Comercio ilegal de medicamentos, problemática enfocada en puntos de distribución y destrucción: unidades de eliminación de medicamentos e insumos / Illegal trade in medicines, problems focused on points of distribution and destruction: units for the disposal of medicines and supplies

Introducción: La falsificación y/o adulteración de medicamentos es un problema de salud pública el cual cada día se ve más reflejado en el país; una forma de evitarlo ya sea en mínima escala, es la correcta utilización de las unidades de eliminación de medicamentos e insumos, ayudando así a una eficaz desnaturalización y destrucción de estos.Objetivo General:Reconocer la importancia de la prevención del comercio ilegal de medicamentos mediante la utilización de las unidades de eliminación de medicamentos e insumos, en las etapas de comercialización y destrucción del producto, en los municipios de Santiago de Cali, La Unión y Jamundí en el Departamento del Valle del Cauca.Objetivos Específicos:•Medir el grado de conocimiento de las unidades de eliminación de medicamentos e insumos en cuanto a su funcionalidad e impacto en la población de Santiago Cali y en el municipio de La Unión Valle.•Analizar la incidencia de hallazgos de medicamentos en el material de reciclaje y su nivel de comercialización en Santiago de Cali y Jamundí.Método:Se realizó un estudio descriptivo- comparativo, de corte transversal, con enfoque cuantitativo que incluyó una muestra de 171 personas del municipio de Santiago de Cali y 89 personas en el municipio de La Unión Valle; una muestra de 21 recicladores del municipio de Santiago de Cali y 20 recicladores del municipio de Jamundí. El estudio fue realizado entre octubre y noviembre del 2022. Se utilizaron dos cuestionarios validados, diligenciados uno de forma virtual (grupo A) y otro de forma presencial (grupo B), el cual fue desarrollado de forma voluntaria.Resultados: Respecto al grupo de personas encuestadas en el grupo A, 45 que equivalen al 26.3% del universo de la población encuestada en Cali tienen conocimiento de las unidades de eliminación de medicamentos e insumos, 126 personas que equivalen al 73.7% no tienen conocimiento acerca del mismo.(AU)

Introduction: Counterfeiting and/or adulteration of medicines is a public health problem which is increasingly reflected in the country; One way to avoid it, whether on a small scale, is the correct use of the blue dot, thus helping to effectively denature and destroy them.General Objective: Recognize the importance of preventing the illegal trade of medicines using the blue point, in the stages of commercialization and destruction of the product, in the municipalities of Santiago de Cali, La Unión and Jamundí in the Department of Valle del Cauca.Specific Objectives: Measure the degree of knowledge of the blue dot in terms of its functionality and impact on the population of Santiago Cali and the municipality of La Uniòn Valle.Analyze the incidence of drug display in recycling material and its level of commercialization in Santiago de Cali and Jamundi.Method: A descriptive-comparative, cross-sectional study was conducted, with a quantitative approach that included a sample of 171 people from the municipality of Santiago de Cali and eighty-nine people from the municipality of La Union Valle, a sample of twenty-one recyclers from the municipality of Santiago de Cali and twenty recyclers from the municipality of Jamundí. The study was conducted between October and November 2022. Two validated questionnaires were used, one completed online (group A) and the other in person (group B), which was developed voluntarily.Results: Regarding the group of people surveyed in group A, 45, equivalent to 26.3% of the universe of the population surveyed in Cali, are aware of the blue dot, while 126 people, equivalent to 73.7%, are unaware of it. In Unión Valle, 14 people, equivalent to 15.7%, know about the blue dot, while 75 people, equivalent to 84.3%, are unaware of it.(AU)

La "nueva normalidad": ¿qué opinan nuestros pacientes? / The "new normality": what do our patients think?

