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1.
Aten Primaria ; 56(5): 102836, 2024 May.
Artículo en Español | MEDLINE | ID: mdl-38150850

RESUMEN

OBJECTIVE: To analyze, using the medication review program, Revisem®, the prevalence of drug-related problems (DRP) in patients in the province of Valencia who were on active treatment with proton pump inhibitors (PPI) in 2022. DESIGN: Descriptive and retrospective observational study. MATERIAL AND METHODS: The pharmacotherapeutic history of 295 patients was analyzed following the criteria proposed by the Pharmaceutical Care Network Europe, using the Revisem® digital platform of the Muy Ilustre Colegio Oficial de Farmacéuticos (MICOF). RESULTS: The mean age of the patients was 81.8 ± 11.1 years and 66.4% were women. At least one DRP was detected in 97.3% of patients. 46.9% of the DRP analyzed were interactions, of which 29.7% involved a PPI, with omeprazole being the most frequent. DRPs with PPI are significantly related to certain patient conditions and pharmacological groups, such as female sex, age over 54 years and polypharmacy. CONCLUSIONS: The application of the Revisem® digital platform allows the detection of a high prevalence of DRP at the provincial level. The application of new technological tools to detect the prevalence of DRP is essential to optimize patient treatments.


Asunto(s)
Inhibidores de la Bomba de Protones , Humanos , Inhibidores de la Bomba de Protones/uso terapéutico , Femenino , Masculino , Estudios Retrospectivos , Anciano de 80 o más Años , Anciano , Persona de Mediana Edad , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología
2.
Actas Dermosifiliogr ; 114(8): 708-717, 2023 Sep.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37088291

RESUMEN

Managing atopic dermatitis, one of the most common dermatologic conditions, is often challenging. To establish consensus on recommendations for responding to various situations that arise when treating atopic dermatitis, a group of hospital pharmacists and dermatologists used the Delphi process. A scientific committee developed a Delphi survey with 2 blocks of questions to explore the group's views on 1) evaluating response to treatment in the patient with atopic dermatitis and 2) cooperation between the dermatology department and the hospital pharmacy service. The experts achieved an overall rate of consensus of 86% during the process. Conclusions were that dermatologists and hospital pharmacists must maintain good communication and coordinate their interventions to optimize the management of atopic dermatitis and patients' responses to treatment.


Asunto(s)
Dermatitis Atópica , Humanos , Consenso , Dermatitis Atópica/tratamiento farmacológico , Dermatólogos , Estudios de Seguimiento , Farmacéuticos , Guías de Práctica Clínica como Asunto
3.
Aten Primaria ; 54(1): 102198, 2022 01.
Artículo en Español | MEDLINE | ID: mdl-34688193

RESUMEN

Interdisciplinary collaboration between health professionals is essential to improve health outcomes. The competences of pharmacists make them professionals capable of contributing to the comprehensive management of pharmacotherapy in collaboration with other healthcare professionals. The Council of Europe adopted resolution CM/Res(2020)3 on implementation of pharmaceutical care for the benefit of patients and health services in order to promote the appropriate and safe use of medicines. One of the activities to be carried out through the pharmaceutical care process is the detection of drug related problems, such as contraindications, duplications, prescription errors, interactions, etc. In many cases, it involves regular patient follow-up and needs an evaluation of the interventions performed, requiring the establishment of an appropriate interprofessional collaboration framework. This article discusses the issues to be addressed to face the change of model towards a care-based pharmacy.


