Validez y fiabilidad del cuestionario ARMS-e en pacientes con Diabetes mellitus tipo 2 / Validity and reliability of the ARMS-e questionnaire in patients with type 2 Diabetes mellitus

Introducción: El cuestionario “Adherence to Refills and Medications Scale” (ARMS) se diseñó para medir adherencia al tratamiento. Fue traducido y adaptado al español, pero no se han evaluado sus propiedades psicométricas. El objetivo fue evaluar dichas propiedades en una población con diabetes mellitus tipo 2. Método: El estudio se llevó a cabo en farmacias comunitarias de Granada (España) mediante entrevista. Se realizó un análisis factorial de componentes principales (AFCP) con rotación Varimax (validez de constructo), un análisis de concordancia (validez de criterio concurrente y fiabilidad por estabilidad temporal) y alfa de Cronbach y correlación ítem-total (fiabilidad por homogeneidad). Resultados: 107 pacientes entraron en el estudio. El 54,2 % (58) fueron hombres y la edad media fue 70,5 años (D.E.: 9,7). El AFCP extrajo 4 factores que explicaron el 57,49 % de la varianza total. El alfa de Cronbach= 0,428 y el test-retest κ= 0,627 (p > 0,001). Conclusiones: El ARMS-e no puede ser considerado una herramienta útil para medir la adherencia al tratamiento antidiabético oral en esta muestra. (AU)

Introduction: The Adherence to Refills and Medications Scale questionnaire (ARMS) was designed to measure ad-herence to treatment. It was translated and adapted into Spanish, but its psychometric properties have not been evaluated. The aim was to evaluate these properties in a population with type 2 diabetes mellitus. Method: The study was carried out in community pharmacies in Granada (Spain) by interview. A principal compo-nent factor analysis (PCA) with Varimax rotation (construct validity), a concordance analysis (concurrent criterion validity and reliability by temporal stability) and Cronbach’s alpha and item-total correlation (reliability by homo-geneity) were performed. Results: 107 patients entered the study. 54.2 % (58) were male and the mean age was 70.5 (SD: 9.7). The PCA extract-ed 4 factors that explained 57.49 % of the total variance. Cronbach’s alpha= 0.428, and in the test-retest κ= 0.627 (p > 0.001). Conclusions: The ARMS-e cannot be considered a useful tool to measure adherence to oral antidiabetic treatment in this sample. (AU)

Prevalence of poor sleep quality and associated lifestyle habits: A cross-sectional study in community pharmacies / Prevalencia de la mala calidad del sueño y hábitos de vida relacionados en farmacias comunitarias

Introduction: Many lifestyle habits can negatively affect sleep quality (SQ) and lead to poor quality of life. This makes it important to determine the prevalence of poor SQ in the population and the lifestyle habits that may be associated with it, with a view to designing appropriate interventions for improving SQ. The aim of this study was to examine the prevalence of poor SQ among the population of Salamanca (Spain) and its relationship with specific lifestyle habits. Method: A cross-sectional study was carried out between July and November 2019. SQ was studied in 261 patients using the Pittsburgh Sleep Quality Index, and the frequency with which patients performed a series of lifestyle hab-its was quantified. The association between variables was assessed using multivariate binary logistic regression. Results: Almost half of the study population (48.7%) was found to have poor SQ. Physical exercise was a protective factor against poor SQ (OR = 0.221; CI95%: 0.081-0.603). Risk factors for poor SQ included being disturbed at night (OR = 3.606; CI95%: 1.892-6.872), going to bed preoccupied (OR = 3.145; CI95%: 1.528-6.471), reading trivial material (OR = 2.475; CI95%: 1.208-5.070), and playing video games (OR = 3.639; CI95%: 1.326-9.984). Conclusions: In Salamanca (Spain), almost half of the study population stated that they suffered poor SQ. Although numerous lifestyle habits that may relate to poor SQ were studied, a statistically significant relationship was only found for a few of them. (AU)

