Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 90
Filtrar
1.
Int J Clin Pharm ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32026354

RESUMO

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.

2.
Farm. comunitarios (Internet) ; 11(4): 21-31, dic. 2019. graf, tab
Artigo em Espanhol | IBECS-Express | ID: ibc-ET2-4050

RESUMO

Introducción: la colaboración entre médicos y farmacéuticos es necesaria en el manejo de los síntomas menores, ya que el paciente acude a ambos profesionales sanitarios para su tratamiento. El objetivo del estudio fue elaborar protocolos de trabajo consensuados entre farmacéuticos comunitarios y médicos de atención primaria para el Servicio de Indicación Farmacéutica (SIF). Material y método: se utilizaron dos metodologías: revisión bibliográfica y grupo de expertos para el consenso. Estos protocolos se actualizaron y diseñaron a partir de un documento previo de 2008. En el grupo de expertos se incluyeron cuatro farmacéuticos comunitarios de SEFAC (2), MICOF (2) y cuatro médicos de atención primaria de semFYC (2) y SEMERGEN (2). Resultados: se consensuaron protocolos de trabajo para 31 síntomas menores distribuidos en cinco grupos: respiratorios, dolor moderado, digestivos, dermatológicos y otros. Se añadieron cinco síntomas nuevos al documento de partida. Respecto a la estructura de cada síntoma se consideró: concepto, causas más frecuentes, criterios de derivación al médico (edad, síntomas de alarma, duración de los síntomas, otros problemas de salud y/o medicamentos y situaciones especiales), recomendaciones para la prevención y tratamiento (no farmacológico y farmacológico). Conclusión: el documento desarrollado mediante colaboración entre profesionales de la medicina y la farmacia es una herramienta que contribuye a la mejora de la actuación del farmacéutico en el manejo de los síntomas menores desde la farmacia comunitaria, con énfasis en la definición de indicadores que señalan la necesidad de derivar el paciente al médico de atención primaria


Background: To increase the collaboration between community pharmacists and medical practitioners working in primary care it is critical to have collaborative protocols in place. Minor ailments could be a good example where this collaboration would benefit patient care as patients are seeking treatment in both settings. These collaborative protocols would assist in diminishing the variability of treatments in both settings. The aim of the study was to develop care protocols for minor ailments agreed between medical practitioners and pharmacists Methods: Two different methodologies were used to arrive at a consensus for the proto-cols: literature review and expert group. Some of the clinical protocols were updated from a previous document created in 2008. Expert group was composed of four community pharma-cists (SEFAC, MICOF) and four medical practitioners (SemFyC y Semergen). Results: Thirty-one protocols for minor ailments were agreed and allocated to five groups (five new minor ailments protocols were added: respiratory tract-related conditions, gastrointestinal disturbance, pain, dermatological problems and others.Protocols were structured following: definition, more frequent causes, referral criteria (pa-tient’s age, red flags, symptom’s duration, patient’s health problems and treatments and physiological situations), recommendations for management (prevention, non-pharmacological and pharmacological treatment) and references used. Conclusions: Clinical protocols agreed between health professionals of medicine and phar-macy are a tool that contribute to better management of minor ailments in community pharmacy

3.
BMJ Open ; 9(6): e028467, 2019 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-31230025

RESUMO

OBJECTIVES: The usefulness of telemedicine (TM) in type 2 diabetes mellitus (T2DM) has been discussed in recent years. The aim of this study is to describe patients' perceptions about TM and to identify preferences on TM resources, in Spain. DESIGN: An observational, cross-sectional study was conducted using a structured questionnaire. PARTICIPANTS: 1036 patients with T2DM accepted to participate in the study (response rate: 68%). RESULTS: Blood glucose values were recorded by 85.9% of the patients while data such as lifestyle habits were only recorded by 14.4% of the patients. Previous experience in TM was reported by 9.8% of the patients, out of which 70.5% were satisfied with its service and 73.5% considered that the use of TM had optimised their T2DM management. However, most of these patients noted aspects to be improved such as user-friendliness (81.4%), interaction with the medical team (78.4%) and time required for recording/transferring data (78.4%). Experienced patients had better perception about TM usefulness than naïve patients for all listed aspects (p<0.05). Among naïve patients, 38.2% expressed their willingness to participate in TM programmes, but only 4.7% were invited to do so. Patients considered that physicians' (77.5%) and pharmacists' (75.5%) encouragement can boost the use of TM. CONCLUSIONS: In Spain, nearly 10% of patients with T2DM have experience with TM and it is well accepted, especially one based on glucometers. Nevertheless, in order to promote TM use, easier and time-saving programmes for patient-physician interaction should be optimised.

