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Introduction: The problem of drug shortages is not new, but it has reached unprecedented levels in recent years. In community pharmacies, pharmacists are forced to develop daily strategies to deal with such shortages and ensure patient care. These efforts result in significant constraints and adjustments to pharmacists' daily practices. The aim of this study is to explore the possible relationship between the consequences of drug shortages and the well-being of pharmacists in pharmacies. Material & method: This study adopts an exploratory qualitative approach by interviewing pharmacists working in community pharmacies in Wallonia. The data were collected between March and June 2023 through individual semi-structured interviews using a resolute guide. The interview guide was adapted as the interviews progressed and according to the pharmacists' views. 16 participants were included, including 7 owner pharmacists, 3 non-owners, and 6 non-titular pharmacists. The interviews were transcribed and then analyzed through a thematic approach. Results: An in-depth study of the day-to-day reality of pharmacies that is open to the public highlights the time-consuming nature of drug shortages, with various implications for pharmacists' relationships, finances, and workload. However, these professionals also highlight the recognition of patients when a solution is discovered, with some sources saying that shortages value the pharmacist's ability and enhance the profession. Finally, about the possibility of change in the training of pharmacists is also addressed by some pharmacists. Conclusion: Drug shortages demand changes in pharmaceutical practice and appear to affect the well-being of pharmacists in public settings. However, the impact seems complex and is amplified by the lack of personnel. With shortages continuing to rise in recent years, it would be wise to analyze the longer-term effects of this phenomenon.
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INTRODUCTION: Professionalism is fundamental to the existence of professions. In pharmacy, interest in this theme improved with events that examined the resocialization of pharmacists in care. With this, evaluating professionalism can help the operationalization of the theme and, consequently, the development of strategies for pharmacy consolidation before its challenges. Therefore, this study aimed to evaluate the professionalism of Brazilian pharmacists. METHODS: To meet the objective, a cross-sectional study was conducted between March 2022 and August 2023. Data were collected using the Brazilian version of the "Modification of Hall's Professionalism Scale for Use with Pharmacists". The scale has 39 items grouped into the domains: autonomy, vocation, professional council, self-regulation, continuing education, and altruism. Data were analyzed using descriptive statistics and an ANOVA analysis of variance with post-hoc Hochberg or Games-Howell tests with Bootstrapping was conducted to verify differences between groups. RESULTS: 600 pharmacists participated in this study. The majority (69%) was female and carried out their professional activities in community pharmacies (50%). Professionalism scores ranged between 14 and 29 points, with an average of 22.8 points. Pharmacists working in outpatient clinics had higher scores in most factors, namely, altruism, continuing education, professional council, vocation, and autonomy. This indicates that the inclination of pharmacists to occupy areas focused on care can be significant to assess professionalism. CONCLUSIONS: The data obtained indicate that pharmacists working in outpatient clinics had higher professionalism scores compared to others. This corroborates the worldwide trend experienced by pharmacy in recent decades, which is the execution of increasingly patient-centered practice models.
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Farmacêuticos , Profissionalismo , Humanos , Profissionalismo/normas , Estudos Transversais , Feminino , Masculino , Brasil , Adulto , Papel Profissional , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Artificial intelligence (AI) is a broad concept that includes the study of the ability of computers to perform tasks that would normally require the intervention of human intelligence. By exploiting large volumes of healthcare data, artificial intelligence algorithms can identify patterns and predict outcomes, which can help healthcare organizations and their professionals make better decisions and achieve better results. Machine learning, deep learning, neural networks or natural language processing are among the most important methods, allowing systems to learn and improve from data without the need for explicit programming. AI has been introduced in biomedicine, accelerating processes, improving safety and efficiency, and improving patient care. By using AI algorithms and Machine Learning, hospital pharmacists can analyze a large volume of patient data, including medical records, laboratory results, and medication profiles, aiding them in identifying potential drug-drug interactions, assessing the safety and efficacy of medicines, and making informed recommendations. AI integration will improve the quality of pharmaceutical care, optimize processes, promote research, deploy open innovation, and facilitate education. Hospital pharmacists who master AI will play a crucial role in this transformation.