Introducción: Muchos de los hábitos de vida pueden influir negativamente en la calidad de sueño (CS) y por lo tanto pueden desembocar en una mala calidad de vida. Por esa razón es importante determinar la prevalencia de mala CS en la población y qué hábitos de vida pueden estar relacionados con ella. De este modo se podrán diseñar intervenciones adecuadas que permitan mejorar la CS. El objetivo de este estudio fue estudiar la prevalencia de mala CS de la población de Salamanca (España) y su relación con ciertos hábitos de vida. Método: Se estudió la CS de 261 pacientes mediante el “Pittsburg Sleep Quality Index” y se cuantificó la frecuencia con la que éstos realizaban una serie de hábitos de vida. La asociación entre variables se estudió mediante una regresión logística binaria multivariante. Resultados: Casi la mitad de la población (48,7%) mostró tener mala CS. El ejercicio físico fue un factor protector para la mala CS (OR = 0,221; 95%CI: 0,081-0,603). Fueron factores de riesgo para la mala CS ser molestado por la noche (OR = 3,606; 95%CI: 1,892-6,872), ir a la cama preocupado (OR = 3,145; 95%CI: 1,528-6,471), leer cosas no transcendentales (OR = 2,475; 95%CI: 1,208-5,070), o jugar a videojuegos (OR = 3,639; 95%CI: 1,326-9,984). Conclusiones: Casi la mitad de la población de estudio indicó padecer una mala CS en Salamanca (España). Pese a que muchos hábitos de vida están relacionados con la mala CS, solo se encontró relación estadísticamente significativa con algunos de ellos. (AU)

Relación entre el control de la presión arterial y la adherencia al tratamiento medida mediante el sistema de receta XXI en Granada (España) / Relationship between blood pressure control and treatment adherence measured using the electronic prescription in Granada (Spain)

Introducción: La adherencia al tratamiento ha sido identificada como uno de los factores más importantes para conseguir valores de presión arterial adecuados en pacientes hipertensos. Objetivo: Describir cuál es la adherencia de los pacientes al tratamiento antihipertensivo determinada mediante los registros de retirada de medicamentos por prescripción electrónica (Receta XXI) y estudiar la relación que existe entre dicha adherencia y el control de la presión arterial (PA). Método: Descriptivo transversal desde mayo de 2017 hasta mayo de 2019, en 6 farmacias comunitarias de la provincia de Granada (España). Se incluyeron pacientes mayores de 18 años que tomaban al menos un medicamento antihipertensivo durante un mínimo de 6 meses. Variables principales: Control de la presión arterial y adherencia al tratamiento antihipertensivo mediante el Sistema Receta XXI. Resultados: 95 pacientes fueron incluidos en el estudio. 49 (51,6%) no tenían controlada la PA y 29 (30.5%) paciente mostraron tener una adherencia sub-óptima. El análisis multivariante mostró que el grado de adherencia no estaba asociado a ninguna de las variables incluidas en el estudio y el control de la PA sólo estuvo relacionado con el sexo (OR: 0,044; IC95%: 0,005-0,427), con haber padecido arritmia cardiaca (OR: 0,004; IC95%: 0,000-0,106) y con padecer ansiedad (OR: 0,109; IC95%: 0,013-0,933). Conclusión: La prevalencia de hipertensión arterial no controlada fue muy elevada (51,6%) y no hubo asociación con factores de riesgo sociodemográficos habituales como la actividad física, tabaquismo o IMC. La falta de adherencia al tratamiento también tuvo una prevalencia muy alta (30.5%) sin embargo no mostró ser factor de riesgo PA no controlada. (AU)

Background: Treatment adherence has been identified as one of the most relevant factors in achieving adequate blood pressure values in hypertensive patients. Aims: To describe patient adherence to antihypertensive treatment determined by drug collection records of the electronic prescription system and study the relationship between this adherence and blood pressure control. Methods: Cross-sectional study conducted from May 2017 to May 2019, in 6 community pharmacies in the province of Granada (Spain). Patients over 18 years of age who took at least one antihypertensive medication for at least six months were included. Main outcome measure: Blood pressure control and adherence to antihypertensive treatment using the electronic prescription. Results: A total of 95 patients were included in the study. A total of 49 patients (51.6%) showed no blood pressure control, and 29 patients (30.5%) showed suboptimal adherence. The multivariate analysis showed no association between the degree of adherence and the variables included in the study, and blood pressure control was only related to sex (OR: 0.044; 95%CI: 0.005-0.427), to cardiac arrhythmia (OR: 0.004; 95% CI: 0.000-0.106) and to anxiety (OR: 0.109; 95% CI: 0.013-0.933). Conclusion: The prevalence of uncontrolled blood pressure was very high (51.6%), and no association with common sociodemographic risk factors, such as physical activity, smoking, or body mass index, was found. Non-adherence to treatment also had a very high prevalence (30.5%), but it was not associated with disease control. (AU)

Questionnaires on adherence to antihypertensive treatment: a systematic review of published questionnaires and their psychometric properties.

