Fernando Fernandez-Llimos

Fernando Fernandez-Llimos
University of Porto | UP · Laboratory of Pharmacology - Department of Drug Sciences

Ph.D. MPharm MBA.

About

433
Publications
94,534
Reads
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4,807
Citations
Citations since 2017
188 Research Items
3324 Citations
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20172018201920202021202220230200400600
20172018201920202021202220230200400600
20172018201920202021202220230200400600
Additional affiliations
February 2020 - present
University of Porto
Position
  • Professor
January 2007 - February 2020
University of Lisbon
Position
  • Professor (Assistant)
January 1999 - December 2006
University of Granada
Position
  • University of Granada
Education
October 1979 - July 1984
Complutense University of Madrid
Field of study
  • Pharmacy

Publications

Publications (433)
Article
Anticholinergic burden tools have relevant pharmacological gaps that may explain their limited predictive ability for clinical outcomes. The aim of this study was to provide a universal pharmacological-based list of drugs with their documented affinity for muscarinic receptors. A comprehensive literature review was performed to identify the anticho...
Chapter
Nonadherence to prescribed medicines is a major public health issue intricately related to multimorbidity and polypharmacy. Increasing the number of medicines prescribed to a patient, regardless of whether polypharmacy can be classified as appropriate or inappropriate, increases the risk of medication nonadherence. Nonadherence is one of the factor...
Article
Full-text available
Abstract Pharmacists acting in pharmacies and drugstores stores are some of the most accessible healthcare providers and the last to intervene before the patient takes their medicine. This puts the pharmacist in a position of authority that should be harnessed for the benefit of health. Thus, this professional is strategic for performing pharmacovi...
Article
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Objective and design The current study aimed to summarize the evidence of compounds contained in plant species with the ability to block the angiotensin-converting enzyme 2 (ACE-II), through a scoping review. Methods PubMed and Scopus electronic databases were used for the systematic search and a manual search was performed Results Studies includ...
Article
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Background There is an urgent need for health care systems to be more efficient and efficacious. An approach to integrate public and private provider organizations such as community pharmacies and public primary health care (PHC) merits consideration. The objective of this review was to identify the types of integration in health care settings and...
Article
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Background We aimed to synthesize the evidence on the efficacy and safety of different treatment regimens for latent tuberculosis infection (LTBI) in children and adolescents. Methods A systematic review with network meta-analysis was performed (CRD142933). Searches were conducted in Pubmed and Scopus (Nov-2021). Randomized controlled trials compa...
Article
Primary hyperhidrosis (HH), the excessive sweating exceeding physiological demand, has been associated to a complex dysfunction of the autonomic nervous system which may explain the disfunction in sweating but may also cause unrevealed alterations in skin blood flow regulation. In fact, HH patients present a sympathetic over-function with less refl...
Article
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Background: Medical Subject Headings (MeSH) thesaurus contribute towards efficient searching of biomedical information. However, insufficient coverage of specific fields and inaccuracies in the indexing of articles can lead to bias during literature retrieval. Objectives: This meta-research study aimed to assess the use of 'Pharmaceutical Servic...
Article
Background: Therapy management in patients suffering from mental health disorders is complex and the risks derived from changes or interruptions of treatment should not be ignored. Medication reconciliation in psychiatry may reduce medication errors and promote patient safety during transitions of care. Objective: To identify the influence of co...
Article
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Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide. Assessing the patients' CVD risk, controlling the risk factors, and ensuring the guideline-adherent cardiovascular pharmacotherapy are crucial interventions to improve health outcomes. This study aimed to evaluate the potential of pharmacists to improve the adhe...
Article
Coronavirus disease 2019 (COVID‐19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2), which has a high mortality rate and transmissibility. In this context, medicinal plants have attracted attention due to the wide availability and variety of therapeutic compounds, such as alkaloids, a vast class with several proven pharmac...
Article
Objectives: To evaluate and update the evidence on the comparative efficacy and safety of antimicrobial drugs regimens for treating pulmonary drug-susceptible tuberculosis (DS-TB). Methods: A systematic review was performed with searches in PubMed and Scopus (PROSPERO-CRD42019141463). We included randomised controlled trials comparing the effect...
Conference Paper
Full-text available
Background and importance Different criteria were created to identify acute kidney injury (AKI) based on serum creatinine (SCr) levels, namely AKIN, KDIGO, RIFLE. Aim and objectives To assess the ability to monitor AKI occurrence based on the availability of timely measured SCr levels in a retrospective cohort of patients admitted to hospital. Ma...
Article
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Objective To estimate the prevalence of inadequate vitamin D level and its associated factors for women of childbearing age in Brazil. Methods A systematic review was conducted (last updated May 2020). Meta-analyses were performed using the inverse-variance for fixed models with summary proportion calculation by Freeman-Tukey double arcsine. Report...
