Competencias profesionales del farmacólogo en farmacoepidemiología / The pharmacologist's professional competences in pharmacoepidemiology

Introducción: Los retos y las exigencias del mundo contemporáneo requieren de profesionales de la salud con una formación académica basada en competencias. La especialidad de Farmacología en Cuba no ha definido sus competencias profesionales. Objetivo: Definir las competencias profesionales de los especialistas en Farmacología para su desempeño como farmacoepidemiólogos. Métodos: Estudio de desarrollo en el que se obtuvieron las competencias profesionales genéricas y específicas que los especialistas en Farmacología debían alcanzar para desempeñarse como farmacoepidemiólogos. El trabajo se realizó en La Habana entre marzo de 2018 y febrero de 2019. Se aplicaron técnicas cualitativas y revisiones documentales sobre las temáticas relacionadas con el objeto de la investigación. Se trabajó con dos grupos de expertos en dos etapas. Se empleó la metodología Delphi. Resultados: Se construyeron 24 competencias, genéricas y específicas, de las áreas funcionales asistencial, investigativa, docente y gerencial, que los especialistas en Farmacología debían alcanzar para desempeñarse como farmacoepidemiólogos. Conclusiones: Las competencias definidas permiten al farmacoepidemiólogo lograr un uso racional de los medicamentos, lo cual tributa a su propósito clave: una atención de calidad durante el proceso salud-enfermedad(AU)

Introduction: The challenges and demands of the contemporary world require health professionals with competency-based academic training. The specialty of pharmacology in Cuba has not defined its professional competencies. Objective: To define the professional competences of pharmacology specialists for their performance as pharmacoepidemiologists. Methods: Development study that allowed obtaining the generic and specific professional competences that pharmacology specialists should reach to practice as pharmacoepidemiologists. The work was carried out in Havana between March 2018 and February 2019. Qualitative techniques were applied, together with documental reviews on the topics related to the research object. Two groups of experts participated in the work during two stages. The Delphi methodology was used. Results: Twenty-four competencies, either generic or specific, were determined, belonging to the functional areas of care, research, teaching and management, which pharmacology specialists should achieve to practice as pharmacoepidemiologists. Conclusions: The competencies defined allow the pharmacoepidemiologist to achieve a rational use of drugs, which contributes to the key purpose of the specialized profession: quality care during the health-disease process(AU)

Satisfacción de los alumnos de la maestría de Farmacoepidemiología con el uso del aula virtual / Satisfaction of the students of the Master Course in Pharmacoepidemiology with the use of the virtual classroom

Introducción: la maestría de Farmacoepidemiología de la Escuela Nacional de Salud Pública utiliza el aula virtual como apoyo a la docencia presencial; no se conoce la opinión que los maestrantes tienen sobre su utilidad, esto importante porque refleja la eficiencia de la estrategia docente. Objetivo: valorar la satisfacción de los alumnos de la maestría de Farmacoepidemiología con el uso del aula virtual. Métodos: se realizó un estudio exploratorio de corte transversal, en los meses de julio-agosto de 2015; el universo estuvo constituido por 49 alumnos, alumnos egresados de la segunda edición y de la edición en curso de la maestría; se midió la satisfacción con el aula virtual, expresada en alta o baja según respuestas a una encuesta aplicada. Resultados: se observó predominio de la respuesta "el acceso a la plataforma virtual es normal" (38,8 por ciento); 46,0 por ciento consideró útil la fase no presencial de los cursos; 77,6 por ciento calificó adecuado el tiempo dedicado a actividades en el aula virtual; 57,1 por ciento accede más desde su centro de trabajo al aula virtual y la mayoría (61,2 %) prefiere que los cursos se desarrollen con el apoyo del aula virtual; todo esto llevó a valorar la satisfacción de los alumnos con el aula virtual como alta en 51,0 por ciento. Conclusiones: a pesar que la mayoría de los alumnos de la Maestría de Farmacoepidemiología refirieron alta satisfacción con el aula virtual como apoyo a la docencia presencial, una buena parte de ellos no está satisfecho; es necesario profundizar en el tema en investigaciones futuras(AU)