4.
Daru ; 27(1): 379-387, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30778915

RESUMO

BACKGROUND: Pharmacovigilance (PV) plays an essential role in monitoring and raising awareness of adverse drug reactions (ADRs). Increasingly, ADRs are reported and PV information and activities are circulated via the Internet. PV actions are carried out by the Regulatory Agencies (RAs) responsible for medicinal products in each country. OBJECTIVE: The objective of this study is to ascertain and assess the operation and areas of competence of the PV system in Brazil and to compare them with those of Spain, the European Union (EU) and the United States (USA), through the information available on the websites of the RAs in each country. METHODS: A search of the information provided on the websites of these countries' RAs, establishing indicators to assess how far the information is available and accessible. RESULTS: The RAs we studied are similarly organised and they complied with most of the 38 indicators we defined to obtain and assess the information they provide on PV procedures and their systems for electronic reporting of ADRs. Brazil's RA, ANVISA, complied with 100% of the areas of competence analysed and with 92.11% of the indicators established for the study. CONCLUSIONS: Brazil's PV system, through ANVISA, achieves a good level of performance, both in itself and compared to the other RAs. There is room for improvement in three of the indicators analysed.


Assuntos
Legislação de Medicamentos/organização & administração , Farmacovigilância , Brasil , União Europeia , Humanos , Internet , Indicadores de Qualidade em Assistência à Saúde , Espanha , Estados Unidos
6.
Ars pharm ; 58(3): 115-126, jul.-sept. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-168841

RESUMO

Introducción: La presente guía está enfocada en ayudar al paciente con Enfermedad Inflamatoria Intestinal que asiste a la oficina de farmacia, mediante la oferta de servicios de atención farmacéutica como son la farmacovigilancia y el seguimiento farmacoterapéutico que buscan promover la inclusión del farmacéutico comunitario en el equipo de salud. Objetivo: Elaborar una guía de actuación para el Farmacéutico Comunitario en pacientes con Enfermedad Inflamatoria Intestinal Metodología: El protocolo de revisión sistemática para la elaboración de la presente guía fue desarrollado en base a los criterios en el que se establecen: Identificar la pregunta de investigación, realizar un plan de estrategia en bases de datos electrónicos, utilizar un enfoque de equipo para la extracción de información, realizar un análisis temático y resumir la información. Resultados: La elaboración de algoritmos en la presente guía permite aportar información oportuna para el farmacéutico comunitario acorde a las características individuales que se presenten en cada paciente permitiendo detectar de manera rápida y eficaz los problemas que se pudieren presentar durante la enfermedad para poder prevenirlos e intervenir de manera oportuna. Discusión: La información aportada ayuda a reforzar los conocimientos teórico-prácticos del farmacéutico comunitario, incentivándolo a promover y promocionar servicios de atención farmacéutica enfocados en las necesidades del paciente


Introduction: This guide is focused on helping the patient with Inflammatory Bowel Disease who attends the pharmacy office by offering pharmaceutical care services such as pharmacovigilance and pharmacotherapeutic follow-up that seek to promote the inclusion of the community pharmacist in the team of health. Objective: To develop an action guide for the Community Pharmacist in patients with Inflammatory Bowel Disease Methodology: The systematic review protocol for the development of this guide was developed based on the criteria in which they establish: Identify the research question, make a strategy plan in electronic databases, use a team approach to the extraction of information, perform a thematic analysis and summarize the information. Results: The development of algorithms in this guide allows to provide timely information for the community pharmacist according to the individual characteristics presented in each patient, allowing the rapid and effective detection of problems that may arise during the illness in order to prevent and intervene timely


Assuntos
Humanos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Assistência Farmacêutica/organização & administração , Guias como Assunto , Serviços Comunitários de Farmácia/organização & administração , Farmacovigilância , Monitoramento de Medicamentos/métodos
7.
Int J Clin Pharm ; 39(4): 750-758, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28434119

RESUMO

Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.


