Posicionamiento de la Sociedad Española de Farmacia Clínica, Familiar y Comunitaria sobre telefarmacia: teleatención farmacéutica (TAF) / Position of the Spanish Society of Clinical, Family and Community Pharmacy on telepharmacy: telepharmaceutical telecare (TAF)

Las nuevas tecnologías de la información y comunicación (TIC) están desarrollándose desde hace bastantes años, pero la pandemia de COVID-19 ha acelerado la transformación digital de la sociedad. En el campo de la salud han surgido nuevas actividades y de esta forma términos como telemedicina, teleasistencia o teleconsulta empiezan a ser habituales. Indudablemente suponen un avance, pero tienen el riesgo de deshumanizar el contacto de sanitarios y pacientes.En el campo de la farmacia ha surgido la telefarma cia con unas innegables connotaciones logísticas y comerciales. Desde la Sociedad Española de Farmacia Clínica, Familiar y Comunitaria se prefiere utilizar el término teleatención farmacéutica (TAF), definiéndolo como la práctica farmacéutica asistencial a distancia que utiliza las TIC para complementar la atención farmacéutica presencial que precise el paciente. La TAF incluye la prestación a distancia de algunos servicios profesionales farmacéuticos asistenciales (SPFA). La TAF debe ayudar al farmacéutico comunitario a prestar algunos SPFA, mejorando así la practica farmacéutica clínica sin caer en la deshumanización que la aplicación indiscriminada de las TIC puede producir. (AU)

Tecnologías de la información y la comunicación al servicio de la atención farmacéutica: “Tu farmacéutico de guardia”, una web por y para los pacientes / Information and communication technologies at the service of pharmaceutical care: «Your pharmacist on duty», a website by and for patients

Objetivo: Alineado con la recomendación de la OMS de incorporar a la atención sanitaria diferentes estrategias de salud digital, el objetivo es doble: describir las funcionalidades y recursos de una página web creada para formar e informar a los pacientes y analizar la actividad de la herramienta tras un periodo de funcionamiento de seis años.Material y métodos: Los pasos que se siguieron en la creación de la web fueron: 1) desarrollo del logotipo y sistema de marca; 2) creación de contenidos tanto escritos como audiovisuales y 3) campaña de lanzamiento. Para evaluar su uso se realizó un estudio descriptivo retrospectivo (septiembre 2015 – noviembre 2021) en el que se recogieron los indicadores clave de rendimiento.Resultados: La web se estructuró en 11 grupos de patologías disponiendo de información escrita (179 fichas) y audiovisual (61 videos) sobre medicamentos y un repositorio de temas actuales sobre la salud a modo de noticias (515 reseñas publicadas). Desde su lanzamiento se han registrado un total de 176.530 visitas por 150.004 usuarios diferentes. En noviembre de 2020 se rediseñó la web, optimizándola para móviles con un diseño de marca renovado; hecho que reportó un importante crecimiento de las visitas, siendo el móvil (74,9%) el dispositivo de visualización más utilizado en este último periodo. (AU)

Objectives: To write the functionalities and resources of a web page created to train and inform patients and to analyze the activity of the tool after a six-year operating period. These two objectives are aligned with the WHO recommendation to incorporate different digital health strategies into health care.Material and methods: To create the web page we followed the next steps: 1) development of the logo and brand system; 2) creation of written and audiovisual content and 3) launch campaign. To evaluate the use of the web page, a retrospective descriptive study was carried out (September 2015 – November 2021) and key performance indicators were collected.Results: The website was structured into 11 groups of pathologies, including written information (179 files) and audiovisual information (61 videos) about drugs and a repository of current health topics shown as news (515 published reviews). Since its launch, a total of 176,530 visits have been registered by 150,004 different users. In November 2020 the web was redesigned, optimizing it for mobile devices and with a renewed brand design. This update reported a significant growth in visits, with mobile phones being the most used display (74.9%) in this last period. (AU)