Introduction: The Master Course in Pharmacoepidemiology of the National School of Public Health uses the virtual classroom in support of on-site teaching; the students' opinion about its usefulness is not known, which is important because it reflects the efficiency of the teaching strategy. Objective: To evaluate the satisfaction of the students of the Master Course in Pharmacoepidemiology with the use of the virtual classroom. Methods: An exploratory cross-sectional study was carried out in July-August 2015; the universe was made up by 49 students, who graduated in the second edition and the current edition of the Master Course; we measured satisfaction with the virtual classroom, expressed as high or low according to responses to an applied survey. Results: The predominance of the response was "access to the virtual platform is normal" (38.8 percent); 46.0 percent considered the distance phase of the courses useful; 77.6 percent qualified the time dedicated to activities in the virtual classroom; 57.1 percent access more from their work centers to the virtual classroom, and most of them (61.2 percent) prefer that the courses be developed with the support of the virtual classroom; all this led to assess the satisfaction of students with the virtual classroom as high, with 51.0 percent. Conclusions: Although most students of the Master Course in Pharmacoepidemiology reported high satisfaction with the virtual classroom as a support for on-site teaching, a fair number of them are not satisfied; it is necessary to go deeper into the subject in future research(AU)

Satisfacción de los alumnos de la maestría de Farmacoepidemiología con el uso del aula virtual / Satisfaction of the students of the Master Course in Pharmacoepidemiology with the use of the virtual classroom

Introducción: la maestría de Farmacoepidemiología de la Escuela Nacional de Salud Pública utiliza el aula virtual como apoyo a la docencia presencial; no se conoce la opinión que los maestrantes tienen sobre su utilidad, esto importante porque refleja la eficiencia de la estrategia docente. Objetivo: valorar la satisfacción de los alumnos de la maestría de Farmacoepidemiología con el uso del aula virtual. Métodos: se realizó un estudio exploratorio de corte transversal, en los meses de julio-agosto de 2015; el universo estuvo constituido por 49 alumnos, alumnos egresados de la segunda edición y de la edición en curso de la maestría; se midió la satisfacción con el aula virtual, expresada en alta o baja según respuestas a una encuesta aplicada. Resultados: se observó predominio de la respuesta "el acceso a la plataforma virtual es normal" (38,8 por ciento); 46,0 por ciento consideró útil la fase no presencial de los cursos; 77,6 por ciento calificó adecuado el tiempo dedicado a actividades en el aula virtual; 57,1 por ciento accede más desde su centro de trabajo al aula virtual y la mayoría (61,2 %) prefiere que los cursos se desarrollen con el apoyo del aula virtual; todo esto llevó a valorar la satisfacción de los alumnos con el aula virtual como alta en 51,0 por ciento. Conclusiones: a pesar que la mayoría de los alumnos de la Maestría de Farmacoepidemiología refirieron alta satisfacción con el aula virtual como apoyo a la docencia presencial, una buena parte de ellos no está satisfecho; es necesario profundizar en el tema en investigaciones futuras(AU)

Introduction: The Master Course in Pharmacoepidemiology of the National School of Public Health uses the virtual classroom in support of on-site teaching; the students' opinion about its usefulness is not known, which is important because it reflects the efficiency of the teaching strategy. Objective: To evaluate the satisfaction of the students of the Master Course in Pharmacoepidemiology with the use of the virtual classroom. Methods: An exploratory cross-sectional study was carried out in July-August 2015; the universe was made up by 49 students, who graduated in the second edition and the current edition of the Master Course; we measured satisfaction with the virtual classroom, expressed as high or low according to responses to an applied survey. Results: The predominance of the response was "access to the virtual platform is normal" (38.8 percent); 46.0 percent considered the distance phase of the courses useful; 77.6 percent qualified the time dedicated to activities in the virtual classroom; 57.1 percent access more from their work centers to the virtual classroom, and most of them (61.2 percent) prefer that the courses be developed with the support of the virtual classroom; all this led to assess the satisfaction of students with the virtual classroom as high, with 51.0 percent. Conclusions: Although most students of the Master Course in Pharmacoepidemiology reported high satisfaction with the virtual classroom as a support for on-site teaching, a fair number of them are not satisfied; it is necessary to go deeper into the subject in future research(AU)

