Rasch analysis of the dermatology life quality index (DLQI) in patients with mild to moderate-severe psoriasis.

Background The Dermatology Life Quality Index (DLQI) is a valuable tool for assessing the quality of life in adult patients with psoriasis. Aims To analyse the reliability and validity of the DLQI to measure the quality of life in patients with mild to moderate-severe psoriasis. Methods This was a secondary validation study nested in a follow-up study. The Rasch-Andrich model was utilised to perform response function, item and person fit, differential item functioning, dimensionality, and reliability analyses. Results A total of 1439 patients were analysed, 52.1% male, mean age of 48.7 years (SD 16.1). Psoriasis vulgaris was the phenotype in 43.1% of patients, and 86% had a mild Psoriasis Area Severity Index (PASI). Adequate adjustment of the response function and the items was observed in the best-fit sample, except for item 7 (work and study). The measure explained 60.9% of the variance and presented a reliability of 0.86. Differential item functioning was identified by age, with a relevant bias in the estimation for older adults. Item-person maps are provided. Limitations This study was performed at a single centre, with most patients presenting a mild PASI score, limiting generalisation of the findings. Conclusion The validity evidence favours the use of the DLQI in moderate-severe psoriasis. However, the instrument biases the estimate of older adults. This population group should consider a specific version of the instrument.

Aspectos farmacológicos y adherencia al tratamiento antirretroviral en pacientes VIH

Introducción: La adherencia al tratamiento farmacológico favorece la supresión viral y reduce la resistencia a la terapia antirretroviral de gran actividad a largo plazo. Objetivo: Determinar la relación entre los aspectos farmacológicos y la adherencia al tratamiento antirretroviral de una IPS colombiana. Metodología: Estudio analítico transversal en pacientes con diagnóstico de VIH en tratamiento antirretroviral entre los años 2012 a 2020. Se utilizó un modelo de regresión logística binaria múltiple con fines explicativos. Resultados: Se analizaron 9835 pacientes donde la proporción de adherencia fue de 90 % y en el modelo ajustado se evaluó su relación con los antecedentes de no adherencia (ORa:0,52 IC95 °/o:0,40-0,66), grupo farmacológico (2 ITIAN + 1 IP u otro) (ORa:1,22 IC95 %:0,99-1,76), dos tomas al día (ORa:1,02 IC95 %:0,74-1,40), unidades al día (≥ 3) (ORa:0,69 IC95 %:0,47-1,02), reacciones adversas a medicamentos (ORa:0,56 IC95 °%:0,40-0,78), polimedicación (ORa:1,36 IC95 %:1,00-1,85), tiempo TAR (1 a 2 años) (ORa:1,63 IC95 %:1,27-2,09),tiempo TAR (6 a 12 meses) (ORa:1,66 IC95 %:1,27-2,18), tiempo TAR (<6 meses) (ORa:1,36 IC95 %:1,03-1,78), tasa de reclamación de los medicamentos (ORa:0,42 IC95 %:0,32-0,55) y antecedentes PRUM (ORa:0,11 IC95 %:0,09-0,14). Discusión: La proporción de adherencia obtenida es superior a lo descrito para otros países (entre 60-77 %); sin embargo se encuentra que los hallazgos correspondientes al efecto de las variables farmacológicas analizadas son acordes a lo descrito en estudios previos en el tema Conclusión: Los antecedentes de no adherencia, reacciones adversas, tasa de reclamación de los medicamentos y antecedentes de problemas relacionados con el uso de medicamentos son aspectos que reducen la probabilidad de adherencia; mientras que el mayor tiempo de uso del tratamiento aumenta la misma.