Asunto(s)
Servicios Comunitarios de Farmacia , Servicios Farmacéuticos , Farmacias , Farmacia , Humanos , Farmacéuticos , Prescripciones
4.
Gastroenterol Hepatol ; 40(4): 265-275, 2017 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-27292268

RESUMEN

BACKGROUND AND OBJECTIVE: Population-based bowel screening programmes with faecal occult blood (FOB) tests need to achieve high uptake rates and offer quality services. We invited participants in the Barcelona Programme to complete a satisfaction survey, in order to explore factors influencing uptake and respondents' opinion and satisfaction with each step of the screening process. MATERIAL AND METHOD: Telephone survey using an ad hoc questionnaire (see annex) administered to a final sample of 1189 people: 310 non-participants in the programme (NoP), 553 participants with a negative test result (PNeg), and 326 participants with a positive result (PPos). RESULTS: High scores were obtained for the clarity of the information provided by the programme (mean 8.9 on a scale 0-10), and for the accessibility and attention at the pharmacy as well as its role as the point for collection and return of FOB test cards (mean >9.3). Aspects that were not so highly rated were: preparation for the colonoscopy (41.6% reported quite a lot or a lot of discomfort), and to a lesser extent telephone accessibility (27.1% reported some difficulties). Participants also expressed concern about receiving a positive test result by telephone (78.9% reported some concern). CONCLUSIONS: Respondents' opinion of the programme was positive overall, and supports the pharmacy as the point for distributing and collecting FOB test cards, as well as the role of the pharmacist in the context of the programme. Some aspects of the screening process will be reviewed in order to improve participant satisfaction and eventually increase uptake.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Servicios Comunitarios de Farmacia , Detección Precoz del Cáncer , Sangre Oculta , Satisfacción del Paciente/estadística & datos numéricos , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad
5.
Aten Primaria ; 48(9): 586-595, 2016 Nov.
Artículo en Español | MEDLINE | ID: mdl-27142591

RESUMEN

OBJECTIVES: To determine the test-retest reliability of a questionnaire, with a validation preliminary, to assess knowledge of cardiovascular risk (CVR) and cardiovascular disease in patients attending community pharmacies in Spain. To complement the external validity, establishing the relationship between an educational activity and the increase in knowledge about CVR and cardiovascular disease. DESIGN: Sub-analysis of a controlled clinical study, EMDADER-CV, in which a questionnaire about knowledge concerning CVR was applied at 4 different times. LOCATION: Spanish Community Pharmacies. PARTICIPANTS: There were 323 patients in the control group, from the 640 who completed the study. MAIN MEASUREMENTS: Intraclass correlation coefficient to assess the reliability in 3 comparisons (post-educational activity with week 16, post-educational activity with week 32, and week 16 with week 32); and the non-parametric Friedman test to establish the relationship between an oral and written educational activity with increasing knowledge. RESULTS: For the 323 patients in the 3 comparisons, the intraclass correlation coefficient values were 0.624; 0.608 and 0.801, respectively (fair-good to excellent reliability). So, the Friedman test showed a statistically significant relationship between educational activity and increased knowledge (p < .0001). CONCLUSIONS: According to the intraclass correlation coefficient, the questionnaire aimed at assessing the knowledge on CVR and cardiovascular disease has a reliability between acceptable and excellent, which added to the previous validation, shows that the instrument meets the criteria of validity and reliability. Furthermore, the questionnaire showed the ability to relate an increase in knowledge with an educational intervention, feature that complements its external validity.


Asunto(s)
Enfermedades Cardiovasculares , Conocimientos, Actitudes y Práctica en Salud , Educación del Paciente como Asunto , Farmacias , Humanos , Reproducibilidad de los Resultados , Factores de Riesgo , España , Encuestas y Cuestionarios
6.
Aten Primaria ; 48(5): 308-15, 2016 May.
Artículo en Español | MEDLINE | ID: mdl-26415743

