Objectives: To describe health literacy, patient activation, and functional capacity in individuals with rheumatoid arthritis and to evaluate the associations of health literacy and activation level with functional capacity. Methods: A cross-sectional study involving patients with rheumatoid arthritis was carried out at the rheumatology service of a teaching hospital. Health literacy was assessed by applying the short version of the Test of Functional Health Literacy in Adults. Patient Activation was measured by using the summarized version of the Patient Activation Measure. The Health Assessment Questionnaire was applied to evaluate functional capacity. Sociodemographic and clinical variables were also collected to carried out univariate and multivariate analyses by using logistic regression. Results: The sample was composed of 179 patients, of whom 90.5% (n = 162) were women. The participants’ average age was 58.3 ± 11.4 years. The prevalence of patients with inadequate or marginal health literacy was high (67%). In contrast, 74% of the patients showed high activation levels. The average score on the Health Assessment Questionnaire was 1.08 ± 0.7. Adequate health literacy was negatively associated with higher Health Assessment Questionnaire scores (OR = 0.42; 95% CI 0.20 – 0.86; p = 0.018), and high activation levels were negatively associated with moderate to severe functional limitation (level 3/moderate activation level – OR = 0.24; 95% CI 0.10 – 0.56; p = 0.001; level 4/high activation level – OR = 0.22; 95% CI 0.08 – 0.50; p = 0.000). Conclusion: Health professionals must be aware of health literacy and activation levels of patients with rheumatoid arthritis, given that interventions to improve them represent an opportunity to increase functional capacity.

In Comprehensive medication management (CMM), the practitioner applies a decision-making method to assess patients’ pharmacotherapy in order to identify and solve drug therapy problems. Grounded theory was used to understand how pharmacists make clinical decisions when providing CMM service. Data collection included individual semi structured interviews with 11 pharmacists, observation of clinical case discussions and CMM consultations provided by the participating pharmacists. Two main categories emerged: 1. Understanding the rational method of decision-making: the foundation of the patient care process. 2. Balancing the care equation: the objective and the subjective, which includes a theoretical proposal explaining the pharmacists’ decision-making process and the factors that can modify this process. The pharmacotherapy knowledge should guide the anamnesis. Thus, the professional can evaluate the indication, effectiveness, safety and convenience of medications used by the patient. After exploring patients’ medication experiences, pharmacists can follow two courses of action: helping the patient overcome barriers to medication use; or matching the pharmacotherapy to the patient’s routine. Professional autonomy and absence of the patient at the time of the decision were some factors that influenced the pharmacist’s decision. Findings provide a broad understanding of pharmacists’ decision-making process during the care of patients using medications. It can be applied as a basis for educational interventions to train professionals on decision-making.

In this review, the main goal was to answer the question: What are the family caregivers’ experiences in the process of providing care to older people? To do so, a systematic literature review was carried out by consulting the MEDLINE, Cochrane, and Lilacs databases. Two reviewers selected the studies independently, and discrepancies were sorted out by a third reviewer. The Critical Appraisal Skills Programme was used to evaluate the methodological quality of the included studies, and thematic analysis was applied to synthesize the results. The analytical themes addressed in the synthesis were developed through researchers’ interpretations and new constructs. Confidence in the findings was reviewed using GRADE-CERQual. The study adhered to Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. Eighteen studies were included in the synthesis. Three analytical themes emerged: "Mixed feelings", "You have no life. Your own life gets put on hold”, and "The need for increasing coping strategies". Several conflicting feelings emerged in the process of care, showing the complexity of the caregivers’ experience. Either way, the caregivers put their lives on hold to provide care and sought coping strategies, such as formal and informal support and spirituality. Therefore, both health professionals and policymakers must ensure comprehensive care for the older adults and their families, so that caregivers do not compromise their own lives and health in order to take care of others.

Objective To build a theoretical model that represents the experience of family caregivers of elderly people during the COVID-19 pandemic. Method Qualitative study that used the Grounded Theory as a methodology, carried out in Minas Gerais State in August 2020. 16 caregivers were interviewed. Results Uncomfortable emotions emerged and drove the caregivers’ actions to: adopt preventive measures to protect the elderly from contracting the coronavirus; guarantee their healthcare; and make them aware of the pandemic. However, when these emotions manifested in an exacerbated manner, they needed to be alleviated so that they could adopt such initiatives. Conclusion The emotions felt by caregivers can compromise their health and quality of life. Therefore, health professionals need to create strategies to ensure that they are well assisted, enabling care through telehealth. Guidance on the pandemic for caregivers could reflect better care for the elderly people.

This study aims to reveal the patients’ experiences with a comprehensive medication management (CMM) service delivered in a specialty pharmacy in Brazil. This is a qualitative study performed from September 2015 to February 2016. In-depth semi-structured interviews were conducted with 10 patients followed-up in a CMM service in a specialty pharmacy located in Minas Gerais state. The interviews were recorded, transcribed and analyzed with the assistance of the NVivo11® software. According to the participants, they did not know what to expect from CMM at first. They showed difficulties on establishing a solid concept for CMM, however, they pointed some key aspects of pharmaceutical care philosophy based on their experience with the service. The interviewees identified the CMM pharmacist, seen as a care professional, as a different professional compared to the traditional pharmacist, mainly identified by them as a salesman. The ability to listen and the time that the CMM professional dedicated in the consultations were highlighted as primordial in the process of building a therapeutic relationship with the patient. The difficulties the patients have for establishing a solid concept for CMM might be due to the lack of pharmacists exerting this function, considering CMM is still a new service in Brazil. The results of this work can guide efforts to build a better interaction between patients and pharmacists, in a constant search for offering the best care possible.