Introduction: Adherence to drug treatment promotes viral suppression and reduces long-term resistance to highly active antiretroviral therapy (HAART). Objective: To determine the relationship between the pharmacological aspects and adherence to antiretroviral treatment in a Colombian IPS. Methodology: Cross-sectional analytical study in patients with HIV on antiretroviral treatment between 2012 and 2020. A multiple binary logistic regression model was used for explanatory purposes. Results: A total of 9,835 patients were analyzed where the proportion of adherence was 90 % and in the adjusted model its relationship with history of non-adherence was assessed (ORa: 0,52 95 % CI: 0,40-0,66), pharmacological group (2 NRTI + 1 PI or other) (ORa: 1,22 95 % CI: 0,99-1,76), two doses per day (ORa: 1,02 95 % CI: 0,74-1,40), units per day (≥ 3 ) (ORa: 0,69 95 % CI: 0,47-1,02), adverse drug reactions (ORa: 0,56 95 % CI: 0,40-0,78), polypharmacy (ORa: 1,36 95 % CI : 1,00-1,85), ART time (1 to 2 years) (ORa: 1,63 95 % CI: 1,27-2,09), ART time (6 to 12 months) (ORa: 1,66 95 % CI: 1,27-2,18), ART time (<6 months) (ORa: 1,36 95 % CI: 1,03-1,78), inconsistency in the claim (ORa: 0,42 95 % CI: 0,32-0,55) and PRUM history (ORa: 0,11 95 % CI: 0,09-0,14). Discussion: The proportion of adherence obtained is higher than that described for other countries (between 60-77 %); however, the findings corresponding to the effect of the pharmacological variables analysed are in line with those described in previous studies on the subject. Conclusion: The history of non-adherence, adverse reactions, inconsistencies in the claim fill history and problems related to the use of medications are aspects that reduce the probability of adherence. While the longer time of use of the treatment increases adherence.

Related factors to non-adherence to antiretroviral therapy in HIV/AIDS patients.

OBJECTIVE: To identify sociodemographic, clinical, and pharmacological factors  associated with nonadherence to antiretroviral treatment in patients with  human immunodeficiency virus/acquired immunodeficiency syndrome treated  between 2017 and 2020 in four cities in Colombia. METHOD: An observational, cross-sectional, retrospective study was conducted of a population of patients with human immunodeficiency virus/acquired immunodeficiency syndrome treated between 2017 and 2020. The Morisky-Green scale, the simplified medication adherence  questionnaire, and the simplified scale to detect adherence problems to  antiretroviral treatment were applied to determine patient adherence. A  binomial multiple logistic regression was performed to evaluate the factors that  best explain nonadherence. RESULTS: A total of 9,835 patients were evaluated, of whom 74.4% were men,  71.1% were aged between 18 and 44 years, 76.0% had attended at most  secondary school, 78.1% were single, and 97.6% resided in an urban area.  After applying three different scales to each patient, 10% of the study  population were identified as nonadherent to treatment. The risk of  nonadherence was significantly higher in patients who presented any drug- related problem or had an adverse reaction to antiretroviral drugs. CONCLUSIONS: The variables most strongly associated with nonadherence to  antiretroviral treatment were drug-related problems, adverse drug reactions, a  history of nonadherence to treatment, and psychoactive substance use.

OBJETIVO: Identificar los factores sociodemográficos, clínicos y farmacológicos asociados a la no adherencia al tratamiento antirretroviral en pacientes con infección por virus de la inmunodeficiencia humana/sida atendidos entre 2017 y 2020 en diferentes ciudades de Colombia.Método: Se realizó un estudio observacional, de corte transversal y retrospectivo, con una población de pacientes con infección por virus de la  inmunodeficiencia humana/sida atendidos entre 2017 a 2020. Se aplicaron las  escalas Morisky-Green, el cuestionario simplificado de adherencia a la  medicación y la escala simplificada para detectar problemas de adherencia al  tratamiento antirretroviral, para determinar la adherencia de los pacientes. Se  realizó una regresión logística múltiple para evaluar los factores que mejor  explican la no adherencia. RESULTADOS: Se evaluaron 9.835 pacientes, de los cuales el 74,4% eran hombres, el 71,1% tenían una edad entre 18 a 44 años, el 76,0% cursó como máximo hasta secundaria, el 78,1% eran solteros y el 97,6%  residían en zona urbana. Se encontró una proporción de no adherencia al  tratamiento del 10% después de aplicar tres escalas diferentes a cada paciente. Las personas que presentaron algún problema relacionado con los medicamentos tuvieron un riesgo significativamente mayor de no ser adherentes, al igual que aquellos que tuvieron alguna reacción adversa a los medicamentos antirretrovirales. CONCLUSIONES: Los problemas relacionados con el uso de medicamentos, las  reacciones adversas a medicamentos, los antecedentes de no adherencia al  tratamiento y el consumo de sustancias psicoactivas fueron las variables que  más se asociaron con la no adherencia al tratamiento antirretroviral.

