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1.
An Real Acad Farm ; 85(3): 232-247, jul.-sept. 2019. mapas, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-184873

RESUMO

Este estudio analiza la influencia de los planes urbanísticos, de ordenación del territorio y de descongestión industrial, trazados tanto por el Ayuntamiento de Madrid como por el Gobierno de la Nación, sobre la localización de la industria farmacéutica instalada en la ciudad de Madrid y su entorno provincial, lo que nos lleva a valorar las coincidencias y las singularidades de este tipo de industria respecto del resto de establecimientos que vertebraron el espacio industrial madrileño durante el Franquismo


This paper analyzes the influence of the urban planning, territorial planning and industrial decongestion plans, drawn up both by the Madrid’s City Council and by the Government of the Nation, on the location of the pharmaceutical industry installed in the city of Madrid and its provincial environment, which leads us to assess the coincidences and singularities of this type of industry with respect to the rest of the establishments that formed the backbone of Madrid's industrial space during the Franco regime


Assuntos
História do Século XIX , História do Século XX , Indústria Farmacêutica/história , Indústria Farmacêutica/organização & administração , Farmácias/história , Espanha , População Urbana/história , Farmácias/organização & administração
2.
Hipertens. riesgo vasc ; 36(3): 137-144, jul.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183953

RESUMO

Introducción y objetivos: El objetivo es cuantificar la validez diagnóstica de la medida de la presión arterial en farmacia comunitaria (PAFC) y establecer los puntos de corte de la presión arterial sistólica (PAS) y de la presión arterial diastólica (PAD) que maximicen la citada validez, usando como patrón de oro la monitorización ambulatoria de la presión arterial (MAPA) de 24 h. Material y métodos: Estudio transversal, con selección consecutiva de pacientes usuarios de la farmacia comunitaria andaluza. Se midió la PAFC y, a continuación, una MAPA de 24 h, con lo que se evaluó la validez diagnóstica de PAFC. También se calculó el área bajo la curva ROC para PAS y PAD, los valores predictivos positivos y negativos para diferentes prevalencias, así como la variación de la sensibilidad y de la especificidad para los distintos puntos de corte de PAS/PAD, lo que sirvió para el cálculo de los puntos de corte óptimos. Resultados: Colaboraron 167 farmacias comunitarias, con 1.170 pacientes, de los que 1.110 aportaron datos válidos. La PAFC presenta una sensibilidad del 60,41% (IC 95%: 56,40-64,29), una especificidad del 79,77% (IC 95%: 76,12-82,99), un valor predictivo positivo de 76,96% (IC 95%: 72,89-80,57) y un valor predictivo negativo de 64,31% (IC 95%: 60,55%-67,90%). Por el método de curva ROC, los puntos de corte óptimos para la PAS y para la PAD son, respectivamente, 134/81mm Hg, puntos donde la sensibilidad y la especificidad se equilibran y se maximiza el índice de Youden. Conclusiones: La sensibilidad es relativamente baja. Para mejorarla se propone bajar el punto de corte de PAS y PAD. El óptimo calculado es 134/81mm Hg. Viene ello a aportar datos sobre la conveniencia de revisar a la baja el actual punto de corte (140/90), como propone la guía de 2017 de ACC/AHA


Introduction and objectives: The aim of this study is to determine the diagnostic validity of blood pressure measurement in the community pharmacy (CPBP), and to set the cut-off points in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in order to maximise the aforementioned validity, using 24 hour ambulatory blood pressure monitoring (ABPM) as the reference method. Material and methods: A cross-sectional study with consecutive selection of patient users of the community pharmacy in Andalusia. The CPBP was measured, followed by 24-hour ABPM, which assessed the diagnostic validity of the CPBP. The AUC of the ROC curve was also calculated for SBP and DBP, along with the positive and negative predictive values, for different prevalences and the variation of sensitivity and specificity for the different cut-off points for SBP/DBP. Results: A total of 167 community pharmacy participated with 1,170 patients, of which 1,110 were valid. The CPBP showed a sensitivity of 60.41% (95% CI: 56.40-64.29), and a specificity of the 79.77% (95% CI: 76.12-82.99), a positive predictive values of 76.96% (95% CI: 72.89-80.57), and a negative predictive values of 64.31% (95% CI: 60.55%-67.90%). By using the ROC curve method, the optimal cut-off points are 134/81mm Hg, the point where the sensitivity and specificity and are balanced and the Youden index is maximised. Conclusions: The sensitivity is relatively low. To improve it tends to lower the cut-off points of SBP and DBP. The calculated optimum is 134/81mm Hg. This provides data on the desirability to review the current cut-off points (140/90), as proposed by the ACC/AHA 2017


