Publications by authors named "Maria Teresa Herdeiro"

Article Synopsis
  • - Antibiotic resistance (AR) is a major global public health issue leading to hard-to-treat respiratory infections, highlighting the need for better prescription practices among healthcare professionals.
  • - The eHealthResp project offers an online course and mobile app to educate healthcare providers about proper antibiotic use for upper respiratory tract infections (URTIs), showing positive outcomes for those who participated.
  • - Study results indicate that primary care physicians and pharmacists utilized these digital tools effectively, with common cases indicating mild symptoms, suggesting a focus on managing self-limited infections, and emphasizing the need for broader participation and improved educational strategies.
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Introduction: As the global population ages, managing medication use in older adults becomes increasingly complex due to polypharmacy and the associated risks of adverse drug events. To improve the safety and appropriateness of medication use in the older population, tools like the Screening Tool of Older Persons' Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) criteria have been developed. The availability of updated criteria is crucial to better support healthcare professionals in Portuguese-speaking regions.

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Background: Pharmaceutical Care is a professional practice in high demand for implementation in Primary Health Care within the Public Health System. Consequently, it was necessary to develop and validate an instrument to assess the obstacles to this process.

Methods: A methodological study was conducted in three stages: first, the questionnaire was developed based on the APOTECA framework, which includes Attitudinal, Political, Technical, and Administrative domains.

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Prostate cancer (PCa) accounts for 20% of new cancer cases and 10.5% of cancer-associated mortality in Portugal. Associated risk factors include advanced age, family history, genetic alterations, and race/ethnicity.

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Introduction: Considering the increase in the proportion of the older population worldwide, the demand for health system resources also arises. These tools optimize clinical decision-making, thus avoiding iatrogenesis and thus contributing to a better quality of life for the older population. In response, we created an online web application, the APIMedOlder, that provides access to healthcare professionals to allow healthcare professionals to access potentially inappropriate medication identification criteria through a useful tool with a simplified profile, allowing its applicability in clinical practice.

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Nodular thyroid pathologies (NThyPs) are prevalent thyroid diseases, with a steadily increasing global incidence. Although their exact causes remain uncertain, various modifying factors, such as nutrition, influence their development. We aimed to systematically identify and synthesize the influence of dietary exposures on NThyPs risk.

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Background: Considering the vulnerability of older adults to adverse drug reactions, medications with strong anticholinergic properties are considered potentially inappropriate for this population. This study aims to characterize older adults' profile of anticholinergics use and to identify the factors associated with their potentially inappropriate use.

Research Design And Methods: A retrospective study was conducted on 1200 older adults in primary health care centers of Portugal between April 2021 and August 2022.

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Background: At the time of the emergence of COVID-19, denialist and anti-vaccine groups have also emerged and are shaking public confidence in vaccination.

Methods: A qualitative study was conducted using online focus groups. Participants had not received any doses of vaccination against the disease.

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Objective: This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use.

Methods: We conducted a systematic review of dentists' knowledge, attitudes and perceptions regarding antibiotic use, by searching the MEDLINE, EMBASE and Web of Science for all original paper published from January 1990 to July 2023, in accordance with the Preferred Reporting Items for systematic Reviews and Meta-analyses (PRISMA 2020) guidelines.

Results: The review included 37 papers, (7 qualitative and 30 quantitative studies).

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The European Medicines Agency adopted their Geriatric Medicines Strategy more than a decade ago. The strategy aims at elucidating the evidence basis for marketing authorization of new medicines which will be used in the older population, and at ensuring the appropriate communication of findings to the patient and healthcare provider. During the past decade new tools and data sources have emerged to support the strategy goals, and their use should be considered.

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Article Synopsis
  • Disproportionality analyses in pharmacovigilance are essential for detecting safety signals from individual case safety reports, but there are no clear guidelines for publishing these analyses, leading to potential misunderstandings.
  • The READUS-PV statement was created to address these concerns by providing a set of 14 guidelines aimed at improving the transparency and comprehensiveness of disproportionality studies.
  • By promoting better reporting standards, the READUS-PV guidelines aim to enhance the accuracy of drug safety data interpretation and support evidence-based decision-making in pharmacovigilance.
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Article Synopsis
  • Disproportionality analyses are key for detecting drug safety signals but are often poorly reported, prompting the creation of new guidelines called READUS-PV for better reporting practices.
  • A panel of 34 international experts developed these guidelines through surveys and consensus meetings, resulting in a checklist of 32 recommendations for reporting in main articles and 12 for abstracts.
  • The implementation of READUS-PV aims to enhance transparency and improve the quality of publications related to drug safety signals.
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Background: The association between use of antipsychotics and COVID-19 outcomes is inconsistent, which may be linked to use of these drugs in age-related diseases. Furthermore, there is little evidence regarding their effect in the nongeriatric population. We aim to assess the association between antipsychotic use and risk of disease progression and hospitalization due to COVID-19 among the general population, stratifying by age.