Factores relacionados con la no adherencia a la terapia antirretroviral en pacientes con VIH/sida / Related factors to non-adherence to antiretroviral therapy in HIV/AIDS patients

Objetivo: Identificar los factores sociodemográficos, clínicos y farmacológicos asociados a la no adherencia al tratamiento antirretroviral enpacientes con infección por virus de la inmunodeficiencia humana/sidaatendidos entre 2017 y 2020 en diferentes ciudades de Colombia.Método: Se realizó un estudio observacional, de corte transversal yretrospectivo, con una población de pacientes con infección por virusde la inmunodeficiencia humana/sida atendidos entre 2017 a 2020.Se aplicaron las escalas Morisky-Green, el cuestionario simplificado deadherencia a la medicación y la escala simplificada para detectar problemas de adherencia al tratamiento antirretroviral, para determinar laadherencia de los pacientes. Se realizó una regresión logística múltiplepara evaluar los factores que mejor explican la no adherencia.Resultados: Se evaluaron 9.835 pacientes, de los cuales el 74,4% eranhombres, el 71,1% tenían una edad entre 18 a 44 años, el 76,0% cursócomo máximo hasta secundaria, el 78,1% eran solteros y el 97,6% residían en zona urbana. Se encontró una proporción de no adherencia altratamiento del 10% después de aplicar tres escalas diferentes a cadapaciente. Las personas que presentaron algún problema relacionado conlos medicamentos tuvieron un riesgo significativamente mayor de no seradherentes, al igual que aquellos que tuvieron alguna reacción adversa alos medicamentos antirretrovirales. (AU)

Objective: To identify sociodemographic, clinical, and pharmacological factors associated with nonadherence to antiretroviral treatment inpatients with human immunodeficiency virus/acquired immunodeficiencysyndrome treated between 2017 and 2020 in four cities in Colombia.Method: An observational, cross-sectional, retrospective study was conducted of a population of patients with human immunodeficiency virus/acquired immunodeficiency syndrome treated between 2017 and 2020.The Morisky-Green scale, the simplified medication adherence questionnaire, and the simplified scale to detect adherence problems to antiretroviral treatment were applied to determine patient adherence. A binomialmultiple logistic regression was performed to evaluate the factors that bestexplain nonadherence.Results: A total of 9,835 patients were evaluated, of whom 74.4%were men, 71.1% were aged between 18 and 44 years, 76.0% hadattended at most secondary school, 78.1% were single, and 97.6% resided in an urban area. After applying three different scales to eachpatient, 10% of the study population were identified as nonadherent totreatment. The risk of nonadherence was significantly higher in patientswho presented any drug-related problem or had an adverse reaction toantiretroviral drugs. (AU)

Factors associated with virologic failure in HIV patients on antiretroviral therapy.

OBJECTIVE: To determine the factors associated with virologic failure n HIV  patients on antiretroviral treatment treated in a Colombian health institution. METHOD: This was a cross-sectional observational retrospective analytical study of HIV patients receiving antiretroviral treatment between 2007­2020. Sociodemographic, pharmacological and clinical variables were collected, including viral load, adherence, and the medication  possession ratio. For statistical analysis, crude and adjusted odds ratios and confidence intervals were obtained. RESULTS: In a population of 5,406 patients, the proportion of virologic failure  was 16.7%. Moreover, in the adjusted model, an association was found  between virologic failure and time on treatment greater than one year,  medication possession ratio under 80%, failure to claim medications from the  pharmacy due to dose omission or discontinuation, adherence under 85%, CD4  count under 500, total cholesterol levels above 201 mg/dL, high density  lipoproteins under 39 mg/dL and presence of mycosis. CONCLUSIONS: In our cohort of HIV patients, short treatment periods, CD4 counts under 200, a low medication possession ratio, failure to timely claim medications from the pharmacy due to omission or  discontinuation, and a lower degree of adherence were factors related to  virologic failure.

