Concordancia entre las listas de medicamentos esenciales y las guías para diabetes en América Latina y el Caribe / Concordance between essential medicines lists and diabetes guidelines in Latin America and the Caribbean / Concordância entre as listas de medicamentos essenciais e diretrizes para diabetes na América Latina e no Caribe

[RESUMEN]. Objetivo. Analizar la existencia y actualización de las listas de medicamentos nacionales (LMN) y guías de práctica clínica (GPC) para el tratamiento de la diabetes en América Latina y el Caribe (ALC). Comparar los fármacos incluidos en las listas y guías de cada país, entre sí y con los de la Organización Mundial de la Salud (OMS). Métodos. Estudio de corte transversal. Se identificaron las LMN y GPC para diabetes en los sitios web de la Organización Panamericana de la Salud y de las autoridades sanitarias nacionales. Se relevaron los fármacos y se analizaron por grupo farmacológico según el cuarto nivel de la nomenclatura ATC. Se utilizó el puntaje F1 para evaluar la proximidad de las LMN con la lista modelo de medicamentos esenciales (LMME) de la OMS. Resultados. Del total de países, 87,2% cuentan con LMN, y 91% con GPC (78% y 45% actualizadas en los últimos 5 años, respectivamente). En comparación con los 6 grupos de hipoglucemiantes de la LMME, las LMN tenían una mediana (rango) de 6 (4-13) y un puntaje F1 de 0,80; esto indica una consonancia adecuada. Las GPC tenían una mediana (rango) de 12 (1-12) hipoglucemiantes frente a los 8 de las guías de la OMS. Las GPC tuvieron una mediana de 15 fármacos más que las respectivas LMN. Conclusiones. Si bien la mayoría de los países de ALC cuentan con LMN y GPC para diabetes, la falta de concordancia entre ellas limita su eficacia. Es necesario alinear los procesos y criterios de elaboración de estas dos herramientas de la política de medicamentos.

[ABSTRACT]. Objective. Conduct an analysis to determine the existence and updating of national essential medicines lists (EMLs) and clinical practice guidelines (CPGs) for the treatment of diabetes in Latin America and the Carib- bean (LAC); and compare the medicines included in each country's list and guidelines both with each other and with those of the World Health Organization (WHO). Methods. Cross-sectional study. EMLs and CPGs for diabetes were found on the websites of the Pan Amer- ican Health Organization and national health authorities. Medicines were noted and analyzed according to pharmacological group, based on the fourth level of nomenclature of the Anatomical Therapeutic Chemical (ATC) classification system. F1 scoring was used to assess the proximity of EMLs to the WHO Model List of Essential Medicines (MLEM). Results. Of the total number of countries, 87.2% have EMLs, and 91% have CPGs (78% and 45% updated in the last five years, respectively). Compared to the six hypoglycemic groups of the MLEM, the EMLs had a median (range) of 6 (4–13) and an F1 score of 0.80; This indicates proper alignment. CPGs had a median (range) of 12 (1–12) hypoglycemic drugs compared to eight in the WHO guidelines. CPGs had a median of 15 more drugs than their respective EMLs. Conclusions. While most LAC countries have EMLs and CPGs for diabetes, the lack of concordance among them limits their effectiveness. It is necessary to align the processes and criteria for the development of these two tools for policymaking on medicines.

[RESUMO]. Objetivos. Analisar a existência e a atualização das listas nacionais de medicamentos (LNMs) e guias de prática clínica (GPCs) para o tratamento do diabetes na América Latina e no Caribe (ALC). Comparar os medicamentos incluídos nas listas e nas diretrizes de cada país entre si e com as da Organização Mundial da Saúde (OMS). Métodos. Estudo transversal. Foram identificadas LMNs e GPCs para o diabetes nos sites da Organização Pan-Americana da Saúde e das autoridades sanitárias nacionais. Os medicamentos foram pesquisados e analisados por grupo farmacológico de acordo com o quarto nível da classificação ATC. A pontuação F1 foi utilizada para avaliar o grau de proximidade das LMNs com a lista-modelo de medicamentos essenciais (LMME) da OMS. Resultados. Do total de países, 87,2% dispõem de uma LNM e 91%, de GPCs (78% e 45%, respectivamente, atualizadas nos últimos 5 anos). Em comparação com os seis grupos de agentes hipoglicemiantes da LMME, as LMNs tinham uma mediana (intervalo) de 6 (4 a 13) e uma pontuação F1 de 0,80, o que indica uma con- formidade adequada. As GPCs tinham uma mediana (intervalo) de 12 (1 a 12) agentes hipoglicemiantes, em comparação com 8 nos guias da OMS. As GPCs tinham uma mediana de 15 medicamentos a mais do que as respectivas LNMs. Conclusões. Embora a maioria dos países da América Latina e do Caribe disponha de LNMs e GPCs para o diabetes, a falta de concordância entre elas limita sua eficácia. É necessário alinhar os processos e os critérios de desenvolvimento dessas duas ferramentas da política de medicamentos.

