Desarrollo y protocolización de un modelo de optimización de respuestas a las consultas en los centros de información del medicamento / Development and protocolisation of a model for optimising responses to queries at the medicines information centres

INTRODUCCIÓN: los Centros de Información de Medicamento (CIM) tienen como objetivo servir a los farmacéuticos como fuente de información técnica, científica y actualizada de los medicamentos y productos sanitarios para promover el uso racional de estos y mejorar el cuidado y la salud del paciente. El farmacéutico ha de disponer de la mejor información sobre el medicamento para dar un buen servicio profesional.OBJETIVO: elaboración, implantación y validación de un protocolo de respuestas a las consultas recibidas en el CIM que permita el registro normalizado de las preguntas recibidas, así como un modelo optimizado de respuestas basado en la recuperación eficiente de información en las bases de datos especializadas.MATERIALES Y MÉTODOS: estudio observacional retrospectivo de las consultas recibidas y desarrollo de una base de datos propia para el registro de las consultas generadas (CAC). Las consultas se clasificaron siguiendo criterios de categorización a través de 25 ejes (comercialización, indicación, seguridad, posología, etc.), fármaco consultado y grupo ATC al que pertenece. Una vez procesadas las consultas de 7 meses, se procedió a la implantación del protocolo normalizado de resolución de consultas para evaluar su eficiencia.RESULTADOS Y DISCUSIÓN: durante el periodo de tiempo comprendido entre junio de 2021 y enero de 2022 se han registrado 248 consultas, que se han categorizado en base al tipo de consulta y fármaco consultado. En febrero, tras iniciar la validación, se recibieron 38 consultas de las cuales se repitieron 9 fármacos consultados (3,21 %), 10 grupos ATC (3,57 %) y se repitieron las mismas consultas 4 veces (1,43 %). Estos resultados permitieron responder de forma rápida y efectiva a las consultas que se repitieron durante el primer mes de validación. (AU)

Informes de posicionamiento terapéutico: experiencia en España en el periodo 2013-2019 / Therapeutic positioning reports: Experience in Spain during the period 2013-2019

OBJETIVO: Describir las características de los informes de posicionamiento terapéutico (IPT) publicados en España en el periodo 2013-2019. Diseño y fuente de datos: Revisión sistemática de todos los IPT publicados en la página web de la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS). Selección de estudios: Se incluyeron todos los IPT realizados desde mayo de 2013, hasta marzo de 2019. Extracción de datos: Las principales variables recogidas fueron los grupos terapéuticos evaluados, el número de IPT, el tiempo de elaboración, la existencia de restricciones a las indicaciones autorizadas y la información sobre la eficiencia. RESULTADOS: En el periodo evaluado se realizaron 214 IPT, con un tiempo medio de elaboración de 8,8 meses, casi tres veces el objetivo de 3 meses planteado inicialmente. El 57% de los IPT establecieron restricciones de uso respecto a las indicaciones de sus fichas técnicas. El 26% de los IPT hicieron referencia a la existencia de datos económicos, aunque ninguno incluyó detalles sobre la eficiencia. Se actualizaron el 10% de los IPT. CONCLUSIONES: Para que los IPT puedan cumplir su objetivo de mejorar la eficiencia del proceso de evaluación y la coherencia en las decisiones sobre precio, reembolso y financiación de medicamentos por parte del SNS es preciso que se cumplan los plazos establecidos para su publicación, se incorpore sistemáticamente información sobre la eficiencia de los fármacos y se actualicen los informes con la nueva información generada

OBJECTIVE: Describe the characteristics of the therapeutic positioning reports (TPRs) published in Spain in the period 2013-2019. Design and data source: Systematic review of all TPRs published in the website of the Spanish Agency of Medicines and Health Products (AEMPS). Selection of studies: All TPRs published since May 2013, until March 2019 Data extraction: The main variables collected were the therapeutic groups assessed, the number of TPRs, the time of elaboration, the existence of restrictions versus the authorized indications and the information on the efficiency of medicines. RESULTS: During the period under review, 214 TPRs were carried out, with an average production time of 8.8 months, almost three times the objective of 3-month initially set. 57% of the TPRs established restrictions of use with respect to the approved indications. 26% of TPRs referred to the existence of economic data, although none included details on the efficiency. 10% of TPRs were updated. CONCLUSIONS: For TPRs to meet their objective of improving the efficiency of the assessment process and the consistency in the decisions on price, reimbursement and financing of medicines by the SNS, the deadlines established for publication must be met, incorporating systematically information on the efficiency of the drugs and including periodic updates with the new information generated

Facilitators and barriers in implementing medication safety practices across hospitals within 11 European Union countries