OBJETIVO: Determinar los factores asociados al fracaso virológico en pacientes  con el virus de la inmunodeficiencia humana con tratamiento antirretroviral  atendidos en una institución de salud colombiana.Método: Estudio transversal, observacional, retrospectivo y analítico en pacientes con el virus de la inmunodeficiencia humana con tratamiento antirretroviral entre 2007-2020. Se recogieron variables  Sociodemográficas, farmacológicas y clínicas, incluyendo la carga viral, el  grado de adherencia y la tasa de reclamación de medicamentos. Para el  análisis estadístico se obtuvieron las odds ratio crudas y ajustadas y los  intervalos de confianza. RESULTADOS: De una población de 5.406 pacientes, la proporción de fracaso  virológico fue de 16,7% y en el modelo ajustado se encontró asociación entre  el fracaso virológico con el tiempo en el tratamiento mayor a un año, la tasa de posesión de la reclamación inferior al 80%, la no reclamación oportuna por  omisión o suspensión, la adherencia inferior al 85%, el recuento de CD4  inferior a 500, niveles de colesterol total mayores de 201 mg/dl, lipoproteína  de alta densidad menor de 39 mg/dl y presencia de micosis. CONCLUSIONES: En nuestra cohorte de pacientes con el virus de la  Inmunodeficiencia humana, un menor tiempo en tratamiento, un recuento de CD4 menor de 200, una baja tasa de reclamación de los medicamentos, así  como la no reclamación oportuna por omisión y suspensión y un menor grado  de adherencia son factores que se relacionan con el fracaso virológico.

Factores asociados al fracaso virológico en pacientes VIH con tratamiento antirretroviral / Factors associated with virologic failure in HIV patients on antiretroviral therapy

Objetivo: Determinar los factores asociados al fracaso virológico enpacientes con el virus de la inmunodeficiencia humana con tratamientoantirretroviral atendidos en una institución de salud colombiana.Método: Estudio transversal, observacional, retrospectivo y analítico enpacientes con el virus de la inmunodeficiencia humana con tratamientoantirretroviral entre 2007-2020. Se recogieron variables sociodemográficas,farmacológicas y clínicas, incluyendo la carga viral, el grado de adherenciay la tasa de reclamación de medicamentos. Para el análisis estadístico seobtuvieron las odds ratio crudas y ajustadas y los intervalos de confianza.Resultados: De una población de 5.406 pacientes, la proporción defracaso virológico fue de 16,7% y en el modelo ajustado se encontró asociación entre el fracaso virológico con el tiempo en el tratamiento mayora un año, la tasa de posesión de la reclamación inferior al 80%, la noreclamación oportuna por omisión o suspensión, la adherencia inferior al85%, el recuento de CD4 inferior a 500, niveles de colesterol total mayores de 201 mg/dl, lipoproteína de alta densidad menor de 39 mg/dl ypresencia de micosis.Conclusiones: En nuestra cohorte de pacientes con el virus de la inmunodeficiencia humana, un menor tiempo en tratamiento, un recuento deCD4 menor de 200, una baja tasa de reclamación de los medicamentos,así como la no reclamación oportuna por omisión y suspensión y un menorgrado de adherencia son factores que se relacionan con el fracaso virológico. (AU)

Objective: To determine the factors associated with virologic failurein HIV patients on antiretroviral treatment treated in a Colombian healthinstitution.Method: This was a cross-sectional observational retrospective analytical study of HIV patients receiving antiretroviral treatment between2007-2020. Sociodemographic, pharmacological and clinical variableswere collected, including viral load, adherence, and the medication possession ratio. For statistical analysis, crude and adjusted odds ratios andconfidence intervals were obtained.Results: In a population of 5,406 patients, the proportion of virologicfailure was 16.7%. Moreover, in the adjusted model, an association wasfound between virologic failure and time on treatment greater than oneyear, medication possession ratio under 80%, failure to claim medications from the pharmacy due to dose omission or discontinuation, adherence under 85%, CD4 count under 500, total cholesterol levels above201 mg/dL, high density lipoproteins under 39 mg/dL and presence ofmycosis.Conclusions: In our cohort of HIV patients, short treatment periods, CD4counts under 200, a low medication possession ratio, failure to timelyclaim medications from the pharmacy due to omission or discontinuation,and a lower degree of adherence were factors related to virologic failure. (AU)

Therapeutic failure in moderate and severe psoriasis patients in a health institution - a transversal study of prevalence and demographic determinants.