Article
The lack of commonly agreed terminology in pharmacy field is highly prevalent and may have influence on the relevance and robustness of the area, especially how others see pharmacy literature. Potential consequences of this poor perception of pharmacy field by the National Library of Medicine (NLM) could be the omission of several pharmacy-related...
Chapter
Meta-analysis, a statistical technique that combines the results of different studies to obtain a pooled or summary estimate of data, has become an integral part of evidence-based decision-making processes. This tool is being increasingly used in medical and nonmedical disciplines as it is able to quantitatively synthesize a large and often complex...
Article
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Abstract The delivery of clinical pharmacy services has been growing in Brazilian community pharmacies, and it is necessary to have a comprehensive understanding of the topic. This scoping review aimed to provide an overview of Brazilian studies about clinical pharmacy services in community pharmacies. Original research articles, with no restrictio...
Poster
Introduction The use of inconsistent and outdated information may significantly compromise healthcare decision-making. We aimed to assess the extent of lag times in the publication and indexing of network meta-analyses (NMAs). Methods Searches for NMAs on drug interventions were performed in PubMed (May 2020). Lag times were measured as the time b...
Article
Introduction and objectives Patient knowledge about hypertension is an important patient-related determinant for poor blood pressure control and is a target for more effective interventions. We aimed to evaluate hypertensive patients’ knowledge and awareness about hypertension and its influence on their beliefs about their medication and their adhe...
Article
Full-text available
Community pharmacies and pharmacists predominantly operate in a retail environment independently of other health care providers, and they are not often viewed as an integral member of the healthcare team. Thus, they remain overlooked or excluded during integration processes of health care systems. At the same time, there are calls by the profession...
Article
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Rheumatoid arthritis (RA) is among the most prevalent chronic autoimmune and inflammatory diseases worldwide. The aim of this study was to establish a pooled estimate of the RA prevalence in South America by means of a meta-analysis of the available epidemiologic studies. Systematic searches in PubMed, Lilacs, SciELO, Scopus, and Web of Science dat...
Article
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Background: Despite the several options available for supplements containing vitamins C and E, evidence regarding the prevalence of deficiency or insufficiency of these vitamins is weak. Objectives: To estimate the prevalence of deficiency or insufficiency of vitamins C and E and associated factors among women of childbearing age, in Brazil. De...
Article
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Objective We assessed the extent of lag times in the publication and indexing of network meta-analyses (NMAs). Study design This was a survey of published NMAs on drug interventions. Setting NMAs indexed in PubMed (searches updated in May 2020). Primary and secondary outcome measures Lag times were measured as the time between the last systemati...
Article
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Background: Despite current policies of salt iodination, iodine deficiency is still a global public health problem, especially in women. So far, conflicting evidence has been suggested for the prevalence of iodine deficiency in Brazil. Objective: To estimate the prevalence of iodine deficiency and associated factors in women of childbearing age in...
Article
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Background Scholarly publishing system relies on external peer review. However, the duration of publication process is a major concern for authors and funding bodies. Objective To evaluate the duration of the publication process in pharmacy practice journals compared with other biomedical journals indexed in PubMed. Methods All the articles publi...
Article
Background Meta-analyses of clinical pharmacy services are frequently criticized for restricted data transparency and reproducibility. Objectives To describe the methodological characteristics of meta-analyses of pharmacist-led medication reviews, to identify the elements that limit their replicability and robustness, and to propose recommendation...
Article
Background: Burkitt lymphoma (BL) is an aggressive hematologic cancer. This study synthetized the evidence about the efficacy and safety of chemotherapy treatments used in patients with BL using the World Health Organization classification. Materials and methods: A systematic review of interventional studies was performed. A search was carried o...
Article
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We aimed to determine how Portuguese physicians handle major bleeding. We also aim to establish global diagnostic and therapeutic recommendations to be followed in clinical practice by using a step-wise approach of evidence generation. This study followed a three-step process: a steering committee desk review, a Delphi technique, an expert panel me...
Article
Introduction Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of unknown etiology which causes progressive deterioration of the joints, leading to severe pain and functional disability. Vitamin D and its receptor (VDR) play a significant part in the onset of autoimmune diseases such as RA. The purpose of this study was to eval...
Article
Introduction Drug information (DI) services should work toward efficiency by identifying knowledge gaps and actively creating resources to address those needs. The aim was to identify training needs and active information opportunities in primary care by analyzing DI requests and to calculate labor cost associated with DI requests addressable with...