A utilização de tecnologias da informação em saúde para o enfrentamento da pandemiado Covid-19 no Brasil / The use of healthinformation technologies to face the Covid-19 pandemic in Brazil / El uso de tecnologías de la información en salud para enfrentar la pandemia Covid-19 en Brasil

Objetivos: demonstrar como o uso de tecnologias da informação em saúde, por meio do monitoramento de redes de acesso público, contribui na redução de agravos das condições de saúde em pandemias, avaliando o uso das tecnologias nas experiências internacionais e sua potencial aplicação à realidade brasileira. Metodologia:foi realizada revisão integrativa com levantamento de artigos nas bases de dados Scielo, Pubmede Google Acadêmico. Foram selecionados 21 artigos e 11 documentos diversos, como peças jornalísticas, capítulos de livros, resenhas, entre outros. Os artigos passaram por leitura e análise crítica por dois pesquisadores distintos. Um terceiro pesquisador foi responsável pela interpretação dos resultados.Resultados: o estudo demonstrou que existe uma grande tendência mundial para o uso de tecnologias da informação e comunicação como ferramentas no auxílio ao enfrentamento de pandemias, visto que foram diversos os exemplos mundiais que trataram da utilização das tecnologias para o controle do Covid-19, e esse uso depende de uma evolução e de aprimoramento das ferramentas tecnológicas e das legislações envolvidas. No Brasil, existe um grande potencial para evolução nessa área, com o aumento da captação e utilização dos dados, auxiliando nas estratégias e ações na saúde pública. Porém,em todos os cenários apresentados, faz-se necessário aprimoramento e adequações no âmbito legislativo ­conferindo maior responsabilidade legal aos direitos de privacidade­e social,com a ampliação da infraestrutura da internet,alcançando toda população e,principalmente,com a maior confiabilidade dos dados. Conclusão:a partir do entendimento sobre o cenário de utilização das Tecnologias da Informação e Comunicação em diversos países e como foram às respostas nos respectivos territórios, foi feita uma comparação com o Brasil e percebeu-se que a capacidade tecnológica brasileira é limitada de uma forma geral. As questões socioculturais no Brasil se destacam, por se tratarem, por vezes, de barreiras existentes no cenário brasileiro, e que devem ser discutidas,visando um melhor entendimento sobre o uso dessas tecnologias nas políticas públicas de forma a alcançar toda população. Com isso, fora visto que é necessária a participação consciente e ativa dos cidadãos no fornecimento de informações corretas, para o aprimoramento conjunto e contínuo da captação de dados, e a utilização correta dos dados por parte do Estado, sem ferir a privacidade dos cidadãos e melhorando a assistência à saúde da população.

Objectives: to demonstrate how the use of health information technologies, by monitoring public access networks, contributes to the reduction of health conditions in pandemics, evaluating the use of technologies in international experiences and its potential applicability to Brazilian context. Methods:an integrative review was carried out with a survey of articlesin the Scielo, Pubmed and Google Scholar databases. 21 articles and 11 different documents were selected, such as journalistic pieces, book chapters, reviews, among others. The articles were read and critically analyzed by two different researchers. A third researcher was responsible for interpreting the results. Results:the study demonstrated that there is a great worldwide trend towards the use of Information and Communication Technologies as tools to help fight pandemics, since there were several world examples that dealt with the use of technologies to control Covid-19, and that use depends on the evolution and improvement of technological tools and the legislation involved. In Brazil, there is great potential for evolution in this area, with increased data collection and use, assisting in public health strategies and actions. However, in all scenarios presented, there is a need for improvement and adjustments in the legislative scope ­giving greater legal responsibility to privacy rights ­and social, with the expansion of the internet infrastructure, reaching the entire population and, mainly, with the greatest reliability of the data. Conclusion:based on the understanding of the scenario of use of Information and Communication Technologies in several countries and how the responses were made in their respective territories, a comparison was made with Brazil and it was noticed that the Brazilian technological capacity is limited in a way general. Sociocultural issues in Brazil stand out, because they are, at times, barriers that exist in the Brazilian scenario, and which must be discussed, aiming at a better understanding about the use of these technologies in public policies in order to reach the entire population. With that, it was seen that it is necessary the conscious and active participation of citizens in providing correct information, for the joint and continuous improvement of data collection, and the correct use of data by the State, without harming the privacy of citizens and improving health care for the population.