Long-Term Care medicines formularies: any reasons for pharmacists' concern?

Abstract This study aimed to characterize and compare medicines formularies (MFs) used in Long-Term Care (LTC) facilities in Portugal, and to identify the prevalence of Potentially Inappropriate Medicines (PIMs). A systematic contact with LTC facilities was undertaken in December 2021. MFs were systematized according to the Anatomical Therapeutical Chemical classification system (ATC), followed by descriptive content analysis. A structured comparison between MFs developed by public organizations and private LTC facilities was performed. After duplicate removal and exclusion of medicines not for systemic use, two explicit criteria - the Algorithm of medication review in frail older people and the EU(7)-PIM list - were employed for PIMs identification. Five MFs were obtained and assessed. The three MFs developed by private institutions covered 23% of the national LTC facilities and approximately 34% of the national total of beds. Heterogeneity was particularly high for the Alimentary tract and metabolism, Blood and blood-forming organs, Musculoskeletal system, and Respiratory system ATC groups. A PIM prevalence of 29,4% was identified. Medicines distribution between the MFs suggests the need to develop national guidelines towards harmonizing medicines usage in LTC. The prevalence of PIMs found highlights the importance of a particular optimized use of this health technology in aged sub-populations

Listado de procedimientos médicos y sanitarios del Sector Salud del Documento Técnico "Catálogo de Procedimientos Médicos y Sanitarios del Sector Salud". Modifica Anexo Nº 1 / List of medical and sanitary procedures of the Health Sector of the Technical Document "Catalogue of Medical and Sanitary Procedures of the Health Sector". Amends Annex No. 1

El documento contiene la modificatoria al anexo N° 1 del listado de procedimientos médicos y sanitarios del Sector Salud, que es parte del Documento Técnico "Catálogo de Procedimientos Médicos y Sanitarios del Sector Salud". Además incorpora en el Anexo Nº1: Listado de Procedimientos Médicos y Sanitarios del Sector Salud del Documento Técnico "Catálogo de Procedimientos Médicos y Sanitarios del Sector Salud", aprobado mediante Resolución Ministerial Nº860-2021/MINSA, el procedimiento médico y sanitario correspondiente a la Vacuna contra el síndrome respiratorio agudo severo coronavirus 2 (SARS-CoV-2) (enfermedad por coronavirus [COVID-91]),uso intramuscular, dosis pediátrica desde 6 meses hasta los 4 años 11 meses 29 días con R.M 801-2022-MINSA.

Consideration of cancer medicines as part of the revisions to 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc): Section 8: Immunomodulators and Antineoplastics

This summary has been prepared by the Health Technologies and Pharmaceuticals (HTP) programme at the WHO Regional Office for Europe. It is intended to communicate changes to the 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) to national counterparts involved in the evidence-based selection of medicines for inclusion in national essential medicines lists (NEMLs), lists of medicines for inclusion in reimbursement programmes, and medicine formularies for use in primary, secondary and tertiary care.

Listado de procedimientos médicos y sanitarios / List of medical and sanitary procedures

El documento lista los procedimientos médicos y sanitarios contenidos en el plan esencial de aseguramiento en salud.PEAS vigente y su costo estándar.

A comparison of national essential medicines lists in the Americas

[ABSTRACT]. Objectives. To compare national essential medicines lists (NEMLs) from countries in the Region of the Americas and to identify potential opportunities for improving those lists. Methods. In June of 2017, NEMLs from 31 countries in the Americas were abstracted from documents included in a World Health Organization (WHO) repository. The lists from the Americas were compared to each other and to NEMLs from outside of the Americas, as well as with the WHO Model List of Essential Medicines, 20th edition (“WHO Model List”) and the list of the Pan American Health Organization (PAHO) Regional Revolving Fund for Strategic Public Health Supplies (“Strategic Fund”). Results. The number of differences between the NEMLs from the Americas and the WHO Model List were similar within those countries (median: 295; interquartile range (IQR): 265 to 347). The NEMLs from the Americas were generally similar to each other. While the NEMLs from the Americas coincided well with the Strategic Fund list, some medicines were not included on any of those NEMLs. All the NEMLs in the Americas included some medicines that were withdrawn due to adverse effects by a national regulatory body (median: 8 withdrawn medicines per NEML; IQR: 4 to 12). Conclusions. The NEMLs in the Americas were fairly similar to each other and to the WHO Model List and the Strategic Fund list. However, some areas of treatment and some specific medicines were identified that the countries should reassess when revising their NEMLs.