BACKGROUND: Psoriasis is a chronic disease that seriously impacts quality of life. There are known genetic and environmental factors that influence its onset and progression. Even though there is no cure for it, there are a variety of treatments available today to control its symptoms, although many of them fail to do so substantially. OBJECTIVE: To identify the association of multiple sociodemographic, clinical, and pharmacological factors with therapeutic failure. METHODS: Observational, descriptive, cross-sectional, retrospective, and analytical study of therapeutic failure in patients with moderate or severe psoriasis between 2020 and 2021 was performed. RESULTS: In total 1051 patients with moderate or severe psoriasis were evaluated. Gender (ORa: 0.579 CI 95%: 0.382-0.878), type of therapy (biologic or non-biologic; ORa: 1.939 CI 95%: 1.242-3.027), age (ORa: 1.018 CI 95%: 1.003-1.034), days of treatment (ORa: 1 CI 95%: 0.999-1) and DLQI (ORa: 1.212 CI 95%: 1.172-1.253) are significantly associated with therapeutic failure. CONCLUSION: Being male and receiving biologic therapy are associated with a higher incidence of therapeutic failure in the treatment of moderate or severe psoriasis. The increase in DLQI increase in the probability of failure, and mayor age or days of treatment decrease in the probability of failure.

Clinical, sociodemographic, pharmacological and quality of life characterization of patients with a diagnosis of moderate to severe psoriasis treated in a specialized psoriasis clinic / Caracterización clínica, sociodemográfica, farmacológica y calidad de vida de pacientes con diagnóstico de psoriasis moderada a severa atendidos en una clínica especializada en psoriasis

Abstract Introduction: psoriasis is a systemic, inflammatory, and chronic disease with a global prevalence between 0.6-6.5 %. It is related to multiple comorbidities and generates a significant decrease in quality of life. Objective: to characterize sociodemographic, clinical, pharmacological, and quality of life variables in a population of patients with moderate-severe psoriasis. Methods: descriptive observational study the patients with a diagnosis of severe-moderate psoriasis treated in the Clínica Integral de Psoriasis-CLIPSO between May 2018 - June 2020. A collection format was designed for defined variables and a univariate analysis was performed. Results: 948 patients were identified with a median age of 50 years (IQR: 38-60) of which 51.0 % were women. 23.6 % were incidents with a median treatment time of 114 days (IQR: 98-127) and 73.9 % were prevalent with a median treatment time of 228 days (IQR: 160-371). The type of therapy used was mainly non-biological systemic and 90.9 % of the patients were adherent to the treatment. The clinical variables were similar for both groups and the most common phenotype was psoriasis vulgaris (57.1 %). The health-related quality of life in both groups was greater than 60 points and the affected dimensions were physical and psychological health. 27.3 % of the patients had comorbidities associated with cardiovascular risk and 44.7 % were overweight. Conclusion: knowing the sociodemographic, clinical, pharmacological, and quality of life characteristics of patients with moderate-severe psoriasis allows the identification of risk factors and comprehensive management of the disease.