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Inteligência Artificial , Serviço de Farmácia Hospitalar , Serviço de Farmácia Hospitalar/organização & administração , Humanos , Farmacêuticos , Algoritmos , Aprendizado de Máquina , Redes Neurais de ComputaçãoRESUMO
OBJECTIVE: To develop by consensus a dashboard model to standardize and promote the evaluation of research activity in Spanish Hospital Pharmacy Services. METHODS: The study was carried out in 5 phases following the modified Delphi methodology: constitution of the coordinating group, elaboration of a list of scenarios, selection of participating centers, evaluation of the list of scenarios, and analysis of the results. The coordinating group designed a questionnaire with 114 questions. General research questions and different scenarios (indicators) were included to form the dashboard. The Hospital Pharmacy Services with the highest number of publications were identified to participate in the Delphi consultation. Two rounds of consultations were conducted in which the "Need" and/or "Feasibility" of their measurement was evaluated for each of the scenarios, using a numerical scale from 1 (lowest score) to 9 (highest score). RESULTS: Sixteen Hospital Pharmacy Services, belonging to 8 different autonomous communities, participated in the Delphi consultation. A total of 100% of them responded to all the questions in the 2 rounds of consultations. It was considered that the Hospital Pharmacy Services should have a research dashboard (need = 100%) with a basic structure and a common minimum set of data for all them (need = 87.5%). The consensus was reached on distinguishing research projects led by the Hospital Pharmacy Services from those led by other groups in which the Hospital Pharmacy Services collaborate (need = 87.5%), and a definition was approved on the leadership of these projects according to whether they are single-center or multicenter. A consensus was reached on 40 indicators to form the dashboard, which evaluates publications (13 indicators), human resources (12 indicators), research projects (9 indicators), doctoral theses (4 indicators), and patents and intellectual property registrations (2 indicators). CONCLUSIONS: This is the first consensus dashboard developed to evaluate the research activity of the Hospital Pharmacy Services, which will help to analyze the productivity and impact of research systematically and continuously. In addition, it will allow comparison between them and will help to establish synergies and identify trends, patterns, and challenges.
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Técnica Delphi , Serviço de Farmácia Hospitalar , Serviço de Farmácia Hospitalar/organização & administração , Espanha , Inquéritos e Questionários , Consenso , HumanosRESUMO
OBJECTIVE: To develop by consensus a dashboard model to standardise and promote the evaluation of research activity in Spanish Hospital Pharmacy Services. METHODS: The study was carried out in 5 phases following the modified Delphi methodology: constitution of the coordinating group, elaboration of a list of scenarios, selection of participating centres, evaluation of the list of scenarios, and analysis of the results. The coordinating group designed a questionnaire with 114 questions. General research questions and different scenarios (indicators) were included to form the dashboard. The Hospital Pharmacy Services with the highest number of publications were identified to participate in the Delphi consultation. Two rounds of consultations were conducted in which the "Need" and/or "Feasibility" of their measurement was evaluated for each of the scenarios, using a numerical scale from 1 (lowest score) to 9 (highest score). RESULTS: Sixteen Hospital Pharmacy Services, belonging to 8 different Autonomous Communities, participated in the Delphi consultation. A total of 100% of them responded to all the questions in the 2 rounds of consultations. It was considered that the Hospital Pharmacy Services should have a research dashboard (Need=100%) with a basic structure and a common minimum set of data for all them (Need=87.5%). The consensus was reached on distinguishing research projects led by the Hospital Pharmacy Services from those led by other groups in which the Hospital Pharmacy Services collaborate (Need=87.5%), and a definition was approved on the leadership of these projects according to whether they are single-centre or multicentre. A consensus was reached on 40 indicators to form the dashboard, which evaluates publications (13 indicators), human resources (12 indicators), research projects (9 indicators), doctoral theses (4 indicators), and patents and intellectual property registrations (2 indicators). CONCLUSIONS: This is the first consensus dashboard developed to evaluate the research activity of the Hospital Pharmacy Services, which will help to analyse the productivity and impact of research systematically and continuously. In addition, it will allow comparison between them and will help to establish synergies and identify trends, patterns, and challenges.