Article
Full-text available
PurposeTo quantitatively assess the benefit–risk ratio on the efficacy and safety of all phosphodiesterase type 5 inhibitors (PDE5i) in men with erectile dysfunction.MethodsA systematic review with network meta-analysis, surface under the cumulative ranking analysis and stochastic multicriteria acceptability analyses were performed. Searches were c...
Article
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In the past years, several factors such as evidence-based healthcare culture, quality-linked incentives, and patient-centered actions, associated with an important increase of financial constraints and pressures on healthcare budgets, resulted in a growing interest by policy-makers in enlarging pharmacists’ roles in care. Numerous studies have demo...
Article
Background Several anticholinergic scales and equations to evaluate the anticholinergic burden have been previously created. Association of these instruments with the anticholinergic outcomes are usually estimated by means of hypothesis contrast tests, which ignore the size of the association effect. Objective To evaluate the effect size of the ass...
Article
Objectives To compare the 12-month retention rate, effectiveness and tolerability of perampanel (PER) as a first or late add-on treatment in adult patients with focal-onset seizures (FOS), including focal to bilateral tonic-clonic seizures (FBTCS). Methods This retrospective, observational, multicenter study was carried out in patients with FOS th...
Article
Aim: Given the discrepancies between PDDs (prescribed daily doses) and DDDs (defined daily doses), we aimed to assess the extent of error in the results of an 18-year population-level study on statin utilization in Portugal. Methods: Portuguese regulatory agency provided 2000-2018 data on statin dispensing (C10AA). The DDDs were gathered from th...
Article
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Scholarly publishing is in a crisis, with the many stakeholders complaining about different aspects of the system. Authors want fast publication times, high visibility and publications in high-impact journals. Readers want freely accessible, high-quality articles. Peer reviewers want recognition for the work they perform to ensure the quality of th...
Chapter
Healthcare professionals, especially pharmacists, are constantly involved with drug information and should be able to properly select resources and keep updated on new literature and new tools to address a variety of drug information requests. The provision of accurate in-depth drug information requires the development of drug information skills th...
Chapter
Evidence-based practice is a key element and indicator of high-quality patient care. Healthcare professionals must effectively acquire the necessary knowledge, skills, and attitudes to gather, assess, and interpret the best available evidence in order to ground their clinical decisions. Both achieving competency and delivering instruction in eviden...
Article
Regulatory agencies are responsible for collecting and evaluating spontaneous reports of suspected problems related to medications, including those from substandard medicines (SM). Objectives: The aim was to evaluate the profile of SM reports submitted to the Brazilian Health Surveillance Notification System (Notivisa) and classify these reports ob...
Article
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A pandemia da COVID-19 vem requerendo múltiplos esforços da assistência farmacêutica hospitalar 1. Houve substancial empenho das equipes de farmácia na discussão e definição de estratégias para a prevenção e controle da COVID-19 2,3 , o manejo do desabastecimento de diversos insumos 4,5 e a adaptação do plano de cuidado a um novo perfil e volume de...
Article
Full-text available
A pandemia da COVID-19 vem requerendo múltiplos esforços da assistência farmacêutica hospitalar. Houve substancial empenho das equipes de farmácia na discussão e definição de estratégias para a prevenção e controle da COVID-19, o manejo do desabastecimento de diversos insumos e a adaptação do plano de cuidado a um novo perfil e volume de cuidado de...
Article
Background A suboptimal meta-analysis with misleading conclusions, frequently published in the healthcare journals, can compromise decision making in clinical practice. Objective To evaluate the reporting quality, methodological quality, and risk of bias of meta-analyses of pharmacy services. Methods Systematic searches to identify all the meta-a...
Article
The use of anticholinergic drugs and other drugs with anticholinergic activity is highly prevalent in older people. Cumulative anticholinergic effects, known as anticholinergic burden, are associated with important peripheral and central adverse effects and outcomes. Several methods have been developed to quantify anticholinergic burden and to esti...
Article
Full-text available
Objectives: Current evidence on fecal microbiota transplantation for inflammatory bowel disease is inconclusive. We conducted a systematic review to gather evidence on the efficacy and safety of fecal microbiota transplantation for inflammatory bowel disease. Methods: Systematic searches were conducted in PubMed, Scopus, and Web of Science. Clin...
Article
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Background: The recently published short version of the Maastricht Utrecht Adherence in Hypertension (MUAH) questionnaire (MUAH-16) suggests that MUAH-16 better represents a patient's adherence to antihypertensive medication than the original MUAH questionnaire. Objective: The aim of our study was the cultural adaptation and validation of the sh...
Article
Pharmacists have a societal duty of care. How to best provide that type of care requires scientific study. Pharmacy practice is a scientific discipline that studies the different aspects of the practice of pharmacy, and its impact on health care systems, medicine use, and patient care. Its scope has expanded globally to encompass clinical, behaviou...