Objetivos: demostrar cómo el uso de las tecnologías de la información en salud, mediante el monitoreo de las redes de acceso público, contribuye a la reducción de las condiciones de salud en las pandemias, evaluando el uso de las tecnologías en las experiencias internacionales y su aplicabilidad en la realidad brasileña. Metodología:Se realizó una revisión integradora con una encuesta de artículos en las bases de datos Scielo, Pubmedy Google Scholar. Se seleccionaron 21 artículos y 11 documentos diferentes, tales como piezas periodísticas, capítulos de libros, reseñas, entre otros. Los artículos fueron leídos y analizados críticamente por dos investigadores diferentes. Un tercer investigador se encargó de interpretar los resultados. Resultados:el estudio demostró que existe una gran tendencia mundial hacia el uso de las tecnologías de la información y las comunicaciones como herramientas para ayudar a enfrentar las pandemias, ya que hubo varios ejemplos mundiales que versaron sobre el uso de tecnologías para el control de Covid-19, y ese uso depende de la evolución y mejora de las herramientas tecnológicas y la legislación involucrada. En Brasil, existe un gran potencial de evolución en esta área,con una mayor recopilación y uso de datos, ayudando en las estrategias y acciones de salud pública. Sin embargo, en todos los escenarios presentados, existe la necesidad de mejoras y ajustes en el ámbito legislativo -otorgando mayor responsabilidad legala los derechos de privacidad -y social, con la expansión de la infraestructura de internet, llegando a toda la población y, principalmente, con la mayor confiabilidad. de los datos. Conclusión: a partir del entendimiento del escenario de uso de las tecnologías de la información y las comunicaciones en varios países y cómo se dieron las respuestas en sus respectivos territorios, se realizó una comparación con Brasil y se notó que la capacidad tecnológica brasileña es de alguna manera limitada general. Los temas socioculturales en Brasil se destacan, porque son, a veces, barreras que existen en el escenario brasileño, y que deben ser discutidas, buscando un mejor entendimiento sobre el uso de estas tecnologías en las políticas públicas para llegar a toda la población. Con ello, se vio que es necesaria la participación consciente y activa de la ciudadanía en la provisión de información correcta, para la mejora conjunta y continua de la recolección de datos, y el correcto uso de los datos por parte del Estado, sin dañar la privacidad de los ciudadanos y mejorar la atención de la salud de la población.

Códigos QR y sus aplicaciones en las ciencias de la salud / QR codes and their uses in health sciences

El Código QR es un código bidimensional, fácilmente identificable por los tres cuadros ubicados en las esquinas superiores e inferior izquierda. Puede contener información de caracteres alfanuméricos, símbolos, Kanji, Hiragana, Katakana, códigos binarios y códigos de control. Es omnidireccional y su lectura puede realizarse desde un dispositivo móvil. Se realizó una revisión de artículos de las bases Scielo y Pubmed con el objetivo de indagar acerca de las aplicaciones de estos códigos en las ciencias de la salud y proponer algunas de estas para el Sistema Nacional de Salud cubano, cuya introducción ha sido paulatina, principalmente en la práctica y en la educación médica. Sin embargo, la diseminación y el uso es aún incipiente y existen muchas oportunidades. Un sistema de identificación nacional en salud permitiría una autentificación más fácil, rápida y efectiva, con un ahorro sustancial de recursos. Las empresas farmacéuticas podrían emplear un sistema similar, en este caso con informaciones de medicamentos. A pesar de sus limitaciones, son diversas las aplicaciones que poseen estos códigos en los servicios de salud. Esto, unido a la expansión tecnológica que vive hoy Cuba, permitirá en un futuro mediato la generalización y la difusión de estas tecnologías en beneficio de la sociedad(AU)