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Técnica Delphi , Serviço de Farmácia Hospitalar , Serviço de Farmácia Hospitalar/organização & administração , Espanha , Consenso , Inquéritos e Questionários , HumanosRESUMO
The training of hospital pharmacists in the coming years must adapt and respond to constant current and future social and technological challenges, without neglecting the basic areas of the profession. It is necessary to acquire knowledge in what is known as digital comprehensive health: Artificial intelligence, technology and automation, digital skills, and new forms of communication with patients, such as telemedicine and telepharmacy that are already a reality in many hospitals. We must provide knowledge in automated systems for the distribution and dispensing of medicines, robots for preparing sterile preparations, traceability systems, the use of drones in clinical care, etc., as well as including training in the application of technology in pharmaceutical care, through devices and applications that help identify patients who require specific care early and effectively. In this digital scenario, new risks and challenges must be faced, such as cybersecurity and cyber-resilience, which makes the training and education of healthcare professionals in general, and hospital pharmacists in particular, essential. On the other hand, the appearance of increasingly complex and innovative therapies has a great impact not only on health population but also on economic and environmental issues, which makes new competencies and skills essential to develop and implement disruptive and competent financing, equity, and sustainability strategies. In this demanding and hyper-connected environment, it is understandable that the well-known "burned out worker syndrome" appears, which prevents the correct personal and professional development of the team and highlights the importance of quality training for its prevention and management. In short, in the next decade, the training of hospital pharmacists must be aimed at providing knowledge in innovation and in basic skills needed to adapt and succeed to current demands and changes.
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Farmacêuticos , Serviço de Farmácia Hospitalar , Humanos , Educação em Farmácia , Telemedicina , Inteligência ArtificialRESUMO
Hospital Pharmacy is today a profession marked by therapeutic advances, with a proactive attitude, focussed on people and their health. The evolution of processes is constant, with the full presence of digitalisation, robotisation, and even artificial intelligence, in an environment that also requires the efficient and sustainable use of these tools. In this context, it is necessary to have a roadmap that guides the advancement of the profession and Hospital Pharmacy Services. Continuing with the philosophy of the 2020 initiative which, with the slogan "Towards the future, safely", defined the strategic lines to advance in the improvement of Hospital Pharmacy practice, the Spanish Society of Hospital Pharmacy wanted to raise the challenges the profession is currently facing and with a view to 2030. With this strategic planning objective, 20 challenges have been identified and developed, which cover the different areas of action and involvement of Hospital Pharmacy and which cover clinical activities, transversal aspects, training, and research, as well as areas related to people and to the organisations or health systems. For each of them, the objectives, standards, tools, and resources have been defined. It is also planned to provide tools that facilitate monitoring of implementation and the impact on the profession, patients, and the environment.
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Serviço de Farmácia Hospitalar , Serviço de Farmácia Hospitalar/organização & administração , Humanos , Espanha , PrevisõesRESUMO
Artificial intelligence is a broad concept that includes the study of the ability of computers to perform tasks that would normally require the intervention of human intelligence. By exploiting large volumes of healthcare data, Artificial intelligence algorithms can identify patterns and predict outcomes, which can help healthcare organizations and their professionals make better decisions and achieve better results. Machine learning, deep learning, neural networks, or natural language processing are among the most important methods, allowing systems to learn and improve from data without the need for explicit programming. Artificial intelligence has been introduced in biomedicine, accelerating processes, improving accuracy and efficiency, and improving patient care. By using Artificial intelligence algorithms and machine learning, hospital pharmacists can analyze a large volume of patient data, including medical records, laboratory results, and medication profiles, aiding them in identifying potential drug-drug interactions, assessing the safety and efficacy of medicines, and making informed recommendations. Artificial intelligence integration will improve the quality of pharmaceutical care, optimize processes, promote research, deploy open innovation, and facilitate education. Hospital pharmacists who master Artificial intelligence will play a crucial role in this transformation.
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Inteligência Artificial , Serviço de Farmácia Hospitalar , Serviço de Farmácia Hospitalar/organização & administração , Humanos , Farmacêuticos , Algoritmos , Aprendizado de MáquinaRESUMO
The training of hospital pharmacists in the coming years must adapt and respond to constant current and future social and technological challenges, without neglecting the basic areas of the profession. It is necessary to acquire knowledge in what is known as digital comprehensive health: artificial intelligence, technology and automation, digital skills, and new forms of communication with patients, such as telemedicine and telepharmacy that are already a reality in many hospitals. We must provide knowledge in automated systems for the distribution and dispensing of medicines, robots for preparing sterile preparations, traceability systems, the use of drones in clinical care, etc. as well as training in the application of technology in pharmaceutical care, through devices and applications that help identify patients who require specific care early and effectively. In this digital scenario, new risks and challenges must be faced, such as cybersecurity and cyber resilience, which makes the training and education of healthcare professionals in general, and hospital pharmacists in particular, inexcusable. On the other hand, the appearance of increasingly complex and innovative therapies has a great impact not only on health population but also on economic and environmental issues, which makes new competencies and skills essential to develop and implement disruptive and competent financing, equity, and sustainability strategies. In this demanding and hyper-connected environment, it is understandable that the well-known "burned out worker syndrome" appears, which prevents the correct personal and professional development of the team and highlights the importance of quality training for its prevention and management. In short, in the next decade, the training of hospital pharmacists must be aimed at providing knowledge in innovation and in basic skills needed to adapt and succeed to current demands and changes.