BACKGROUND: The study was carried out as part of the European Network for Patient Safety (EUNetPas) project in 2008-2010. OBJECTIVE: To investigate facilitators and barriers in implementation process of selected medication safety practices across hospitals within European Union countries. METHODS: This was an implementation study of seven selected medication safety practices in 55 volunteering hospitals of 11 European Union (EU) member states. The selected practices were: two different versions of medicine bed dispensation; safety vest; discharge medication list for patients; medication reconciliation at patient discharge; medication reconciliation at patient admission and patient discharge, and sleep card. The participating hospitals submitted an evaluation report describing the implementation process of a chosen practice in their organisation. The reports were analysed with inductive content analysis to identify general and practice-specific facilitators and barriers to the practice implementation. RESULTS: Altogether 75 evaluation reports were submitted from 55 hospitals in 11 EU member states. Implementation of the medication safety practices was challenging and more time consuming than expected. The major reported challenge was to change the work process because of the new practice. General facilitators for successful implementation were: existence of safety culture, national guidelines and projects, expert support, sufficient resources, electronic patient records, interdisciplinary cooperation and clinical pharmacy services supporting the practice implementation. CONCLUSIONS: The key for the successful implementation of a medication safety practice is to select the right practice for the right problem, in the right setting and with sufficient resources in an organization with a safety culture

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La información al paciente sobre los servicios profesionales farmacéuticos asistenciales de farmacia comunitaria / Information to patients on professional pharmaceutical care services of Community Pharmacy

La prestación de servicios profesionales farmacéuticos asistenciales (SPFA) al paciente des-de la farmacia comunitaria ha de realizarse observando una serie de garantías sanitarias y legales previas que aseguren los derechos del paciente. Toda actuación en el ámbito de la salud de un paciente necesita su consentimiento libre y voluntario una vez que haya recibido la in-formación adecuada. Esta información que, como regla general, se proporcionará verbalmente (salvo en los casos de procedimientos invasivos, que son los que entrañan riesgos más graves), ha de ser veraz e incluir como mínimo la finalidad y la naturaleza de cada intervención, sus riesgos y sus consecuencias, y se debe comunicar al paciente de forma comprensible y adaptada a sus necesidades, de forma que le ayude a tomar decisiones de acuerdo con su propia y libre voluntad. De este modo, para que el paciente consienta que se le preste un SPFA ha de recibir previamente una información específica sobre dicho servicio. Aunque esta información se po-dría proporcionar solo verbalmente, al ser los SPFA servicios novedosos con los que el paciente no está familiarizado, es recomendable proporcionarla también por escrito ya que esta vía per-mite garantizar que se comunica de forma uniforme, comprensible, evitando equivocaciones y olvidos, y además el paciente tendrá más tiempo para estudiarla en su casa. Este artículo analiza la información mínima que se debe proporcionar a los pacientes y usuarios en la prestación de los SPFA. Además, muestra como ejemplo tanto la información que se proporciona al paciente en cinco de los SPFA que gestiona la aplicación SEFAC e_XPERT®, como un modelo de consen-timiento informado válido para dichos servicios y que incluye el resto de información necesaria que también se debe comunicar previamente al paciente

The provision of professional pharmaceutical care services (SPFA) to the patient from the community pharmacy must be carried out by observing a series of previous health and legal guarantees that ensure the rights of the patient. Any action in the area of a patient’s health requires his or her free and voluntary consent once he or she had received the appropriate information. This information will, as a general rule, be provided orally (except in the case of invasive procedures, which are the ones with the most serious risks), must be truthful and include at least the purpose and nature of each intervention, its risks and its consequences, and must be communicated to the patient in a way that is understandable and adapted to his or her needs, in a way that helps you make decisions according to your own free will. Thus, in order for the patient to consent to the provision of an SPFA, he must first receive specific information about that service. Although this information could be provided only verbally, as SPFAs are novel services with which the patient is not familiar, it’s advisable to provide it also in writing, as this way ensures that it communicates uniformly, comprehensively, avoiding mistakes and forgetfulness, and also that the patient will have more time to study it at home. This article discusses the minimum information to be provided to patients and users in the provision of SPFA. In addition, it shows, as an example, the information provided to the patient in five of the SPFA that manage the SEFAC e_XPERT®application, as well as an informed consent model which includes all other necessary information which must also be communicated to patient

Information seeking behavior and awareness among physicians regarding drug information centers in Saudi Arabia