Background Non-adherence to antihypertensive treatment is currently considered one of the most significant risk factors in failure to achieve controlled blood pressure values. It is therefore extremely important to measure patient adherence to antihypertensive treatment. One way to measure adherence is through questionnaires. Numerous questionnaires for measuring adherence to antihypertensive treatment have been validated, but it not easy to choose one of them as being more appropriate than all of the others. Aim of the review The aim of this study was to identify and assess questionnaires designed to measure non-adherence to antihypertensive treatment, and to discuss their psychometric properties. Method A systematic review of the literature contained in PubMed and Scopus databases was undertaken to identify validated questionnaires on adherence to antihypertensive treatment up to October 2017. PRISMA guidelines were followed to conduct and report this review. Selection of articles and data extraction were performed by two independent researchers. When there was lack of agreement, a third researcher mediated in the discussion between the first two authors so that consensus could be reached. Results 39 articles were obtained containing 17 different questionnaires for measuring adherence to antihypertensive treatment. These questionnaires were validated in 15 countries. The number of items in the questionnaires ranged from three in QAM-Q to 33 in TAQPH. Hill-Bone compliance to high blood pressure therapy scale, Morisky-Green-Levine test and an 8-item Self-Reported Medication Adherence Measurement were the most widely validated questionnaires. Validity was analyzed more than reliability. Many of the questionnaires do not provide information on content validity. Construct validity and concurrent validity are analyzed in almost all of the questionnaires, and give highly variable results. By contrast, known-groups validity was not analyzed to any great degree. As regards reliability, almost all of the questionnaires provided Cronbach's alpha information with reasonably acceptable results, but temporal stability was not analyzed to any great degree. Conclusion None of the questionnaires included in the review demonstrates fulfilling all of the validity tests (content validity, construct validity and criterion-related validity) and reliability tests (homogeneity and temporal stability) in an acceptable manner. Therefore, none of them can be considered a Gold Standard.

Effectiveness of a protocolized dispensing service in community pharmacy for improving patient medication knowledge.

Background Sufficient patient medication knowledge is essential for appropriate use. The dispensing service provided in community pharmacies is one method that may be used to educate patients on their medications. Objective To compare the effectiveness of protocolized dispensing (following a dispensing protocol that includes standardized patient education), with the effectiveness of traditional dispensing (provision of medication without standardized patient education and information provided only if directly requested), for improving patient medication knowledge. Method Pre-post quasi-experimental study of patients or caregivers over 18 years of age requesting one or more medications for their own use or for others. The intervention consisted of using a protocolized process for dispensing medicines in a community pharmacy. The association between the dispensing effectiveness (patient medication knowledge pre and post dispensing) and predictor variables was studied using a multivariate binary logistical regression model. Results In total 661 participant medication requests were included in the study. Protocolized dispensing was more effective than traditional dispensing for improving medication knowledge (OR 2.390; 95 % CI 1.373-1.162). Conclusion As a means to improve patient medication knowledge it may be recommended that protocolized dispensing processes should be developed, evaluated and implemented with the ultimate aim of improving the appropriate use of medicines.

Development and testing of two implementation tools to measure components of professional pharmacy service fidelity.

RATIONALE, AIMS AND OBJECTIVES: There is a need to evaluate both service process and implementation outcomes as professional services are being implemented into pharmacy practice. Fidelity is an implementation outcome, which may be used for service optimization, by associating service components to patient outcomes, as well as use in process evaluation. The objective of this study was to develop tools to measure components of fidelity, specifically, an adherence index (adherence of the service provider to the elements of the service) and a patient responsiveness scale for the professional pharmacy service, medication review with follow-up. METHODS: The procedure described by DeVellis was followed to develop the tools. An expert panel was used to create items and establish content validity. Primary data were collected from 190 service provider pharmacists from 128 pharmacies across 11 provinces of Spain using Spanish version tools as part of an ongoing implementation study (English translations appended to the online version of the article as supplementary material). An initial assessment of item functionality was performed using descriptive statistics and item discrimination for both tools. The patient responsiveness scale's internal consistency was confirmed by calculating Cronbach's alpha coefficient and inter-item correlations. In addition, for the patient responsiveness scale, the number of factors to retain was based on Kaiser criterion, parallel analysis and Cattell's scree test and the number of items was optimized as guided by iterative exploratory factor analysis (EFA). RESULTS: Acceptability of both tools was high. An adherence index of 39 items was developed. After five EFA iterations, four items were removed, resulting in a reliable, 12-item, two-factor patient responsiveness scale, explaining 53.9% of total variance. CONCLUSIONS: Two tools for measuring implementation fidelity, an adherence index and a patient responsiveness scale, have been developed and tested. Future assessment, in particular to establish criterion validity, is recommended.