Assuntos
Serviços Comunitários de Farmácia/economia , Análise Custo-Benefício/métodos , Revisão de Uso de Medicamentos/economia , Revisão de Uso de Medicamentos/métodos , Farmacêuticos/economia , Papel Profissional , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Espanha/epidemiologia
8.
Psychol Health Med ; 22(5): 578-587, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27295564

RESUMO

Professional pharmaceutical services may impact on patient's health behaviour as well as influence on patients' perceptions of the pharmacist image. The Health Belief Model predicts health-related behaviours using patients' beliefs. However, health beliefs (HBs) could transcend beyond predicting health behaviour and may have an impact on the patients' perceptions of the pharmacist image. This study objective was to develop and test a model that relates patients' HBs to patient's perception of the image of the pharmacist, and to assess if the provision of pharmacy services (Intervention group-IG) influences this perception compared to usual care (Control group). A qualitative study was undertaken and a questionnaire was created for the development of the model. The content, dimensions, validity and reliability of the questionnaire were pre-tested qualitatively and in a pilot mail survey. The reliability and validity of the proposed model were tested using Confirmatory Factor Analysis (CFA). Structural Equation Modelling (SEM) was used to explain relationships between dimensions of the final model and to analyse differences between groups. As a result, a final model was developed. CFA concluded that the model was valid and reliable (Goodness of Fit indices: x²(80) = 125.726, p = .001, RMSEA = .04, SRMR = .04, GFI = .997, NFI = .93, CFI = .974). SEM indicated that 'Perceived benefits' were significantly associated with 'Perceived Pharmacist Image' in the whole sample. Differences were found in the IG with also 'Self-efficacy' significantly influencing 'Perceived pharmacist image'. A model of patients' HBs related to their image of the pharmacist was developed and tested. When pharmacists deliver professional services, these services modify some patients' HBs that in turn influence public perception of the pharmacist.


Assuntos
Atitude Frente a Saúde , Serviços Comunitários de Farmácia , Farmacêuticos , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários
9.
Res Social Adm Pharm ; 13(2): 313-320, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27185270

RESUMO

BACKGROUND: The roles of community pharmacists are evolving to include provision of expanded professional pharmacy services, thus leading to an increased interest in pharmacist-patient interactions. Role theory can be used to explain the interaction between this pair of individuals, by focusing on the roles performed by each one. OBJECTIVE: To develop and test a model that relates patients' image of the pharmacist to their expectations of pharmacist's role, and how this then influences patients' reactions toward the pharmacist's role. METHODS: A qualitative study was undertaken, and a questionnaire was created for the development of the model, based on role theory. The content, dimensions, validity and reliability of the questionnaire were pre-tested qualitatively and in a pilot mail survey. The reliability and validity of the proposed model were tested using confirmatory factor analysis (CFA). Structural equation modelling (SEM) was used to explain relationships between dimensions of the final model. RESULTS: A final model was developed. CFA concluded that the model was valid and reliable (Goodness of Fit indices: χ2(109) = 227.662, P = 0.000, RMSEA = 0.05, SRMR = 0.05, GFI = 1.00, NNFI = 0.90, CFI = 0.92). SEM indicated that "perceived pharmacist image" was associated positively and significantly with both "professional expectations" (the standardized path coefficient of (H) = 0.719, P < 0.05), as well as "courtesy expectations" (the standardized path coefficient of (H) = 0.582, P < 0.05). At the same time, "professional expectations" were associated positively and significantly with "positive reactions" (the standardized path coefficient of (H) = 0.358, P < 0.05), but negatively with "Negative reactions" (the standardized path coefficient of (H) = -0.427, P < 0.05). "Courtesy expectations" were associated positively and significantly with "positive reactions" (the standardized path coefficient of (H) = 0.081, P < 0.05), as well as "negative reactions" (the standardized path coefficient of (H) = 0.450, P < 0.05). CONCLUSIONS: A valid and reliable model of patients' image of the pharmacist related to their expectations and reactions to the pharmacist's role was developed and tested. When the perceived image of the pharmacist is enhanced, patients' expectations of the pharmacist are heightened; in turn, these expectations were associated with reactions of patients.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Modelos Teóricos , Farmacêuticos/organização & administração , Relações Profissional-Paciente , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Projetos Piloto , Papel Profissional , Reprodutibilidade dos Testes , Inquéritos e Questionários
10.
Res Social Adm Pharm ; 13(3): 614-627, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27423785