The QR code is a two-dimensional code easily identifiable by the three boxes located in the top corners and the bottom left corner. It may contain information in alphanumeric characters, symbols, Kanji, Hiragana, Katakana, binary codes and control codes. It is omnidirectional and may be read from a mobile device. A review was conducted of papers from the databases Scielo and Pubmed about the uses of these codes in health sciences so as to propose some of those to the Cuban National Health System, where their introduction has been gradual, mainly in medical practice and education. However, their spread and use is still incipient and many opportunities still lie ahead. A national identification system for the health sector would allow easy, fast, effective authentication with substantial resource savings. Pharmaceutical enterprises could use a similar system, in their case with information about drugs. Despite their limitations, these codes may be used for a variety of purposes in health services. This possibility, combined with the current technological expansion experienced by Cuba, will permit generalization and dissemination of these technologies in the near future for the benefit of society(AU)

Códigos QR y sus aplicaciones en las ciencias de la salud / QR codes and their uses in health sciences

El Código QR es un código bidimensional, fácilmente identificable por los tres cuadros ubicados en las esquinas superiores e inferior izquierda. Puede contener información de caracteres alfanuméricos, símbolos, Kanji, Hiragana, Katakana, códigos binarios y códigos de control. Es omnidireccional y su lectura puede realizarse desde un dispositivo móvil. Se realizó una revisión de artículos de las bases Scielo y Pubmed con el objetivo de indagar acerca de las aplicaciones de estos códigos en las ciencias de la salud y proponer algunas de estas para el Sistema Nacional de Salud cubano, cuya introducción ha sido paulatina, principalmente en la práctica y en la educación médica. Sin embargo, la diseminación y el uso es aún incipiente y existen muchas oportunidades. Un sistema de identificación nacional en salud permitiría una autentificación más fácil, rápida y efectiva, con un ahorro sustancial de recursos. Las empresas farmacéuticas podrían emplear un sistema similar, en este caso con informaciones de medicamentos. A pesar de sus limitaciones, son diversas las aplicaciones que poseen estos códigos en los servicios de salud. Esto, unido a la expansión tecnológica que vive hoy Cuba, permitirá en un futuro mediato la generalización y la difusión de estas tecnologías en beneficio de la sociedad.

The QR code is a two-dimensional code easily identifiable by the three boxes located in the top corners and the bottom left corner. It may contain information in alphanumeric characters, symbols, Kanji, Hiragana, Katakana, binary codes and control codes. It is omnidirectional and may be read from a mobile device. A review was conducted of papers from the databases Scielo and Pubmed about the uses of these codes in health sciences so as to propose some of those to the Cuban National Health System, where their introduction has been gradual, mainly in medical practice and education. However, their spread and use is still incipient and many opportunities still lie ahead. A national identification system for the health sector would allow easy, fast, effective authentication with substantial resource savings. Pharmaceutical enterprises could use a similar system, in their case with information about drugs. Despite their limitations, these codes may be used for a variety of purposes in health services. This possibility, combined with the current technological expansion experienced by Cuba, will permit generalization and dissemination of these technologies in the near future for the benefit of society.

[Assessment method for mobile health applications in Spanish: The iSYScore index]. / Método de valoración de aplicaciones móviles de salud en español: el índice iSYScore.

The widespread of mobile smartphones among the population has resulted in a growing range of mobile applications in health using iOS and Android devices. The level of confidence that such applications deserve and the health information available online to the general population is a widely debated issue. The main objective of this work was to develop a tool -a scale-, for evaluating the reliability of health apps. The scale was developed using a systematic evidence-based approach, and with an expert consensus, built with a Delphi process. This was followed by a health app catalogue, which was used to test and validate our method that helps to recommend the best apps for non-medical experts across 3 different user interest axes: 1) popularity and interest; 2) trust and quality; and 3) usefulness.

Quality of antenatal and childbirth care in rural health facilities in Burkina Faso, Ghana and Tanzania: an intervention study.

