Pharmacotherapeutic follow-up of patients with Chagas disease using benznidazole: drug-related problems and pharmaceutical interventions

• Published in: Revista da Sociedade Brasileira de Medicina Tropical 2017-05, Vol.50 (3), p.334-340
• Main Authors: Correia, João Paulo Ramalho, Costa, Alanna Carla da, Rocha, Eduardo Arrais, Quidute, Ana Rosa Pinto, Cândido, Darlan da Silva, Ponciano, Ângela Maria de Souza, Fonteles, Marta Maria de França, Oliveira, Maria de Fátima
• Format: Article
• Language: English
• Subjects: Adhesion; Benznidazole; Brazil; Chagas disease; Chagas Disease - drug therapy; Colleges & universities; Disease control; Drug therapy; Drug-Related Side Effects and Adverse Reactions - classification; Education; Etiology; Female; Follow-Up Studies; Humans; Male; Medication Adherence - statistics & numerical data; Middle Aged; Nitroimidazoles - adverse effects; Nitroimidazoles - therapeutic use; Patients; Pharmaceutical care; Pharmaceuticals; Pharmacology; Pharmacotherapy; Rural areas; Safety; Socioeconomic Factors; Therapeutic applications; TROPICAL MEDICINE; Trypanocidal Agents - adverse effects; Trypanocidal Agents - therapeutic use; Vector-borne diseases
• ISSN: 0037-8682; 1678-9849; 1678-9849; 0037-8682
• DOI: 10.1590/0037-8682-0474-2016

Benznidazole (BNZ) is a drug available for the etiological treatment of Chagas disease. However, this drug is toxic and has a limited effectiveness on the chronic phase of this disease, often leading to poor treatment adherence. This is a descriptive and exploratory study conducted at the Pharmaceutical Care Service for Chagas disease patients of the Federal University of Ceará. Drug-related problems (DRPs) and pharmaceutical interventions (PIs) were classified according to the Second Consensus of Granada. The average age of patients with Chagas disease was 62 years, with the majority residing in the Ceará countryside (86.7%), and having low education levels (63.3% with elementary school education). Regarding family income, most patients belonged to a household that earned ≤1-2 times the minimum wage per month. Approximately 73% of these patients complied with the BNZ treatment, and nearly 7% underwent therapy interruption after medical evaluation. A total of 189 DRPs were identified, of which 51.9% (n=98) were classified as potential, and 48.1% (n=91) as actual. The most frequent DRPs were related to safety (qualitative safety; n=70; 37%), necessity (non-adherence; n=52; 27.5%), and effectiveness (qualitative effectiveness/non-optimal drug selection; n=45; 23.8%). Among the 216 PIs conducted, the majority were related to patient education (n=168; 77.8%) and pharmacological strategy (n=42; 19.4%). This study indicates the need for pharmacotherapeutic monitoring in patients with Chagas because of the high number of therapeutic interventions, DRPs (approximately 3 DRPs/patient), BNZ adherence, and polypharmacy.