Background: The role of Drug Information Center (DIC) in a health-care setting has increased tremendously owing to the high influx of pharmaceutical molecules that pose serious challenges to physicians. DIC promotes rational prescribing behavior among physicians, leading to better patient outcome. Objectives: This study aimed to explore information-seeking behaviors and awareness of physicians regarding DIC services in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted among physicians working in government and private sectors between June to November 2018 by using an 18-item electronic anonymous questionnaire. Descriptive and inferential statistics were performed using IBM SPSS (Version 21). A P-value of <0.05 was taken as the level of significance between responses. Results: In total, 500 questionnaires were distributed among the included hospitals, and only 254 physicians (response rate: 50.8%), including 193 males (76%), participated in the study. The majority of participants (n = 83, 32.7%) had more than ten years of experience, and many of the respondents (n=131) worked as residents. Most of the physicians (62.9%) were aware of their institutional DIC. UpToDate was the most preferred drug information database among physicians. Regarding the improvement required in the DIC services, most of the physicians (23.6%) opined that the contact details should be available in all clinical wards. Conclusions: Only 10% of the respondents were not aware of the presence of DIC at their institution. The UpToDate online drug information database was the most frequently used database by the physicians. Our findings showed that there is a need for conducting educational programs for physicians regarding DIC services. Such an attempt can increase the frequency of drug-related queries and promote patient safety

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Source of medicines and medicine information by self-reported persons living with hypertension and diabetes in rural and urban Ghana

Objectives: This study was conducted to determine the source of medicines and medicine information of persons living with hypertension and diabetes in rural and urban Ghana and assessing if they are influenced by predisposing and enabling factors as defined by Andersen's behavioural model. Methods: A population based cross sectional study was conducted in four (4) rural and four (4) urban districts in the Ashanti Region of Ghana. A multistage and proportional sampling method was used in enrolling participants aged 18 years and above. A pre-tested structured questionnaire was used to collect primary data from respondents. Data collected was exported to STATA for analysis. Descriptive analysis was performed. Chi-square tests/Fisher's exact test and multinomial logistic regression models were used to establish association between variables. Results: A total of 336 self -reported persons with hypertension and diabetes were enrolled in the study with 199(59.23%) living in urban communities. The majority of participants with hypertension and diabetes living in the rural communities 77 (56.20%) were females contrasting with the male majority in urban communities 106 (53. 27%). In the rural communities, 49 (35.77%) of participants sourced medicines from the health centre while 45 (32.85%) and 35(25.55%) sourced medicines from the hospital and over the counter medicine shop (OTCMS) respectively. In the urban communities, 153 (76.88%) sourced medicines from the hospital while 33 (16.58%) sourced medicines from the pharmacy. The predisposing factor age (OR: 1.1, 95%CI 1.040-1.210) under OTCMS, age (OR 1.0, 95%CI: 1.002-1.066) under hospital and enabling factor socioeconomic status (OR: 0.3, 95%CI 0.085-0.855) under Hospital influenced participant's source of medicine in the urban communities. The results also revealed that majority of participants in both rural 99 (72.26%), and urban 164 (82.41%) communities sourced medicine information mainly from public healthcare facilities, pre-disposing factors; age (OR 1.1 95%CI 1.032-1.270) under family member, age (OR 1.1, 95%CI 1.022-1.167) under friend health professional, age (OR 1.1, 95%CI 1.050-1.147) under nearest health institution, marital status (OR: 0.004, 95%CI 0.003-0.441) under friend health Professional were found to influence participants' source of medicine information in the urban communities while in the rural communities the predisposing factor marital status (OR 10.6, 95%CI 1.044 -106.835), education (OR: 26.1, 95%CI 1.271-537.279) under friend health professional, age (OR 1.1, 95%CI 1.002-1.187), educational level (OR 30.6, 95%CI 1.718-546.668) under nearest health institution and enabling factor socio-economic status (OR 6.6, 95%CI 1.016 -43.510) under nearest health institution influenced one's source of medicine information. Conclusions: Majority of inhabitants with hypertension and diabetes in both rural and urban communities, sourced medicines and medicine information from public health institutions though a larger proportion was recorded in the urban communities. More participants in the rural communities than in the urban communities sourced medicines and medicine information from community pharmacies. Participants' source of medicine and medicine information was influenced by both predisposing and enabling factors

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Community pharmacists' perceptions towards online health information in Kuala Lumpur, Malaysia

Objective: The current study was carried out to assess community pharmacists' perceptions towards online health information, to examine the type of information seek from Internet and to identify the barriers when they retrieved online health information. Methods: The study was designed as a cross-sectional questionnaire-based survey whereby all (300) community pharmacists practicing in Federal Territory of Kuala Lumpur, Malaysia were targeted for data collection. A 35-itemed questionnaire was posted out along with a stamped addressed envelope, invitation letter and support letter. Responses were also accepted via online response. Both descriptive and inferential statistics were used for data analysis. All statistical analysis was performed using SPSS v. 20.0. Results: A total of 67 responses were received with a response rate of 22.3%. The top three frequently health information searched by respondents were medicine information, general healthcare information and disease-related information. High number of respondents agreed that Internet had too much health information to scan through. Gender (p=0.018) showed significant association with visiting established health websites. Meanwhile, statistical significant was observed between age and searching medicine information (p=0.037), undertaking online continuing professional development (p=0.023), as well as searching clinical guidelines (p=0.047). Respondents' education level showed significant association with uncertainty about the reliability of online health information (p=0.023) and unsure about filtering the information (p=0.007). Conclusions Majority of the respondents expressed positive perception with the use of Internet for health information. The findings of the current study showed the widely use of Internet for health information among community pharmacists. Hence, this study provides opportunity for future works to further examine community pharmacist's retrieval and appraisal skills for online health information, as well as application of this information into their daily pharmacy practice

