Improving the Quality of Publications in and Advancing the Paradigms of Clinical and Social Pharmacy Practice Research: The Granada Statements / Mejorando la calidad de las publicaciones y avanzando en todos los paradigmas de la investigación de la farmacia asistencial, clínica y social: las declaraciones de Granada

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as “the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care”. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors’ selection of the most appropriate pharmacy practice journal to submit their work (AU)

Stakeholder analysis in health innovation planning processes: A systematic scoping review.

Integrating health innovations into the health system is a complex endeavour that requires a well-designed planning process engaging key stakeholders. Stakeholder analyses lay the foundations to inform appropriate planning processes and undertake strategic actions. A systematic scoping review was performed to explore how stakeholder analyses are applied in health innovation planning processes and a guideline to report stakeholder analyses was developed. The literature search was conducted in PubMed, Scopus and DOAJ; grey literature was sought using Google. Articles reporting stakeholder analyses during the planning process of health policies, systems, products and technologies, and services and delivery methods were included. Fifty-one records were incorporated in the qualitative synthesis. Stakeholder analyses were conducted worldwide, used in all types of health innovations, applied in all phases of the planning process and conducted both prospectively and retrospectively. The steps followed to perform stakeholder analysis, the methods used, the stakeholder attributes analysed and how authors reported the analyses were heterogeneous. Forty-one studies reported the identification of stakeholders, 50 differentiated/categorised them and 25 analysed stakeholder relationships. Only some authors proposed future actions based on the results obtained in their stakeholder analysis. A list of Reporting Items for Stakeholder Analysis (i.e., the RISA tool) is proposed to contribute to the reporting guidelines to enhancing the quality and transparency of health research.

Comparing cytochrome P450 pharmacogenetic information available on United States drug labels and European Union Summaries of Product Characteristics.

Regulatory agencies are increasing the pharmacogenomic information in their official drug labeling. However, despite the importance of regulatory harmonization, this implementation may not be running in parallel among major agencies. Comparing labeling of medicines approved by different agencies may identify gaps to solve. Our study compared the cytochrome P450 pharmacogenetic information included in the United States (US) Food and Drug Administration (FDA) drug labels and European Union (EU) Summaries of Product Characteristics (SmPCs). US labels presented significantly more specific pharmacogenetic subheadings (51 vs 26%), more prevalence and pharmacokinetic data for each metabolic phenotype (59 vs 25% and 82 vs 48%, respectively) and more applicable information about dose modifications required (25 vs 5%). Approximately 75% of the US labels evaluated scored higher on the overall quality than the analogous EU SmPCs, and this difference was not associated with the time since the EU SmPCs' last review. To enhance harmonization, regulatory agencies should simultaneously introduce the pharmacogenetic information in their drug labeling.

Orientación hacia el paciente en la enseñanza de farmacia en España / Patient centeredness in Pharmacy education in Spain

La educación de un profesional consiste en la aportación de conocimientos, actitudes y habilidades que hacen posible el ejercicio. El paradigma de la enseñanza universitaria se ha desplazado desde el ‘sabe’, o incluso el ‘sabe cómo’, hacia el ‘muestra cómo’ y, más importante aún, el ‘hace’. Este era uno de los fundamentos en los que se basaba la modernización del Espacio Europeo de Educación Superior (EEES), creado por la Declaración de Boloña. Como consecuencia de esta normativa, los currículos de los estudios de farmacia han sufrido modificaciones en los pasados años. Varios organismos internacionales apoyan el movimiento del papel del farmacéutico hacia el de un profesional involucrado en los cuidados directos al paciente. Este enfoque en el paciente de la práctica farmacéutica, debería estar basado en similar enfoque en la educación del farmacéutico, lo que no siempre se está consiguiendo en España y en la mayoría de los países del EEES

Education of professionals comprises providing knowledge, attitudes and skills that enable them to practice. The paradigm of university education has shifted from ‘knows’, or even ‘knows how’, to ‘shows how’ and, even more important, to ‘does’. This was one of the fundamentals to build the modern European Higher Education Area (EHEA) created with the Bologna Declaration. As a consequence of this regulation, pharmacy curricula have been modified in the past years. Several international institutions support the movement of pharmacists’ role towards a professional involved on direct patient care. This patient focusing of pharmacy practice should be supported by a similar patient focus pharmacy education, which not always has been achieved in Spain and the majority of EHEA members

