Telefarmacia y atención farmacéutica: Una revisión narrativa de la Federación Internacional Farmacéutica / Telepharmacy and pharmaceutical care: A narrative review by International Pharmaceutical Federation

La tecnología surgida de la transformación digital ha traído consigo cambios en la asistencia sanitaria. En los próximos años, la Telefarmaciaprevisiblemente se convertirá en uno de los aspectos más importantes dela Telemedicina, ya que ofrece a los pacientes un acceso más inmediato ala atención farmacéutica, supone una reducción de costes tanto para lospacientes como para los sistemas sanitarios, y deriva en una mayor satisfacción, experiencia y comodidad de los pacientes, mejorando así losresultados clínicos. Debido en gran medida a la pandemia de COVID-19,la Telefarmacia ha adquirido gran importancia en el ámbito de la atención farmacéutica, ya que esta crisis ha provocado una enorme presiónsobre los sistemas sanitarios de todo el mundo. Se pueden encontrar multitud de experiencias publicadas en la literatura científica sobre modelos deTelefarmacia en diferentes países del mundo. Existen algunos modelosinnovadores de servicios de Telefarmacia orientados a optimizar y mejorar el acceso a la atención farmacéutica, lo que se traduce en una mejorade la seguridad y los resultados de los pacientes. Entre las ventajas dela Telefarmacia se incluye el aumento del valor para las farmacias y losfarmacéuticos y la adaptación a las necesidades de los pacientes, lamejora de la atención interprofesional, el aumento de la eficiencia de los sistemas sanitarios y la mayor prestación de servicios centrados enel paciente, entre otras. Sin embargo, a pesar de presentar múltiplesventajas, siguen existiendo importantes barreras para la implantación dela Telefarmacia, como la confidencialidad del paciente y la privacidadde la información clínica. Estas barreras para la implantación de la Telefarmacia pueden dividirse en cuatro ámbitos: tecnológico, organizativo,humano y económico. La prestación de atención y servicios farmacéuticosa través de medios digitales es una prioridad clave de la FederaciónInternacional Farmacéutica. (AU)

Digital transformation impacts health care through technology. Telepharmacy is set to become one of the most important aspects of Telemedicinein the years to come with its ability to provide patients with increased andmore timely access to pharmaceutical care, reduced costs for individualsand health systems, improved patient satisfaction, experience and convenience, and better health outcomes. Telepharmacy has gained increasingimportance in the delivery of pharmaceutical care, largely due to theCOVID-19 pandemic which has placed enormous pressures on healthcaresystems globally. There is a significant amount of published literature fromdifferent countries around the world that provide examples of Telepharmacy. There are some innovative models of Telepharmacy services aimedat optimizing and improving access to pharmaceutical care, resulting inimproved patient safety and outcomes. The benefits of Telepharmacyinclude increased value for pharmacies and pharmacists and adaptingto patients´ needs, enhanced interprofessional care and increased efficiency of health systems and increased provision of patient-centred services, among others. However, despite these benefits, major barriers forimplementation of Telepharmacy remain such as patient confidentialityand privacy of health information. These barriers to the implementation of Telepharmacy have been identified and can be divided into four differentenvironments: technological, organizational, human and economic. Delivering pharmaceutical care and services through digital media is identified as a key priority for the International Pharmaceutical Federation. (AU)

Sodium valproate increases the brain isoform of glycogen phosphorylase: looking for a compensation mechanism in McArdle disease using a mouse primary skeletal-muscle culture in vitro.

McArdle disease, also termed 'glycogen storage disease type V', is a disorder of skeletal muscle carbohydrate metabolism caused by inherited deficiency of the muscle-specific isoform of glycogen phosphorylase (GP-MM). It is an autosomic recessive disorder that is caused by mutations in the PYGM gene and typically presents with exercise intolerance, i.e. episodes of early exertional fatigue frequently accompanied by rhabdomyolysis and myoglobinuria. Muscle biopsies from affected individuals contain subsarcolemmal deposits of glycogen. Besides GP-MM, two other GP isoforms have been described: the liver (GP-LL) and brain (GP-BB) isoforms, which are encoded by the PYGL and PYGB genes, respectively; GP-BB is the main GP isoform found in human and rat foetal tissues, including the muscle, although its postnatal expression is dramatically reduced in the vast majority of differentiated tissues with the exception of brain and heart, where it remains as the major isoform. We developed a cell culture model from knock-in McArdle mice that mimics the glycogen accumulation and GP-MM deficiency observed in skeletal muscle from individuals with McArdle disease. We treated mouse primary skeletal muscle cultures in vitro with sodium valproate (VPA), a histone deacetylase inhibitor. After VPA treatment, myotubes expressed GP-BB and a dose-dependent decrease in glycogen accumulation was also observed. Thus, this in vitro model could be useful for high-throughput screening of new drugs to treat this disease. The immortalization of these primary skeletal muscle cultures could provide a never-ending source of cells for this experimental model. Furthermore, VPA could be considered as a gene-expression modulator, allowing compensatory expression of GP-BB and decreased glycogen accumulation in skeletal muscle of individuals with McArdle disease.