Identification of validated questionnaires to measure adherence to pharmacological antihypertensive treatments.

BACKGROUND: Low adherence to pharmacological treatments is one of the factors associated with poor blood pressure control. Questionnaires are an indirect measurement method that is both economic and easy to use. However, questionnaires should meet specific criteria, to minimize error and ensure reproducibility of results. Numerous studies have been conducted to design questionnaires that quantify adherence to pharmacological antihypertensive treatments. Nevertheless, it is unknown whether questionnaires fulfil the minimum requirements of validity and reliability. The aim of this study was to compile validated questionnaires measuring adherence to pharmacological antihypertensive treatments that had at least one measure of validity and one measure of reliability. METHODS: A literature search was undertaken in PubMed, the Excerpta Medica Database (EMBASE), and the Latin American and Caribbean Health Sciences Literature database (Literatura Latino-Americana e do Caribe em Ciências da Saúde [LILACS]). References from included articles were hand-searched. The included papers were all that were published in English, French, Portuguese, and Spanish from the beginning of the database's indexing until July 8, 2013, where a validation of a questionnaire (at least one demonstration of the validity and at least one of reliability) was performed to measure adherence to antihypertensive pharmacological treatments. RESULTS: A total of 234 potential papers were identified in the electronic database search; of these, 12 met the eligibility criteria. Within these 12 papers, six questionnaires were validated: the Morisky-Green-Levine; Brief Medication Questionnaire; Hill-Bone Compliance to High Blood Pressure Therapy Scale; Morisky Medication Adherence Scale; Treatment Adherence Questionnaire for Patients with Hypertension (TAQPH); and Martín-Bayarre-Grau. Questionnaire length ranged from four to 28 items. Internal consistency, assessed by Cronbach's α, varied from 0.43 to 0.889. Additional statistical techniques utilized to assess the psychometric properties of the questionnaires varied greatly across studies. CONCLUSION: At this stage, none of the six questionnaires included could be considered a gold standard. However, this revision will assist health professionals in the selection of the most appropriate tool for their individual circumstances.

Fiabilidad de los cuestionarios utilizados en ciencias de la salud / Reliability of the questionnaires used in the health sciences

La entrevista al paciente es una de las actividades más frecuentes en la actividad biomédica. Es necesario ayudarse de herramientas que faciliten la recolección de los datos de una forma oportuna. Esta es una de las razones por la que se utilizan cuestionarios. No obstante, para que un cuestionario, pueda ser considerado útil, existen ciertas características que debe cumplir, como es su validez y fiabilidad. La consistencia interna, el test retest y la fiabilidad inter-observador son pruebas que demuestran que un cuestionario es fiable. Todas ellas deben ser demostradas con el fin de asegurar que los valores obtenidos son repetibles. Por esta razón, estas propiedades deberían ser comprobadas en cada muestra de estudio para asegurar la bondad de los resultados y apoyar la evidencia existente de que es una buena herramienta de medida o no

The interview is one of the most frequently used strategies in health research. Tools which help to obtain accurate data are essential. This is why questionnaires are used. However, a questionnaire is considered useful only if it has certain characteristics such as validity and reliability. Internal consistency, test- retest and inter-observer reliability are evidence that a questionnaire is reliable. All of the above must be demonstrated in order to ensure reproducible results. These properties should be tested in each study sample, to ensure the reproducibility of the results and support the existing evidence that the tool is a good measurement or not

Validez de los cuestionarios utilizados en ciencias de la salud / Validity of the questionnaires used in the health sciences