RESUMEN

OBJECTIVE: To evaluate the long-term impact of a brief pharmacist intervention (PI) compared with usual care (UC) on prevention of depression relapse. DESIGN: randomised controlled clinical trial SETTING: Primary Care PARTICIPANTS: Of the 179 depressed patients initiating antidepressants, the 113 whose clinical symptoms had remitted (main definition) at 6 months assessment were selected for this secondary study (PI=58; UC=55). INTERVENTION: PI was an interview to promote medication adherence when patients get antidepressants from pharmacy. MAIN MEASUREMENTS: Baseline, 3 months, and six-months follow-up assessments were made. The severity of depressive symptoms was evaluated with PHQ9. Patients presenting a remission of symptoms were selected. The patient medical records were reviewed to identify a relapse in the following 12 months by using 4 indicators. RESULTS: There was a lower proportion of patients that relapsed in the PI group than in the UC group 18 months after initiation of treatment, but the difference was not statistically significant either in the intent-to-treat analysis (OR=0.734 [95%CI; 0.273-1.975]) or the per-protocol analysis (OR=0.615 [95%CI; 0.183 -2.060]). All the sensitivity analyses showed consistent results. The sample size and adherence to the protocol in the intervention group were low. CONCLUSION: PI group showed a non-statistically significant tendency towards presenting fewer relapses. This could be related to the improvement in adherence among patients that received the intervention.


Asunto(s)
Antidepresivos/uso terapéutico , Depresión/tratamiento farmacológico , Atención Primaria de Salud , Prevención Secundaria , Femenino , Humanos , Masculino , Persona de Mediana Edad
7.
Aten Primaria ; 48(6): 366-73, 2016.
Artículo en Español | MEDLINE | ID: mdl-26520414

RESUMEN

OBJECTIVE: To examine the use of analgesics, from the perspective of the pharmacist community, and pharmaceutical practice in mild-moderate pain. DESIGN: A cross-sectional, observational study was performed between April and September 2013. SETTING: 696 community pharmacies in 20 Spanish provinces. PARTICIPANTS: Community pharmacists with a minimum professional experience of one year. MAIN MEASUREMENTS: Characterisation of the demand for analgesics, analgesic users, and pharmaceutical intervention for mild-moderate pain from the perspective of the pharmaceutical community. RESULTS: The main reason why a patient with mild-moderate pain visits a pharmacy is to receive a drug with prescription (45.5%), and the most common condition is headache (35.2%). Ibuprofen and paracetamol are the most commonly used drugs for mild-moderate pain. More than one-third (38.9%) of pharmacists follow a protocol for counselling. A correlation was found between the pharmacist's professional experience and the application of counselling process (Fisher P<.05). Some 87.8% of pharmacists checked two indicators from the dispensing service, and only 1.3% did not check any. Referral to a physician was made by 14.8% of pharmacists, with the main reason being the detection of alarm indicators. CONCLUSIONS: Protocols need to be designed and adapted to the characteristics of the 3 profiles identified, in order to increase the efficiency of pharmaceutical services in mild-moderate pain relief. Practical and specific training in pain are required to implement services to ensure the correct and systemic use of analgesics and positive clinical outcomes.


Asunto(s)
Analgésicos/uso terapéutico , Actitud del Personal de Salud , Utilización de Medicamentos/estadística & datos numéricos , Manejo del Dolor/estadística & datos numéricos , Dolor/tratamiento farmacológico , Farmacéuticos , Farmacia , Adulto , Estudios Transversales , Utilización de Medicamentos/normas , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , España
8.
Aten Primaria ; 47(4): 228-35, 2015 Apr.
Artículo en Español | MEDLINE | ID: mdl-25175910

RESUMEN

INTRODUCTION: The lack of patient knowledge about their medication is considered to be one of the main reasons for an inappropriate use. OBJECTIVE: This study the level of knowledge in patients about their prescribed antibiotic, and describes some of the factors related to this. DESIGN: A cross-sectional, descriptive and observational study with an analytical component. SITE: A community pharmacy in Murcia. METHODS: The study form was offered to all customers who arrived to obtain antibiotics while the study was taking place. A validated form was used to determined the level of knowledge was a validated form. RESULTS: A total of 126 patients, most of them women, with an average age of 44.6 years were included. Half of the study population had no knowledge which could ensure the correct use of the antibiotic they were taking. The «process of use¼ of the medication was the best known dimension by the study population, followed by the «therapeutic aim¼. The dimension related to the «safety¼ of the medication was the one with the lowest values. After a logistic regression, a link between the knowledge of the antibiotic and the «know the name of the antibiotic¼ (p=.05; r=2.15) and the «number of antibiotic the patient takes¼ (p=.02; r=0.30) variables. CONCLUSIONS: The results show that there is a certain lack of information on the use of antibiotics by the study sample. Thes results could help to show the way to follow in future studies, targeted to meet the need of information.