Assuntos
Humanos , Pressão Arterial/fisiologia , Farmácias/organização & administração , Monitorização Ambulatorial/instrumentação , Monitorização Ambulatorial/métodos , Estudos Transversais , Sensibilidade e Especificidade , Intervalos de Confiança , Curva ROC
3.
Am J Health Syst Pharm ; 76(Supplement_3): S74-S78, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31418772

RESUMO

PURPOSE: The development and implementation of centralized mail-order pharmacy services in an academic healthcare system are described. SUMMARY: The use of mail-order pharmacy services continues to increase, as mail-order services offer patient benefits such as reduced copayments and improved clinical outcomes. Prior to undertaking an initiative to improve its mail-order pharmacy services, the University of Utah Health system's pharmacy department offered decentralized mail-order pharmacy services at all of its retail pharmacies, but there was no standardized process for processing mail-order prescriptions or providing phone support to mail-order patients. Centralized mail-order pharmacy services were developed and implemented by creating (1) a standard process for mail-order pharmacy services, (2) a centralized mail-order prescription filling center, and (3) a call center to support mail-order pharmacy services. Implementation of centralized mail-order pharmacy services resulted in an almost 50% reduction in time spent by pharmacy team members on mail-order prescription filling and packaging tasks. Use of a central call center resulted in a decreased call abandonment rate and contributed to a decreased pharmacy workload resulting from an overall reduction in call volume due to an increased rate of first-call issue resolution. CONCLUSION: Establishment of a centralized mail-order pharmacy service along with operational and infrastructure improvements resulted in improved quality and regulatory compliance and enhanced labor efficiency and patient communication.


Assuntos
Implementação de Plano de Saúde , Farmácias/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Serviços Postais , Call Centers/organização & administração , Hospitais Universitários/organização & administração , Hospitais Universitários/estatística & dados numéricos , Humanos , Farmácias/estatística & dados numéricos , Farmacêuticos/organização & administração , Farmacêuticos/estatística & dados numéricos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Carga de Trabalho/estatística & dados numéricos
4.
Ethiop J Health Sci ; 29(3): 401-408, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31447509

RESUMO

Background: Frequent stock-out of drugs in the public hospitals causes National Health Insurance Scheme (NHIS) enrollees to purchase most of their medicines out-of-pocket in community pharmacies, thereby imposing financial constraints on them against the main objective of the scheme. The objectives of this study were to determine and compare the level of participation of private retail community pharmacies (PRCPs) in the NHIS of Nigeria and Ghana, to describe their spatial distribution, and to highlight from literature major factors that would influence the participation of these pharmacies in the scheme. Methods: PRCPs data were collected from the Nigerian NHIS active secondary healthcare providers list of 1st July 2017 and the Ghanaian NHIS active providers online list of 2018. PRCPs densities at the national levels were calculated from last published national coverage data for each country. Results: The total number of PRCP accredited by NHIS of both Nigeria and Ghana is 964(639[66.3% versus 325[33.7%]). NHIS accredited PRCPs densities for Nigeria and Ghana were 1 PRCP per 9, 390 enrollees and 1 PRCP per 33, 108 enrollees respectively. Across the Nigerian States, it was noted that Lagos State has the highest proportion (21.4%, n = 137) of community pharmacy participation in the scheme whereas, in Ghan, Greater Accra Region has the highest participation (34.2%, n = 111). Conclusion: This study revealed low participation of PRCPs and skewed spatial distribution between urban and rural areas of both countries, although there was higher participation of these pharmacies in Nigeria due to Nigerian lower NHIS coverage data compared to Ghana.


Assuntos
Medicamentos Essenciais/provisão & distribução , Programas Nacionais de Saúde/organização & administração , Farmácias/organização & administração , Gana , Humanos , Programas Nacionais de Saúde/estatística & dados numéricos , Nigéria , Farmácias/estatística & dados numéricos , Setor Privado/organização & administração , Setor Privado/estatística & dados numéricos
5.
J Oncol Pharm Pract ; 25(8): 1979-1986, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31203716

RESUMO

BACKGROUND: Onkofar Health Devices Inc. offers solutions and service for safe and accurate preparation of anticancer agents. Due to the necessity of specific instructions for the drug preparation systems and the widespread use of services including personnel, the company has to train the personnel employed as oncology pharmacy practitioner technicians. PURPOSE: This study aimed to investigate the contribution of the training program to the theoretical knowledge and the opinions of the participants about the training by retrospectively analyzing the related data. METHODS: The training program consisted of a comprehensive theoretical part and an applied practical part. Participants took pre-tests and post-tests and filled out a standard training evaluation form. Between November 2014 and September 2018, 100 people participated in the training. This study included 71 participants' pre-test and post-test results and 72 participants' evaluation forms. RESULTS: The test results showed that the post-test score was higher in all participants. There was a 34% increase between the average of scores. The improvement percentage was at least 9%, whereas the most considerable improvement was 61%. Overall, almost all of the participants conveyed their positive thoughts about the training. The participants' interest seemed to be mostly related to their applied practice. CONCLUSIONS: Increased post-test scores showed an increase in theoretical knowledge level. The training was found to meet the expectations and needs to a great extent. Participants' opinions contributed to the shaping of the educational content for future training programs. This study showed that the training program provided improvement and value for participants.


