Estudio de la adherencia al tratamiento en pacientes con la enfermedad de Parkinson desde la farmacia comunitaria y las asociaciones de Parkinson de la Región de Murcia / Study of the treatment adherence in patients with Parkinson's disease from the community pharmacy and the Parkinson associations from the Region of Murcia

Introducción: La falta de adherencia al tratamiento farmacológico es uno de los principales problemas en pacientes con enfermedades crónicas. Una falta de adherencia se relaciona con un aumento de la discapacidad y de los costes sanitarios. El objeti-vo principal de este artículo es conocer el grado de adherencia al tratamiento en pacientes con la enfermedad de Parkinson. Método: se ha realizado un estudio observacional, longitudinal y prospectivo en colaboración con la Federación de Asociaciones de Parkinson de la Región de Murcia (FEPAMUR) y farmacias colabo-radoras de la Región de Murcia. Se llevó a cabo un procedimiento de recogida de datos demográficos del paciente (sexo y edad) con el fin de caracte-rizarlos, y se evaluó la adherencia al tratamiento mediante el Test de Morisky-Green y el test de Hermes.Resultados: Al estudiar la adherencia con el Test de Morisky-Green se aprecia que el 64% obtuvo una adherencia baja al tratamiento, el 19% presentó una adherencia media, mientras que sólo el 17% de los pacientes fue muy adherente. Según el test de Hermes se observa que un 42% de los pacientes son adherentes al tratamiento. Conclusiones: Existe una baja adherencia al trata-miento farmacológico, según el test de Hermes y el test de Morisky-Green. En función del sexo se con-cluye que las mujeres son más adherentes que los hombres y si nos enfocamos en la edad, se erigen como más adherentes aquellos pacientes con una edad menor a 60 años. (AU)

Introduction: Lack of adherence to drug treatment is one of the main problems in patients with chronic diseases. A lack of adherence is related to an in-crease in disability and healthcare costs. The main objective of this article is to evaluate the degree of adherence to treatment in patients with Parkinson's disease. Method: An observational, longitudinal and pros-pective study has been carried out in collaboration with the Federation of Parkinson's Associations of the Region of Murcia (FEPAMUR) and collaborating pharmacies of the Region of Murcia. A patients demographic data collection procedure (sex and age) was carried out in order to characterize them. Besides, adherence to treatment was evaluated using the Morisky-Green test and the Hermes test.Results: When studying adherence with the Moris-ky-Green Test, it could be seen that 64% had low adherence to treatment, 19% had medium adhe-rence, while only 17% of the patients were highly adherent. According to the Hermes test, it was observed that 42% of the patients were adherent to treatment.Conclusions: There is a low adherence to pharma-cological treatment, according to the Hermes test and the Morisky-Green test. According to sex, we conclude that women are more adherent than men, and if we focus on the age, patients under 60 years of age are more adherent. (AU)

Adherencia y satisfacción del paciente con enfermedad pulmonar obstructiva crónica desde la farmacia comunitaria / Pacient with chronic obstructive pulmonary disease adherence and satisfaction in community pharmacy

Introducción: Numerosos estudios demuestran que actualmente la enfermedad pulmonar obstruc-tiva crónica (EPOC) está mal controlada e infra-diagnosticada en numerosos pacientes debido a la utilización inadecuada de la farmacoterapia. El conocimiento de los pacientes sobre los complejos medicamentos que manejan puede no ser sufi-ciente, y es aquí donde la dispensación activa del farmacéutico comunitario juega un papel esencial. Los objetivos de este artículo son medir la adheren-cia al tratamiento y el grado de satisfacción con la intervención del farmacéutico de los pacientes que utilizan inhaladores. Método: Se ha realizado un estudio observacional transversal en 105 pacientes diagnosticados de enfermedad pulmonar obstructiva crónica (EPOC) tratados con inhaladores y que acuden a la farma-cia comunitaria. A todos los pacientes se les realizó el test de Morisky-Green de adherencia al trata-miento y un test para valorar el grado de satisfac-ción de los pacientes que utilizan inhaladores con la intervención del farmacéutico. Resultados: Presentan adherencia al tratamiento el 60% de los pacientes. La adherencia al tratamiento es superior en mujeres que en hombres, y mayor en pacientes de edad igual o superior a 65 años. Res-pecto al grado de satisfacción con el farmacéutico se observa que el 52,4 % de los pacientes conside-ra adecuada la intervención llevada a cabo por el farmacéutico y el 43,8 % totalmente adecuada.Conclusiones: Los pacientes con EPOC tienen una adherencia al tratamiento bastante mejorable y es-tán satisfechos con la intervención del farmacéuti-co en la mejora de la utilización de los inhaladores. (AU)