Preferencias de formación continua en farmacéuticos comunitarios de la provincia de Badajoz / Badajoz community pharmacistpreferences for continuing education

La formación continua es un deber ético y una obligación legal de los farmacéuticos comunitarios para mantener sus competencias actualizadas. Objetivos: Identificar las preferencias de los farmacéuticos de la provincia de Badajoz en cuanto a las actividades de formación continuada, tomando como marco referencial una encuesta nacional de 1992. Métodos: Estudio transversal realizado entre julio y noviembre de 2014, mediante una encuesta a una muestra aleatoriamente seleccionada (por generación de números aleatorios) de farmacéuticos propietarios (n=200) y farmacéuticos adjuntos (n=88) en ejercicio en la provincia de Badajoz. Se utilizó como marco referencial la encuesta de Martínez Romero y colaboradores de 1992. Resultados: Se obtuvo una tasa de respuesta del 99,3%. La mayoría de los encuestados (50,4%) no considera tener la suficiente formación y el 95,9% asistiría a una formación si fuese de su agrado. Un 58,3% se posicionó a favor de la obligatoriedad de la formación para el ejercicio profesional. El viernes fue el día con más adeptos, pero no hubo un patrón de horario preferido. Los Colegios Oficiales continúan siendo la entidad que se considera como idónea para organizar la formación (31,7%), mientras que la credibilidad de la Universidad para este cometido ha descendido drásticamente (del 33% al 3%). Conclusiones: Los farmacéuticos comunitarios continúan considerando necesaria la formación continuada y mayoritariamente aprueban su obligatoriedad. No hay patrones de preferencias en cuanto a horarios y días para las actividades, y no hay grandes diferencias entre las preferencias de farmacéuticos propietarios y adjuntos

Continuing education is an ethical duty and a legal requirement of community pharmacists to keep their competencies updated. Objective: To identify the preferences of community pharmacists from Badajoz province regarding the continuing education activities, using a 1992 National survey as a referential framework. Methods: Cross-sectional study performed between July and November 2014, by means of a survey to a randomized (list of numbers randomly generated) selected sample of owner pharmacists (n=200) and staff pharmacists (n=88) practicing in Badajoz province. As a referential framework, the 1992 Martinez Romero et al. survey was used. Results: A 99.3% response rate was obtained. The majority of respondents (50,4%) consider not having sufficient education and 95.9% would attend an educational activity if it seem interesting. 58.3% positioned in favor of a mandatory continuing training to practice. Friday appeared as the preferred day, but no common patterns appeared for a preferred timing. Official Pharmacists Associations keep being the ideal entity to organize the continuing education (31.7%), while University reliability for this task has drastically decreased (from 33% to 3%). Conclusion: Community pharmacists persist considering continuing education as necessary and mostly support their obligatoriness. No common patters regarding preferred timing and day of the week to set the activities. No big differences exist among owners and staff pharmacists

Seguimiento de pacientes con diabetes tipo 2 en una unidad de atención primaria de salud / Medication follow-up in type 2 diabetes patients at a primary health care center

Objetivo: Evaluar el impacto de un programa de seguimiento farmacoterapéutico de pacientes con diabetes mellitus en un centro de salud, mediante la evaluación de los resultados clínicos y humanísticos. Método: Estudio de intervención sobre una cohorte de pacientes en seguimiento farmacoterapéutico entre octubre 2011 y julio 2012. El médico de familia seleccionó todos los pacientes atendidos en el centro con diagnóstico de diabetes tipo 2. Una farmacéutica comunitaria, desplazada al centro de salud, realizó seguimiento farmacoterapéutico a los pacientes que voluntariamente aceptaron participar en el estudio. Se realizaron 4 consultas de seguimiento, además de la inicial. Se registraron datos sociodemográficos, estilos de vida, medicación y comorbilidades, así como los biomarcadores que permitían evaluar la evolución de los pacientes. Resultados: De los 58 pacientes con diabetes en el centro de salud, los 22 que aceptaron participar tenían una edad de 70,4 (DE=7,4) años, y 54,5% eran hombres.Todos los incluidos tenían hipertensión arterial, y el 59,1% hiperlipidemia.Se realizaron 128 intervenciones, de las que 75 (58,6%) fueron aceptadas e implementadas por el médico. Se consiguieron diferencias significativas (Willcoxon Signed Ranks tests) en hemoglobina glicosilada A1c (p=0,049), glucemia en ayunas (p=0,007), presión arterial sistólica (p=0,006), conocimiento de la diabetes (cuestionario Berbés) (p=0,007), satisfacción con la enfermedad (dominio satisfacción DQOL) (p=0,009). Conclusiones: Un farmacéutico realizando seguimiento farmacoterapéutico en un centro de salud mejora, en estrecho contacto con el médico de familia, la mayoría de los resultados clínicos y humanísticos de los pacientes con diabetes