OBJETIVO: Valorar la satisfacción percibida con el programa de Telefarmacia y envío a domicilio implantado, así como las preferencias de los pacientes y /o cuidadores por el modelo asistencial de atención farmacéutica y dispensación cuando se alcance la "nueva normalidad". MÉTODO: Se diseñó una encuesta electrónica anónima mediante la aplicación Microsoft Forms. La población diana fueron los pacientes, o cuidadores, atendidos en la Unidad de Atención Farmacéutica a Pacientes Externos mediante el modelo de Telefarmacia y envío de medicación a su domicilio entre el 30 de abril al 18 de mayo de 2020. RESULTADOS: Se enviaron 327 cuestionarios, obteniendo una tasa de respuesta del 45,0%. El 95,9% indicó que recibió la medicación correctamente en su domicilio, ajustándose al tiempo estimado de entrega y en perfecto estado. El 99,3% refirió estar satisfecho con el servicio de Telefarmacia y envío a domicilio. El 76,2% prefieren, una vez finalizado el estado de alarma, la Telefarmacia y envío a domicilio de la medicación. La única variable sociodemográfica que se asoció de manera significativa con las preferencias de los pacientes por el modelo de Telefarmacia y envío a domicilio fue la distancia al domicilio del paciente. CONCLUSIONES: Se considera necesario adecuar los modelos asistenciales, debiendo incorporar a la práctica diaria el modelo de atención farmacéutica telemática, junto con el envío domiciliario de medicación, modelo válido, sustentado en la factibilidad de los envíos domiciliarios, el mantenimiento de la atención farmacéutica y la satisfacción y preferencias de los pacientes. Afortunadamente, los primeros pasos están dados y el proceso es irreversible

AIM: To assess the perceived satisfaction with the implemented Telepharmacy and home drug delivery program, as well as the preferences of patients and / or caregivers for the healthcare model of pharmaceutical care and dispensing when the "new normality" is reached. METHOD: An anonymous electronic survey was designed using the Microsoft Forms application. The target population were the patients, or caregivers, treated in the Outpatient Unit using the Telepharmacy model who received the prescribed medication in their homes between April 30 to May 18, 2020. RESULTS: 327 questionnaires were sent, obtaining a response rate of 45.0%. 95.9% indicated that they received the medication correctly at home, adjusting to the estimated delivery time and in perfect condition. 99.3% reported being satisfied with the Telepharmacy and home delivery service. 76.2% prefer, once the alarm state is over, Telepharmacy and home drug delivery of the medication. The only sociodemographic variable that was significantly associated with patient preferences for the Telepharmacy and home drug delivery model was the distance to the patient's home. CONCLUSIONS: The healthcare models should be modified, and the telematic pharmaceutical care model should be incorporated into daily practice together with the home delivery of medication. It is considered a valid model, based on the feasibility of home delivery, the maintenance of pharmaceutical care and patient satisfaction and preferences. Fortunately, the first steps are taken, and the process is irreversible

Assessment of diarrhea treatment and counseling in community pharmacies in Baghdad, Iraq: A simulated patient study

Background: Because community pharmacists are the most accessible healthcare professionals, they are often involved in managing minor ailments within the community setting. Objective: This study evaluated the community pharmacists' history taking practice, medicine dispensing and advice in response to acute diarrhea. Methods: Authors conducted a simulated-patient study in 75 community pharmacies in Baghdad, Iraq from February to May 2015. The female simulated-patient complained of acute diarrhea that had lasted for one day and requested for medicine to treat her condition. After exiting each pharmacy, she then assessed the practices of the community pharmacists through the use of a specially designed checklist adopted with modifications from relevant guidelines. For history taking, a maximum total of eight was the highest obtainable score. Data collected was quantitatively analyzed and Mann-Whitney, Chi-square or Fishers exact tests were used at an alpha level of 0.05. Results: All of the 75 pharmacies visited were managed by professionally qualified pharmacists. The most common questions asked during history taking were number of diarrheal episodes (n=62; 82.7%); duration of symptoms (n=59; 78.7%) and presence of other diseases and if any drug had been taken (n=58; 77.3%). Female pharmacists had a higher total mean score (6.45, SD=1.33) for history taking when compared to their male counterparts (4.34, SD=2.13); p <0.001. Medicine combination of diphenoxylate HCl 2.5mg + atropine sulphate 0.025mg (n=34; 27.9%) was most frequently dispensed while the least was oral rehydration salt (n=1; 0.8%). Around 20% (n=15) of pharmacists dispensed antimicrobial agents. Over half (n=46; 61.3%) of pharmacists indicated the frequency of use on the medicine packet. Conversely, less than half (n=33; 44.0%) gave any advice on food and fluid intake. Conclusions: Majority of the community pharmacists asked at least four questions while taking patient history and was very likely to recommend antidiarrheal medicines as first line treatment options. The authors recommend the development of a minimum standard of practice as well as enhanced training for Iraqi community pharmacists