Asunto(s)
Antibacterianos , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Autoinforme , Adulto Joven
9.
Aten Primaria ; 47(3): 141-8, 2015 Mar.
Artículo en Español | MEDLINE | ID: mdl-25155895

RESUMEN

AIM: To compare health education (HE) and drug therapy monitoring (DTM) interventions in patients with cardiovascular risk factors (CVRF). DESIGN: Randomised experimental studys: 100 patients per group. SETTING: Playa-Miramar pharmacy (Valencia, Spain). March 2010-November 2011. PARTICIPANTS: Patients with one or more CVRF detected based on medication they were taking or questions they asked when drugs were dispensed. Patients were assigned to one of the two groups (HE or DTM) using a random number table. 100 patients by group were included. INTERVENTIONS: Six months of DTM (DTMG) or health education (HEG) per patient. MAIN MEASUREMENTS: The primary variables were modifiable CVRF: hypertension, dyslipidaemia, diabetes, smoking, obesity and low physical activity. Secondary variables were non modifiable CVRF (age, sex, cardiovascular disease), heart rate, body mass index, waist measurement, waist-to-hip ratio, waist-to-height ratio, body fat, treatment compliance. RESULTS: The differences in the reduction percentages were statistically greater in DTMG than in HEG for the following variables: systolic pressure 5.40% (p=0.001); heart rate 2.95%(p=0.015); weight 2.00% (p=0.002); BMI 2.24% (p=0.003); fasting glucose 8.65% (p=0.004); total cholesterol 6.45% (p=0.002); waist measurement 1.85% (p=0.010); and waist-to-height ratio 1.66% (p=0.002). Triglycerides and body fat were reduced by 12.78% (p<0.001) and 1.84% (p<0.001) more, respectively, in DTMG. These differences were not statistically significant. CONCLUSIONS: The reduction percentages were generally higher for all variables in DTMG except diastolic blood pressure, which decreased by 4.7% (P<.001) more in HEG because the baseline values were higher.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Monitoreo de Drogas , Educación en Salud , Servicios Comunitarios de Farmacia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo
10.
Farm Hosp ; 2024 Jun 17.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38890067

RESUMEN

Hospital pharmacy worldwide has proven to be a crucial element in healthcare. In Latin America, it draws inspiration from 2 main models: United States, which promoted clinical pharmacy and later pharmaceutical care, and Spain, which shares similar healthcare practices and the added advantage of a common language. Both models influenced the implementation of hospital pharmacy residencies in Argentina since the 1980s. Hospital pharmacy residencies in Argentina constitute a paid system of intensive postgraduate training on a full-time basis with exclusive dedication. They are carried out in 11 provinces across Argentina in services with recognized teaching experience. Currently, there are 46 locations with a total of 75 annual vacancies for applicants. The objective of hospital pharmacy residencies is to train pharmaceutical professionals with the necessary competencies to ensure the care of patients through the optimization of the safe, effective, and efficient use of medications and healthcare products tailored to each patient's individual therapy. Hospital pharmacy residencies have demonstrated that pharmacists acquire specialized training that can be decisive in influencing healthcare policies related to the safe use of medications and healthcare products. Therefore, actions to promote and encourage interest in this field among pharmaceutical professionals are necessary, involving scientific societies, universities, pharmaceutical associations, and the political sphere.