Objective: To evaluate the impact of a medication follow-up program in patients with diabetes mellitus at a primary health care center, through the assessment of clinical and humanistic outcomes. Methods: Intervention study on a cohort of patients followed from October 2011 to July 2012. The family physician selected all the patients that went into the health care centre with a diagnosis of type 2 diabetes. A community pharmacist, who was transferred to the health care centre, made a medication follow-up to the patients that voluntarily agreed to participate in the study. Apart from the initial consultation, four more follow-up consultations were done. Socio-demographic data, life styles, medication and comorbidities, as well as biomarkers that enabled the evaluation of the patients’ evolution were recorded. Results: Out of the 58 patients with diabetes in the health care centre, the 22 that agreed to participate in the study were 70.4 (SD=7.4) years old, and 54.4% were males. All the patients had hypertension and 59.1% hyperlipidemia. A total of 128 interventions were done, 75 (58.6%) of them were accepted and implemented by the physician. Significant differences (Willcoxon Signed Ranks tests) in A1c glycosylated hemoglobin (p=0.049), fasting blood glucose (p=0.007), systolic blood pressure (p=0.006), diabetes knowledge (Berbes questionnaire) (p=0.007) and satisfaction with the disease (DQOL satisfaction domain) (p=0.009) were obtained. Conclusion: A pharmacist who makes a medication follow-up in a health care centre and who is in close contact with a physician improves the majority of clinical and humanistic results in patients with diabetes

Evaluación de 10 años del primer programa institucional de uso racional de antibióticos en Gipuzkoa: 1999-2009 / Assessment of the first 10 years institutional programme on rational use of antibiotics in Gipuzkoa: 1999-2009

En 1999 el COF de Gipuzkoa puso en marcha un programa institucional con el objetivo de promover el uso racional de antibióticos, conocer la situación de la demanda y dispensación de antibióticos con y sin receta en las farmacias de Gipuzkoa y reforzar la actuación profesional del farmacéutico. En este estudio se presenta la evaluación de los resultados de 10 años de duración del programa. Método: Se diseñó un protocolo de actuación y un procedimiento de recogida de datos en la farmacia, para su posterior evaluación, siendo la participación voluntaria. Resultados: Se presentan los datos obtenidos en 3 puntos de corte, al inicio del programa (1999), a los cinco y a los 10 años del inicio (2009). El número de farmacias participantes disminuyó desde 152 (54,7%) a 86 (30,6%), con una media de 280 farmacias existentes en la provincia. El número de solicitudes de antibióticos sin receta disminuyó de un 13,6% a un 1,5% respecto a la solicitud total de antibióticos, con o sin receta. En cuanto a la dispensación de antibióticos sin receta se pasó de un 68,9% al 39,2% respecto a los solicitados sin receta. Sobre la demanda total de antibióticos, con o sin receta, se pasó del 9,8% al 0,6%. Conclusiones: Durante los 10 años de duración del I Programa institucional de uso racional de antibióticos en Gipuzkoa, se disminuyó tanto la solicitud de antibióticos sin receta, como la dispensación de los mismos sin receta. Este tipo de Programas contribuyen a mejorar el uso prudente de antibióticos