[RESUMEN]. Objetivos. Comparar las listas nacionales de medicamentos esenciales (LNME) de países de la Región de las Américas e identificar oportunidades potenciales de mejorarlas. Métodos. En junio de 2017, se extrajeron las LNME de 31 países de la Región de documentos incluidos en un repositorio de la Organización Mundial de la Salud (OMS). Se compararon estas listas entre sí y con listas de fuera de la Región, así como con la Lista Modelo de Medicamentos Esenciales de la OMS (20ª edición) y la lista del Fondo Rotatorio Regional para Suministros Estratégicos de Salud Pública de la Organización Panamericana de la Salud. Resultados. El número de diferencias entre las LNME de la Región y la Lista Modelo de la OMS fue similar dentro de esos países (mediana: 295; rango intercuartil (RIC): 265 a 347). Las LNME de la Región en general fueron similares entre sí. Si bien las LNME de la Región mostraron una coincidencia adecuada con la lista del Fondo Rotatorio, algunos medicamentos no estaban incluidos en ninguna de las primeras. Todas las LNME de la Región incluían algunos medicamentos que habían sido retirados del mercado por las autoridades regulatorias nacionales debido a efectos adversos (mediana: 8 medicamentos retirados en cada lista; RIC: 4 a 12). Conclusiones. Las LNME en la Región de las Américas son bastante similares entre sí y con la Lista Modelo de la OMS y la lista del Fondo Rotatorio de la OPS. Sin embargo, se identificaron algunas áreas terapéuticas y algunos medicamentos específicos que los países deberían reevaluar al revisar sus LNME.

[RESUMO]. Objetivos. Comparar as listas nacionais de medicamentos essenciais (LNME) dos países da Região das Américas e identificar oportunidades potenciais de melhoria. Métodos. Em junho de 2017, as LNME de 31 países das Américas foram obtidas de documentos incluídos em um repositório da Organização Mundial da Saúde (OMS). As listas foram comparadas entre si, com listas de fora da Região, com a Lista Modelo de Medicamentos Essenciais da OMS (20ª edição) e com a lista do Fundo Rotativo Regional para Fornecimentos Estratégicos de Saúde Pública da Organização Pan-Americana da Saúde (Fundo Estratégico). Resultados. As LNME dos países das Américas eram semelhantes entre si e apresentaram um número semelhante de diferenças em relação à Lista Modelo da OMS (mediana: 295; intervalo interquartil: 265-347). Embora as LNME nas Américas fossem altamente consistentes com a lista do Fundo Estratégico, alguns dos medicamentos do Fundo não apareciam em nenhuma dessas LNME. Todas as LNME nas Américas incluíam medicamentos retirados do mercado por algum organismo regulador nacional devido a efeitos adversos (mediana: 8 medicamentos retirados por LNME; intervalo interquartil: 4-12). Conclusões. As LNME nas Américas são bastante semelhantes entre si e próximas da Lista Modelo da OMS e da lista do Fundo Estratégico. Contudo, foram identificadas algumas áreas terapêuticas e alguns medicamentos específicos que os países deveriam reavaliar ao rever as suas LNME.

Изменения в Примерном перечне ВОЗ основных лекарственных средств для взрослых и Примерном перечне ВОЗ основных лекарственных средств для детей в издании 2019 г.

Настоящее резюме было подготовлено Программой по медицинским технологиям и лекарственным средствам Европейского регионального бюро ВОЗ. В нем изложена информация об изменениях в Примерном перечне ВОЗ основных лекарственных средств для взрослых и Примерном перечне ВОЗ основных лекарственных средств для детей в издании 2019 г., предназначенная для национальных партнеров, задействованных в научно обоснованном выборе лекарственных средств для внесения в национальные перечни основных лекарственных средств, перечни лекарственных средств для включения в программы возмещения стоимости и лекарственные формуляры для учреждений первичного, вторичного и третичного уровней системы оказания медицинской помощи.

Рассмотрение лекарственных средств для лечения сахарного диабета в рамках пересмотра Примерного перечня ВОЗ основных лекарственных средств для взрослых (Перечень ОЛС) в издании 2019 г.: аналоги инсулина длительного действия: инсулин гларгин; инсулин детемир; инсулин деглудек (и биоаналоги)

Настоящее резюме было подготовлено Программой по медицинским технологиям и лекарственным средствам Европейского регионального бюро ВОЗ. В нем изложена информация об изменениях в Примерном перечне ВОЗ основных лекарственных средств для взрослых и Примерном перечне ВОЗ основных лекарственных средств для детей в издании 2019 г., предназначенная для национальных партнеров, задействованных в научно обоснованном выборе лекарственных средств для внесения в национальные перечни основных лекарственных средств, перечни лекарственных средств для включения в программы возмещения стоимости и лекарственные формуляры для учреждений первичного, вторичного и третичного уровней системы оказания медицинской помощи.