Los farmacéuticos comunitarios se están incorporando a la investigación biomédica. Para esto suelen utilizar herramientas de medida. Una de las más utilizadas son los cuestionarios. No obstante, para que un cuestionario, pueda ser considerado útil, existen ciertas características que debe cumplir, como es su validez y fiabilidad. Tradicionalmente la validez de una escala se ha dividido en validez de contenido, validez aparente, validez de criterio y validez de constructo. Todas ellas deben ser demostradas con el fin de asegurar que los valores obtenidos representan de forma fidedigna la realidad estudiada. Por esta razón, estas propiedades deberían ser comprobadas en cada muestra de estudio para asegurar la bondad de los resultados y apoyar la evidencia existente de que es una buena herramienta de medida o no

Community pharmacists are getting incorporated to biomedical research. Measurements tools are often used. One of the most used is questionnaires. However, a questionnaire is useful if it has certain characteristics such as validity and reliability. Traditionally the validity of a scale is divided into "content validity", "face validity", "criterion validity" and "construct validity". In order to ensure that obtained values represent faithfully the studied facts, all of them must be demonstrated. For this reason, these properties should be checked in each study sample, to ensure the accuracy of the results and support the existing evidence that is a good measurement tool or not

Tratamiento de la neutropenia febril: filgrastim y pegfilgrastim / Febrile neutropenia treatment: filgrastim and pegfilgrastim

Objetivos: El uso terapéutico de los factores estimulantes de colonias de granulocitos resulta desconocido en comparación con el uso como profilaxis de los mismos. El objetivo de este estudio fue recopilar la información relativa al uso terapéutico encontrada en estudios llevados a cabo del año 2003 en adelante. Métodos: La búsqueda se realizó en siete bases de datos electrónicas en mayo de 2012. Resultaron elegibles los estudios publicados en inglés, francés y español desde el año 2003 en adelante. Se buscaron estudios que abordasen el uso terapéutico de filgrastim y pegfilgrastim en neutropenia febril secundaria a quimioterapia. La búsqueda se completó revisando las referencias de los artículos seleccionados. Resultados: Hubo cuatro estudios que reunieron los criterios de selección. Uno se llevó a cabo en un hospital del Líbano, otro en un hospital británico, otro fue un estudio multicéntrico en España y el último se realizó en Australia a través de una encuesta electrónica a especialistas en cáncer. En el estudio del Líbano, 59 de 137 ciclos de tratamiento con factores estimulantes de colonias de granulocitos se realizaron como uso terapéutico. En el estudio LEARN en España, el 29,7% de los pacientes que usaron factores estimulantes de colonias de granulocitos los utilizaron como tratamiento, al igual que el 17,3% de los pacientes que recibieron pegfilgrastim. El 9,7% de los tratamientos con filgrastim fueron terapéuticos en el hospital británico. Finalmente, en Australia, el 27% de los hematólogos utilizarían factores estimulantes de colonias de granulocitos en el primer caso de los que se les presentaron (bajo riesgo de complicaciones médicas). El 7% de los oncólogos los utilizaría en su caso de bajo riesgo de complicaciones médicas y el 9% los utilizaría en el segundo caso (riesgo mayor). La duración media de la terapia en los diferentes estudios varió de 4,8 a 6 días. El efecto adverso más frecuente fue el dolor de huesos. Conclusiones: Según los resultados de esta revisión, los factores estimulantes de colonias de granulocitos de uso diario se utilizaron más que el pegfilgrastim para uso terapéutico, siendo el último poco utilizado e incluso considerado una excepción. Las terapias fueron cortas y seguras

Aim: The use of granulocyte colony-stimulating factors in the therapeutic setting of febrile neutropenia is still unknown with regard to the prophylaxis one. The aim of the present work was to collect the information about this therapeutic use found out in the studies performed since 2003. Methods: Seven electronic databases were searched in May 2012. Eligibility included works published in English, French and Spanish from 2003 on. Studies that involved the therapeutic use of filgrastim or pegfilgrastim in chemotherapy-induced febrile neutropenia were sought. Reviews, meta-analysis and works published as abstracts were excluded. The search was completed by checking the reference lists from the selected studies. Results: One of them was performed in a hospital in the Lebanon, another one in a British hospital, another was a multi-centre study in Spain and the last one was performed in Australia through an electronic survey made to cancer specialists. In the Lebanon study, 59 out of 137 granulocyte colony-stimulating factors treatment courses were performed in the therapeutic setting. In the LEARN study in Spain 29.7% patients treated with daily granulocyte colony-stimulating factors used them as treatment, so did 17.3% patients receiving pegfilgrastim. 9.7% treatments with filgrastim were therapeutic in the British hospital. Finally, in Australia 27% haematologist would use granulocyte colony-stimulating factors in case 1 (low risk of medical complications). 7% oncologists would use them in their low risk case of medical complications and 9% would use them in case 2 (higher risk). The mean duration of the therapy in the different studies ranged between 4.8 and 6 days. The most frequent adverse effect was bone pain. Conclusions: The results from the present review showed that daily granulocyte colony-stimulating factors were used more than pegfilgrastim in the treatment setting, being the latter used very little and even considered an exception. Therapies were short and safe