Assuntos
Composição de Medicamentos/normas , Assistência Farmacêutica/organização & administração , Farmácias/organização & administração , Técnicos em Farmácia/organização & administração , Antineoplásicos/administração & dosagem , Humanos , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos
8.
Farm. comunitarios (Internet) ; 11(2): 5-13, jun. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-186873

RESUMO

Introducción: el proyecto mundial May Measurement Month pretende sensibilizar a la población de todos los países participantes, entre ellos España, sobre la importancia de la medida periódica de las cifras de presión arterial (PA). Objetivo: el objetivo principal de este estudio es difundir entre la población española, a través de las farmacias comunitarias, la importancia de conocer sus cifras de PA para poder prevenir los problemas derivados de su mal control. Métodos: estudio descriptivo transversal realizado en farmacias comunitarias de las 17 comunidades autónomas españolas durante el mes de mayo 2017. Participaron voluntarios mayores de edad. Variables principales: presión arterial sistólica (PAS), presión arterial diastólica (PAD) en milímetros de mercurio (mmHg) y frecuencia cardíaca en latidos/minuto.Resultados: se realizaron 3.267 determinaciones por 190 farmacéuticos. El 25,6 % de los participantes tenía cifras elevadas de PA. El 40,6 % del total estaba con tratamiento para la hipertensión arterial. El 40,2 % de los que estaban en tratamiento no tenían la PA controlada. El 43,3 % de los participantes con cifras de PA elevada no recibía tratamiento. Conclusiones: la campaña MMM17 se difundió a través de las farmacias comunitarias en todas las comunidades autónomas y ha permitido realizar medidas de PA a sujetos que nunca y/o que hacía más de un año que se la habían medido. Un cuarto de la población mostraba valores elevados de PA. El grado de control en los participantes con tratamiento antihipertensivo era malo y casi la mitad de los que tenían valores elevados de PA no recibía tratamiento


Introduction: May Measurement Month is a global project that aims to raise awareness among the population in all participating countries, including Spain, of the importance of regular measurement of blood pressure (BP). Aim: The primary objective of this research is to raise awareness among the Spanish population through the community pharmacies of the importance of knowing their BP figures in order to prevent problems resulting from poor control. Methods: Cross-sectional descriptive study carried out in community pharmacies of the 17 Spanish Autonomous Communities during the month of May 2017. Volunteer adults participated. Primary endpoints: systolic blood pressure (SBP), diastolic blood pressure (DBP) in millimetres of mercury (mmHg) and heart rate in beats per minute. Results: 3.267 measurements were performed by 190 pharmacists. 25.6% of participants had high BP figures. 40.6% of the total were treated for hypertension. 40.2% of those on treatment had uncontrolled BP. 43.3% of participants with high BP figures were untreated. Conclusions: MMM17 campaign was spread through community pharmacies in all Autonomous Communities and has allowed to carry out BP measurements in patients who had never been measured and/or who had it measured more than a year ago. A quarter of the population showed high BP values. The degree of control in participants with antihypertensive treatment was poor and almost half of those with elevated BP values were untreated


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Promoção da Saúde/organização & administração , Pressão Arterial , Farmácias/organização & administração , Farmacêuticos/normas , Espanha , Epidemiologia Descritiva , Estudos Transversais , Tamanho da Amostra , Pressão Sanguínea , Tabagismo/complicações , Anti-Hipertensivos
9.
J Manag Care Spec Pharm ; 25(6): 688-695, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31134865