Farmacovigilancia en el programa de Farmacología de la carrera de Medicina / Pharmacovigilance in the program of Pharmacology of Medicine pre-grade studies

Introducción: la Farmacología como ciencia es muy amplia, y comprende todos los aspectos relacionados con los fármacos o medicamentos. Constituye el sustento científico de la terapéutica que se imparte en todas las asignaturas clínicas. Objetivo: identificar los contenidos de farmacovigilancia en el programa de la asignatura de Farmacología en la carrera de Medicina. Materiales y Métodos: estudio descriptivo transversal que constató la presencia de la farmacovigilancia en el programa de Farmacología de la carrera de Medicina. Se aplicó una metodología propuesta para el análisis documental. Resultados: el análisis de los documentos arrojó que en los objetivos educativos de la Farmacología se encuentra: desarrollar una concepción, conducta y actuación que contribuyan a la educación en el uso racional y científico de los medicamentos, en todos los niveles de atención de la salud con énfasis en la primaria. Se incluyen los principales grupos de sustancias tendentes a ocasionar dependencia en el hombre, así como la aplicación de los conocimientos sobre las bases farmacológicas de la dependencia o adicción. Se constató la existencia de ejemplos de plantas medicinales y medicamentos herbarios que pueden producir reacciones adversas o interacciones con medicamentos. Conclusiones: los estudiantes de Medicina deben recibir formación sobre los principios de la prescripción racional antes de participar en la asistencia médica. Incorporar el estudio de la seguridad de los medicamentos desde la óptica del consumo, puede traducirse tanto en términos beneficiosos como perjudiciales, esta última condición se refleja en las reacciones adversas que pueden aparecer siempre que haya exposición a un fármaco (AU).

Introduction: Pharmacology is very wide as a science, and includes all the aspects related with the drugs or medications. It is the scientific support of the therapeutics that is taught in all the clinical subjects. Objective: to identify the pharmacovigilance contents in the program of the subject Pharmacology in the Medicine pre-grade studies. Materials and Methods: descriptive, cross-sectional study stating the presence of pharmacovigilance in the Pharmacology program of the Medicine pre-grade studies. A methodology proposed for the documental analysis was used. Results: the documental analysis showed that among the Pharmacology educative aims are: to develop a conception, behaviour and performance contributing to the training in the rational and scientific use of medications in all the levels of the health care, with emphasis in the primary one. There are included the main groups of substances tending to create dependence in people, and also the application of the knowledge on the pharmacological bases of dependence and addiction. It was stated the existence of medicinal plants and herbal medicines that could produce adverse reactions or interactions with medications. Conclusions: Medicine students should be trained on the principles of rational prescription before participating in medical care. Studying medications security from the point of view of their consumption may have both, beneficial and harmful effect. The last ones reveals in adverse reactions that may appear always when there is exposition to a medication (AU).

