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Authors
Advisor(s)
Abstract(s)
As benzodiazepinas sĆ£o fĆ”rmacos utilizados no tratamento da ansiedade e insĆ³nia. Apesar
de eficazes, estes apresentam diversas contraindicaƧƵes como a criaĆ§Ć£o de dependĆŖncia,
de tolerĆ¢ncia, aparecimento de sintomas de abstinĆŖncia, entre outros, sendo que nĆ£o Ć©
recomendada a sua utilizaĆ§Ć£o durante elevados perĆodos de tempo. Atualmente Portugal
continua com um dos maiores Ćndices de consumo de benzodiazepinas por 1000 habitantes
quando comparado com os restantes paĆses da UniĆ£o Europeia, especialmente em utentes
idosos.
Com o objetivo de mitigar esta problemĆ”tica, foi publicado o Manual de DescontinuaĆ§Ć£o de Benzodiazepinas - Ashton. Este descreve um algoritmo para a criaĆ§Ć£o de cronogramas de descontinuaĆ§Ć£o substituindo a benzodiazepina inicial por uma de longa duraĆ§Ć£o, neste caso o Diazepam. O principal problema destes algoritmos Ā“e serem manuais e descritos em formato de texto, algo que torna a tarefa dos mĆ©dicos Ć”rdua e demorada, diminuindo a probabilidade de este processo ser sugerido.
Esta tese descreve a implementaĆ§Ć£o de um algoritmo computacional de descontinuaĆ§Ć£o de benzodiazepinas, baseado em algoritmos jĆ” existentes. De forma a validar os resultados obtidos, foi efetuada uma comparaĆ§Ć£o de resultados com os jĆ” existentes. Para alĆ©m disto, tambĆ©m Ā“e descrita a elaboraĆ§Ć£o de uma plataforma web onde este algoritmo se encontra disponĆvel para os profissionais de saĆŗde. Esta permite efetuar a gestĆ£o de
mĆ©dicos e utentes, permitindo a criaĆ§Ć£o e acompanhamento dos cronogramas uma tarefa fĆ”cil e intuitiva. Foram tambĆ©m desenvolvidas diferentes estatĆsticas que futuramente serĆ£o ferramentas importantes na avaliaĆ§Ć£o do sucesso dos processos. A plataforma foi desenvolvida com recurso a diversas linguagens de programaĆ§Ć£o (HTML, CSS, JavaScript e PHP) e os dados encontram-se alojados numa base de dados do tipo SQL, encontrando-se jĆ” em produĆ§Ć£o.
Benzodiazepines are drugs used in the treatment of anxiety and insomnia. Although being effective, they have multiple contraindications such as the potential for dependence, tolerance, withdrawal symptoms, among others, causing their use is not being recommended for extended periods of time. Portugal currently continues with one of the highest consumption rates of benzodiazepines per 1000 inhabitants, when compared to other European Union countries, especially among elderly patients. To address this issue, there have been published over the years various guides for discontinuing the use of benzodiazepines, based on the method described on the Benzodiazepine Discontinuation Manual - Ashton. This describes an algorithm for the creation of discontinuation schedules by substituting the initial benzodiazepine with a long-acting one, in this case, Diazepam. The main problem with these algorithms is that they are manual and described in text format, making the task arduous and time-consuming for doctors, and therefore reducing the likelihood of this process being suggested. This thesis describes the implementation of a computational algorithm for benzodiazepine discontinuation, based on the existing algorithms. To validate the obtained results, a comparison was made with existing results. Additionally, it is described the development of a web platform where this algorithm is implemented. This platform eases the management of doctors and patients, making the creation and monitoring of schedules an easy and intuitive task. Various statistics were also developed, which will be important tools for the future evaluation of the processā success. This platform was developed using multiple programming languages (HTML, CSS, JavaScript, and PHP) and the data is stored in an SQL database, already in production.
Benzodiazepines are drugs used in the treatment of anxiety and insomnia. Although being effective, they have multiple contraindications such as the potential for dependence, tolerance, withdrawal symptoms, among others, causing their use is not being recommended for extended periods of time. Portugal currently continues with one of the highest consumption rates of benzodiazepines per 1000 inhabitants, when compared to other European Union countries, especially among elderly patients. To address this issue, there have been published over the years various guides for discontinuing the use of benzodiazepines, based on the method described on the Benzodiazepine Discontinuation Manual - Ashton. This describes an algorithm for the creation of discontinuation schedules by substituting the initial benzodiazepine with a long-acting one, in this case, Diazepam. The main problem with these algorithms is that they are manual and described in text format, making the task arduous and time-consuming for doctors, and therefore reducing the likelihood of this process being suggested. This thesis describes the implementation of a computational algorithm for benzodiazepine discontinuation, based on the existing algorithms. To validate the obtained results, a comparison was made with existing results. Additionally, it is described the development of a web platform where this algorithm is implemented. This platform eases the management of doctors and patients, making the creation and monitoring of schedules an easy and intuitive task. Various statistics were also developed, which will be important tools for the future evaluation of the processā success. This platform was developed using multiple programming languages (HTML, CSS, JavaScript, and PHP) and the data is stored in an SQL database, already in production.
Description
Keywords
Benzodiazepinas Diazepam DescontinuaĆ§Ć£o Ashton Algoritmo computacional Plataforma web Benzodiazepines Computational algorithm Diazepam Tapering Deprescribing Ashton manual