RESUMO

BACKGROUND: Medication therapy management (MTM) programs are designed to improve clinical outcomes and enhance appropriate medication use. Comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs) are 2 broad interventions defined within MTM services. While MTM services have been extensively researched, there are few comparisons of CMR versus non-CMR interventions. Given the variability in MTM interventions and lack of a consistent TMR definition in the literature, this study sought to compare CMRs and TMRs that were clearly defined based on Centers for Medicare & Medicaid Services (CMS) criteria. OBJECTIVES: To (a) compare acute inpatient admissions and emergency department (ED) visits between patients participating in MTM services (CMR, TMR, or both) and eligible nonparticipating patients and (b) examine the effect of receiving TMR services on medication adherence. METHODS: This was a retrospective cohort study of patients with Medicare Part D coverage who received MTM services and a 1:1 propensity score-matched control group. Participants had to be eligible for MTM services in 2014 or 2015 based on CMS requirements. CMRs were offered to all MTM-eligible patients, while TMRs were completed based on clinical rules that helped identify medication-related problems (MRPs). The date of MTM intervention, or eligibility for the control group, was considered the index date. Participants had to be continuously enrolled in a Medicare Advantage plan that included prescription drug coverage during the study period and have at least 6 months of data before and after the index date. Medical and pharmacy claims were assessed to examine trend-adjusted inpatient admissions and ED visits from pre-index to post-index date for participants and matched controls. RESULTS: In 2014 and 2015, receipt of TMR interventions was associated with statistically significant reductions in acute inpatient admissions. In 2014, there were 55.2 fewer admits per 1,000 individuals (95% CI = 29-81) and 30.8 fewer admits per 1,000 individuals in 2015 (95% CI = 20-42). Receipt of CMR-only interventions was associated with fewer acute inpatient admissions only when coupled with preidentification of MRPs (36.8 [95% CI = 25-49] fewer admits per 1,000 individuals). In 2015, there were significant reductions in ED visits for participants receiving TMR-only interventions or TMR/CMR interventions (26.1 [95% CI = 11-41] and 12.0 [95% CI = 1-23] fewer ED visits per 1,000 individuals, respectively). In both years, a larger percentage (0.4% for oral diabetes medications; 7.7% for antihypertensives; 3.0% for statins) of MTM participants had greater improvements in medication adherence in the post-index period compared with controls. CONCLUSIONS: Receiving MTM services targeted at resolution of MRPs (TMR or CMR/TMR) resulted in positive reductions in health care utilization and increases in medication adherence. Given the importance of optimal medication utilization, this study highlights the need for additional focus on resolution of MRPs through TMRs and CMRs that can support improved clinical outcomes. DISCLOSURES: No outside funding supported this study. Researchers completed the work as part of their employment with Humana. All authors are or were employees of Humana at the time of the study. There are no other conflicts of interest to disclose. This study was previously presented at AMCP Nexus 2017 on October 16, 2017, in Dallas, TX.


Assuntos
Medicare Part D/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , Conduta do Tratamento Medicamentoso/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Farmácias/organização & administração , Idoso , Idoso de 80 Anos ou mais , Uso de Medicamentos/economia , Uso de Medicamentos/estatística & dados numéricos , Serviço Hospitalar de Emergência/economia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Medicare Part D/economia , Conduta do Tratamento Medicamentoso/economia , Pessoa de Meia-Idade , Admissão do Paciente/economia , Admissão do Paciente/estatística & dados numéricos , Farmácias/economia , Farmácias/estatística & dados numéricos , Estudos Retrospectivos , Estados Unidos
10.
Pharmazie ; 74(3): 186-190, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30961687

RESUMO

Medication refill reminder services (MRRS), having the potential to support the detection of non-adherence and to promote periodic medication refilling by addressing forgetfulness, are not generally available in community pharmacy practice. Based on a new software module, a MRRS was developed. The acceptance of this service was tested in community pharmacies in Germany. Patients were recruited by trained pharmacy staff. Supported by the software, the pharmacies reminded patients to refill their prescription. After 7 months, the service was evaluated by patients and pharmacy staff. The pharmacy owners/managers were interviewed. Ten pharmacies applied the service to 148 patients, with 806 refill reminders for 391 drugs. Seventy-five patients (50.7%) chose to be reminded by a phone call, followed by text message (n=25), and email (n=18). Of all patients, 75 (50.7%) completed the paper-based questionnaire. Sixty-eight (90.7%) rated the service as good or very good and 54 (72.0%) felt more satisfied with their pharmacy. Sixty-four patients (85.3%) considered the service as supportive and wanted to continue. Thirty-nine pharmacy staff members (61.9%) answered the online questionnaire. Twenty-four (61.5%) stated that they found it difficult to use and apply the MRRS; twenty-six (66.6%) experienced technical problems. The service was rated good by 16 (41.0%) pharmacy staff members. They regarded the service helpful for some patients and wanted to continue after the end of the study. The majority of the ten interviewed pharmacy owners/managers expressed the opinion that the service was not very suitable for increasing customer loyalty and not cost-effective. Nevertheless, six (60.0%) of them wanted to continue using the service. The MRRS seems to be feasible, apart from technical difficulties. Patients rated the service as supportive, and the personal contact seems to be of high importance; most patients would like to continue the service. However, offering the service to patients turned out to be challenging in daily German community pharmacy practice.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Sistemas de Registro de Ordens Médicas , Farmácias/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Alemanha , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Farmacêuticos , Farmácia , Inquéritos e Questionários , Adulto Jovem
11.
J Manag Care Spec Pharm ; 25(6): 641-644, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30977701