RESUMO

Pharmacist-led medication review services are recognized as a key to medicines management. This case study describes the implementation process of a medication review with follow-up service in a community pharmacy setting and evaluates its initial outcomes. An implementation-effectiveness hybrid study was undertaken in a community pharmacy setting. The implementation process was divided into four different phases: Exploration and adoption, program installation, initial implementation, and full operation. A core set of implementation outcomes was measured, including penetration, implementation costs, feasibility, fidelity, acceptability, appropriateness and efficiency. The penetration rate of the service was nearly 62.5%, and the implementation costs were 57,359.67€. There was a high retention-participation rate of patients. For every month of service provision, there was a 1.27 increase in the number of patients requesting the service, compared to the number of patients being offered the service. The time spent on service provision was 171.7 min per patient. Average patient satisfaction with the service was 4.82 (SD: 0.39, scale 1-5), and the acceptance rate of care plans by patients and general medical practitioners were 96.99% and 96.46%, respectively. There were 408 negative outcomes associated with the use of medications were identified during the study (3.09 per patient), of which 96.3% were resolved. The average time per patient spent on service provision significantly decreased along the 18 months of service provision. This case report can assist individual pharmacists and professional organizations interested in implementing evidence-based services by offering an example on how to approach the implementation process in a systematic way.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Conduta do Tratamento Medicamentoso/organização & administração , Satisfação do Paciente , Farmacêuticos/organização & administração , Humanos , Papel Profissional , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Fatores de Tempo
11.
Eur J Health Econ ; 18(9): 1069-1078, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27913940

RESUMO

BACKGROUND: Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient's health outcomes through an optimization of the medication. OBJECTIVE: To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis. METHODS: The economic evaluation was based on a cluster randomized controlled trial. Patients in the intervention group (IG) received the MRF service and the comparison group (CG) received usual care. The analysis was conducted from the national health system (NHS) perspective over 6 months. Direct medical costs were included and expressed in euros at 2014 prices. Health benefits were estimated by assigning a monetary value to the quality-adjusted life years. One-way deterministic sensitivity analysis was undertaken in order to analyse the uncertainty. RESULTS: The analysis included 1403 patients (IG: n = 688 vs CG: n = 715). The cost analysis showed that the MRF saved 97 € per patient in 6 months. Extrapolating data to 1 year and assuming a fee for service of 22 € per patient-month, the estimated savings were 273 € per patient-year. The cost-benefit ratio revealed that for every 1 € invested in MRF, a benefit of 3.3 € to 6.2 € was obtained. CONCLUSION: The MRF provided health benefits to patients and substantial cost savings to the NHS. Investment in this service would represent an efficient use of healthcare resources.


Assuntos
Reconciliação de Medicamentos , Polimedicação , Anos de Vida Ajustados por Qualidade de Vida , Idoso , Análise Custo-Benefício , Seguimentos , Humanos , Farmácias
12.
Int J Clin Pharm ; 38(5): 1057-62, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27450503

RESUMO

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.


Assuntos
Serviços Comunitários de Farmácia , Conhecimento do Paciente sobre a Medicação/métodos , Farmacêuticos , Papel Profissional , Terapia Assistida por Computador/métodos , Adulto , Idoso , Serviços Comunitários de Farmácia/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Conhecimento do Paciente sobre a Medicação/tendências , Farmacêuticos/tendências , Terapia Assistida por Computador/tendências , Resultado do Tratamento
13.
Aten. prim. (Barc., Ed. impr.) ; 48(6): 366-373, jun.-jul. 2016. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-153911