Prevalencia y factores asociados al insomnio y mala calidad de sueño en pacientes con VIH/SIDA en Sevilla, España / Prevalence and associated factors to insomnia and poor sleep in patients with HIV/AIDS at Seville, Spain

Antecedentes: La mala calidad de sueño puede tener un impacto negativo sobre la calidad de vida de lapoblación en general, y en pacientes VIH+ puede influir negativamente sobre la adherencia del tratamientoantirretroviral. A pesar de ello, hay pocos trabajos que hayan estudiado la cantidad de personas con VIH/SIDA que padecen este trastorno del sueño. Objetivos: Determinar la prevalencia y factores asociadosal insomnio y mala calidad de sueño en un grupo de pacientes con VIH+ en España. Método: Estudioobservacional descriptivo trasversal. En el estudio se incluyó a pacientes mayores de 18 años diagnosticadoscon VIH/SIDA pertenecientes al programa de Atención Farmacéutica del servicio de farmaciadel Hospital Virgen de Valme de Sevilla (España). Todos los pacientes completaron el Pittsburgh SleepQuality Index para medir la calidad de sueño, y el Insomnia Severity Index para medir la gravedad delinsomnio. Los factores asociados con la calidad de sueño fueron determinados mediante una regresiónlogística multivariante. Por su parte, los factores asociados a la gravedad del insomnio fueron estudiadosmediante una regresión lineal multivariante. Resultados: Se incluyó 188 pacientes con una edad mediade 45 años (desviación estándar DE = 8,4). El 78,7% fueron hombres. El recuento medio de CD4+ fue609,3 (DE = 318,0), y de CD8+ fue 868,7 (DE = 446,7). La media del PSQI fue de 7,0 (DE = 4,6), y105 (55,9%) pacientes fueron clasificados como malos dormidores (PSQI > 5). La puntuación mediaobtenida en el ISI fue 7,3 (DE = 9,1). En los buenos dormidores la puntuación media fue de 1,3 (DE =2,3) y en los malos dormidores fue de 12,0 (DE = 9,7) (p < 0,001). En los malos dormidores, el 40,9%tuvieron insomnio moderado o grave. La correlación entre la puntuación del PSQI y el ISI fue 0,775 (p< 0,001). Variables como adherencia, género, edad, recuento de CD4 ó CD8 no estuvieron relacionadascon el trastorno del sueño...

Background:Poor sleep quality could have a negative impact on quality of life in general population, and in HIV-infected patients could have a negative influence on adherence to antiretroviral treatment. However,only a few researches have studied the amount of patients VIH-infected that have this sleep disorder.Objective: To determine the prevalence and associated factors of poor sleep quality and insomnia in HIV+ patients in Spain.Method: Cross-sectional study.Subjects aged 18 or older diagnosed with HIV/AIDS and that were participating in a pharmaceutical care program of the Virgen de Valme Hospital of Seville (Spain) were included. All patients completed the Pittsburgh Sleep Quality Index to measure sleep quality and Insomnia Severity Index to measure severity of insomnia. Associations of factors with sleep quality were determined by multivariate logistic regression. On the other hand, associations of factors with severity of insomnia were found by means of multivariate linear regression.