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Impact on process results of clinical decision support systems (CDSSs) applied to medication use: overview of systematic reviews

Objective: The purpose of this overview (systematic review of systematic reviews) is to evaluate the impact of clinical decision support systems (CDSS) applied to medication use in the care process. Methods: A search for systematic reviews that address CDSS was performed on Medline following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane recommendations. Terms related to CDSS and systematic reviews were used in combination with Boolean operators and search field tags to build the electronic search strategy. There was no limitation of date or language for inclusion. We included revisions that investigated, as a main or secondary objective, changes in process outcomes. The Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) score was used to evaluate the quality of the studies. Results: The search retrieved 954 articles. Five articles were added through manual search, totaling an initial sample of 959 articles. After screening and reading in full, 44 systematic reviews met the inclusion criteria. In the medication-use processes where CDSS was used, the most common stages were prescribing (n=38 (86.36%) and administering (n=12 (27.27%)). Most of the systematic reviews demonstrated improvement in the health care process (30/44 - 68.2%). The main positive results were related to improvement of the quality of prescription by the physicians (14/30 - 46.6%) and reduction of errors in prescribing (5/30 - 16.6%). However, the quality of the studies was poor, according to the score used. Conclusion: CDSSs represent a promising technology to optimize the medication-use process, especially related to improvement in the quality of prescriptions and reduction of prescribing errors, although higher quality studies are needed to establish the predictors of success in these systems (AU)

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Brazilian Drug Information Centre: descriptive study on the quality of information 2010-2015 / Centro Brasileño de Información sobre Medicamentos: estudio descriptivo de la calidad de la información 2010-2015

Objective: To define the activities of the Drug Information Centre of the Federal Council of Pharmacy (Cebrim/FCP), to describe the passive information and the satisfaction of its users. Method: The centre has a computerized system for recording and storing the received questions and their answers: the Sistema de Informação Farmacoterapêutica SIFAR (Pharmacotherapeutical Information System) that generates management reports; out of these, the reports from the period 2010 to 2015 were analyzed. Results: The main activity carried out by the centre was the passive information provided to pharmacists and undergraduate Pharmacy students. The most frequent subjects were: administration and way of use of medicines and indication and drug interactions, which were answered in less than 24 hours in most cases. Approximately 80% of those users who completed the satisfaction survey rated the service provided as good and optimal. Conclusion: Cebrim/FCP provides objective, updated and timely information (passive information) on medicines for pharmacists, with administration and way of use as the most recurrent subjects, and the majority of applicants were satisfied with the service (AU)

Objetivo: Caracterizar las actividades del Centro de Información sobre Medicamentos del Consejo Federal de Farmacia (Cebrim/CFF), describir la información pasiva y la satisfacción de sus usuarios. Método: El centro cuenta con un sistema informatizado de registro y almacenamiento de preguntas y respuestas recibidas (Sistema de Informação Farmacoterapêutica SIFAR), que genera informes gerenciales, del cual fueron analizados los informes del período de 2010 a 2015. Resultados: La actividad principal realizada por el centro fue la información pasiva brindada a farmacéuticos y estudiantes de pregrado de Farmacia. Los temas más frecuentes fueron administración y modo de uso de los medicamentos e indicación e interacciones medicamentosas, con respuesta en menos de 24 h, en la mayoría de los casos. Entre los usuarios que cumplimentaron la encuesta de satisfacción, aproximadamente el 80% de los usuarios clasificaron el servicio brindado como bueno y óptimo. Conclusión: Cebrim/CFF brinda información objetiva, actualizada y oportuna (información pasiva) sobre medicamentos para profesionales farmacéuticos, con administración y modo de uso como temas más recurrentes, y la gran mayoría de los solicitantes están complacidos con el servicio (AU)