In 1999, Gipuzkoa Professional Association of Pharmacists set up an institutional programme with the following objectives: to promote the rational use of antibiotics; to know the situation of both: the demand and the dispensing of antibiotics, with and without prescription in Gipuzkoa pharmacies and to reinforce the professional role of the pharmacist. This study includes the evaluation of the results of the 10-year programme. Methods: A protocol of action and a data collection procedure in pharmacies were developed. The participation in the programme was voluntary. Results: Data obtained were presented with three different cut-off points: the beginning of the programme (1999), within five years of the beginning and within 10 years (2009). The number of pharmacies decreased from 152 (54.7%) to 86 (30.6%), with an average of 280 chemist’s shops in the province. The number of demands for antibiotics without prescription decreased from 13.6% to 1.5% in relation with the total amount of antibiotics demands, with and without prescription. The dispense of antibiotics without prescription went from 68.9% to 39.2% in relation with the antibiotics demanded without prescription. With respect to the total demand of antibiotics, it went from 9.8% to 0.6%. Conclusions: Both, the demand of antibiotics without prescription and their corresponding dispense were reduced during the 10-year institutional programme on rational use of antibiotics held in Gipuzkoa. This kind of programmes contributes to a better and more rational use of antibiotics

Prácticas de prescripción de nutrición parenteral neonatal en Portugal / Neonatal parenteral nutrition prescription practices in Portugal

INTRODUCCIÓN: La utilización de normas de orientación para la nutrición parenteral neonatal mejora la eficiencia y la seguridad de su prescripción. OBJETIVO: Evaluar la práctica de prescripción de nutrición parenteral neonatal en Portugal y el cumplimiento del Consenso Nacional (2008). MÉTODOS: Encuesta de respuesta múltiple sobre la prescripción de nutrición parenteral (NP) enviada a los coordinadores de las 50 unidades de cuidados especiales neonatales portuguesas, tanto públicas como privadas, siendo 25 de nivel II y 25 de nivel III. RESULTADOS: Se prescribe NP en 32 unidades neonatales, habiendo 23 (71,9%) respondido la encuesta. De estas, 19 (82,6%) afirman tener como referencia el Consenso Nacional y las restantes siguen protocolos internos; 17 (73,9%) afirman preferir la prescripción mediante soporte informático. En recién nacidos pretérmino, la mayoría reporta una administración cautelosa de líquidos en la primera semana posnatal; inicio de aminoácidos desde el primer día posnatal con 1,5-3 g/kg/día y aumento hasta 3-4 g/kg/día; inicio de lípidos en los 3 días posnatales con 1 g/kg/día y aumento hasta 3 g/kg/día; administración de 40-70 mg/kg/día de calcio y fósforo, con un ratio calcio: fósforo de 1,7:1 (mg:mg), y estimación de la osmolaridad de las soluciones y control semanal de la trigliceridemia, uremia, fosforemia y función hepática. CONCLUSIONES: Por la elevada tasa de respuesta la muestra probablemente es representativa de la práctica de prescripción de nutrición parenteral neonatal en Portugal. La mayoría de las unidades tienen como referencia el Consenso Nacional, lo que contribuye a unos mejores cuidados de los recién nacidos

INTRODUCTION: The use of guidelines for neonatal parenteral nutrition (PN) improves its clinical efficiency and the safety of prescription. OBJECTIVE: To evaluate the practices of neonatal parenteral nutrition prescription in Portugal, and the adherence to the National Consensus on neonatal PN (2008). METHODS: A questionnaire based on a multiple choice response on parenteral nutrition prescription was conducted, and sent to the coordinators of the 50 public and private Portuguese neonatal special care units, 25 being level III and 25 level II. RESULTS: Parenteral nutrition was prescribed in 32 neonatal units, 23 of which (71.9%) responded to the questionnaire. Of the respondents, 19 (82.6%) refer to follow the National Consensus, the remaining following local guidelines; 17 (73.9%) of units referred to using an electronic based system for prescription. In preterm neonates, most mentioned: administering judiciously the fluid intake during the first post-natal week; starting amino acids from the first post-natal day with 1.5-3 g/kg/d, increasing up to 3-4 g/kg/d; starting lipids from the first three post-natal days with 1 g/kg/d, increasing up to 3 g/kg/d; administering 40-70 mg/kg/d of calcium and of phosphorus with the fixed calcium: phosphorus ratio of 1.7: 1 (mg:mg); and estimating the osmolality of the solutions, and weekly monitoring of serum triglycerides, blood urea, serum phosphorus and liver function. CONCLUSIONS: The high response rate is probably representative of the practice of PN prescription in Portugal. Most of the units used the National Consensus on neonatal PN as a reference, thus contributing to better nutritional support for neonates

[Neonatal parenteral nutrition prescription practices in Portugal]. / Prácticas de prescripción de nutrición parenteral neonatal en Portugal.