RESUMO

Objetivo: Determinar la percepción del farmacéutico comunitario sobre el uso de analgésicos y evaluar la práctica farmacéutica en dolor leve-moderado prestada en farmacias comunitarias españolas. Diseño: Se realizó un estudio observacional transversal, método encuesta, entre abril y septiembre de 2013. Emplazamiento: Un total de 696 farmacias comunitarias de 20 comunidades autónomas españolas. Participantes: Farmacéuticos comunitarios con experiencia profesional mínima de un año. Mediciones principales: Caracterización de la demanda de analgésicos, del usuario de analgésicos y de la intervención farmacéutica en dolor leve-moderado desde la perspectiva del farmacéutico comunitario. Resultados: En base a la práctica farmacéutica el 45% de los pacientes con dolor acuden a la farmacia a retirar un medicamento con receta médica. La patología más consultada es el dolor de cabeza (35%). El 21% de los usuarios de analgésicos se automedican. El ibuprofeno y el paracetamol son los fármacos más utilizados. El 39% de los farmacéuticos afirman seguir un protocolo de indicación. Se encontró correlación entre la experiencia profesional del farmacéutico y los indicadores de proceso de indicación (Fisher p < 0,05). El 88% de los farmacéuticos verifican 2 indicadores del servicio de dispensación. El 15% de los farmacéuticos derivan al médico. Conclusiones: Se diferencian 3 grupos mayoritarios de usuarios de analgésicos según solicite el servicio de indicación, dispensación o se automedique. Se requiere una mayor formación de los farmacéuticos en protocolos de dolor individualizados a los perfiles de pacientes identificados y en criterios de derivación al médico, que permitan asegurar de manera sistemática la utilización correcta de analgésicos y la obtención de resultados clínicos positivos (AU)


Objective: To examine the use of analgesics, from the perspective of the pharmacist community, and pharmaceutical practice in mild-moderate pain. Design: A cross-sectional, observational study was performed between April and September 2013. Setting: 696 community pharmacies in 20 Spanish provinces. Participants: Community pharmacists with a minimum professional experience of one year. Main measurements: Characterisation of the demand for analgesics, analgesic users, and pharmaceutical intervention for mild-moderate pain from the perspective of the pharmaceutical community. Results: The main reason why a patient with mild-moderate pain visits a pharmacy is to receive a drug with prescription (45.5%), and the most common condition is headache (35.2%). Ibuprofen and paracetamol are the most commonly used drugs for mild-moderate pain. More than one-third (38.9%) of pharmacists follow a protocol for counselling. A correlation was found between the pharmacist's professional experience and the application of counselling process (Fisher P < .05). Some 87.8% of pharmacists checked two indicators from the dispensing service, and only 1.3% did not check any. Referral to a physician was made by 14.8% of pharmacists, with the main reason being the detection of alarm indicators. Conclusions: Protocols need to be designed and adapted to the characteristics of the 3 profiles identified, in order to increase the efficiency of pharmaceutical services in mild-moderate pain relief. Practical and specific training in pain are required to implement services to ensure the correct and systemic use of analgesics and positive clinical outcomes (AU)


Assuntos
Humanos , Masculino , Feminino , Analgésicos/administração & dosagem , Analgésicos/uso terapêutico , Percepção , Manejo da Dor , Assistência Farmacêutica/métodos , Assistência Farmacêutica/organização & administração , Farmácia/organização & administração , Serviços Comunitários de Farmácia , Assistência Farmacêutica/normas , Assistência Farmacêutica/tendências , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/normas , Inquéritos e Questionários/normas , Inquéritos e Questionários , Estudos Transversais/métodos
14.
Ars pharm ; 57(2): 89-92, abr.-jun. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-156812

RESUMO

En la actualidad los conceptos de Problemas Relacionados con Medicamentos (PRM) y Resultados Negativos Asociados a la Medicación (RNM) ya consensuados, se encuentran bien integrados en la práctica farmacéutica, aunque se han detectado ciertas discrepancias en la interpretación de estos conceptos que precisan aclaración. En la presente nota clínica se procede, de acuerdo a la evidencia aportada, a clarificar estos conceptos fundamentalmente en los que se refieren a la categoría de necesidad


Currently the concepts of problems associated with drugs and negative outcomes related to medicines as agreed, are well integrated into the pharmacy practice, although they have been detected certain discrepancies in the interpretation of these concepts requiring clarification. In this note clinic one proceeds, according to the evidence provided, to clarify these concepts fundamentally in which refer to the category of necessity


Assuntos
Humanos , Masculino , Feminino , Conduta do Tratamento Medicamentoso/organização & administração , Conduta do Tratamento Medicamentoso , Sistemas de Medicação/normas , Assistência Farmacêutica/organização & administração , Assistência Farmacêutica/normas , Assistência Farmacêutica , Avaliação de Processos e Resultados (Cuidados de Saúde)/organização & administração , Avaliação de Processos e Resultados (Cuidados de Saúde)/normas , Avaliação de Resultado de Intervenções Terapêuticas/métodos , Assistência Farmacêutica/métodos , Assistência Farmacêutica/tendências
15.
Br J Clin Pharmacol ; 82(3): 831-8, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27195696