Assessment and use of drug information references in Utah pharmacies

Objective: To determine which drug references Utah pharmacists use most frequently. To determine which types of drug information questions are most commonly asked, and whether Utah pharmacists have access to adequate references to respond to these questions. Methods: A 19-question survey was created using Qualtrics, LLC (Provo, Utah) software. An electronic survey link was sent to 1,431 pharmacists with a valid e-mail address listed in the Department of Professional Licensing database. Questions focused on available references in the participant’s pharmacy, how current the references are, and the participant’s use of the references. Surveys were analyzed for participants practicing in either community or hospital pharmacies in the state of Utah. Results: A total of 147 responses were included in the analysis. Approximately 44% of respondents practiced in the community, and 56% practiced in a hospital setting. The most commonly used references by Utah pharmacists are Micromedex, Lexicomp, UpToDate, Clinical Pharmacology, and Drug Facts & Comparisons. Pharmacists in the community frequently receive questions related to adverse drug reactions, drug interactions, and over-the-counter medications. Pharmacists in the hospital frequently receive questions relating to dosage and administration, drug interactions, and adverse drug reactions. About 89% of community pharmacists and 96% of hospital pharmacists feel available references are adequate to answer the questions they receive. Conclusions: Utah pharmacists generally use large reference suites to answer drug information questions. The majority of pharmacists consider the references available to them to be adequate to answer the questions they receive (AU)

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Fiabilidad de los ensayos clínicos. El peligroso camino de la desregulación de los medicamentos / The reliability of clinical trials. The risky way towards drug deregulation

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Patients' views on electronic patient information leaflets

Background: Information in society and in health care is currently undergoing a transition from paper to digital formats, and the main source of information will probably be electronic in the future. Objective: To explore patients’ use and perceptions of the patient information leaflet included in the medication package, and their attitude towards a transition to an electronic version. Methods: The data was collected during October to November 2014 among individuals in South-Eastern Sweden, using a questionnaire (n=406, response rate 78%) and interviews (n=15). Results: The questionnaire showed that the majority of the respondents (52%) occasionally read the patient information leaflet, 37% always read it, and 11% never read it. Almost half of the patients (41%) were positive towards reading the patient information leaflet electronically while 32% were hesitant and 26% neutral. A majority of the patients would request to get the patient information leaflet printed at the pharmacy if it was not included in the package. There were differences in attitude related to age and gender. The interviews showed that patients had mixed views on a transition to an electronic patient information leaflet. The patients perceived several positive aspects with an electronic patient information leaflet but were concerned about elderly patients. Conclusion: Although many were positive towards reading the patient information leaflet electronically, the majority prefer the patient information leaflet in paper form. Providing appropriate and useful eHealth services for patients to access the patient information leaflet electronically, along with education, could prepare patients for a transition to electronic patient information leaflet (AU)

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Optimización de la información sobre la medicación de personas polimedicadas en atención primaria / Optimization of information on the medication of polypharmacy patients in primary care

Dentro del protocolo de pacientes polimedicados/as elaborado por el Servicio de Salud del Principado de Asturias, los/las médicos/as de atención primaria reciben periódicamente los listados de los tratamientos de pacientes de cualquier edad que consumen 10 o más medicamentos/día durante un período de 6 meses. Actualmente, el Servicio de Salud del Principado de Asturias está desarrollando un proyecto orientado a evaluar las medicaciones de pacientes polimedicados/as, con el fin de identificar: 1) el consumo de medicamentos de utilidad terapéutica baja, 2) el consumo de fármacos potencialmente nefrotóxicos en pacientes con filtrado glomerular disminuido, y 3) la posible prescripción inadecuada en pacientes mayores de 65 años. El proyecto se inició con una primera fase llevada a cabo en el Área Sanitaria II y actualmente se pretende extenderlo a las áreas sanitarias restantes. Consideramos que su automatización y aplicación generalizada podrían ser útiles para optimizar la prescripción de medicamentos (AU)

As part of the protocol of the Health Service of the Principality of Asturias (Spain), primary care physicians periodically receive listings of the treatments of patients of any age taking 10 or more drugs/day for 6 months. Currently, the Health Service of the Principality of Asturias is developing a project that aims to assess the medications of polypharmacy patients. The aim is to identify: 1) the consumption of medicines of low therapeutic usefulness, 2) the consumption of potentially nephrotoxic drugs in patients with a low glomerular filtration rate, and 3) potentially inappropriate prescribing in patients aged 65 years or older. The project was started in Health Area II and the aim is to extend it to the remaining health areas. In our opinion, its automation and general implementation could be useful to optimize drug prescription (AU)

Inhibidores de la bomba de protones: análisis de su utilización en una oficina de farmacia / Proton pump inhibitors: analysis of its usage in a community pharmacy