INTRODUCTION: The use of guidelines for neonatal parenteral nutrition (PN) improves its clinical efficiency and the safety of prescription. OBJECTIVE: To evaluate the practices of neonatal parenteral nutrition prescription in Portugal, and the adherence to the National Consensus on neonatal PN (2008). METHODS: A questionnaire based on a multiple choice response on parenteral nutrition prescription was conducted, and sent to the coordinators of the 50 public and private Portuguese neonatal special care units, 25 being level III and 25 level II. RESULTS: Parenteral nutrition was prescribed in 32 neonatal units, 23 of which (71.9%) responded to the questionnaire. Of the respondents, 19 (82.6%) refer to follow the National Consensus, the remaining following local guidelines; 17 (73.9%) of units referred to using an electronic based system for prescription. In preterm neonates, most mentioned: administering judiciously the fluid intake during the first post-natal week; starting amino acids from the first post-natal day with 1.5-3g/kg/d, increasing up to 3-4g/kg/d; starting lipids from the first three post-natal days with 1g/kg/d, increasing up to 3g/kg/d; administering 40-70mg/kg/d of calcium and of phosphorus with the fixed calcium:phosphorus ratio of 1.7: 1 (mg:mg); and estimating the osmolality of the solutions, and weekly monitoring of serum triglycerides, blood urea, serum phosphorus and liver function. CONCLUSIONS: The high response rate is probably representative of the practice of PN prescription in Portugal. Most of the units used the National Consensus on neonatal PN as a reference, thus contributing to better nutritional support for neonates.

Clinical pharmacology information in summaries of product characteristics and package inserts.

The aim of the study was to assess the clinical pharmacology information provided in the summaries of product characteristics (SPCs) of European drugs compared with their package inserts. A list of the 150 most prescribed drugs at the local Health Service was assessed. To analyze clinical pharmacology information contained in package inserts and SPCs, Spyker's systematized scoring approach was used (scoring from 0 to 2). Ninety-one SPCs (84.3%) and 108 package inserts were obtained. The mean score for core information provided in the package inserts was 7.94 (confidence interval (CI) 95 %: 7.34-8.53), whereas for the SPCs it was 17.62 (CI 95 %: 16.48-18.75; 35.2% of the maximum). One core information item and two extra credit items were not contained in any of the SPCs. In the European Union the clinical pharmacology information found in SPCs is clearly insufficient. An improved access to and regular review of the SPCs might substantially improve the access and quality of clinical pharmacology and other prescribing information.

Indicaciones autorizadas en España de los fármacos antiosteoporóticos / Indications authorised in Spain of osteoporosis drugs

No disponible

Respuesta de la industria farmacéutica ante una consulta específica / REsponse of the pharmaceutical industry to a specific consultation

No disponible

Cumplimiento, conocimiento y automedicación como factores asociados a los resultados clínicos negativos de la farmacoterapia / Therapy compliance, patient knowledge of medicines and self-medication as associated factors in negative clinical outcomes in pharmacotherapy

El paciente juega un papel primordial en la consecución de los resultados terapéuticos. El incumplimiento, la automedicación, o la falta de conocimiento del la farmacoterapia pueden ser causas de esos resultados clínicos negativos, denominados en ocasiones problemas relacionados con medicamentos (PRM). El método Dáder se utilizó para la evaluación, identificación y clasificación de PRM. La asociación de variables se estableció mediante el estadístico chi cuadrado. El conocimiento de la medicación, el cumplimiento y la automedicación fueron estudiados como causa de estos resultados negativos de la medicación. Fueron entrevistados 2556 pacientes durante el año de estudio, resultando 2261 casos válidos. El 33 % presentaron un PRM como causa de visita a urgencias. El conocimiento de la medicación, el cumplimiento y la automedicación fueron estudiados solo en la población que presentó un PRM y se demuestra que son aspectos asociados a las distintas dimensiones de PRM. No es posible establecer asociación entre la existencia o no de resultados clínicos negativos en los pacientes con el conocimiento de la medicación, el cumplimiento y la automedicación, debido a que estas variables no son atributos del paciente sino que están asociadas a cada medicamento