Medida de adherencia al tratamiento en pacientes con hiperuricemia o gota / No disponible

Objetivos: Medir la adherencia a los medicamentos antigotosos en pacientes con hiperuricemia o gota y determinar los factores asociados a la adherencia en el tratamiento antigotoso. Método: Estudio observacional descriptivo transversal llevado a cabo en Farmacia Gómez Parera, Armilla (Granada). Se incluyeron pacientes mayores de 18 años con prescripción médica para el tratamiento de la hiperuricemia o gota. Se midió la uricemia (Refloton®) y la adherencia al tratamiento mediante el cuestionario BMQ (The Brief Medication Questionnaire). Se realizó un análisis de regresión logística multivariante para estudiar la relación entre la uricemia y los distintos factores asociados. Resultados: Se incluyeron 19 pacientes, donde el 89,5% fueron hombres. La media de edad fue de 65,5 (DE: 12,94) años. El valor medio de uricemia fue de 6,03 (DE 2,06). Como resultado del BMQ se obtuvo que solo 10,5% era adherente al tratamiento antigotoso y por cada punto de aumento en el recuento del BMQ, aumenta por término medio 2,65 mg/dl el AU en sangre. Las variables incluidas explicaron un 64,1% de la variabilidad de la uricemia en el modelo. Conclusiones: Los pacientes que toman medicamentos para la gota o la hiperuricemia, tienen baja adherencia al tratamiento y los valores de AU en sangre están relacionados con el grado de adherencia al tratamiento de estos pacientes (AU)

Aim: To measure the gout medication adherence in patients with hyperuricemia or gout and to determine the factors associated with adherence to anti-gout treatment. Method: Cross-sectional observational study conducted in Pharmacy Gomez Parera, Armilla (Granada). We included patients older than 18 with medical prescription to treat hyperuricemia or gout. Uric acid was measured (Refloton ®) and adherence to treatment by the questionnaire BMQ (The Brief Medication Questionnaire). Performed a multivariate logistic regression analysis to study the relationship between serum uric acid and the various associated factors. Results: We included 19 patients, where 89.5% were men. The mean age was 65.5 (SD: 12.94) years. The average value was 6.03 uricemia (SD 2.06). BMQ as a result it was found that only 10.5% were adherent and anti-gout treatment for each point increase in the count of BMQ increases averaged 2.65 mg / dl blood AU. The variables included explained 64.1% of the variability in the model uricemia. Conclusions: Patients who take medicine for gout or hyperuricemia, have low adherence to therapy and blood AU values are related to the degree of adherence to treatment of these patients (AU)

Predictors of the community pharmacy white-coat effect in treated hypertensive patients. The MEPAFAR study.

OBJECTIVE: To determine whether age, gender, body mass index (BMI), community pharmacy blood pressure (CPBP), daytime ambulatory BP (ABP) variability, treatment compliance, number of anti-hypertensive drugs and smoking status are factors associated with the community pharmacy white-coat effect (CPWCE) in treated hypertensive patients. SETTING: Eight community pharmacies in Gran Canaria, Spain. METHOD: A cross-sectional study was carried out from June 2008 to June 2009. The study included treated hypertensive patients older than 18 years. Patients were excluded if: systolic BP (SBP)/diastolic BP (DBP) ≥ 200/110 mmHg, not-recommended or unable to perform home BP measurements, changes in anti-hypertensive treatment <4 weeks, history of cardiovascular disease <6 months or pregnancy. Blood pressure (BP) was measured by a community pharmacist at 4 visits to the community pharmacy and using ABP monitoring (24 h). MAIN OUTCOME MEASURE: The CPWCE was calculated as the difference between the mean BP in the community pharmacy and daytime ABP. Independent predictors of the CPWCE were identified using multivariate linear regression analysis. RESULTS: Two hundred thirteen patients agreed to participate in the study. After exclusion and withdrawal, 169 patients were included in the analysis. Multiple linear regression analysis for systolic CPWCE revealed only community pharmacy SBP as an independent factor (ß = 0.35; P < 0.001). The regression analysis for diastolic CPWCE revealed female gender (ß = 4.88; P < 0.001), BMI (ß = 0.48; P < 0.001) and community pharmacy DBP (ß = 0.24; P < 0.001) as independent determinants. CONCLUSION: In this sample of treated hypertensive patients, factors such as gender, community pharmacy DBP and BMI were positively associated and may exert an important influence on the magnitude of the diastolic CPWCE. On the other hand, the CPWCE on SBP increased as the community pharmacy SBP increased.