Introducción: Los inhibidores de la bomba de protones (IBP) son uno de los grupos de medicamentos que más se dispensan en la farmacia comunitaria. Actúan sobre los síntomas derivados de una excesiva acidez gástrica. Objetivos: Analizar el uso de los IBP en una oficina de farmacia comunitaria, comparando los resultados con los obtenido en estudios similares. Métodos: Se invitó a 34 pacientes (62% mujeres, edad media 61,47 años), que acudieron a retirar un IBP para uso propio, a cumplimentar un cuestionario estructurado con 10 preguntas relacionadas con el uso de estos medicamentos. Resultados: La primera prescripción del IBP fue realizada por el médico de atención primaria en 65% y por el especialista en el 32%. Omeprazol fue el IBP más prescrito (88%). El 91% de los pacientes llevaba tomando el fármaco más de un año y el 35% más de 10 años. Un 47% de los pacientes habían interrumpido el tratamiento en alguna ocasión; presentando el 63% molestias gástricas sugestivas de rebote ácido tras la interrupción. Los motivos para el uso de IBP fueron: patología digestiva diagnosticada (21%) o no diagnosticada (21%), toma de AINEs (21%) y de otros medicamentos (37%). Se demostró una falta de conocimiento generalizada sobre los objetivos del uso de IBP y la forma de utilizarlos. Conclusiones: Los IBP, se utilizan de forma excesiva, tanto por las indicaciones como por la duración del tratamiento. Este uso no racional puede desencadenar problemas de salud

Introduction: Proton pump inhibitors (PPI) are one of the drugs most frequently dispensed by pharmacies. They are used to decrease the symptoms derived of an excessive gastric acid secretion. Objectives: To analyse the usage of PPIs in a community pharmacy, comparing the results with those reported in similar studies. Methods: 34 patients (62% women, average age 61.47 years), who came to remove a PPI for own use, were invited to complete a questionnaire with 10 questions related to the usage of PPI. Results: The primary care physician provided the first prescription of PPIs in 65% of patients, while in 32% the prescription was done by a specialist. Omeprazole was the most prescribed PPIs (88%). Most patients (91%) had been taking the drug over a year and 35% over 10 years. Discontinuation of treatment was reported by 47% of the patients, with 63% showing gastric discomfort suggestive of acid rebound. Prescription of PPIs was related to diagnosed (21%) or undiagnosed (21%) digestive diseases, intake of NSAIDs (21%) or other medications (37%). A general lack of knowledge about the objectives of PPI usage and how to use them were also demonstrated. Conclusions: This study shows the overuse of PPI regarding both, the indications and the duration of therapy. The improper usage of PPI may trigger negative consequences for patients

Valoración de la información educacional sobre analgesia obstétrica recibida en el tercer trimestre de gestación / Assessment of patient-education on obstetric epidural analgesia received in the third quarter of pregnancy

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Nueva aplicación que facilitará la consulta de fármacos a los profesionales sanitarios del 061 / No disponible

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Valoración de una Encuesta sobrde Atención Farmacéutica a Farmacéuticos de Alicante / Survey’s Assessment of the Pharmaceutical Care Services Carried out by Alicante’s Pharmacists

Introducción: Hay descritas barreras y facilitadores para implantar la AF. Algunos facilitadores podrían ser proporcionados desde los colegios profesionales. Objetivo: Conocer el interés de los farmacéuticos comunitarios alicantinos por los servicios de AF, y sus preferencias para implantar/mejorar éstos. Método: Estudio transversal realizado marzo-mayo de 2012, mediante un cuestionario anónimo a todos los colegiados ejercientes en OF, consensuado por la comisión de AF del COFA, disponible en la web colegial 70 días. Con preguntas referentes a su implantación, protocolización, registros, evaluación y ayudas sugeridas para su implantación/mejora. Resultados: Respondieron 19,9% de los colegiados ejercientes en FC, afirmando la mayoría querer mejorar su trabajo. Siguen protocolos para IF el 58%, automedicación un 60% y 33% para dispensación con receta. Realizan SFT un 23% y SPD 15%. La mayoría no registra las actuaciones, siendo 77% en IF, 70% en automedicación, 78% dispensación con receta, excepto SFT con 25%. Como formato de registro, se prefiere papel, excepto en SFT que son aplicaciones informáticas. La mayoría evalúa el resultado en ocasiones, solo un 8% lo hace siempre. En SFT lo evalúan siempre un 29%. Se prefiere un servicio de información frente a dudas, seguido de uno de apoyo a la implantación. Conclusiones: Existe interés entre los farmacéuticos alicantinos por la AF. Sería deseable un mayor grado de implantación de estos servicios, existiendo gran recorrido de mejora en la protocolización, el registro y la evaluación de los resultados. Como herramientas para ello, destaca la solicitud al colegio de un servicio de información frente a dudas