11.
Farm Hosp ; 2024 Apr 01.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38565424

RESUMEN

Hospital Pharmacy worldwide has proven to be a crucial element in healthcare. In Latin America, it draws inspiration from two main models: United States, which promoted clinical pharmacy and later pharmaceutical care, and Spain, which shares similar healthcare practices and the added advantage of a common language. Both models influenced the implementation of Hospital Pharmacy residencies in Argentina since the 1980s. Hospital Pharmacy residencies in Argentina constitute a paid system of intensive postgraduate training on a full-time basis with exclusive dedication. They are carried out in 11 provinces across Argentina in services with recognized teaching experience. Currently, there are 46 locations with a total of 75 annual vacancies for applicants. The objective of Hospital Pharmacy residencies is to train pharmaceutical professionals with the necessary competencies to ensure the care of patients through the optimization of the safe, effective, and efficient use of medications and healthcare products tailored to each patient's individual therapy. Hospital Pharmacy residencies have demonstrated that pharmacists acquire specialized training that can be decisive in influencing healthcare policies related to the safe use of medications and healthcare products. Therefore, actions to promote and encourage interest in this field among pharmaceutical professionals are necessary, involving scientific societies, universities, pharmaceutical associations, and the political sphere.

12.
Farm Hosp ; 48(3): T93-T100, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38480046

RESUMEN

OBJECTIVE: To describe a compounding training plan in a tertiary hospital pharmacy service. The project aimed pharmacy assistant technicians to use a digital training platform and simulation techniques. METHODS: Two training programs were designed, one for sterile and the other for non-sterile drugs. Each programme consists of several phases: a basic online training course (digital e-learning platform), a practical simulation workshop, a supervised practice in real conditions, and a final verification by the pharmacist to qualify the technician. Both programs include continuous and accredited evaluation by the hospital's Continued Education Commission. A satisfaction survey on training (e-lerning platform) was designed and conducted for pharmacy technicians (sterile and non-sterile). RESULTS: The project has been running for 3 years. Six specialist pharmacists from different areas involved in compounding are responsible for training and continuous evaluation. Twenty-one technicians have been trained, and nineteen have obtained qualifications. Two of them were found to be unfit. Currently, we employ13 pharmacy technicians who were initially trained. The participation rate in the satisfaction survey on training (e-learning platform) was 61.5% (n=8) out of a total number of current developers (n=13). Overall, 62.5% of technicians reported being satisfied or very satisfied, while the remaining 37.5% were indifferent. CONCLUSIONS: Compounding training program is currently in its third year. It has been crucial in delegating tasks to pharmacy technicians. The use of digital technology is essential in this training. We consider that, specific training in compounding, is indispensable and should be included in the academic plan for pharmacy technicians.


Asunto(s)
Composición de Medicamentos , Servicio de Farmacia en Hospital , Técnicos de Farmacia , Técnicos de Farmacia/educación , Humanos , Educación Continua en Farmacia
13.
J Healthc Qual Res ; 39(2): 65-79, 2024.
Artículo en Español | MEDLINE | ID: mdl-38160121

RESUMEN

INTRODUCTION AND OBJECTIVE: In 2015, the Spanish Society of Hospital Pharmacy (SEFH) launched the Strategic Map for Outpatient Pharmaceutical Care (MAPEX), with the purpose of adapting the activity offered in Hospital Pharmacy outpatient clinics to the new healthcare context. The aim of the present study was to analyse the evolution of outpatient pharmaceutical care in Hospital Pharmacy Services in Spain in the period 2016-2021 after the implementation and development of the MAPEX initiative. MATERIAL AND METHOD: The implementation and development of the project was carried out by a group of experts from SEFH and consisted of five phases: creation of the structure, consensus conference, situation analysis, development of strategic initiatives and evolutionary analysis. To analyse the evolutionary development, a specific 43-item questionnaire was developed that addressed aspects related to structure, context, integration, processes, outcomes and research and was answered in 2016 and 2021 (in the latter case by adding 3 additional questions). RESULTS: 141 hospitals participated in the status survey in 2016 and 138 in 2021. Significant differences were found in all dimensions analysed. None of the aspects assessed suffered a setback in this period. The most highly rated aspects at the general level were the improvement of the care model (65.0%) and at the local level, the incorporation of non-face-to-face pharmaceutical care (42.8%). Further progress in the coming years in the expansion and practical application of the methodology proposed in the project was considered a priority. CONCLUSIONS: The implementation and development of the MAPEX initiative has had a positive impact in terms of quality of care for outpatient pharmaceutical care in Hospital Pharmacy services in Spain.