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Farmacêuticos , Serviço de Farmácia Hospitalar , Humanos , Educação em Farmácia , Telemedicina , Inteligência Artificial , PrevisõesRESUMO
OBJECTIVE: To quantify the impact of a revised third-year (P3) introductory pharmacy practice experience (IPPE) curriculum on student opportunities for direct patient care and to evaluate student and preceptor perceptions of advanced pharmacy practice experience (APPE) readiness. METHODS: An intentional, structured curriculum redesign shifted 50 IPPE hours from each the 1st- and 2nd-years into the P3 year. A survey was developed and administered to students in the graduating classes of 2023 (original curriculum) and 2024 (revised curriculum) at the end of their first APPE rotation. The survey quantified the frequency of patient care activities completed during P3 IPPEs and assessed student perceptions of the effectiveness of P3 IPPEs in preparation for APPEs. At the conclusion of the first APPE, preceptors answered a single question assessing student APPE readiness. RESULTS: A total of 213/226 (94%) students responded to the optional survey. A significantly higher proportion of students in the 2024 cohort had the opportunity to complete several direct patient care activities compared to the 2023 cohort in community, institutional, and elective IPPEs. Additionally, the 2024 cohort was provided with greater access to the electronic health record (EHR). Although the 2024 cohort had higher perceived APPE readiness in areas of navigating the EHR and administering vaccines, student- and preceptor-perceived overall APPE readiness was similar between the two cohorts. CONCLUSION: Transferring more IPPE hours into the last didactic year can increase student opportunities for direct patient care while promoting APPE readiness. Activity quantification could be used by other pharmacy programs to optimize IPPEs.
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Introduction: Perception and relief of pain exhibit variability among individuals. Age, gender, ethnicity, educational level, actual stress level, mood, or medical conditions can modify the personal interpretation of pain and responses to pharmacological treatment. These differences may play a significant role in the effects, sometimes unwanted, of analgesic treatment. Objectives: Define patient typologies with Failed Back Syndrome regarding attitudes toward the disease, treatment, healthcare, and the follow-up they receive from their healthcare professionals. Create a tool for patient profile identification. Materials and Methods: A clinical case series study, observational, descriptive, and cross-sectional. Study population: patients from the Pain Unit of Nuestra Señora de La Candelaria University Hospital (HUNSC) in Tenerife, conducted in three phases: collection of medical history data (F0), initial visit (F1), and personal interview (F2). Results: Five patient typologies are obtained based on responses to 17 items. Regression equations are calculated from these responses to predict the patient type. They are grouped into "Classics," "Dependents," "Critics," "Unconscious," and "Responsible." Additionally, two tools with 17 items and another with 7 optimized items are developed to simplify the process. Conclusions: These tools enable Community Pharmacy (CP) to identify patients based on their characteristics to direct personalized strategies for each of them.
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78-year-old patient, polymedicated and enrolled in the medication compliance aids service. When she went to pick up her medication, she informed us that for a few months she has been suffering from fatigue, weakness, dizziness and confusion. A medication review is performed, focused on the dosage of renal metabolism or elimination medications, based on the patient's estimated Glomerular Filtration Rate (eGFR). A referral was made to the Primary Care Physician (PCP) through a report, in which the dose reduction of losartan and manidipine was recommended according to the patient's eGFR. The PCP reduced the dose of antihypertensives. A follow-up of the case was carried out, which allowed to observe that the patient stopped presenting the symptoms initially described.