No disponible

A qualitative study exploring physicians' perceptions on the role of community pharmacists in Dubai

Objective: The aim of this study is to explore the perceptions of physicians operating within the boundaries of Dubai on the role of community pharmacists. Methods: Semi-structured interviews were done with 12 physicians working within the boundaries of Dubai Health Authority. Interviews mainly focused on understanding the perceptions of physicians on the role of community pharmacists in addition to willingness to integrating pharmacists in patient care process. Results: Key findings show that all interviewees agree that community pharmacists are important healthcare professionals. However, 7 physicians restrict the role of pharmacists to dispensing medicines. Physicians in Dubai are willing to collaborate with pharmacists, but more than half of them (7) think that pharmacists might interfere with their jobs. Conclusion: The study concludes that all informants agree that collaboration between community pharmacists and physicians definitely enhances patients’ drug therapy outcomes (AU)

No disponible

Non-prescription dispensing of emergency oral contraceptives: recommendations from the German Federal Chamber of Pharmacists [Bundesapothekerkammer]

Background: Emergency hormonal contraceptives (EHC) are contraceptives used to prevent unintended pregnancy following unprotected sexual intercourse (USI) or contraceptive failure. The EHCs available without a prescription include medicines containing levonorgestrel (LNG) in more than 80 countries and, recently, based on an EU-switch ellaOne®, which contains ulipristal acetate (UPA). EHCs work by stopping or delaying ovulation. Those containing LNG can be used up to 72 hours after USI or contraceptive failure, while UPA can be used up to 120 hours. In the context of the UPA implementation process, Germany switched LNG to non-prescription status as well. Objectives: To develop recommendations, a protocol, and a continuing education program for pharmacists to assure quality when giving advice and dispensing EHCs in community pharmacies without a medical prescription. Methods: The recommendations were developed by an iterative process of drafting, recognizing, and discussing comments and proposals for amendments as well a seeking agreement with a number of stakeholders such as the Federal Ministry of Health (BMG), Federal Institute for Drugs and Medical Devices (BfArM), Federal Chamber of Physicians (BÄK), Drug Commission of German Physicians (AkdÄ), professional organizations/associations of gynaecologists, pharmaceutical OTC-industry as well as government-controlled, private, and church-based organizations and centres providing advice on sex education and family planning. Results: The recommendations were eventually endorsed by the BMG in consultation with the BfArM. Conclusions: The recommendations were made public, published in the professional journal and used in an uncounted number of continuing education programs based on the curriculum and provided by the State Chambers of Pharmacists (AU)

No disponible

Estudio coste/efectividad de neveras portátiles. En unidades móviles de emergencias de la Comarca de Alcañiz (Teruel) / Study cost/effectiveness of portable fridges in the mobile unit of emergencies of Alcañiz (Teruel)

El mantenimiento de la cadena de frío resulta difícil en Unidades Móviles de Emergencia Extrahospitalaria (UME). Este trabajo pretende valorar la efectividad al respecto de neveras portátiles con/sin compresor y su coste/efectividad mediante una simulación informática. Metodología: estudio descriptivo trasversal desarrollado en dos UME de la Comarca de Alcañiz (Teruel) durante un año. Resultados: el 93,8% de las temperaturas de la nevera con compresor se mantuvo entre +2 y +8 ºC, siendo ese porcentaje del 35,7% en la nevera sin compresor. Las ratio coste-efectividad global y específico de las neveras con y sin compresor fueron de 0,063 y 7,411 y de 0,080 y 147,55 respectivamente. Discusión y Conclusiones: la nevera con compresor fue más coste-efectiva, amortizándose rápidamente su precio inicial ya que reguló de forma más eficiente la temperatura, redundando en una mejor conservación de los fármacos termolábiles y ahorrando según el modelo de simulación(AU)