There are described both, barriers and facilitators in the implementation of Pharmaceutical Care. Some facilitators might be provided from the professional associations. Objective: To find the interest of Alicante’s community pharmacists in the Pharmaceutical Care services and their preferences when implementing / improving these services. Method: It was conducted a cross-sectional study from March to May 2012 by using an anonymous questionnaire that was taken to all practicing members in OF. The questionnaire has been agreed by the Pharmaceutical Care Commission of the COFA (Colegio Oficial de Farmacéuticos de Alicante) and was available in the College web for 70 days. It included questions concerning Pharmaceutical Care implementation, its records and evaluation and some suggested aids to be implemented or to improve the Pharmaceutical Care. Results: 19.9% of the collegiate members that are community pharmacists answered the questionnaire. Most of them want to improve their work. Among them, 58% follow protocols for IF, 60% for self-medication and 33% for prescription-only products. Besides, 23% carry out SFT and 15%, SPD. The vast majority of them do not record their performances, among which 77% are in IF, 70% in self-medication, 78% in prescription-only products and the exception of SFT with only 25%. The preferred record format is paper except in SFT in which case they are computer applications. Most of the participants in the questionnaire evaluate the result occasionally; only 8% do so always. In SFT 29% evaluate it always. They prefer an information service against doubts, followed by one of support to the implementation. Conclusions: There is an interest among Alicante’s pharmacists in Pharmaceutical Care. A greater degree of implementation of these services would be desirable: there is a long room for improvement concerning the Pharmaceutical Care records and results evaluation. In order to go on and to improve information against doubts service has been required to the College

An overview of upcoming changes in pregnancy and lactation labeling information / Revisión de los próximos cambios en la información sobre medicamentos en embarazo y lactación

Background: Many medications can be used safely and effectively to provide health benefits for disease state management during pregnancy with minimal risk to the fetus or mother. Today nine out of ten women take at least one medication during pregnancy, and the number of women taking four or more medications has more than doubled over the past 30 years. However, the lack of safety data combined with the generalizations of the current risk category system (A, B, C, D, X) makes risk versus benefit assessment difficult. Discussion: In response to these concerns, the U.S. Food and Drug Administration (FDA) has decided to implement a new pregnancy and lactation labeling rule designed to improve risk versus benefit assessment of drugs used in pregnant and nursing mothers; this rule is set to take effect in June of 2015. This change is designed to provide clear and detailed information for both patients and healthcare providers pertaining to three main categories: pregnancy, lactation, and females and males of reproductive potential. The new labeling rule also removes the previous letter risk categorization system. Conclusion: The upcoming changes regarding pregnancy and lactation safety labeling are going to have a vast impact on drug safety interpretation and prescribing practices. While this rule will provide practitioners with more detailed information pertaining to pregnancy, lactation, and reproduction, it will also place more responsibility on the practitioners to ensure the safety of their patients. This review will summarize these changes and discuss their potential effect on clinical practice (AU)

Antecedentes: Muchos medicamentos pueden ser utilizados con seguridad y efectividad para mejorar la salud en la gestión de enfermedades durante el embarazo con mínimo riesgo para la madre o el feto. Hoy, 9 de cada 10 mujeres toman al menos un medicamento durante el embarazo, y el número de ellas que toma 4 o más medicamentos se ha más que doblado en los últimos 30 años. Sin embargo, la falta de datos de seguridad, combinada con las generalizaciones de la actual categoría de riesgos (A, B, C, D, X) hace difícil la evaluación riesgo contra beneficio. Discusión: En respuesta a estas preocupaciones, la U.S. Food and Drug Administration (FDA) ha decidido implantar una nueva regla de información en embarazo y lactación diseñada para mejorar la evaluación riesgo contra beneficio de los medicamentos usados em madres embarazadas o lactando; esta regla entrará en vigor en junio de 2015. Este cambio está diseñado para proporcionar una información clara y detallada tanto para pacientes como para profesionales de la salud comprendiendo 3 apartados principales: embarazo, lactación, y potencial reproductivo masculino y femenino. La nueva información elimina el anterior sistema de categorización por letras. Conclusión: Los próximos cambios en la información de seguridad de embarazo y lactación van a producir un gran impacto en la interpretación de la seguridad en las prácticas de prescripción. Mientras esta regla proporcionará a los facultativos una información más detallada sobre embarazo, lactación y reproducción, también les dará más responsabilidad para asegurar la seguridad de sus pacientes. Esta revisión resume estos cambios y discute sus efectos potenciales sobre la práctica clínica (AU)

Description of medication errors detected at a drug information centre in Southern Brazil / Descripción de los errores de medicación detectados en un centro de información sobre medicamentos en el sur de Brasil

Objective: To identify and describe actual or potential medication errors related to drug information inquiries made by staff members of a teaching hospital to a Drug Information Centre from January 2012 to December 2013. Methods: Data were collected from the records of inquiries made by health care professionals to the Drug Information Centre throughout this period. Results: During the study period, the Drug Information Centre received 3,500 inquiries. Of these, 114 inquiries had medication errors. Most errors were related to prescribing, preparation, and administration and were classified according to severity as category B (57%) (potential errors) and categories C (26.3%) and D (15.8%) (actual errors that did not result in harm to the patient). Error causes included overdose (13.2%), wrong route of administration (11.4%), inadequate drug storage (11.4%), and wrong dosage form (8.8%). The drugs most frequently involved in errors were vitamin K (4.4%), vancomycin (3.5%), and meropenem (3.5%). Conclusion: In this study, it was not possible to measure the reduction in error rate involving medication use because of the lack of previous data on this process in the institution. However, our findings indicate that the DrugInformation Centre may be used as a strategy to seek improvements in processes involving medication use (AU)