Farmacovigilancia en el programa de Farmacología de la carrera de Medicina / Pharmacovigilance in the program of Pharmacology of Medicine pre-grade studies

Introducción: la Farmacología como ciencia es muy amplia, y comprende todos los aspectos relacionados con los fármacos o medicamentos. Constituye el sustento científico de la terapéutica que se imparte en todas las asignaturas clínicas. Objetivo: identificar los contenidos de farmacovigilancia en el programa de la asignatura de Farmacología en la carrera de Medicina. Materiales y Métodos: estudio descriptivo transversal que constató la presencia de la farmacovigilancia en el programa de Farmacología de la carrera de Medicina. Se aplicó una metodología propuesta para el análisis documental. Resultados: el análisis de los documentos arrojó que en los objetivos educativos de la Farmacología se encuentra: desarrollar una concepción, conducta y actuación que contribuyan a la educación en el uso racional y científico de los medicamentos, en todos los niveles de atención de la salud con énfasis en la primaria. Se incluyen los principales grupos de sustancias tendentes a ocasionar dependencia en el hombre, así como la aplicación de los conocimientos sobre las bases farmacológicas de la dependencia o adicción. Se constató la existencia de ejemplos de plantas medicinales y medicamentos herbarios que pueden producir reacciones adversas o interacciones con medicamentos. Conclusiones: los estudiantes de Medicina deben recibir formación sobre los principios de la prescripción racional antes de participar en la asistencia médica. Incorporar el estudio de la seguridad de los medicamentos desde la óptica del consumo, puede traducirse tanto en términos beneficiosos como perjudiciales, esta última condición se refleja en las reacciones adversas que pueden aparecer siempre que haya exposición a un fármaco (AU).

Introduction: Pharmacology is very wide as a science, and includes all the aspects related with the drugs or medications. It is the scientific support of the therapeutics that is taught in all the clinical subjects. Objective: to identify the pharmacovigilance contents in the program of the subject Pharmacology in the Medicine pre-grade studies. Materials and Methods: descriptive, cross-sectional study stating the presence of pharmacovigilance in the Pharmacology program of the Medicine pre-grade studies. A methodology proposed for the documental analysis was used. Results: the documental analysis showed that among the Pharmacology educative aims are: to develop a conception, behaviour and performance contributing to the training in the rational and scientific use of medications in all the levels of the health care, with emphasis in the primary one. There are included the main groups of substances tending to create dependence in people, and also the application of the knowledge on the pharmacological bases of dependence and addiction. It was stated the existence of medicinal plants and herbal medicines that could produce adverse reactions or interactions with medications. Conclusions: Medicine students should be trained on the principles of rational prescription before participating in medical care. Studying medications security from the point of view of their consumption may have both, beneficial and harmful effect. The last ones reveals in adverse reactions that may appear always when there is exposition to a medication (AU).

Crítica al programa de estudio del curso de Promoción de uso racional de medicamentos de la maestría de farmacoepidemiología / Critic to the syllabus of the course Promotion of medicine rational use of the Masters course in Pharmacoepidemiology

Introducción: la Educación Médica cubana ante la demanda de formar los recursos humanos que la sociedad necesita, precisa de contar con un currículo creativo y flexible. Objetivo: analizar el programa del curso Promoción de uso racional de medicamentos contenido en el programa de la Maestría de Farmacoepidemiología de la Escuela Nacional de Salud Pública. Métodos: se realizó un trabajo en el campo de la educación médica específicamente el diseño curricular, se tomó como unidad de análisis el curso: Promoción de uso racional de medicamentos de la Maestría de Farmacoepidemiología. Se estudió la pertinencia y nexo con el currículo, la ubicación del curso, el proceso enseñanza aprendizaje y la bibliografía. Resultados: el programa analizado tributa al perfil del egresado declarado en la maestría, que está dirigido a formar y brindar los conocimientos, hábitos y habilidades necesarios para dar solución a los principales problemas con los que se enfrenta la atención primaria de salud. Se identificaron áreas de mejora en el diseño de los objetivos y se hicieron propuestas, así como la necesidad de actualización de la bibliografía declarada. Conclusiones: se determinaron los principales problemas en su diseño y se proponen modificaciones del programa con vista a su perfeccionamiento(AU)