Resumen Introducción: la psoriasis es una enfermedad sistémica, inflamatoria y crónica con una prevalencia global entre 0,6-6,5 %. Está relacionada con múltiples comorbilidades y genera una disminución significativa en la calidad de vida. Objetivo: caracterización sociodemográfica, clínica, farmacológica y calidad de vida de un grupo de pacientes con psoriasis moderada-severa. Métodos: estudio observacional descriptivo en pacientes con diagnóstico de psoriasis moderada-severa atendidos en la Clínica Integral de Psoriasis (CLIPSO) entre mayo 2018 y junio 2020. Se diseñó un formato para la recolección de las variables definidas y se realizó un análisis univariado. Resultados: se identificaron 948 pacientes con una mediana de edad de 50 años (RIC:38-60) de los cuales el 51 % eran mujeres. El 23,6 % eran incidentes, con una mediana en tiempo de tratamiento de 114 días (RIC:98-127) y 73,9 % eran prevalentes, con una mediana de tiempo de tratamiento de 228 días (RIC:160-371). El tipo de terapia utilizada fue principalmente sistémica no biológica y el 90,9 % de los pacientes eran adherentes al tratamiento. Las variables clínicas fueron similares en los incidentes y los prevalentes y el fenotipo más común fue psoriasis vulgar (57,1 %). La calidad de vida en ambos grupos fue mayor a 60 puntos y las dimensiones más afectadas en la calidad de vida fueron la salud física y la psicológica. El 27,3 % presentaban comorbilidades asociadas a riesgo cardiovascular y 44,7 % presentaban sobrepeso. Conclusión: conocer las características sociodemográficas, clínicas, farmacológicas y calidad de vida de los pacientes con psoriasis moderada-severa permite la identificación de factores de riesgo y un manejo integral de la enfermedad.

Skills and practices of pharmacy staff for dispensing of drugs with fiscalized substances in drugstores and pharmacies.

OBJETIVE: To evaluate the skills and practices of pharmacy staff during the dispensing of tramadol (drug with fiscalized substance) in drugstores and pharmacies in Medellin, Colombia. METHODS: A cross-sectional study was performed. The simulated patient technique was used. The main outcomes included the information provided on the dispensed drug (tramadol), the use of tools to provide information, and the information provided on drug precautions and use recommendations. RESULTS: We visited 305 drugstores and pharmacies. The average dispensing time was 2.3 min (SD 1.1 min). In nine drugstores and pharmacies (3.0%), tramadol was not dispensed because it was not in stock. In 17 drugstores and pharmacies (5.7%), the simulated patients were actively informed by the dispensing pharmacy staff; of these, 16 provided oral information and one provided oral and written information. Eight patients (2.7%) received information regarding tramadol use. However, 99% of patients were not informed about tramadol side effects such as dependence, sedation, or hypnosis, and none of the simulated female patients were informed on the precautions related to tramadol use during pregnancy or lactation. CONCLUSIONS: Communication skills and appropriate practices of pharmacy staff are critical to patient self-care. However, this study shows their difficulty in counseling about precautions and use recommendations of drugs with fiscalized substances. These outcomes could inform future studies focusing on the rational use of these drugs in drugstores and pharmacies. It is necessary to improve the pharmacy staff competencies through continuing education programs, to facilitate access to information and training.

Programas e intervenciones educativas ofrecidas al personal farmacéutico para mejorar la prestación de los servicios asistenciales farmacéuticos: una revisión estructurada / Educational programs and interventions offered to pharmacy staff to improve the delivery of pharmaceutical assistance services: A structured review

Resumen Objetivo: Describir los programas y las intervenciones educativas ofrecidas al personal farmacéutico, para mejorar la prestación de los servicios asistenciales farmacéuticos y los métodos utilizados para evaluar la efectividad de estos programas. Métodos: Se realizó una revisión estructurada, se utilizó la base de datos PubMed/Medline entre 2007 y 2019, sobre el desarrollo, la descripción, la evaluación del impacto, la efectividad o la comparación de una intervención educativa, un entrenamiento específico o un programa educativo dirigido al personal farmacéutico de farmacias comunitarias (ambulatorias) y/o hospitalarias. Resultados: En total, 1290 referencias bibliográficas fueron identificadas: se incluyeron 26 referencias adicionales y se seleccionaron 90 artículos para su revisión y análisis. Se encontró que el 70 % (63) de los estudios fueron realizados en países desarrollados, principalmente en Estados Unidos, Australia, Canadá e Inglaterra. El 67 % (60) de los estudios se realizaron a nivel ambulatorio, el 10 % (9) a nivel hospitalario y el 23 % (21), en ambos contextos. Las intervenciones fueron clasificadas en tres categorías: Entrenamientos Específicos (41 %), programas de Educación Continua (43 %) y de Desarrollo Profesional Continuo, (16 %). De las metodologías o métodos de provisión de la intervención, la más común fue la presencial en el 72 % (65) de los estudios, seguido de metodologías apoyadas con herramientas virtuales en el de las intervenciones educativas varió entre menos de 1 hora y 120 horas. Conclusión: Se describen los programas y las intervenciones educativas ofrecidas al personal farmacéutico, principalmente para mejorar sus competencias laborales y la prestación de los servicios asistenciales farmacéuticos, además de los métodos utilizados para evaluar la efectividad de las intervenciones educativas.