RESUMO

AIMS: The aims were to assess the impact of a medication review with follow-up (MRF) service provided in community pharmacy to aged polypharmacy patients on the number of medication-related hospital admissions and to estimate the effect on hospital costs. METHODS: This was a sub-analysis of a cluster randomized controlled trials carried out in 178 community pharmacies in Spain. Pharmacies in the intervention group (IG) provided a comprehensive medication review during 6 months. Pharmacists in the comparison group (CG) delivered usual care. For the purposes of this sub-analysis, an expert panel of three internal medicine specialists screened the hospitalizations occurring during the main study, in order to identify medication-related hospitalizations. Inter-rater reliability was measured using Fleiss's kappa. Hospital costs were calculated using diagnosis related groups. RESULTS: One thousand four hundred and three patients were included in the main study and they had 83 hospitalizations. Forty-two hospitalizations (50.6%) were medicine-related, with a substantial level of agreement among the experts (kappa = 0.65, 95% CI 0.52, 0.78, P < 0.01). The number of medication-related hospitalizations was significantly lower in patients receiving MRF (IG 11, GC 31, P = 0.042). The probability of being hospitalized was 3.7 times higher in the CG (odds ratio 3.7, 95% CI 1.2, 11.3, P = 0.021). Costs for a medicine-related hospitalization were €6672. Medication-related hospitalization costs were lower for patients receiving MRF [IG: €94 (SD 917); CG: €301 (SD 2102); 95% CI 35.9, 378.0, P = 0.018]. CONCLUSION: MRF provided by community pharmacists might be an effective strategy to balance the assurance of the benefit from medications and the avoidance of medication-related hospitalizations in aged patients using polypharmacy.


Assuntos
Serviços Comunitários de Farmácia/economia , Revisão de Uso de Medicamentos/economia , Hospitalização/estatística & dados numéricos , Polimedicação , Idoso , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Masculino , Variações Dependentes do Observador , Espanha
16.
J Eval Clin Pract ; 22(5): 808-15, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27198085

RESUMO

OBJECTIVES: To assess medication knowledge in adult patients and to explore its determinants. METHOD: Cross-sectional study. Medication knowledge was the primary outcome and was assessed using a previously validated questionnaire. A multivariate logistic regression analysis was performed to explore the association between medication knowledge and the factors included in the model. RESULTS: Seven thousand two hundred seventy-eight patients participated in the study. 71.9% (n = 5234) (95% CI: 70.9%-73.0%) of the surveyed patients had an inadequate knowledge of the medication they were taking. The dimensions obtaining the highest level of knowledge were the 'medication use process' and 'therapeutic objective of medication'. The items 'frequency' (75.4%), 'dosage' (74.5%) and 'indication' (70.5%) had the highest percentage of knowledge. Conversely, 'medication safety' represented the dimension with the lowest scores, ranging from 12.6% in the item "contraindications" to 15.3% in the item 'side effects'. The odds ratio (OR) of having an inadequate medication knowledge increased for unskilled workers (OR: 1.33; 85% CI:1.00-1.78; P = 0.050), caregivers (OR:1.46; 95% CI:1.18-1.81; P < 0.001), patients using more than one medication (OR: 1.14; 95% CI: 1.00-1.31; P = 0.050) and patients who did not know the name of the medication they were taking (OR: 2.14, 95% CI: 1.71-2.68 P < 0.001). CONCLUSION: Nearly three quarters of the analysed patients had inadequate knowledge regarding the medicines they were taking. Unskilled workers and caregivers were at a higher risk of lacking of medication knowledge. Other factors that correlated with inadequate medication knowledge were the use of more than one drug and not knowing the name of the medication dispensed.