The maintenance of cold chain can result difficult in Emergency Mobil Units that’s why the aim of this study is to value the effectiveness of portable fridges with/without compressor and its cost-effectiveness by a computer simulation. Methodology: This descriptive, transversal and cost effectiveness analysis was developed in two Emergency Mobil Units of 061 Aragón of Alcañiz (Teruel) along a year. Results: The results showed that in the fridge with compressor, the 93'8% of the temperatures was between 2 and 8ºC, where as in the fridge without compressor was of the 35,7%.The global and specific cost effectiveness ratio of the fridge with and without compressor were of 0,063 and 7,411 and of 0,080 and 147,55 respectively. Discussion and Conclusion: Fridge with compressor was more cost-effective, amortizing quickly its initial cost. This fridge had a better and more efficient thermoregulation what supposed a better conservation of drugs and lower costs, according to the model of simulation (AU)

Línea estratégica 1: Nuevas tecnologías / No disponible

No disponible

Valoración desde la dispensación activa de la efectividad y seguridad del uso de medicamentos antihipertensivos / Assessment from the perspective of the community pharmacy of the effectiveness and safety of the use of antihypertensive drugs

Introducción y objetivos: Este estudio pone de manifiesto la situación actual del uso de medicamentos antihipertensivos en pacientes ambulatorios, y valora la efectividad y seguridad de éstos desde la oficina de farmacia. El tema tiene un gran alcance debido a la elevada prevalencia de la hipertensión arterial (HTA) en nuestra sociedad. El objetivo del estudio fue determinar el grado de cumplimiento que tienen los pacientes en el uso de los medicamentos antihipertensivos para así poder valorar la efectividad y seguridad de estos tratamientos. Método: Estudio cualitativo, descriptivo, transversal, multicéntrico y prospectivo, realizado a 335 pacientes ambulatorios atendidos en 12 oficinas de farmacia del Baix Llobregat (Barcelona). Resultados: En el estudio se pudo detectar y prevenir un gran número de problemas relacionados con los medicamentos (PRM) (un total de 131). El grado de control de la HTA en el grupo de pacientes estudiados fue moderado (62% de los casos) y el grado de cumplimiento de la población estudiada según el test de Morisky-Green fue del 72 ± 4,8%. Conclusiones: Se observó la relación existente entre el cumplimiento terapéutico según el test de Morisky-Green y los valores de presión arterial medidos. Las intervenciones farmacéuticas mejoraron la implicación del paciente en el tratamiento en relación con la adherencia e incidieron en la modificación de sus hábitos. El estudio concluye que los datos y los resultados recogidos permiten afirmar que los tratamientos estudiados para la HTA son moderadamente efectivos y mayoritariamente seguros (AU)

Background: This study illustrates the current situation in terms of the use of antihypertensive drugs by ambulatory patients and assesses the effectiveness and safety of these medications from the perspective of the community pharmacy. The problem is of utmost importance owing to the high prevalence of hypertension in our society. The objective of this study was to determine the degree of patient compliance in terms of the use of antihypertensive drugs for the purpose of assessing the effectiveness and safety of these treatments. Methods: A prospective, qualitative, descriptive, cross-sectional, multicenter study involving 335 patients was carried out in 12 community pharmacies in Baix Llobregat, Barcelona, Spain. Results: This study has enabled the detection of a large number of drug-related problems (n= 131). The degree of hypertension control in the group of patients studied was moderate (62% of the cases) and the degree of compliance among the study population, according to the Morisky-Green test, was 72% ± 4.8%. Conclusions: From the perspective of the community pharmacy, there is a direct relationship between treatment compliance, according to Morisky-Green’s test, and the arterial blood pressure values. Pharmaceutical interventions improve the involvement of the patients in their treatment in relation to adherence to the treatment, and influence the modification of their habits. The study concludes that the data and the results gathered demonstrate that the treatments for hypertension studied are reasonably effective and, for the most part, safe (AU)

Intervención sobre uso racional del medicamento: experiencia piloto en centros de atención primaria y las farmacias de su entorno / No disponible