RESUMO

Formularies that Include prior authorization and utilization management are widely used by managed care organizations (MCOs), Including health plans and pharmacy benefit management companies. Utilization management criteria are essential to optimizing patient outcomes and reducing waste, error, unnecessary drug use, and cost. The Academy of Managed Care Pharmacy (AMCP) Professional Practice Committee has developed the following 9 specific concepts for effective prior authorization practices by MCOs: (1) patient safety and appropriate medication use, (2) clinical decision making, (3) evidence-based review criteria, (4) automated decision support, (5) transparency and advanced notice, (6) emergency access, (7) provider collaboration, (8) need for timeliness and avoiding disruptions in therapy, and (9) cost-effectiveness and value. AMCP supports these concepts to allow for further collaboration between prescribers and payers in order to ensure that patients receive appropriate and timely access to drugs, devices, and other therapeutic agents. DISCLOSURES: No funding was received for the conceptualizing, writing, and/or editing of this manuscript. The Professional Practice Committee is composed of volunteers selected from current Academy of Managed Care Pharmacy members in good standing. Concepts presented in this document were developed by request of the Academy of Managed Care Pharmacy and are not intended to represent the views of committee members' employers or affiliated organizations.


Assuntos
Revisão de Uso de Medicamentos , Programas de Assistência Gerenciada/organização & administração , Assistência Farmacêutica/organização & administração , Medicamentos sob Prescrição , Autorização Prévia/organização & administração , Análise Custo-Benefício , Humanos , Seguro de Serviços Farmacêuticos/economia , Assistência Farmacêutica/economia , Farmácias/economia , Farmácias/organização & administração , Autorização Prévia/economia
12.
Drugs ; 79(6): 647-654, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30941607

RESUMO

OBJECTIVE: A recurrent observation is that associations between self-reported and objective medication adherence measures are often weak to moderate. Our aim was therefore to identify patients with different profiles on self-reported and objective adherence measures. STUDY DESIGN AND SETTING: This was an observational study of 221 community pharmacy patients who were dispensed antidepressants. Adherence profiles were estimated with Latent Profile Analysis (LPA) using data on self-reported adherence (Medication Adherence Rating Scale) complemented with data on medication beliefs (perceived necessity and concerns measured with the Beliefs about Medicines Questionnaire) and data from objective adherence measures (electronic monitoring of medication taking and the Medication Possession Ratio calculated from pharmacy dispensing data). RESULTS: 'Goodness-of-fit' statistics indicated the presence of three classes: "concordantly high adherent" (83%, high adherence on all measures), "concordantly suboptimal adherent" (11%, low adherence on all measures), and "discordant" (6%, high self-reported adherence but lower adherence on objective measures). CONCLUSION: Most patients had concordant outcomes on self-reported and objective measures of adherence. A small discordant class had high self-reported but low objective adherence. LPA will enable sensitivity analyses in future studies, for example excluding patients from the discordant class.


Assuntos
Antidepressivos/farmacologia , Medicamentos sob Prescrição/farmacologia , Adulto , Idoso , Feminino , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Farmácias/organização & administração , Projetos Piloto , Projetos de Pesquisa , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
13.
Farm. comunitarios (Internet) ; 11(1): 5-13, mar. 2019. graf, tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-186868

RESUMO

Introducción: La adherencia al tratamiento en enfermedades crónicas como la diabetes mellitus (DM) es de vital importancia. El incumplimiento está directamente implicado en el aumento del número de medicamentos prescritos en enfermos crónicos y es una de las causas más importantes de fracaso de los tratamientos. Objetivos: Evaluar en la farmacia comunitaria la prevalencia de no adherencia al tratamiento en DM tipo 2 mediante la realización del cuestionario MMAS-8. Material y métodos: Estudio observacional transversal realizado en mayo y junio de 2018. Se seleccionaron pacientes mayores de 45 años, en tratamiento con hipoglucemiantes. Se midió la adherencia farmacoterapéutica mediante la administración del cuestionario (MMAS-8) según la puntuación obtenida en el test y la percepción que tienen sobre su tratamiento. Resultados: Participaron 64 pacientes, 29 (45,3%) mujeres y 35 (54,7) hombres. Las mujeres tenían 65,5 años de edad media (DE=15,3) y los hombres 65,6 años (DE=12,3). La puntuación media del test de MMAS-8 fue de 6,2±2,1, no encontrando diferencias significativas entre sexos. Se encontró que el número de pacientes con baja adherencia fueron 21 (32,8%), con media adherencia 19 (29,7%) y con alta adherencia 24 (37,5%). No se encontró relación entre el porcentaje de adherencia al tratamiento con el sexo, edad, nivel de estudios y condición laboral. La creencia de que el tratamiento mejora la enfermedad y que los medicamentos prescritos son los adecuados aumenta la adherencia. Conclusiones: El cuestionario MMAS-8 se ha mostrado como una herramienta rápida y sencilla para la evaluación de la adherencia del tratamiento en la farmacia comunitaria