Introduction: Cuban medical education facing the demand for training human resources required by the society, need to have a creative and flexible syllabus. Objective: To analyze the syllabus of the course Promotion of medicine rational use of the Master's course in Pharmacoepidemiology of the National School of Public Health. Methods: A work in the field of medical education was carried out specifically regarding syllabus design. The course Promotion of medicine rational use of the Master's course in Pharmacoepidemiology was taken as unit of analysis. Pertinence and link to the syllabus was studies, together with the teaching-learning process and the bibliography. Results: The syllabus analyzed contributes with the graduate's working profile as declared in the master's degree course, directed to training and providing knowledge, habits and skills necessary for giving solution to the main problems faced by primary health care. Improvement areas were indentifies regarding the design of the objectives and proposals were made, together with the update necessity concerning the bibliography declared. Conclusions: The main problems in its design were determined and modifications were proposed to the program for its improvement(AU)

Pharmacoepidemiology at Nordic School of Public Health NHV: Examples from 1999 to 2014.

BACKGROUND: Pharmacoepidemiology is a branch of public health and had a place at the Nordic School of Public Health. Courses, Master's theses and Doctorates of Public Health (DrPH) in Pharmacoepidemiology were a relatively minor, but still important part of the school's activities. METHODS: This paper gives a short background, followed by some snapshots of the activities at NHV, and then some illustrative case-studies. These case-studies list their own responsible co-authors and have separate reference lists. RESULTS: In the Nordic context, NHV was a unique provider of training and research in pharmacoepidemiology, with single courses to complete DrPH training, as well as implementation of externally-funded research projects. CONCLUSIONS: With the closure of NHV at the end of 2014, it is unclear if such a comprehensive approach towards pharmacoepidemiology will be found elsewhere in the Nordic countries.

Pharmacovigilance teaching in UK undergraduate pharmacy programmes.

PURPOSE: Pharmacists in the UK are able to report spontaneous adverse drug reactions (ADRs) to the Medicines and Healthcare Products Regulatory Authority. The level of reporting by UK pharmacists remains low. This could be explained by poor knowledge of ADR reporting. The primary objective of this study was to investigate the level of pharmacovigilance education provided to pharmacy students on undergraduate pharmacy programmes in the UK. METHODS: A cross-sectional survey was used to obtain data relating to the teaching of pharmacovigilance within schools of pharmacy. The survey was designed to reveal whether core elements pertinent to pharmacovigilance and specifically to spontaneous reporting were taught and to what extent. RESULTS: All of the respondents taught pharmacovigilance within an assessed compulsory module. A small number (23%) did not include pharmacovigilance law within their syllabus. In 54%, the amount of time devoted to teaching pharmacy students about their role in pharmacovigilance was less than 4 h in the 4-year course; only one respondent spent approximately 20 h, the remaining respondents (38%) spent between 4 and 8 h. CONCLUSIONS: The amount of time dedicated to the teaching of pharmacovigilance on pharmacy undergraduate degree programmes is low. Considering the importance of spontaneous reporting in drug safety and the shift in the role of the pharmacists, more time may need to be devoted to pharmacovigilance on pharmacy undergraduate courses. By doing so, new pharmacists would be more informed of the important role they play in drug safety and thereby potentially help enhance the level of ADR reporting.

La evidencia científica y la intervención farmacológica preventiva en geriatría / Scientific evidence and preventive pharmacological intervention in geriatrics

Los adultos mayores constituyen un grupo poblacional que cada día va en aumento, y son ellos los que requieren mayor atención médica y los que consumen un número elevado de fármacos. Este trabajo intenta hacer una revisión sobre la prescripción de fármacos con fines preventivos en el adulto mayor según las evidencias científicas. La polifarmacia en el anciano incrementa las posibilidades de reacciones adversas a los medicamentos, interacciones entre ellos potencialmente deletéreas, aumento de los ingresos hospitalarios por esta causa y aumento de los gastos en salud. Los fármacos constituyen la primera fuente de trastornos yatrogénicos en los ancianos, atribuible a que muchas veces se indican de forma irracional y se aplican malas prácticas de prescripción sin un sustento científico sólido. Se espera contribuir a que el médico desarrolle la habilidad de prescribir el fármaco de manera eficaz, conveniente, con prudencia clínica y distancie las recomendaciones sesgadas del mercado en términos de terapéutica. Es importante mejorar la prescripción farmacológica en aras de una mejor calidad de vida en el adulto mayor(AU)