Objetivo: Analizar la experiencia derivada de la incorporación del farmacéutico en centros de salud y su interrelación con las oficinas de farmacia, para fomentar la calidad de la prescripción y dispensación de medicamentos. Métodos: Durante el año 2004, se incorporaron 4 farmacéuticos, 2 en centros de salud y 2 en las farmacias de su entorno, a fin de llevar a cabo un programa de seguimiento farmacoterapéutico (SFT) coordinado. La población de estudio fue: pacientes > 65 años, tratados como mínimo con 4 medicamentos por vía oral. La intervención farmacéutica en los centros de salud consistió en realizar seguimiento farmacoterapéutico. En las farmacias se registró el cumplimiento farmacológico y en qué grado, por parte del paciente. Resultados: En ambos centros de salud se identificaron 311 problemas relacionados con los medicamentos (PRM). Los de seguridad fueron los más numerosos, 39,9%, incrementándose las notificaciones al Centro Autonómico de Farmacovigilancia. El 77,2% de las intervenciones farmacéuticas sobre los PRM identificados fueron aceptadas por el médico prescriptor. De los pacientes incluidos en el estudio, n=280, se evaluó el cumplimiento en 82,8%. De éstos, el 50,4% presentó incumplimiento terapéutico. Se detectó una disminución progresiva del incumplimiento, a medida que se incrementa el número de intervenciones. La satisfacción de los pacientes refleja que un 83% considera muy ventajosa la intervención del farmacéutico sobre su medicación. Conclusión: La intervención directa del farmacéutico en el ámbito asistencial de atención primaria y oficina de farmacia y su intercomunicación mejora la efectividad y seguridad de los tratamientos farmacológicos de los pacientes (AU)

Objective: This study analyzed the experience derived from the incorporation of pharmacists in health centers and their interrelations with pharmacies in order to improve the quality of medicine prescription and delivery. Methods: In the course of the year 2004 of the four pharmacists involved in this study two were incorporated into primary care centers and the other two into community pharmacies. The population observed was made up of patients aged 65 and above whose treatment included at least 4 orally administered pharmaceuticals. The pharmaceutical intervention in the health centers consisted of pharmacological follow-ups. In the pharmacies, adherence to pharmacological treatment was recorded and the degree of patient compliance with pharmacological treatment was considered. Results: A total of 311 medication-related problems (MRP) were identified in the primary care centers. Safety problems were the most numerous and resulted in a 39,9% increase of side-effect notifications to the Regional Pharmacovigilance Center. 77,2% of pharmaceutical interventions on PRMs were accepted by the prescribing doctor. Evaluated adherence among observed patients (n=280) was of 82,8%. 50,4% of observed patients showed therapeutic non-compliance. A progressive decrease in said non-compliance was detected as the number of interventions increased. Patient satisfaction was reflected in that 83% of them considered the pharmacist’s intervention on their medication as highly beneficial. Conclusion: A pharmacist’s direct intervention in the primary care fields and community pharmacies and his intercommunication improve the effectiveness and safety of patients’ pharmacological treatment (AU)

Estudio de errores de dispensación en Oficinas de Farmacia de Valencia / No disponible

El presente trabajo tiene como objetivo diseñar un método para detectar errores de dispensación en la Oficina de Farmacia, cuantificando y clasificando dichos errores, así como identificar algunas variables que ayuden a establecer medidas de prevención. Para ello se estudiaron 21.703 oportunidades de error en once farmacias comunitarias de Valencia de lunes a sábado, ambos inclusive, durante 4 semanas. El índice Global de Error de Dispensación (IGED) obtenido ha sido de 0,23%. De los 50 errores detectados, 18 (36%) consistieron en la dispensación de un medicamento equivocado, y en 11 de estos, el error se asocia a la similitud de nombres comerciales de los medicamentos implicados. Cabe destacar que en un 62% de los casos, los errores llegan al paciente. Como conclusión, nos parece que el método es capaz de detectar, cuantificar y clasificar errores de dispensación en Oficina de Farmacia, así como que el IGED se puede utilizar como indicador de calidad interno de dispensación (AU)

The objective of the present study is to design a method to detect, quantify and clasify dispensing errors at community pharmacies, and also to identify some associated factors which would help to stablish prevention measures. For this purpose, 21.703 oportunities of error were studied at eleven community pharmacies in Valencia (Spain), from Monday to Saturday for four weeks. Global Dispensing Error Rate (IGED) found was 0,23 %. Eighteen (36 %) of the fifty detected errors were wrong drug dispensing errors. Eleven of these errors were due to look-alike problems with brand names. In 62 % of the cases, the errors achieve patients. It is concluded that the method designed is able to detect, quantify and classify dispensing errors at community pharmacies. Furthermore, Global Dispensing Error Rate (IGED) can be used as a dispensing good quality indicator (AU)

Más allá del Consenso de Atención Farmacéutica / No disponible

No disponible