Terapia lumínica: efectividad en el tratamiento del insomnio en pacientes de edad avanzada / Light therapy: its effectiveness in treating insomnia in elderly patients

No disponible

No disponible

Variación del conocimiento al asistir a un taller de asma para farmacéuticos comunitarios / Changes in knowledge after attending a community pharmacists’ asthma workshop

Antecedentes: Los farmacéuticos pueden jugar un papel importante tanto en la detección de asma como en su seguimiento. Objetivos: Determinar la variación de conocimiento, y las variables asociadas, de los farmacéuticos asistentes al taller de «Seguimiento Farmacoterapéutico en Asma bronquial en Adultos» que realizan el Cetro de Atención Farmacéutica del laboratorio Stada: (CAF-Stada) Método: Todos los asistentes al taller de «Seguimiento Farmacoterapéutico en Asmabronquial en Adultos» completaron un test antes dela sesión y otro después. Aquellos que abandonaron el taller o no cumplimentaron los test fueron excluidos del estudio. El test puntuaba de 0 a 10 y se analizaron las variaciones en las puntuaciones. Resultado: De los 90 participantes, 79 cumplieron los criterios de inclusión. El 81,4% fueron mujeres y la edad media fue de 38,8 años [IC95%=36,65-40,81]. La puntuación media en el test inicial fue 3,65 [IC95%=3,29-4,01]; el 72,2% de los farmacéuticos obtuvo una puntuación inferior a 5 puntos. La puntuación media en el test final fue7,33 [IC95%=7.01-7,65]. La variación de conocimiento media fue 3,68 [IC95%=3,29-4,07]. No hay relación estadísticamente significativa entrevariación de conocimiento y las otras variables analizadas (edad, género, otros cursos, o cargo en la farmacia). Conclusión: El taller de «Seguimiento Farmacoterapéutico en Asma bronquial en Adultos» que realizan el CAF-Stada) aumenta el conocimiento general del farmacéutico (AU)

Background: Pharmacists can play an important role in both the detection of asthma and itsmonitoring in patients with asthma. Objective: To assess the change in asthma knowledge, and associated variables, ofpharmacists attending the «Pharmacotherapy follow up of Adult Bronchial Asthma» workshops run by the Pharmaceutical Care Center of Stada Laboratories. Methods: All participants in the «Pharmacotherapy follow-up of Adult Bronchial Asthma» workshops completed a pre-test and a post-test. Those who left the workshop and those who did not complete the tests were not included in the analysis. Tests were scored from 0 to 10, and the change in scores was analyzed. Results: Of the 90 participating pharmacists, 79fulfilled the inclusion criteria. 81% (64) were female, and their average age was 38.8 years [CI95%=36.65-40.81]. The average pre-test score was 3.65[CI95%=3.29-4.01]; 72.2% of the pharmacistsscored less than 5 points. The average post-test score was 7.33 [CI95%=7.01-7.65]. The average change in scores was 3.68 [CI95%=3.29-4.07] . No statistical significance was found between this change in scores and other variables analyzed (age, gender, previous training, or position in the pharmacy). Conclusion: CAF Stada «Adult Bronchial Asthma» workshops increased pharmacists' general knowledge (AU)

Changes in knowledge after attending a community pharmacists' asthma workshop.

BACKGROUND: Pharmacists can play an important role in both the detection of asthma and its monitoring in patients with asthma. OBJECTIVE: To assess the change in asthma knowledge, and associated variables, of pharmacists attending the "Pharmacotherapy follow- up of Adult Bronchial Asthma" workshops run by the Pharmaceutical Care Center of Stada Laboratories. METHODS: All participants in the "Pharmacotherapy follow-up of Adult Bronchial Asthma" workshops completed a pre-test and a post-test. Those who left the workshop and those who did not complete the tests were not included in the analysis. Tests were scored from 0 to 10, and the change in scores was analyzed. RESULTS: Of the 90 participating pharmacists, 79 fulfilled the inclusion criteria. 81% (64) were female, and their average age was 38.8 years [CI95%= 36.65-40.81]. The average pre-test score was 3.65 [CI95%=3.29-4.01]; 72.2% of the pharmacists scored less than 5 points. The average post-test score was 7.33 [CI95%=7.01-7.65]. The average change in scores was 3.68 [CI95%=3.29-4.07]. No statistical significance was found between this change in scores and other variables analyzed (age, gender, previous training, or position in the pharmacy). CONCLUSION: CAF Stada "Adult Bronchial Asthma" workshops increased pharmacists' general knowledge.