The older adults are a population group that increases every day and they require more medical care and consume a large number of drugs. This paper was intended to make a review on drug prescription for preventive purposes in the elderly on the basis of scientific evidence. The multiple drug consumption by the elderly increases the possibilities of suffering adverse reactions to drugs, potentially deleterious interactions, rise of admissions at hospital due to this problem and higher health expenses. The drugs are the first source of iatrogenic disorders in the aged people, often attributable to irrational and wrong practices of prescription without any sound scientific support. This paper was expected to contribute to developing the skill of prescribing a drug in an effective, convenient and prudent way, thus paying little attention to the market-biased recommendations in terms of therapeutics. It is important to improve drug prescription towards a better quality of life for the older people(AU)

La evidencia científica y la intervención farmacológica preventiva en geriatría / Scientific evidence and preventive pharmacological intervention in geriatrics

Los adultos mayores constituyen un grupo poblacional que cada día va en aumento, y son ellos los que requieren mayor atención médica y los que consumen un número elevado de fármacos. Este trabajo intenta hacer una revisión sobre la prescripción de fármacos con fines preventivos en el adulto mayor según las evidencias científicas. La polifarmacia en el anciano incrementa las posibilidades de reacciones adversas a los medicamentos, interacciones entre ellos potencialmente deletéreas, aumento de los ingresos hospitalarios por esta causa y aumento de los gastos en salud. Los fármacos constituyen la primera fuente de trastornos yatrogénicos en los ancianos, atribuible a que muchas veces se indican de forma irracional y se aplican malas prácticas de prescripción sin un sustento científico sólido. Se espera contribuir a que el médico desarrolle la habilidad de prescribir el fármaco de manera eficaz, conveniente, con prudencia clínica y distancie las recomendaciones sesgadas del mercado en términos de terapéutica. Es importante mejorar la prescripción farmacológica en aras de una mejor calidad de vida en el adulto mayor

The older adults are a population group that increases every day and they require more medical care and consume a large number of drugs. This paper was intended to make a review on drug prescription for preventive purposes in the elderly on the basis of scientific evidence. The multiple drug consumption by the elderly increases the possibilities of suffering adverse reactions to drugs, potentially deleterious interactions, rise of admissions at hospital due to this problem and higher health expenses. The drugs are the first source of iatrogenic disorders in the aged people, often attributable to irrational and wrong practices of prescription without any sound scientific support. This paper was expected to contribute to developing the skill of prescribing a drug in an effective, convenient and prudent way, thus paying little attention to the market-biased recommendations in terms of therapeutics. It is important to improve drug prescription towards a better quality of life for the older people

[Rational antibiotic prescribing. Challenges and successes]. / Rationale Antibiotikaverordnung. Mehr Herausforderungen als Erfolge.

Rational and prudent antibiotic prescribing strategies are important both for the hospital sector as well as for ambulatory medicine. Prerequisites are the availability of antibiotic use and antibiotic resistance data and of infrastructure and trained personnel needed for implementing and evaluating antibiotic policies. Currently, these requirements are not being met sufficiently in Germany. A major challenge in this country is the lack of adequately trained and experienced personnel. On the other hand there are several projects and initiatives supported in part within the national antibiotic resistance control program which have produced some progress and success. One example is GERMAP, the national antibiotic use and resistance atlas covering both human medicine and the veterinary field. Other examples are the recently improved program for continuous hospital antibiotic use, surveillance and feedback and the Antibiotic Stewardship (ABS) training program with establishment of an ABS expert network. Future perspectives include programs for evaluation of practice guideline adherence and the development and evaluation of quality of care indicators. Intermediate and long-term investment is needed in specialty training and certification of a sufficient number of infectious disease physicians, medical microbiologists and infection control doctors/hospital epidemiologists and hospital pharmacists.