Рассмотрение лекарственных средств, применяемых при онкологических заболеваниях, в рамках пересмотра Примерного перечня ВОЗ основных лекарственных средств (Перечень ОЛС) и Примерного перечня ВОЗ основных лекарственных средств для детей (Перечень ОЛС для детей) в издании 2019 г.: Раздел 8: Иммуномодуляторы и противоопухолевые лекарственные средства

Настоящее резюме было подготовлено Программой по медицинским технологиям и лекарственным средствам Европейского регионального бюро ВОЗ. В нем изложена информация об изменениях в Примерном перечне ВОЗ основных лекарственных средств для взрослых и Примерном перечне ВОЗ основных лекарственных средств для детей в издании 2019 г., предназначенная для национальных партнеров, задействованных в научно обоснованном выборе лекарственных средств для внесения в национальные перечни основных лекарственных средств, перечни лекарственных средств для включения в программы возмещения стоимости и лекарственные формуляры для учреждений первичного, вторичного и третичного уровней системы оказания медицинской помощи.

Рассмотрение антибактериальных лекарственных средств в рамках пересмотра Примерного перечня ВОЗ основных лекарственных средств (Перечень ОЛС) и Примерного перечня ВОЗ основных лекарственных средств для детей (Перечень ОЛС для детей) в издании 2019 г.: Раздел 6.2 Антибактериальные лекарственные средства, в том числе списки антибиотиков групп доступа, наблюдения и резерва

Настоящее резюме было подготовлено Программой по медицинским технологиям и лекарственным средствам Европейского регионального бюро ВОЗ. В нем изложена информация об изменениях в Примерном перечне ВОЗ основных лекарственных средств для взрослых и Примерном перечне ВОЗ основных лекарственных средств для детей в издании 2019 г., предназначенная для национальных партнеров, задействованных в научно обоснованном выборе лекарственных средств для внесения в национальные перечни основных лекарственных средств, перечни лекарственных средств для включения в программы возмещения стоимости и лекарственные формуляры для учреждений первичного, вторичного и третичного уровней системы оказания медицинской помощи.

Consideration of diabetes medicines as part of the revisions to 2019 WHO Model List of Essential Medicines for adults (EML): long-acting insulin analogues: insulin glargine; insulin detemir; insulin degludec (and biosimilars)

This summary has been prepared by the Health Technologies and Pharmaceuticals (HTP) programme at the WHO Regional Office for Europe. It is intended to communicate changes to the 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) to national counterparts involved in the evidence-based selection of medicines for inclusion in national essential medicines lists (NEMLs), lists of medicines for inclusion in reimbursement programmes, and medicine formularies for use in primary, secondary and tertiary care.

Consideration of antibacterial medicines as part of the revisions to 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc): Section 6.2 Antibacterials including Access, Watch and Reserve Lists of antibiotics

This summary has been prepared by the Health Technologies and Pharmaceuticals (HTP) programme at the WHO Regional Office for Europe. It is intended to communicate changes to the 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) to national counterparts involved in the evidence-based selection of medicines for inclusion in national essential medicines lists (NEMLs), lists of medicines for inclusion in reimbursement programmes, and medicine formularies for use in primary, secondary and tertiary care.

Changes to 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc)

This summary has been prepared by the Health Technologies and Pharmaceuticals (HTP) programme at the WHO Regional Office for Europe. It is intended to communicate changes to the 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) to national counterparts involved in the evidence-based selection of medicines for inclusion in national essential medicines lists (NEMLs), lists of medicines for inclusion in reimbursement programmes, and medicine formularies for use in primary, secondary and tertiary care.

Do Brazilian hospital pharmacists record, document, archive and disseminate their clinical practice?

An exploratory study was conducted to present the approach of Brazilian hospital pharmacists to registering, documenting, archiving and disseminating clinical practice. The data were collected using an electronic questionnaire (n=348). In fact, 97.41% of pharmacists record their clinical practice, out of which 64.01% (n=217) do in electronic form, mainly in private hospitals (p<0.000), in the central, southern and southeastern regions (p=0.040), and by professionals with 1-5 years of experience (p=0.001). The main software used is non-specific to clinical practice: an electronic spreadsheet (47.93%; n=104) and text editor (13.37%; n=29). The archiving of records is performed by 87.61% (n=297) of professionals, where 80.13% (n=238) do so in physical form; however, 77.31% (n=184) of these files are kept for less than the standard recommended time. Documentation in medical records is carried out by 55.17% (n=192) of pharmacists, increasing among those with 1-5 years of clinical practice (p=0.001), and dissemination is performed by 74.71% (n=260) of hospital pharmacists, with a lower frequency in public hospitals (p=0.012) and among professionals with fewer hours dedicated exclusively to clinical pharmacy (p=0.012). These results can undergird the revision of competency-based training programs of Brazilian clinical pharmacists to remain pharmacists as a valuable health team member