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Purpose: This study aims to identify PIM prevalence in older adults according to the 2019 Beers criteria, Screening Tool of Older Person's Prescriptions version 2 (STOPP v2) criteria, and the Portuguese EU(7)-PIM list and also to analyze the concordance between these criteria.

Methods: A retrospective study was conducted among 1200 Portuguese older adults (≥ 65 years old), users of primary health care. Demographic, clinical, and pharmacological data were collected concerning the period between April 2021 and August 2022.

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Objective: Digital health is described as the use and development of all types of digital technologies to improve health outcomes. It could be used to prevent medication errors, a priority for health systems worldwide. However, the adoption of such tools remains slow.

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Purpose: Proton Pump Inhibitors (PPIs) have been associated with several adverse effects of particular concern in older populations. Their use for a period longer than 8 weeks is not recommended for older adults. Strategies to discontinue PPIs have been offered; however, their use remains high.

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The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) E7, the guidance for the conduct of clinical trials in people older than age 65 years, dates from 1994. Since then, the inclusion of older people in clinical trials has hardly improved, particularly for the oldest old age group (individuals older than age 75 years), which is the fastest growing demographic bracket in the EU. Even though most medications are taken by this group, relevant endpoints and safety outcomes for this cohort are rarely included and reported, both in clinical trials and regulatory approval documents.

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Male infertility is a prevalent concern affecting couples worldwide. While genetic factors, hormonal imbalances, and reproductive system defects play significant roles, emerging evidence suggests that lifestyle choices also profoundly impact male fertility. This study aimed to explore the effects of several lifestyle factors, including tobacco and alcohol consumption, physical activity, and dietary habits, on semen quality parameters and molecular biomarkers.

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Mercury (Hg) is a global contaminant affecting aquatic ecosystems' health. Chronic exposure to Hg has shown that the normal development of zebrafish embryo-larvae is affected. However, the molecular mechanisms behind the toxicity of Hg on fish embryonic development are still poorly understood.

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Introduction: Differences in digital health literacy levels are associated with a lack of access to digital tools, usage patterns, and the ability to effectively use digital technologies. Although some studies have investigated the impact of sociodemographic factors on digital health literacy, a comprehensive evaluation of these factors has not been conducted. Therefore, this study sought to examine the sociodemographic determinants of digital health literacy by conducting a systematic review of the existing literature.

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Introduction: Underreporting is a major limitation of the voluntary reporting system of adverse drug reactions (ADRs). A 2009 systematic review showed the knowledge and attitudes of health professionals were strongly related with underreporting of ADRs.

Objective: Our aim was to update our previous systematic review to determine factors (sociodemographic, knowledge and attitudes) associated with the underreporting of ADRs by healthcare professionals.

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Background: Spontaneous reporting is the most used method to monitor post-marketing safety information. Although patient involvement in spontaneous reporting has increased overtime, little is known about factors associated with patients' adverse drug reaction (ADR) reporting.

Aim: To identify and assess the sociodemographic characteristics, attitudes and knowledge that influence spontaneous reporting and the reasons associated with ADR underreporting by patients.

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Adverse drug reactions (ADRs) are responsible for almost 5% of hospital admissions, making it necessary to implement different pharmacovigilance strategies. The additional monitoring (AM) concept has been highlighted and intended to increase the number of suspected ADRs reported, namely in medicines with limited safety data. A prospective, descriptive study of active pharmacovigilance (AP) was conducted between 2019 and 2021 in the Local Health Unit of Matosinhos (LHUM) (Porto, Portugal).

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Purpose: To investigate the association between the use of antidepressants and the risk of upper gastrointestinal tract bleeding (UGIB).

Methods: A Case-control study was conducted in a Brazilian hospital complex. Cases were defined as patients with a diagnosis of UGIB and controls as patients admitted for reasons unrelated to gastrointestinal bleeding, gastric concerns, or complications associated with low-dose aspirin (LDA) or nonsteroidal anti-inflammatory drugs (NSAIDs) use.

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