Curricular considerations for pharmaceutical comparative effectiveness research.

In the U.S. pharmacoepidemiology and related health professions can potentially flourish with the congressional appropriation of $1.1 billion of federal funding for comparative effectiveness research (CER). A direct result of this legislation will be the need for sufficient numbers of trained scientists and decision-makers to address the research and implementation associated with CER. An interdisciplinary expert panel comprised mostly of professionals with pharmaceutical interests was convened to examine the knowledge, skills, and abilities to be considered in the development of a CER curriculum for the health professions focusing predominantly on pharmaceuticals. A limitation of the panel's composition was that it did not represent the breadth of comparative effectiveness research, which additionally includes devices, services, diagnostics, behavioral treatments, and delivery system changes. This bias affects the generalizability of these findings. Notwithstanding, important components of the curriculum identified by the panel included study design considerations and understanding the strengths and limitations of data sources. Important skills and abilities included methods for adjustment of differences in comparator group characteristics to control confounding and bias, data management skills, and clinical skills and insights into the relevance of comparisons. Most of the knowledge, skills, and abilities identified by the panel were consistent with the training of pharmacoepidemiologists. While comparative effectiveness is broader than the pharmaceutical sciences, pharmacoepidemiologists have much to offer academic and professional CER training programs. As such, pharmacoepidemiologists should have a central role in curricular design and provision of the necessary training for needed comparative effectiveness researchers within the realm of pharmaceutical sciences.

Describen el nivel de conocimiento acerca del sistema de farmacovigilancia / Description of levels of knowledge on the pharmacovigilance system

Se demuestra la necesidad de continuar con el fomento de la comprensión y la enseñanza de la farmacovigilancia, así como la formación clínica en la materia y una comunicación eficaz dirigida a los profesionales de la salud y a la opinión pública en general.

New postgraduate qualifications in pharmacovigilance from the Drug Safety Research Unit in the UK.

The Drug Safety Research Unit in the UK has recently launched new postgraduate certificate, diploma and masters courses in pharmacovigilance, in association with the University of Portsmouth. These courses have been developed to address the continuing demand for quality accredited education in pharmacovigilance and are aimed particularly at drug safety staff working in the pharmaceutical industry, regulatory bodies or academia. Flexibility is ensured by the availability of a wide choice of units, the use of online facilities for learning and assessment, and the possibility that previous relevant training or experience may be counted towards the awards.

Public pharmacovigilance communication: a process calling for evidence-based, objective-driven strategies.

As a contribution to the debate on how best to communicate information on the effective and safe use of medicines to patients, healthcare professionals and the general public, this article proposes to distinguish between communication and transparency purposes, and to test a strategic health communication approach. Any organization aiming to improve medicines use could adapt this approach to its remits and legal obligations. The approach includes agreeing measurable communication objectives through shared problem ownership of all concerned parties, evidence-based design and a cyclic process for planning, implementation and evaluation of communication as a public health intervention. The evidence base, which supplements risk assessment for product- and situation-specific communication on safety concerns, would be derived from research into drug utilization, medical decision making and risk perception, as well as from the participation of patients and healthcare professionals. It is crucial to address the practical questions and concerns of medicine users and to find out why unfavourable patterns of medicine use persist, in order to develop behaviour change models for overcoming these obstacles. For this purpose, appropriate models for facilitating the participation of medicine users in the risk management process will need to be explored. Such two-way communication would inform risk assessment as well as the analysis of risk minimization options, allow for agreement upon communication objectives and enable understandable, attractive communication materials to be designed. The communication programme should use mixed media and repetition of messages for long-term success. This would require cooperation within healthcare and medical information systems. An evaluation of the effectiveness of the communication should support the sustainability of the programme and provide lessons for the future. Given its mission, the pharmacovigilance community has the standing and duty to expand its scale of action and take the initiative in advancing risk management through a scientific approach to improving public communication for the safety of patients.