Article
Background This study aimed to map the outcome measures of clinical efficacy reported in Randomized Controlled Trials (RCT) to evaluate disease-modifying therapies (DMT) in patients with relapsing forms of multiple sclerosis (RMS). Methods A systematic scoping review was performed to identify RCT that assessed the efficacy of DMT in adult patients...
Article
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Background Although relapsing-remitting multiple sclerosis (RRMS) has a chronic course, little information is known about the comparison between the disease-modifying therapies (DMT) for long-term outcomes. We aimed to conduct a systematic review of randomized clinical trial (RCT) extension and observational studies to examine the efficacy and safe...
Article
Background Different antithrombotic treatments, from vitamin K antagonists to direct oral anticoagulants (DOACs), are available to reduce ischemic risks in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI). Objective To synthetize evidence about the benefit–risk ratio of antithrombotic treatments and their combi...
Article
Full-text available
Alpha-1 antitrypsin deficiency is an autosomal co-dominant inherited disorder that results in decreased circulating levels of alpha-1 antitrypsin (also known as alpha-1 proteinase inhibitor) and predisposes affected individuals to early onset lung and liver disease. There is currently no cure for alpha-1 antitrypsin deficiency. However, appropriate...
Article
Full-text available
Introduction: Obtaining the best possible medication history is the crucial step in medication reconciliation. Our aim was to evaluate the potential contributions of the main data sources available - patient/caregiver, hospital medical records, and shared electronic health records - to obtain an accurate 'best possible medication history'. Materi...
Article
Integrating health innovations into the health system is a complex endeavour that requires a well-designed planning process engaging key stakeholders. Stakeholder analyses lay the foundations to inform appropriate planning processes and undertake strategic actions. A systematic scoping review was performed to explore how stakeholder analyses are ap...
Article
Background: Suboptimal meta-analyses with misleading conclusions are frequently published in the health areas, and they can compromise decision making in clinical practice. Aimofthereview: This systematic review aimed to map the characteristics of published meta-analyses of pharmacy services and their association with the study conclusions. Metho...
Article
Background Although international collaborative research has demonstrated a series of benefits in different scientific disciplines, there is no information regarding international collaborative practices in pharmacy practice research. Objectives To map international collaborations published in pharmacy practice research journals between 2009 and 2...
Chapter
The access to relevant and updated information is important to researchers and healthcare professionals to acquire knowledge and to inform, underpin, or shape scientific research. Information is available in different forms, being usually classified accordingly to their format, originality of data, and periodicity of publication (i.e., primary, sec...
Article
Objective: The objective of the review is to explore randomized controlled trials (RCTs) on disease-modifying therapies for relapsing multiple sclerosis to identify and quantify the different outcome measures, instruments and definitions of efficacy, safety outcomes, health-related quality of life instruments and population subgroups. Introductio...
Article
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The interrelationship between governmental policies and objectives in primary health care and community pharmacy/pharmacists' strategic plans are of the outmost importance, having significant professional, economic and practical consequences for the future of the pharmacy profession, research, education and health care. Sharing information of the p...
Article
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Peer review provides the foundation for the scholarly publishing system. The conventional peer review system consists of using authors of articles as reviewers for other colleagues' manuscripts in a collaborative-basis system. However, authors complain about a theoretical overwhelming number of invitations to peer review. It seems that authors feel...
Poster
Full-text available
To identify specific areas for training and opportunities for the provision of active of drug information from the analysis of drug information requests received in 2016 and 2017 from providers at BSMH.
Chapter
Chronic hyperglycemia in type 2 diabetes mellitus increases the generation of free radicals and induces oxidative stress, which contributes to the establishment of insulin resistance, endothelial dysfunction, and micro- and macrovascular complications. Several studies have addressed the potential role of dietary antioxidants, such as vitamins, in a...
Article
Background: Pharmacy journals constitute a heterogeneous group that can be map to identify Pharmacy scientific subareas. Objective: This study aimed to objectively map Pharmacy journals by means of a lexicographic analysis of the titles of published articles. Methods: Active journals between 2006 and 2016 containing any of the terms 'pharmacy'...
Article
Full-text available
Objectives: This is a randomized controlled trial that aims to evaluate the impact of pharmacist-led discharge counseling on reducing pharmacotherapy problems in the 30-day postdischarge period of cardiology patients from a tertiary hospital in Brazil. Methods: At discharge, two cardiovascular pharmacy residents performed a medication counseling...
Article
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Background Pharmacists‐led medication reviews ( MRs ) are claimed to be effective for the control of cardiovascular diseases; however, the evidence in the literature is conflicting. The main objective of this meta‐analysis was to analyze the impact of pharmacist‐led MRs on cardiovascular disease risk factors overall and in different ambulatory sett...