Objetivo: Identificar y describir los errores de medicación potenciales y reales relacionados con consultas de información sobre medicamentos realizadas por personal sanitario de un hospital universitario a un centro de información sobre medicamentos entre enero 2012 y diciembre 2013. Métodos: Se recogieron los datos de las fichas de consultas realizadas por el personal sanitario al centro de información de medicamentos durante este periodo. Resultados: Durante el periodo de estudio el centro de información de medicamentos recibió 3.500 consultas. De esas, 114 consultas tenían errores de medicación. La mayoría de los errores estaban relacionados con prescripción, preparación y administración, y se clasificaron de acuerdo a su gravedad como categoría B (57%) (errores potenciales) y categorías C (26,3%) y D (15,8%) (errores reales que o produjeron daño en el paciente). Las causas de ero incluían sobredosis (13,2%), via de administración equivocada (11,4%), almacenamiento inadecuado del medicamento (11,4%), y forma farmacéutica equivocada (8,8%). Los medicamentos más involucrados en los errores eran la vitamina K (4,4%), vancomicina (3,5%), y meropenem (3,5%). Conclusión: En este estudio no fue posible medir la reducción de la tasa de errores relativos al uso de medicamentos por la falta de datos previos sobre este proceso en la institución. Sin embargo, nuestros hallazgos indican que el centro de información de medicamentos puede ser utilizado como una estrategia para buscar mejoras en el proceso de uso de medicamentos (AU)

Diseño y pilotaje de un proceso estructurado para el servicio de dispensación de medicamentos / Design and piloting of a structured service medication dispensing process

OBJETIVO: Diseñar y pilotar un protocolo para el servicio de dispensación de medicamentos. DISEÑO: Se partió de los requisitos propuestos en el Consenso de Atención Farmacéutica del Ministerio de Sanidad, se realizó una búsqueda bibliográfica y se aplicaron técnicas cualitativas de consenso. Para el pilotaje se realizó un estudio observacional transversal de marzo a junio de 2009. Emplazamiento: 53 farmacias comunitarias de 24 provincias españolas. PARTICIPANTES: Pacientes que solicitaron uno o varios medicamentos concretos con o sin receta médica para uso propio o para alguien a su cuidado. MEDICIONES PRINCIPALES: La información personalizada sobre el medicamento (IPM), los problemas relacionados con los medicamentos (PRM) y los resultados negativos asociados a la medicación (RNM) detectados por el farmacéutico en cada dispensación, así como la percepción de operatividad del farmacéutico sobre el protocolo. RESULTADOS: Se realizaron 870 dispensaciones, se detectaron 423 (48,6%) casos de falta de información en los que se ofreció IPM. En un 10,11% de las dispensaciones realizadas se detectaron PRM y 68 sospechas de RNM (7,81%): de seguridad (n = 35; 51,5%), efectividad (n = 29; 42,6%) y necesidad (n = 4; 5,8%). El 65,21% de los farmacéuticos afirmaron que el proceso estructurado es operativo. CONCLUSIONES: El protocolo diseñado permite detectar las carencias de información del paciente sobre sus medicamentos, así como los PRM y RNM siendo una herramienta fácil de utilizar y aplicable

OBJECTIVE: The aim of this article is to design and pilot a protocol for the dispensing of medications service. DESIGN:Using the requirements proposed in the Ministry of Health Pharmaceutical Care Consensus, a literature search was made applying qualitative consensus techniques. An observational, cross-sectional study was conducted from March to June 2009. SETTING: A total of 53 community pharmacies from 24 Spanish counties. Participant: Patients who requested one or more particular medications with or without medical prescription for their own use or for someone in their care. MAIN MEASUREMENTS: The personalised medication information (IPM), the problems associated with the medications (PRM), and the negative results associated with the medication (RNM), detected by the pharmacist each time medication was dispensed, as well as the perception of the pharmacist on the operability of the protocol were recorded. RESULTS: A total of 870 medications were dispensed, with 423 (48.6%) cases of lack of personalised medication information (IPM) being detected. PRM were detected in 10.11% of the dispensed medications, as well as 68 (7.81%) suspected RNM: safety (n = 35; 51.5%), effectiveness (n = 29; 42.6%) and necessity (n = 4; 5.8%). Almost two-thirds (65.21%) of the pharmacists said that the protocol is in operation. CONCLUSIONS: The designed protocol helped to detect deficiencies in the information to the patients about their medications, as well as the PRM and RNM, and is shown to be tool that is easy to use and apply