Asunto(s)
Servicio de Farmacia en Hospital , Humanos , Pacientes Ambulatorios , España , Atención Ambulatoria , Atención a la Salud
14.
Farm Hosp ; 2024 Apr 24.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38664075

RESUMEN

OBJECTIVE: To prioritize the initiatives to be developed for the development of the Strategic Map of Outpatient Care (MAPEX) project to improve the quality of care and Pharmaceutical Care for patients seen in Hospital Pharmacy outpatient clinics in the period 2024-2027 in Spain. METHOD: The study was carried out in 4 phases between January and December 2023. For phase 1, a literature review of the evolution of the project was carried out by the coordinating committee with the aim of establishing a basis on which to define a new proposal for initiatives. In addition, an analysis was made of the health trends that will have an impact in the coming years. In phase 2, a working group of 19 specialists from all the autonomous communities was created, who were called regional ambassadors. They all made a preliminary proposal of initiatives and established revisions for their adjustment and final version both online and in telematic meetings. In phase 3, a consensus was established based on the Delphi-Rand/UCLA methodology with two rounds of online voting to select the initiatives classified as: priority and key or breakthrough. Between the first and second round of voting, a face-to-face "Consensus Conference" was held, where the results of the first round were presented. In phase 4, a public presentation was made in scientific forums and through the web. RESULTS: Ten trends in the health sector were identified. A list of 34 initiatives grouped into five lines of work was established. A total of 103 panelists participated in the first round and 76 in the second. Finally, five initiatives were established as priority and 29 as key. Among those prioritized were external visibility, adaptations to the CMO methodology, strengthening certification and improving training. CONCLUSIONS: The initiatives agreed upon as priorities were aimed at improving professional visibility, broadening the methodology of care work, expanding the quality of care, enhancing the training of professionals and the voice of patients.

15.
Farm Hosp ; 48(1): 38-44, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37696709

RESUMEN

OBJECTIVE: To analyze the role played by the clinical pharmacist and its impact in antibiotic stewardship facing suspected allergy to beta-lactam antibiotics. METHOD: We performed two different independent bibliographic searches. A total of 35 articles were found, and the final number included in the study was 12. We analysed the articles and collected variables of efficacy, safety and applicability of evaluation tools applied to patients with suspected allergy to beta-lactams. Also, the variation in the consumption and prescription profile of alternative antibiotics was analyzed. RESULTS: The selected studies analysed questionnaires, allergy delabeling, intradermal tests and oral challenge tests performed by pharmacists. Significant differences in the efficacy endpoint were found in 4 studies in favour of pharmaceutical intervention. In the study of Kwiatkowski et al, cefazolin use increased in surgical patients after pharmacist intervention (65 vs. 28%; p < 0.01). In a quasi-experimental study, the mean defined daily dose of aztreonam and the mean days of therapy per 1000 patients/day decreased (21.23 vs 9.05, p <0.01) and (8.79-4.24, p = 0.016), pre and post-intervention, respectively, increasing antibiotic de-escalations (p ≤ 0.01). In another quasi-experimental study, the prescription of restricted-use antibiotics decreased (42.5% vs. 17.9%, p < 0.01) and the use of pre-surgical prophylactic antibiotics alternative to cefazolin (81.9% vs 55.9%, p<0.01) in another study. Other study showed that the mean time per interview was 5.2 minutes per patient. No adverse events were reported in any study. CONCLUSION: The pharmacist intervention in the evaluation of the patient with suspected allergy to beta-lactams is effective, safe and feasible to implement on daily clinical practice. The standardization of protocols to clarify the history of allergies and development of evaluation tools represent simple screenings to perform delabelling or refer to the Immunoallergology service, improving penicilins use and reducing the need for second line antibiotics. More studies are needed to standardize the desensitization tests made by pharmacists. However, despite these results, the involvement and leadership of the pharmacist in this area is limited and constitutes a future challenge for the profession.