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Abstract: Chronic kidney disease (CKD) is the existence of abnormalities in renal structure or function with an impact on health. This is usually considered when estimated glomerular filtration (eGF) falls under 60 mL/min/1.73m2. Its clinical course leads to renal replacement therapy (dialysis or transplant) when eGF falls under 15 mL/min/1.73m2. Screening in at risk populations has been proven to be cost-effective. The aim of this work is to perform CKD screening in the community pharmacy. In this publication we report and justify the methodology in detail. Methodology: Pharmacists from the community pharmacies taking part selected patients who complied with inclusion and not exclusion criteria. Creatinine was measured by means of a finger prick and eGF calculated with the formula CKD-EPI. If this is lower than a set value, which depends on age, referral to the general practitioner takes place. Results: A total of 141 out of 200 pharmacies took part in the study. In all 2116 patients were recruited and 116 patients were lost. The final sample size was 2000 patients. Discussion: The protocol was successfully implemented by community pharmacists and was extremely well received by community pharmacy users. The age adjustment for eGF thresholds provides a novel additional filter. The aim is not to overburden primary care centres with potential referrals of false positives. Confirmation of the diagnosis is subject to voluntary communication by the patient to the pharmacist.
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Introduction: Pharmaceutical Intervention aims to optimize and rationalize the use, effectiveness, and safety of dispensed medications resolving drug-related problems (DRPs) and negative medicine outcomes (NMOs). Objectives: To evaluate Pharmaceutical Interventions in Benzodiazepines users during the COVID-19 pandemic from a Community Pharmacy. Method: Prospective observational, descriptive, and cross-sectional study (AEMPS code: DAA-CLO-2020-01) of Pharmaceutical Interventions offered by the community pharmacy between August 2020 and February 2021. Results: A total of 306 Pharmaceutical Interventions were conducted involving 127 patients. Health education and personalized medication information were the most common Pharmaceutical Interventions after detecting a high level of unfamiliarity with the Benzodiazepines among patients. Pharmaceutical Interventions leading to medical referrals accounted for 37.8% of the total, triggered by the detection of DRPs and/or NMOs or after identifying the patient as candidate for deprescription. These referrals included patients with a very high level of depression according to the Euroqol 5D-3L test. Pharmaceutical Interventions resulting in Medication Review with Follow-up Service were performed in 3.1% of patients. The patient acceptance rate of Pharmaceutical Interventions reached 98.4%. Conclusions: The high acceptance rate of Pharmaceutical Interventions reinforces the value of Community Pharmacy in optimizing and rationalizing Benzodiazepines usage, while strengthening the pharmacist-patient relationship. The COVID-19 pandemic posed challenges to pharmacist-physician collaboration despite of the availability of telecommunication protocols among healthcare professionals.
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The purpose of this study is to explore the professional and working conditions of community pharmacists in the province of Gipuzkoa.The methodology employed involved: 1) A discussion with owner pharmacists and associate pharmacists, 2) A survey on satisfaction and work-life balance of pharmacists working in community pharmacies, and 3) Analysis of the reasons for cancelling membership of the association of pharmacists in the last 3 years. Data were analysed qualitatively and quantitatively.There was evidence of a range of issues including difficulty in recruiting associate pharmacists, unfavourable work-life balance, low job satisfaction and lack of professional development, poor business hours and other working conditions. Owner pharmacists reported a higher level of job satisfaction and work-life balance than associate pharmacists (p<0.001). However, both groups had a poor work-life balance. The issue of work-life balance is seen as being better in pharmacies with continuous business hours, as opposed to those with split (morning/afternoon) hours. Seventy percent (n=67) of pharmacists who cancelled their membership of the association over the last three years moved to another professional domain, particularly education and industry.In-depth deliberation is required into the professional and working situation of pharmacists working in community pharmacies, with a view to positing global strategies to improve job satisfaction and work-life balance.