OBJECTIVE: To assess the impact of an intervention consisting of a computer-assisted clinical decision support system and performance-based incentives, aiming at improving quality of antenatal and childbirth care. METHODS: Intervention study in rural primary healthcare (PHC) facilities in Burkina Faso, Ghana and Tanzania. In each country, six intervention and six non-intervention PHC facilities, located in one intervention and one non-intervention rural districts, were selected. Quality was assessed in each facility by health facility surveys, direct observation of antenatal and childbirth care, exit interviews, and reviews of patient records and maternal and child health registers. Findings of pre- and post-intervention and of intervention and non-intervention health facility quality assessments were analysed and assessed for significant (P < 0.05) quality of care differences. RESULTS: Post-intervention quality scores do not show a clear difference to pre-intervention scores and scores at non-intervention facilities. Only a few variables had a statistically significant better post-intervention quality score and when this is the case this is mostly observed in only one study-arm, being pre-/post-intervention or intervention/non-intervention. Post-intervention care shows similar deficiencies in quality of antenatal and childbirth care and in detection, prevention, and management of obstetric complications as at baseline and non-intervention study facilities. CONCLUSION: Our intervention study did not show a significant improvement in quality of care during the study period. However, the use of new technology seems acceptable and feasible in rural PHC facilities in resource-constrained settings, creating the opportunity to use this technology to improve quality of care.

[Coverage of cervical cancer screening in Catalonia, Spain (2008-2011)]. / Cobertura del cribado de cáncer de cuello uterino en Cataluña (2008-2011).

OBJECTIVE: To estimate cervical cytology coverage for the period 2008-2011 by age groups and health regions from data recorded in the medical records of women attending centers within the Catalan national health system. METHODS: The data used to estimate coverage were obtained from the primary care information system. This information was anonymous and included age, center, date, and the results of cytological smears for a total of 2,292,564 women aged 15 years or more. RESULTS: A total of 758,690 smears were performed in 595,868 women. Among women aged 25-65 years, the estimated coverage was 32.4% of the assigned population and was 40.8% in the population attended. Geographical variation was observed, with higher coverage among health regions closer to Barcelona. Abnormal Pap smears increased slightly from 2008 to 2011 (from 3% to 3.5%, respectively, p <0.001). In women with a negative first smear, the mean interval until the second smear was 2.4 years, but only 50% of women with a negative first smear in 2008 attended a second round during the study period. CONCLUSIONS: Cervical screening coverage in the National Health Service of Catalonia includes one in three women. Second round participation was poor. Existing computer systems in primary care centers can ensure monitoring of population-based screening programs for cervical cancer. These systems could be used to plan an organized screening program to ensure wider coverage and better follow-up.

[Injuries treated in primary care in the Community of Madrid: analyses of electronic medical records]. / Lesiones atendidas en atención primaria en la Comunidad de Madrid: análisis de los registros en la historia clínica electrónica.

OBJECTIVE: To describe the incidence of injuries treated in primary care by type of injury, age groups, and sex in the publicly-funded health system of the region of Madrid in Spain. METHODS: A descriptive cross sectional study was performed of injury episodes registered in the primary care electronic medical records of the health system of Madrid in 2011. We calculated the global incidence of injuries, injury-specific rates for fractures, sprains, wounds, burns, foreign body injuries, poisoning and bruises, and their rate ratios with 95% confidence intervals, all of which were stratified by sex and age groups. RESULTS: In 2011 there were 707,800 injury episodes (3.5% of all episodes treated in primary care). Most of the injuries occurred in women (54.0%) and in persons older than 34 years (58.0%). The most common injuries were wounds in men (35.3%) and bruises in women (30.6%). Overall, women had higher rates of injuries among the elderly and men had more injuries in the group younger than 15 years. By type of injury, the highest rates of fractures, burns and bruises were observed in the older population, foreign body injuries and wounds in children, sprains in youth, and poisonings in extreme ages. CONCLUSIONS: The special vulnerability of boys younger than 5 years and elderly women suggests that intervention strategies should be targeted to the specific needs of these groups.