Asunto(s)
Hipersensibilidad a las Drogas , Hipersensibilidad , Humanos , beta-Lactamas/efectos adversos , Farmacéuticos , Cefazolina , Antibacterianos/efectos adversos , Hipersensibilidad a las Drogas/tratamiento farmacológico , Hipersensibilidad/tratamiento farmacológico , Penicilinas/efectos adversos
16.
Farm Hosp ; 48(1): T38-T44, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37953114

RESUMEN

OBJECTIVE: To analyze the role played by the clinical pharmacist and its impact in antibiotic stewardship facing suspected allergy to beta-lactam antibiotics. METHOD: We performed 2 different independent bibliographic searches. A total of 35 articles were found, and the final number included in the study was 12. We analyzed the articles and collected variables of efficacy, safety, and applicability of evaluation tools applied to patients with suspected allergy to beta-lactams. Also, the variation in the consumption and prescription profile of alternative antibiotics was analyzed. RESULTS: The selected studies analyzed questionnaires, allergy delabeling, intradermal tests, and oral challenge tests performed by pharmacists. Significant differences in the efficacy endpoint were found in 4 studies in favor of pharmaceutical intervention. In the study of Kwiatkowski et al., cefazolin use increased in surgical patients after pharmacist intervention (65% vs 28%; P < .01). In a quasi-experimental study, the mean defined daily dose of aztreonam and the mean days of therapy per 1000 patients/day decreased (21.23 vs 9.05, P <.01) and (8.79-4.24, P = .016), pre- and post-intervention, respectively, increasing antibiotic de-escalations (P = < .01). In another quasi-experimental study, the prescription of restricted use antibiotics decreased (42.5% vs 17.9%, P < .01)and the use of pre-surgical prophylactic antibiotics alternative to cefazolin (81.9% vs 55.9%, P < .01)in another study. Other study showed that the mean time per interview was 5.2 min per patient. No adverse events were reported in any study. CONCLUSION: The pharmacist intervention in the evaluation of the patient with suspected allergy to beta-lactams is effective, safe, and feasible to implement on daily clinical practice. The standardization of protocols to clarify the history of allergies and development of evaluation tools represent simple screenings to perform delabeling or refer to the Immunoallergology service, improving penicilins use and reducing the need for second-line antibiotics. More studies are needed to standardize the desensitization tests made by pharmacists. However, despite these results, the involvement and leadership of the pharmacist in this area is limited and constitutes a future challenge for the profession.


Asunto(s)
Hipersensibilidad a las Drogas , Hipersensibilidad , Humanos , beta-Lactamas/efectos adversos , Farmacéuticos , Cefazolina , Antibacterianos/efectos adversos , Hipersensibilidad a las Drogas/tratamiento farmacológico , Hipersensibilidad/tratamiento farmacológico , Penicilinas/efectos adversos
17.
Artículo en Inglés | MEDLINE | ID: mdl-38184070