Background: The treatment adherence in chronic diseases such as diabetes mellitus is of vital importance. Noncompliance is directly implicated in the increase of the prescribed drugs number in chronic patients and is one of the most important causes of treatment failure. Objectives: To evaluate in the community pharmacy the prevalence of non-adherence to treatment in type 2 diabetes mellitus by completing the MMAS-8 questionnaire. Methods: Cross-sectional observational study conducted in May and June 2018. Patients older than 45 years were selected, in treatment with hypoglycemic agents. Pharmacotherapeutic adherence was measured by administering the questionnaire (MMAS-8) according to the score obtained in the test and the perception they have of their treatment. Results: 64 patients participated, 29 (45.3%) women and 35 (54.7) men. Women ware 65.5 years of age (SD = 15.3) and men 65.6 years (SD = 12.3). The mean score of the MMAS-8 test was 6.2±2.1, not finding significant differences between sexes. It was found that the number of patients with low adherence was 21 (32.8%), with medium adherence 19 (29.7%) and with high adherence 24 (37.5%). No relation was found between the percentage of adherence to treatment with sex, age, level of education and work condition. The belief that the treatment improves the disease and that the prescribed medications are adequate, increases adherence. Conclusions: The MMAS-8 questionnaire has been shown as a quick and simple tool for evaluating the adherence of the treatment in the community pharmacy


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Cooperação e Adesão ao Tratamento , Farmácias/normas , Hipoglicemia/tratamento farmacológico , Comercialização de Produtos , Hipertensão/epidemiologia , Farmácias/organização & administração , Inquéritos e Questionários , Percepção , Hipoglicemiantes/administração & dosagem , Estudos Transversais , Hipoglicemiantes/uso terapêutico
14.
Farm. comunitarios (Internet) ; 11(1): 14-18, mar. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-186869

RESUMO

Introducción: El deterioro cognitivo (DC) es una enfermedad que aumenta con la edad. Es importante conocer los factores protectores y de riesgo de esta enfermedad. Metodología: Estudio observacional realizado a 729 personas mayores de 65 años en 13 farmacias comunitarias durante dos años. Se recogieron datos demográficos (sexo, edad, nivel de estudios) y de estilos de vida (afición a la lectura, realización de pasatiempos, horas de televisión) y para el cribaje de los pacientes se realizaron los test SPMSQ (Short-Portable Mental State Questionaire) de Pfeiffer y Mini-Mental State Examination (MMSE) versión NORMADERM. También se realizó una revisión bibliográfica del tema. Resultados: Se detectó un 17,6% de DC. Se encontró una asociación estadísticamente significativa como protección frente al DC con la afición a la lectura y el nivel de estudios. No se encontró asociación con las horas de televisión (TV) ni con la realización de pasatiempos. La revisión bibliográfica aportó más factores protectores y de riesgo. Discusión: Con nuestros datos podemos afirmar que tanto la reserva cognitiva (años de estudio) como la estimulación cognitiva (horas de lectura) protegen del DC. Sobre los demás datos obtenidos no se han encontrado coincidencias, por lo que sería necesario aumentar el tamaño muestral para poder realizar una comparación más eficaz. Conclusiones: El nivel educativo bajo es un factor de riesgo de DC, mientras que estudios superiores serían un factor preventivo. La lectura es un factor protector de DC


Introduction: Cognitive Dysfunction (CD) is a disease that increases with age. It is important to know the protective and risk factors for this disease. Methodology: Observational study carried out on 729 people over 65 years of age in community 13 pharmacies for two years. Demographic data were collected (sex, age, level of studies) and lifestyles (love of reading, hobbies such as crossword puzzles or sudokus etc, TV hours), and the SPMSQ (Short-Portable Mental State Questionaire) test of Pfeiffer and MiniMental State Examination (MMSE) were carried out to check the patient's CD. A bibliographic review of the subject was also conducted. Results: 17.6% of CD was detected. A statistically significant association was found as a protection against CD with a love of reading and the level of studies. No association was found with TV hours or hobbies. The literature review provided more protective and risk factors. Discussion: With our data we can affirm that both cognitive reserve (years of study) and cognitive stimulation (hours of reading) protect from CD. No coincidences were found on the other data obtained, so it would be necessary to increase the sample size in order to make a more effective comparison. Conclusions: Low educational level is a risk factor for CD while higher education would be a preventive factor. Reading is a protective factor of CD