Indicadores do uso racional de medicamentos em ambulatório-escola / Indicators of rational use of drugs in school ambulatory care

Introdução: O uso inadequado de medicamentos é um problema de Saúde Pública prevalente em todo o mundo e pode causar danos à saúde da população. A OMS estabeleceu indicadores do uso racional de medicamentos com o objetivo de minimizar os erros relativos ao ato da prescrição. Metodologia: Foi realizado um estudo transversal prospectivo no Ambulatório Central da Faculdade de Medicina de Passo Fundo/RS, entre agosto e novembro de 2006. Foram avaliados os indicadores do uso racional de medicamentos: número médio de medicamentos por receita; porcentagem de medicamentos receitados por seu nome genérico; porcentagem de prescrições contendo antimicrobiano; porcentagem de prescrições com medicamentos injetáveis e porcentagem de medicamentos receitados que constam na lista de medicamentos essenciais (RENAME e REMUME). Resultados: Foram prescritos 1.430 medicamentos e em média 2,62 ±1,80 medicamentos por prescrição. Dos medicamentos, 18,1% eram antimicrobianos e 9,2% eram injetáveis. Dos medicamentos prescritos, 84,8% pertenciam à RENAME e 77,3% à REMUME. Foram prescritos 86,2% dos medicamentos pela denominação genérica. Conclusões: Em relação aos indicadores do uso racional de medicamentos, pode-se observar que a maioria das receitas continha medicamentos da REMUME, que foram prescritos pela denominação genérica e que o número de antimicrobianos e medicamentos injetáveis foi abaixo daqueles indicados por outros estudos. O número médio de medicamentos por prescrição foi maior que o recomendado pela OMS. Entretanto, as outras variáveis foram consideradas adequadas.

Introduction: The inadequate use of medication is a public health issue that is prevalent all over the world and is a threat to the health of the population. The WHO has established indicators of the rational use of medical drugs in order to minimize errors concerning drug prescription. Methods: A prospective transversal study was performed in the Outpatient Center of the Medical School of Passo Fundo-RS from Aug to November 2006. The following indicators of the rational use of medication were assessed: mean number of drugs per prescription; percentage of drugs prescribed by their generic name; percentage of prescriptions containing antimicrobials; percentage of prescriptions of injectable drugs, and percentage of prescribed drugs that are present in the essential medicines lists (RENAME and REMUME). Results: A total of 1,430 drugs were prescribed, with a mean 2.62 ±1.80 drugs per prescription. Of these,18.1% were antimicrobials and 9.2 % were injectable. Of the prescribed drugs, 84.8% were in the RENAME and 77.3% were in the REMUME. 86.2% of the drugs were prescribed by their generic name. Conclusions: Concerning the indicators of the rational use of medication, most of the prescriptions hadREMUME drugs, were prescribed by their generic name, and the number of antimicrobials and injectable substances was below the one reported in other studies. The mean number of drugs by prescription was greater than that recommended by the WHO. However, the other variables were considered appropriate.

Tratamiento de la diarrea: manual clínico para los servicios de salud / Diarrhea treatment: clinical manual for the health services

Este manual hace énfasis en el enfoque de atención integral basada en el estado de salud del niño y niña y no en la enfermedad, presentando en especial las prácticas comunitarias para el crecimiento, desarrollo y la supervivencia infantil. Está dirigido a estudiantes y profesionales de medicina, pediatría, nutrición y enfermería, y espera contribuir en la difusión de conocimientos sobre el control de enfermedades diarreicas en el contexto de la atención de las enfermedades prevalentes de la infancia.