TECHNICAL AND SOCIAL ASPECTS OF PHARMACEUTICAL CARE IN INDIVIDUALS WITH AUTOIMMUNE NEURODEGENERATIVE DISEASES, WITH AN EMPHASIS ON MULTIPLE SCLEROSIS

Abstract

Autoimmunity is a specific immune response against an antigen or a series of substances that may or may not be specific to the individual. The main function of the immune system is to differentiate foreign antigens from the body's own elements present in different tissues. A syndrome caused by tissue damage or a malfunction of the immune system resulting from an autoimmune response is referred to as an autoimmune disease. Multiple sclerosis is a chronic, demyelinating autoimmune disease that affects the central nervous system. The disease affects young people between the ages of 20 and 40 and can be diagnosed in children, causing motor and sensory difficulties. Symptoms vary according to the patient, the area affected by demyelination, and the severity of the disease. The diagnosis is basically clinical and laboratory-based, and it is important to differentiate MS from several diseases that have similar symptoms. Disease-modifying drugs are the most relevant treatment for multiple sclerosis, which aim to delay progression and long-term disability and are provided by the Ministry of Health. The patient's knowledge about MS is important for their well-being and better acceptance of treatment. It is up to a multidisciplinary team to support the patient, improving their living conditions and providing guidance on what they should know about MS. Pharmacists should participate in monitoring medications, preventing discontinuation, and guiding the entire process to achieve treatment adherence. The present study aims to promote a broad discussion on the essentiality of pharmaceutical care in individuals with autoimmune neurological diseases, with an emphasis on multiple sclerosis. To prepare this study, a literature review was conducted on government websites, journals, articles, and dissertations. A questionnaire was administered to people with MS and trained and practicing pharmacists, with 11 questions each. The results showed that most of the individuals participating in the questionnaire had completed higher education, lived in the state of Rio de Janeiro, and had been diagnosed with multiple sclerosis for 5 to 10 years. The most commonly used medications were Fingolimod and Natalizumab. Most did not interrupt treatment, and those who did so did so because of an interruption in the supply of medication and a change in medication. A large number of patients are treated by the SUS (Brazilian Unified Health System), with a small number having been monitored by a pharmacist. Most of the pharmacists who responded to the questionnaire have more than 10 years of training, 73% have treated MS patients in some way, and most believe that pharmaceutical care can be improved by having more information about autoimmune diseases, including the association between MS and depression, but they need to study the subject in greater depth. They believe that it is possible to monitor patients who use medications for multiple sclerosis and other autoimmune diseases. It was concluded that, based on the questions asked of patients and pharmacists, we can see that most patients want treatment and very few have been seen by pharmacists, although pharmacists acknowledge that they have little information on the subject.