Abstract Objective: To describe the educational programs and interventions offered to pharmacy staff, to improve the delivery of pharmaceutical healthcare services and the methods used to evaluate the programs' effectiveness. Methods: A structured review was performed using the PubMed/Medline database from 2007 to 2019. Results: In total, 1290 bibliographic references were identified; besides, 26 references identified by other sources were included and 90 articles for review and analysis were selected. It was found that 70% (63) of the studies were made in developed countries, mainly in the United States, Australia, Canada, and England. 67% (60) of the studies were carried out at the outpatient level, 10% (9) at the hospital level, and 23% (21) in both contexts. The interventions were classified into three categories: Specific settings (41%), Continuing Education (43%), and Continuing Professional Development (16%) programs. The most common methodology or delivery methods for the intervention were face-to-face in 72% (65) of the studies, followed by methodologies supported by virtual tools in 28% (25) and 11% (10) of the studies combined face-to-face and virtual methods. The duration of the educational interventions ranged from less than 1 hour to 120 hours. Conclusion: The educational programs and interventions offered to the pharmacy staff are described, mainly to improve their labor competencies. Additionally the provision of pharmaceutical healthcare services and the methods used to evaluate the effectiveness of the educational intervention.

Design and development of a mobile app of drug information for people with visual impairment.

BACKGROUND: People with visual impairment presents difficulties to access the labels information of medicines. In this sense, technological tools can contribute to improve access to this information and the appropriate use of medicines in this population. However, currently, in Colombia, there are no tools to facilitate this process. OBJECTIVE: To design and development of a mobile app of drug information for people with visual impairment, which allows them to access information for the appropriate use of medicines. METHODS: A user-centered design process is carried out in four phases was used: a) Identification the needs and barriers for appropriate use of medicines; b) Lifting of requirements, c) Interface design and prototyping, and development of the mobile app, and d) Usability test. RESULTS: The study involved 48 people with visual disability, of which 69% required assistance for the use of medicines. The main barriers identified were access to information and dosing. A total of ten user requirements were identified, based on these and international accessibility standards FarmaceuticApp was designed and developed, incorporating the problems that were identified in the usability test. CONCLUSION: A mobile app of drug information for people with visual impairment using a user-centered design process was designed and developed, highlighting the importance of involving the users and other stakeholders in the design and development m-health technologies. FarmaceuticApp could contribute to the appropriate use of medicines and improve therapeutic adherence, as well as autonomy and independence in people with visual impairment.

Relevancia clínica de interacciones de antibióticos relacionadas con cambios en la absorción: revisión estructurada / Clinical relevance of drug interactions with antibiotics related to changes in the absorption: Structured review

Resumen Introducción: Durante el proceso de uso de los medicamentos es complejo establecer un esquema terapéutico eficaz y seguro, especialmente en los pacientes geriátricos, debido a la polimedicación. En este sentido, a medida que aumenta el número de medicamentos también aumenta la probabilidad de aparición de una interacción medicamentosa que podría tener consecuencias clínicas importantes. El objetivo de este estudio fue establecer y evaluar la relevancia clínica de las interacciones de antibióticos relacionadas con cambios en la absorción. Métodos: Búsqueda en PubMed/Medline y Embase de artículos en inglés y español, acceso a texto completo, sin fecha límite, en humanos. La relevancia clínica se estableció con base a la probabilidad y la gravedad. Se identificaron 85 artículos, 46 informaron interacciones de antibióticos relacionadas con cambios en la absorción. Los resultados se orientaron en los antibióticos comercializados en Colombia, acorde con la base de datos del Instituto Nacional de Vigilancia de Medicamentos y Alimentos. Resultados: Se identificaron 74 parejas de interacciones medicamentosas de medicamentos comercializados en Colombia, 63 fueron clínicamente relevantes y 11 con evidencia de ausencia de interacción. Conclusiones: La absorción de los antibióticos puede modificarse por factores como el uso simultaneo de medicamentos o alimentos; igualmente, los antibióticos pueden afectar la biodisponibilidad de algunos medicamentos, principalmente por modificaciones en la microbiota y generando interacciones clínicamente relevantes. El 67 % de las interacciones identificadas son de riesgo alto.