RESUMEN

AIM: To assess the radiopharmacist's role in a multidisciplinary team focused on the contraindications of regadenoson in order to ensure the safe use of pharmacologic vasodilator stress agents in patients undergoing SPECT-MPI. METHODS: We ambispectively studied its safe use in 1905 patients (54.1% female, mean age: 66.6±11.7 years, range: 20-95 years). Sex, age, medical history, medications, drug allergies, and contraindications for stress testing were registered together with recommendations for the nuclear physician in charge. RESULTS: Detected contraindications and corresponding recommendations were as follows: risk factors for QTc interval prolongation 7.5% - measurement of QTc interval previously to test and monitor ECG; prior stroke or TIA 4.2% - consider carotid stenosis assessment; salicylates/sulfonamides allergy 3.1% - use 99mTc-sestamibi; epilepsy or risk factors for seizures 2.4% - use of adenosine or reconsider test indication; systemic corticosteroid therapy for severe COPD 1.3% - reassessment of patient's condition; acute exacerbation of COPD 0.8% - defer test until acute episode is over; severe asthma 0.4% - do not perform test; methylxanthine ingestion 0.3% - avoid consumption previously; other 6.1% - evaluation of other contraindications. No contraindications were detected in 73.6% of patients. The test was canceled due to absolute contraindications in 2.9% of the requests. CONCLUSIONS: Working in a systematic way, the radiopharmacist was able to detect a high number of issues related to regadenoson, with one out of four patients presenting some clinical contraindication. The recommendations given by the radiopharmacist were well accepted by the nuclear physicians who changed their approach contributing to increase the safety of patients referred for MPI.


Asunto(s)
Imagen de Perfusión Miocárdica , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Femenino , Persona de Mediana Edad , Anciano , Masculino , Vasodilatadores/efectos adversos , Imagen de Perfusión Miocárdica/métodos , Seguridad del Paciente , Tomografía Computarizada de Emisión de Fotón Único/métodos , Enfermedad Pulmonar Obstructiva Crónica/inducido químicamente
18.
Farm Hosp ; 48(2): 64-69, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37749003

RESUMEN

OBJECTIVE: Analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between the years 2016 and 2021. METHODS: A committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching and investigation. It was carried out in two periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. RESULTS: 141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialization of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). CONCLUSIONS: The implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement, as well as those areas to be developed through strengthening and corrective actions. The expansion of the project in the coming years will mean progress towards excellence in care and in the improvement of health results.


Asunto(s)
Pacientes Ambulatorios , Servicio de Farmacia en Hospital , Humanos , España , Atención Ambulatoria , Atención a la Salud
19.
Farm Hosp ; 2024 Jun 25.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38926025

RESUMEN

The article examines the impact of artificial intelligence on scientific writing, with a particular focus on its application in hospital pharmacy. It analyzes artificial intelligence tools that enhance information retrieval, literature analysis, writing quality, and manuscript drafting. Chatbots like Consensus, along with platforms such as Scite and SciSpace, enable precise searches in scientific databases, providing evidence-based responses and references. SciSpace facilitates the generation of comparative tables and the formulation of queries regarding studies, while ResearchRabbit maps the scientific literature to identify trends. Tools like DeepL and ProWritingAid improve writing quality by correcting grammatical, stylistic, and plagiarism errors. A.R.I.A. enhances reference management, and Jenny AI assists in overcoming writer's block. Python libraries such as LangChain enable advanced semantic searches and the creation of agents. Despite their benefits, artificial intelligence raises ethical concerns including biases, misinformation, and plagiarism. The importance of responsible use and critical review by experts is emphasized. In hospital pharmacy, artificial intelligence can enhance efficiency and precision in research and scientific communication. Pharmacists can use these tools to stay updated, enhance the quality of their publications, optimize information management, and facilitate clinical decision-making. In conclusion, artificial intelligence is a powerful tool for hospital pharmacy, provided it is used responsibly and ethically.

20.
Farm Hosp ; 48(4): 180-184, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38458852

RESUMEN

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, "Guía de entrevista telemática en atención farmacéutica," as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews. The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment. Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care.


Asunto(s)
Servicio de Farmacia en Hospital , Telemedicina , Humanos , Servicio de Farmacia en Hospital/organización & administración , Entrevistas como Asunto , Consenso , Monitoreo de Drogas/métodos , Sistemas de Liberación de Medicamentos , Farmacéuticos
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