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Aim: To analyze diabetes risk screening using the Findrisc questionnaire, performed in Spanish community pharmacies (CP) since 2014. Methods: Descriptive cumulative study of the results of campaigns from Global Diabetes Day, in 2014, 2016-2018, 2020 and 2021. Subjects: Users ≥18 years not diagnosed with diabetes with signed consent. Variables: Findrisc test score, mean (m) and standard deviation (SD) and subjects at risk intervals, n (%). Demographic (sex, age) and anthropometric variables, body mass index (BMI) (kg/m2), waist circumference (cm), capillary glycaemia (SD) (mg/dL). Results: A total of 1146 pharmacists took part; 12,402 users. A total of 8799 (70.9%) had BMI ≥25 kg/m2; 7366 (59.4%) were taking anti-hypertensives, 6047 (48.8%) with excessive abdominal circumference. In total, 5962 (48.0%) had a family history of diabetes.Average risk (Findrisc score) was 11.3 (4.6), without any sex differences (P>0.05). The number of subjects with high/very high risk (F≥15) was 3107 (25.0%) without any sex differences (P>0.05). The high/very high risk increased with age, from 282 (15.1%) people aged 45 to 54 up to 1695 (40.1%) people aged >64. A total of 1762 (14.2%) were referred to the doctor. There are no data on the result.Average interview time: 10.3 (5.3) minutes, no differences between sexes (P>0.05). Conclusions: One quarter of those surveyed had a high/very high risk and one in seven were referred to the doctor.The most prevalent risk factors were BMI, hypertension, abdominal circumference and family history of diabetes.Interprofessional communication should be improved as no result was obtained from referrals to the doctor.
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Two states-Connecticut and New Hampshire-have created or attempted to create advanced pharmacy technician (APhT) licenses. Both licenses, proposed and actual, have high barriers to entry, such as requiring 1 to 3 years of prior technician experience and passage of various assessments or trainings, such as a state-specific jurisprudence exam. Those obtaining APhT licensure are granted additional authority, such as performing final product verification (e.g., tech-check-tech) and vaccine administration. Compared with practices in other states, the APhT role in CT and NH provides minimal scope gains relative to the requirements imposed; as a result, there has been limited uptake (<1%) among current technicians. As such, it appears unlikely that tiered licensure for technicians will be the preferred mechanism for states to expand the role of pharmacy technicians in the future.
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In the Kingdom of Saudi Arabia, there is an increasing demand for community pharmacists to provide the highest level of clinical knowledge and services. However, evidence regarding Saudi public awareness of the clinical services offered by community pharmacies (CPs) and the barriers to using them is limited. In this cross-sectional study, we used an online questionnaire developed by adapting the Consolidated Framework for Implementation Research. A total of 273 participants completed the survey. Half the participants were generally aware of the availability of some CP services but were not informed about the full range on offer, eg, medication reviews (84%) and online counseling (89%). Most of the participants (69.6%) did not identify differences in the care provided by community pharmacists versus hospital pharmacists (P = 0.02). A commonly reported barrier to using CP services was a general preference for other healthcare professionals to seek pharmaceutical help (85.7%). Many other barriers were also reported, impacting the participants' use of these services. The decision-making authorities should consider improvements to increase patients' awareness and utilization of clinical services and enhance community pharmacists' performance in clinical-oriented pharmaceutical care.
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To continue providing solutions to the great challenges of the present and future of healthcare and the changing needs of patients, we must have a reinforced and coordinated primary care, with the decisive support of the Administration, which embraces technological and digital advances. Now more than ever, community pharmacy must claim reclaim its commitment to patients and its vocation to strengthen primary care, focusing on its clinical value. These are precisely the two points on which the motto of the XI National Congress of Community Pharmacists and IV International Meeting of Community Pharmacists rests, which SEFAC celebrates from May 16 to 18 in Las Palmas with the collaboration of the Official College of Pharmacists of Las Palmas ; three intense scientific-professional days in which top national and international speakers will teach content based on scientific evidence, professional practice and current health news in community pharmacy.
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A 38-year-old patient diagnosed with asthma and anxiety, who takes two medications (salbutamol 100 mcg inhaler (2 puffs every 6 hours), and diazepam 5 mg (0-0-1), visited the Community Pharmacy to pick up a treatment prescribed by the Primary Care Physician (PCP) following a diagnosis of anxious-depressive symptoms.During the Dispensing Service, a potential Drug-Related Problem (DRP) of prescription error is detected, which could be related with a Negative Outcomes Releated to Medicines (NOM) due to the concurrent use of desvenlafaxine and mirtazapine. Additionally, a Health Problem (HP)-related DRP was detected, as the proposal to discontinue the use of diazepam could result in an Insufficiently Treated HP, potentially leading to a NOM of Treatment Necessity due to the risk of worsening anxiety episodes.From de Community Pharmacy, a report was prepared with recommendations that were accepted by the PCP. Subsequent case monitoring revealed an improved management of the patient's health problems, as well as the resolution of the identified DRP and NOM. This ensured a rational, safe, and effective use of the medication.