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Disfunção Cognitiva/prevenção & controle , Farmácias/organização & administração , Fatores de Proteção , Disfunção Cognitiva/epidemiologia , Serviços de Saúde para Idosos , Estudos Transversais , Estilo de Vida , Envelhecimento Cognitivo , Fatores de Risco , Benzodiazepinas , Metformina
16.
BMC Health Serv Res ; 19(1): 5, 2019 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-30611264

RESUMO

BACKGROUND: Community pharmacists' (CPs') interventions have a positive impact on managing respiratory patients. However, methods used by CPs to assess patients' inhaler technique and adherence are subjective. New technologies to objectively assess inhaler technique and adherence were introduced to address such a gap. This study aimed to explore CPs' perceptions towards the management of respiratory patients regarding inhaler technique and adherence. In addition, it explored the views of CPs and their need of technologies to objectively assess inhaler technique and adherence. CPs were probed with a new technology called Inhaler Compliance Assessment (INCA) device, designed to objectively monitor both inhaler technique and adherence of patients using a dry powder inhaler, as an example. METHODS: A qualitative study employing semi-structured interviews was conducted. A convenience and snowballing sampling strategy was employed to recruit CPs working in independent community pharmacies within West and South London. Twenty-three pharmacists were interviewed between August and November 2015. Data was analysed thematically using the framework methodology and coded using NVivo10 software. RESULTS: Analysis revealed five main themes: services and limitations of patient support, the need and acceptability of new technologies to support respiratory patients, fragmented primary care, the need to promote the clinical role of CPs, and professional identity. Patient support was patchy and affected by several barriers related to pharmacists and patients. In addition, lack of communications with different healthcare professionals in primary care and inaccessibility to clinical records were identified as problematic issues. Some CPs perceived their clinical role to be lacking within the patient care pathway. Interestingly, CPs showed positive a attitude towards the use of technologies, such as the INCA technology to support patients and were willing to provide new services. However, remuneration appeared to be a major driver for willingness to offer new services or promote existing services. CONCLUSION: The current study highlighted some measures that can augment CPs' clinical practice while managing patients, such as having accessibility to patients' medical records and the use of technologies such as the INCA technology to promote objective counselling of patients.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pneumopatias/tratamento farmacológico , Comunicação , Serviços Comunitários de Farmácia/organização & administração , Feminino , Humanos , Londres , Masculino , Adesão à Medicação , Nebulizadores e Vaporizadores , Percepção , Farmácias/organização & administração , Farmacêuticos/organização & administração , Atenção Primária à Saúde/organização & administração , Prática Profissional , Papel Profissional , Relações Profissional-Paciente , Pesquisa Qualitativa
17.
Int J Pharm Pract ; 27(1): 3-16, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30697864

RESUMO

OBJECTIVES: The aim of this systematic review was to examine the characteristics of effective lifestyle modification interventions designed for patients with newly diagnosed type 2 diabetes mellitus (T2DM) in order to determine elements that have the potential to be delivered in the community pharmacy setting. KEY FINDINGS: Seven studies, comprising three each of the interventions diet and structured education and one of supported exercise, were identified. Interventions were conducted in hospital diabetes clinics and clinics situated in both urban and rural areas. Interventions were delivered face to face by highly skilled personnel including physicians, nurses and dietitians. Duration of interventions ranged from 3 months to 5 years. SUMMARY: Structured education and dietary interventions in newly diagnosed type 2 diabetes effectively controlled blood glucose levels without pharmacological intervention. Important characteristics included face to face, individualised and multicomponent interventions with a duration of at least 6 months. These characteristics demonstrate potential for delivery in a community pharmacy setting, given its current involvement in delivering face to face, individual services with diet and lifestyle components. Further research is required to provide evidence for ideal intervention duration and frequency as well as training requirements for pharmacists.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Diabetes Mellitus Tipo 2/reabilitação , Estilo de Vida Saudável , Educação de Pacientes como Assunto , Farmácias/organização & administração , Glicemia , Diabetes Mellitus Tipo 2/sangue , Humanos , Farmacêuticos , Resultado do Tratamento
18.
Eur J Public Health ; 29(1): 17-23, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30239673