Abstract Introduction: During the process of drug use, it is demanding to establish an effective and safe therapeutic scheme, especially in elderly patients, because they are polymedicated. In this sense, while the number of medications increases also increases the likelihood of the appearance of an interaction drug, which could have significant clinical consequences. The objective of this study was toestablish and evaluate the clinical relevance of drug interactions whit antibiotics related to changes in the absorption. Methods: A search in PubMed / MedLine and Embase was made for articles in English and Spanish, full-text access, without a cut-off date, in humans. The clinical relevance was established based on the probability of occurrence and the severity of the interaction. The results were oriented in the antibiotics commercialized in Colombia, according to the database of Invima. Results: 74 pairs of drug interactions of drugs marketed in Colombia were identified, 63 were clinically relevant and 11 with evidence of absence of interaction. Conclusion: The absorption of antibiotics can be modified by factors such as the simultaneous use of drugs or food; equally, antibiotics can affect the bioavailability of some drugs, mainly by modifications in the microbiota and generating clinically relevant interactions. 67% of the identified interactions are high risk.

Incompatibilidad de medicamentos intravenosos: revisión estructurada / Incompatibility of intravenous drugs: Structured review

Resumen Introducción: Las incompatibilidades físicas o químicas presentadas entre las mezclas de medicamentos de uso intravenosos pueden comprometer la eficacia y seguridad del tratamiento y del paciente. La disponibilidad de la información relacionada con este aspecto es limitada o fraccionada, lo que restringe su uso. El objetivo del presente trabajo fue sistematizar la información disponible en las bases de datos sobre compatibilidad/incompatibilidad entre medicamentos intravenosos, que favorezca los procesos de prescripción, preparación y administración. Métodos: Revisión estructurada de incompatibilidades de medicamentos intravenosos en PubMed/MedLine utilizando los términos MeSH: Drug Incompatibility, Administration Intravenous, and Infusions Intravenous. Se buscaron artículos en inglés o español, con acceso a texto completo hasta febrero 29 del 2016. Se identificaron 121 artículos, de los cuales se seleccionaron 58; además se incluyeron 18 manuscritos de las referencias considerados como importantes. Resultados: Se estructuró un cuadro sobre compatibilidad/incompatibilidad de 100 medicamentos intravenosos, el tiempo de estabilidad, condiciones de almacenamiento, tipo de compatibilidad/incompatibilidad presentada y tipo de administración recomendada. Conclusión: Se presenta información sobre compatibilidad / incompatibilidad de medicamentos, la cual podría favorecer los procesos de prescripción, preparación y administración por el personal asistencial y con ello contribuir a la efectividad y seguridad de estos medicamentos.

Abstract Introduction: The physical or chemical incompatibilities between mixtures of intravenous drugs may compromise the efficacy and safety of treatment and the patient. The availability of information related to this aspect is limited or fractionated, which restricts its use; in this context. The objective of the present study was to compile in a table the available information in the databases on the compatibility/incompatibility between intravenous drugs, which favors the processes of prescription, preparation and administration of these products. Methods: We completed a structured review of incompatibilities of intravenous drugs in PubMed/Medline using the MeSH terms: Drug Incompatibility, Administration Intravenous, and Infusions Intravenous, we collected articles in English or Spanish, with access to full text until February 29, 2016. We identified 121 articles, from which we selected 58; additionally we included 18 manuscripts of the references considered as important. Results: With the information obtained was structured a table on compatibility/incompatibility of 100 intravenous drugs, the time of stability, conditions of storage, type of compatibility/incompatibility presented and the type of management recommended. Conclusion: We arranged information on compatibility/incompatibility of drugs, which may improve the processes of prescription, preparation and administration by the health care professionals, so it could contribute to the effectiveness and safety of these drugs.