 years old without a previous diagnosis of DM. Glycemia was considered high when its value was ≥ 100 mg/dL fasting and ≥ 140 mg/dL in a casual feeding state. The FINDRISC (Finnish Diabetes Risk Score) was used to estimate the risk for developing T2DM. The prevalence of high blood glucose was estimated and the associated factors were obtained using Poisson's multivariate analysis with robust variance. Results During the national screening campaign, 17,580 people were tested with the majority of the consultations (78.2%) being carried out in private pharmacies. The population was composed mainly of women (59.5%) and people aged between 20 and 45 years (47.9%). The frequency of participants with high blood glucose was 18.4% (95% CI 17.9–19.0). Considering the FINDRISC, 22.7% of people had a high or very high risk for T2DM. The risk factors associated with high blood glucose were: Body Mass Index > 25 kg/m 2 , abdominal circumference > 94 cm for men and > 80 cm for women; education level below 15 years of study, no daily intake of vegetables and fruits; previous diagnosis of arterial hypertension; history of high blood glucose and family history of DM. Conclusions This is the largest screening study that evaluated the frequency of high blood glucose and its associated factors in a population without a previous diagnosis ever performed in community pharmacies in Brazil. These results may help to improve public health policies and reinforce the role of pharmacists in screening and education actions aimed at this undiagnosed population in a continent-size country such as Brazil.

10.1186/s13098-020-00593-5

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Validation of the Brazilian Version of WHODAS 2.0 in Patients with Mental Disorders: Should the 12-Item Scale be an Alternative to 36-Item Scale in DSM-5?

Neuropsychiatry (2018)

FAA¡bio Brasil Andreia MB Brasil Cassyano Januário Correr

The World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Brazilian version was self-applied in 500 psychiatric and 50 non-psychiatric patients in an outpatient medical centre. The instrument was reapplied in 50 psychiatric patients whose treatment with psychotropics was not altered, and in 100 whose it was altered. Confirmatory factor analysis confirmed the theoretical dimensional model proposed by the WHO for the WHODAS 2.0 36- item scale, and a simpler alternative model for the WHODAS 2.0 12-item scale. All the items of the WHODAS 2.0 was proven to be valid and reproducible for use in people with mental disorders from Brazil. The WHODAS 2.0 scores differentiate psychiatric from non-psychiatric patients and exhibited a significant correlation with the Global Assessment of Functioning scale. However, the 12-item scale was more responsive to changes in the patients’ treatment than the 36-item scale, and this should be considered for Diagnostic and Statistical Manual of Mental Disorders.

10.4172/neuropsychiatry.1000397

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Usability and sensitivity of the risk of bias assessment tool for randomized controlled trials of pharmacist interventions

International Journal of Clinical Pharmacy (2019)

Fernanda S. Tonin Livia Amaral Alonso Lopes Inajara Rotta Aline de Fátima Bonetti Roberto Pontarolo

Blinding

10.1007/s11096-019-00818-2

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Humanistic outcomes in hypertension research and practice

Journal of Hypertension (2006)

Renata Berberi Schulz Paula Rossignoli Cassyano Januário Correr Fernando Fernández-Llimós

Schulz, Renata B; Rossignoli, Paula; Correr, Cassyano J; Fernández-Llimós, Fernando Author Information

10.1097/01.hjh.0000239306.78625.da

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Citations (2)

Quality of evidence of anti-obesity pharmacotherapy: an overview of systematic reviews

DOAJ (DOAJ: Directory of Open Access Journals) (2020)

Rosa Camila Lucchetta Bruno Salgado Riveros Roberto Pontarolo Rosana Bento Radominski Fernando Fernández-Llimós

The safety and effectiveness of main anti-obesity drugs are controversial, and there is no consensus among regulatory agencies regarding anti-obesity drugs. We undertook an overview of systematic reviews (SR) of randomized controlled trials (RCT) to summarize the quality of evidence related to anti-obesity drugs. Data sources included Medline, Scopus, The Cochrane Library and PROSPERO. Twenty-one SR (564 RCT; average of 2,356 participants per review) satisfied the inclusion criteria. Ten SR presented a high level of heterogeneity, and only five SR included sensitivity analyses. The most important limitations reported by the SR were a high level of attrition, a small sample size, and a short follow-up. Eight different outcomes for efficacy were used, 15 different outcomes for biomarkers were used, and nine different outcomes for safety were used. Conclusions: In conclusion, the quality of SR pertaining to anti-obesity drugs is low, and these reviews have a high level of heterogeneity. Future SR should present more detailed population inclusion criteria, larger sample sizes, and focus variables reported in a predefined anti-obesity core outcome set.

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Comparative Efficacy of Oral Nucleoside or Nucleotide Analog Monotherapy Used in Chronic Hepatitis B: A Mixed-Treatment Comparison Meta-analysis

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy (2013)

Astrid Wiens Luana Lenzi Rafael Venson Cassyano Januário Correr Inajara Rotta

To compare the efficacy of nucleoside or nucleotide analog monotherapy for the treatment of chronic hepatitis virus B (HBV) with adefovir dipivoxil, entecavir, lamivudine, telbivudine, and tenofovir disoproxil fumarate.Mixed-treatment comparison meta-analysis of nine randomized controlled clinical trials.A total of 3972 adults with a diagnosis of chronic hepatitis B.A systematic review was conducted to search for randomized clinical trials that evaluated the efficacy of nucleoside or nucleotide analogs used as monotherapy. The evaluated outcomes were reduction of HBV DNA levels, normalization of alanine aminotransferase levels, and seroconversion of hepatitis B e antigen (HBeAg). A mixed-treatment comparison was conducted to compare the odds ratios among the treatments and to rank the therapies to determine the optimal treatment option. Tenofovir had the best results among the nucleoside or nucleotide analogs for the three evaluated efficacy outcomes in both HBeAg-positive and -negative patients.Tenofovir has the highest probability of reducing HBV DNA, normalizing alanine aminotransferase levels and inducing HBeAg seroconversion after 1 year of treatment. An efficacy comparison of therapies is an important tool to guide clinicians in selecting the optimal treatment option.

Adefovir

Entecavir

Telbivudine

HBeAg

Hepatitis B

10.1002/phar.1188

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Citations (24)