The patient plays a fundamental role in the attainment of good results in pharmacotherapy. Noncompliance, self-medication, or insufficient knowledge of the therapy being employed may provide a source for the causes of these negative clinical outcomes, otherwise known as medicine related problems (MRP). he Dader method was used in the evaluation, identification and classification of MRP. The association of variables was established through the statistical Chi square test. Patient knowledge of the medicine, degree of compliance to therapy and self-medication were studied as causes of the negative outcomes encountered. 2556 patients were interviewed throughout the year that the study took place, giving a total of 2261 of valid cases. 33% presented an MRP as the cause of his/her visit to the hospital emergency ward. Knowledge of the medicine, compliance and self-medication were only studied in the population that presented an MRP and in this work it is demonstrated that these are aspects that are associated with different dimensions of MRP. It is not possible to establish an association between the existence or not of negative clinical outcomes in patients with the factors of knowledge of medication, compliance and self-medication. This is due to the fact that these variables are not attributable to the patient himself, but rather are associated with the characteristics of each medicine

Morbidity and mortality associated with pharmacotherapy. Evolution and current concept of drug-related problems.

Medicines are a great contribution to the rising life expectancy in XX century. But a lot of drug safety problems were reported since 1960's. More recently, ineffectiveness is also being considered as a problem. Since 1975, the term 'drug-related problem' (DRP) is being used for several definition and purposes. This has led to a number of different DRP classifications. The aim of the present review is to gather different positions, definitions and classifications of DRP. And to present a more modern concept, which is also named as pharmacotherapy failure, corresponding to negative clinical outcomes resulting from the use or the lack of use of medicines. Those pharmacotherapy failures include necessity, effectiveness and safety problems.

[Second Consensus of Granada on pharmacotherapy failure. Cross-cultural translation from Spanish to Portuguese (European)]. / Segundo Consenso de Granada sobre problemas relacionados com medicamentos. Tradução intercultural de Espanhol para Português (Europeu).

The cross-cultural translation from spanish to portuguese (european) of the Second Consensus of Granada on Pharmacotherapy failure has the objective to provide clinicians and researchers, working in drug therapy follow-up, with a working tool translated with the accuracy and the reliability that a biomedical document requires. The common origin of the spanish and portuguese languages emphasizes the need to do a cross-cultural translation. Errors of translation or wrong interpretations can be due to falses cognates. The cross-cultural translation followed three steps: translation, back-translation and review of the translation of the original text of the Second Consensus of Granada on Pharmacotherapy failure. The result was the portuguese version of the Second Consensus of Granada on Pharmacotherapy failure, presented in the annex I.

Programa Dáder de Seguimiento del TratamientoFarmacológico. Resultados de la fase piloto / Pilot phase results of the Dáder programme for drug therapy follow up

La Atención Farmacéutica (Pharmaceutical Care) o el Seguimiento del Tratamiento Farmacológico requiere de una formación de pregrado, pero también de postgrado, continuada y reglada. En ese intento de proporcionar formación continuada, se creó el Programa Dáder de Seguimiento del Tratamiento Farmacológico. Objetivo. El presente trabajo analiza los resultados de la fase piloto de la metodología Dáder para el Seguimiento Farmacoterapéutico, durante los meses de enero a marzo del 2000.Resultados. En 24 farmacias con 48 farmacéuticos comunitarios se realizó Seguimiento Farmacoterapéutico a 174 pacientes. Se intervino en 194 PRM, de los que se resolvieron 167. La distribución de tipos de PRM fue de 31 por ciento de necesidad, 32,9 por ciento de efectividad y 36,1 por ciento de seguridad. Hubo de comunicarse con el médico en el 68 por ciento de las ocasiones, resolviéndose el 81 por ciento de estos, y el 92 por ciento de los que se comunicó sólo con el paciente. Conclusiones: La metodología Dáder para el Seguimiento Farmacoterapéutico es útil para identificar y resolver problemas relacionados con medicamentos (AU)