Introduction: Numerous studies show that chronic obstructive pulmonary disease (COPD) is currently poorly controlled and under-diagnosed in many pa-tients due to inadequate use of pharmacotherapy. Patients' knowledge of the complex medications they manage may not be sufficient. Here it is where the active dispensing by the community pharma-cist plays an essential role. The objectives of this article are to measure adherence to treatment and satisfaction with the pharmacist's intervention in patients using inhalers. Method: A cross-sectional and observational study was conducted in 105 patients. They were diag-nosed with chronic obstructive pulmonary disease (COPD), were treated with inhalers and attended a community pharmacy. All patients made the Morisky-Green test of adherence to treatment and a test to assess the degree of satisfaction of patients using inhalers with the pharmacist's intervention.Results: 60% of the patients showed adherence to treatment. Moreover, it is higher in women than in men and higher in patients aged 65 or more. Re-garding the degree of satisfaction with the pharma-cist, 52.4% of the patients considered the interven-tion carried out by the pharmacist was adequate and 43.8% totally adequate.Conclusions: COPD patients have fairly improvable adherence to treatment and are satisfied with the pharmacist's intervention in improving the use of inhalers. (AU)

OPRM1 Gene Interaction with Sleep in Chronic Pain Patients Treated with Opioids.

BACKGROUND: The experience of chronic non-cancer pain (CNCP) is one of the most common reasons individuals seek medical attention. Patients with CNCP frequently experience concomitant sleep-related problems. OBJECTIVES: The aim was to evaluate sleep problems in opioid naïve CNCP patients, before and after opioid titration, analyzing the influence of OPRM1 gene variants. STUDY DESIGN: A prospective, cohort, observational study. SETTING: This study was performed at the Pain Unit of the Alicante University General Hospital. METHODS: Pain and Medical Outcomes Study Sleep questionnaire (MOS-Sleep) were assessed at baseline and 3 months after opioid titration in 231 opioid naïve CNCP patients. Sleep data was compared with a matched-control group (n = 64). Morphine equivalent daily doses, adverse events, and drugs prescribed for pain were also registered. OPRM1 polymorphism rs1799971 was analyzed by RT-PCR. Ethics Committee approved the study and results were analyzed by R software. RESULTS: After 3 months of opioid titration, patients with CNCP (63 ± 14 years, 64% female, VAS 74 ± 17 mm) significantly decreased pain intensity, anxiety and depression, and increased quality of life. Sleep problems were significantly more frequent in females (P = 0.002). Age, quality of life, anxiety, and depression all influenced sleep disturbances and problems indices, which were significantly different from the control group. Furthermore, the OPRM1 118-GG genotype was also associated with significantly lower sleep adequacy, and more sleep problems. LIMITATIONS: Total number of subjects studied was relatively small and most patients were on other non-opioid centrally-acting medications. CONCLUSIONS: Opioids decreased CNCP severity, improving patients' psychological areas, and quality of life. However, patients with OPRM1 118-GG genotype indicated an increase in sleep problems and worsening sleep pattern while taking opioids. KEY WORDS: OPRM1, pharmacogenetics, MOS-Sleep, opioids, chronic noncancer pain, sleep related problems, sleep problem index SLP-6 and SLP-9.