RESUMO

Background: Moderately elevated blood total cholesterol (TC), blood glucose (BG) and blood pressure (BP) are rarely symptomatic and as such many individuals remain untreated. We studied the yield of an in-pharmacy screening for identifying undetected high TC and strategies to reach those with absence of prior measurement of TC, BG and BP. Methods: A cross-sectional TC screening study with complementary TC measurements and self-administered questionnaire was conducted for 1 week in each of 2012 and 2014 in 148 and 149 BootsTM Norge AS community pharmacies nationwide in Norway. Results: Non-medicated adults (n = 21 090) with mean age 54.5 ± 16.0 were included. The study population resembled the Norwegian population in regards to body mass index, educational level, smokers and physical inactivity level, but with an overrepresentation of middle-aged women. Of 20 743 with available data, 11% (n = 2337) were unaware of their high TC ≥7.0 mmol/L, and an additional 8% were unaware of TC ≥6.2 mmol/L. More than 40% of the study sample had not measured TC or BG before. In order for future screenings to reach those who are less likely to have previously measured TC and BG, our results suggest that young, low-educated, overweight men and women should be targeted for TC measurement, whereas normal weigh men in all ages should be targeted for BG measurement. Conclusions: In total 19% in an in-pharmacy screening were unaware of their elevated TC of ≥6.2 mmol/L. We also identified characteristics that could be used reach those who are less likely to have measured TC and BG.


Assuntos
Doenças Cardiovasculares/diagnóstico , Colesterol/sangue , Serviços Comunitários de Farmácia/organização & administração , Programas de Rastreamento/organização & administração , Farmácias/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega
19.
Int J Pharm Pract ; 27(1): 80-87, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29602180

RESUMO

OBJECTIVES: The aim was to provide a comprehensive overview (using pertinent examples) of the various ways that Google Trends and Google data could inform pharmacy practice. The objectives were to: examine what type of information people search for in relation to a common class of medicines; ascertain where people are directed to (websites) following an initial search for a medicine or medical condition; and establish information about when they search. METHODS: The methodology differed depending on whether Google Trends or Google was being interrogated, but the search domain was always limited to the United Kingdom. Google Trends was queried, typically for a 5-year time frame, and data downloaded for many search inputs relating to medical conditions (self-treatable and non-self-treatable) and medicines (bought over-the-counter and prescribed). Google was queried and data collected for searches related to 'antibiotics'. KEY FINDINGS: Google Trends revealed a previously unknown seasonality pattern for irritable bowel syndrome. Related searches for 'antibiotics' revealed a high level of interest in the appropriateness of concomitant alcohol consumption and queries about what antibiotics are. Largely, people were being directed to reputable websites following their initial search input about a prescription-only medicine. However, searches for over-the-counter medicines were more likely to lead to commercial domains. CONCLUSIONS: This is one of the first studies to investigate use of Google Trends and Google in a pharmacy-specific context. It is relevant for practice as it could inform marketing strategies, public health policy and help tailor patient advice and counselling.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Comunicação em Saúde , Necessidades e Demandas de Serviços de Saúde , Comportamento de Busca de Informação , Farmácias/organização & administração , Aconselhamento/organização & administração , Política de Saúde , Humanos , Internet , Marketing de Serviços de Saúde/organização & administração , Reino Unido
20.
Int J Pharm Pract ; 27(1): 71-79, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29949210

RESUMO

OBJECTIVES: The Healthy Living Pharmacy framework, introduced in England in 2008, provides a tailored approach to the implementation of pharmacy services locally, facilitated by qualified 'Health Champions' (HCs). The study aimed to evaluate the perceived value of the 1-day level 2 HC training by assessing knowledge and confidence of HC pre- and post-training, and changes in practice. The views of additional stakeholders on factors that either obstructed or facilitated pharmacy engagement are also explored. METHODS: This study used a mixed method approach. Pre- and post-training surveys evaluating HC pre-existing knowledge and understanding of their role were used. Additionally, qualitative semi-structured interviews were undertaken with four key groups: participating pharmacists, non-participating pharmacists, Local Pharmaceutical Committee leads and Public Health Leads from Public Health England. KEY FINDINGS: A total of 354 pre-training evaluation surveys were completed on the training day (100%), compared to 54 post-evaluation postal surveys with a 19% (n = 54/282) response rate. The post-evaluation of the training indicated that 83% (n = 45) of qualified HC were actively implementing their new role, with observed increased confidence and service provision. From the 22 interviews conducted two major themes emerged including: Training and Impact. Training had a positive impact on staff knowledge and confidence plus service delivery. CONCLUSION: An immediate impact was observed in increasing HC knowledge and confidence, service delivery and awareness of facilities for patient sign-posting. There was no statistical evidence to support a positive effect stemming from training on services. However, it was identified that time and further training were needed to both provide and assess value within local public health.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Educação em Farmácia/estatística & dados numéricos , Promoção da Saúde/organização & administração , Farmacêuticos/estatística & dados numéricos , Papel Profissional , Competência Clínica/estatística & dados numéricos , Humanos , Londres , Farmácias/organização & administração , Farmácias/estatística & dados numéricos , Farmacêuticos/organização & administração , Farmacêuticos/psicologia , Inquéritos e Questionários/estatística & dados numéricos
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