Assuntos
Conhecimento do Paciente sobre a Medicação , Idoso , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Espanha , Inquéritos e Questionários
18.
Aten Primaria ; 48(6): 366-73, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-26520414

RESUMO

OBJECTIVE: To examine the use of analgesics, from the perspective of the pharmacist community, and pharmaceutical practice in mild-moderate pain. DESIGN: A cross-sectional, observational study was performed between April and September 2013. SETTING: 696 community pharmacies in 20 Spanish provinces. PARTICIPANTS: Community pharmacists with a minimum professional experience of one year. MAIN MEASUREMENTS: Characterisation of the demand for analgesics, analgesic users, and pharmaceutical intervention for mild-moderate pain from the perspective of the pharmaceutical community. RESULTS: The main reason why a patient with mild-moderate pain visits a pharmacy is to receive a drug with prescription (45.5%), and the most common condition is headache (35.2%). Ibuprofen and paracetamol are the most commonly used drugs for mild-moderate pain. More than one-third (38.9%) of pharmacists follow a protocol for counselling. A correlation was found between the pharmacist's professional experience and the application of counselling process (Fisher P<.05). Some 87.8% of pharmacists checked two indicators from the dispensing service, and only 1.3% did not check any. Referral to a physician was made by 14.8% of pharmacists, with the main reason being the detection of alarm indicators. CONCLUSIONS: Protocols need to be designed and adapted to the characteristics of the 3 profiles identified, in order to increase the efficiency of pharmaceutical services in mild-moderate pain relief. Practical and specific training in pain are required to implement services to ensure the correct and systemic use of analgesics and positive clinical outcomes.


Assuntos
Analgésicos/uso terapêutico , Atitude do Pessoal de Saúde , Uso de Medicamentos/estatística & dados numéricos , Manejo da Dor/estatística & dados numéricos , Dor/tratamento farmacológico , Farmacêuticos , Farmácia , Adulto , Estudos Transversais , Uso de Medicamentos/normas , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Espanha
19.
Patient Educ Couns ; 99(3): 339-347, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26475728

RESUMO

OBJECTIVE: To identify health care professional-patient relationship theoretical models and individual factors that may have an influence on this relationship and be relevant to community pharmacy practice. METHODS: Using the recommended methodology by Prisma Statement, a search was undertaken in PubMed for health care professional-patient relationship theoretical models that included individual factors. RESULTS: Eight theoretical models met the inclusion criteria. These models were classified based on their aim, their focus on the interaction process, external factors influencing the process, and their practical applications. The most common influential modifiable factors were knowledge, needs, values, expectations, beliefs and perceptions. CONCLUSION: 'The Theory of Goal Attainment' (TGA) appears to be the most useful model for community pharmacy practice. The perceptions and expectations of both patients and pharmacists could be the two most interesting modifiable factors to apply in pharmacy practice. These modifiable influential factors could be altered by specific training such as behavioral aspects. PRACTICE IMPLICATIONS: No theoretical model has been specifically developed for analyzing the community pharmacist-patient relationship. TGA may be appropriate for community pharmacy practice, since it takes into consideration both, attaining patients health outcomes, as well as improving patient-pharmacist relationship.


Assuntos
Serviços Comunitários de Farmácia , Modelos Teóricos , Farmacêuticos , Papel Profissional , Relações Profissional-Paciente , Feminino , Humanos , Assistência Centrada no Paciente , Qualidade da Assistência à Saúde
20.
Eur Respir J ; 47(4): 1134-43, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26677937

RESUMO

The objective of this systematic review was to evaluate the impact of pharmacists' interventions on clinical asthma outcomes on adult patients and to identify the outcome indicators used.PubMed, Scopus, Web of Science and Scielo were searched. Studies addressing pharmacists' interventions on adult asthma patients reporting clinical asthma outcomes were incorporated.11 clinical outcomes were identified in 21 studies. 10 studies measured the impact of the intervention on asthma control. Randomised controlled trials (RCT) and non-RCTs found positive results in percentages of controlled patients and Asthma Control Questionnaire (ACQ) scores. Discordant results were found for Asthma Control Test results. Asthma severity was assessed in four studies. One RCT found a significant decrease in the percentage of severe patients; two non-RCTs found significant improvements in severity scores. 11 studies reported pulmonary function indicators, showing inconsistent results. Eight studies measured asthma symptoms; three RCTs and four non-RCTs showed significant improvements.RCTs and non-RCTs generated similar results for most outcomes. Based on the evidence generated by RCTs, pharmacists' have a positive impact on the percentage of controlled patients, ACQ scores, severity and symptoms. Future research should report using the core outcome set of indicators established for asthma (PROSPERO CRD42014007019).


Assuntos
Asma/tratamento farmacológico , Farmacêuticos , Adulto , Bases de Dados Factuais , Humanos , Adesão à Medicação , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes de Função Respiratória , Inquéritos e Questionários , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA