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Abstract: Chronic kidney disease (CKD) is the existence of abnormalities in renal structure or function with an impact on health. This is usually considered when estimated glomerular filtration (eGF) falls under 60 mL/min/1.73m2. Its clinical course leads to renal replacement therapy (dialysis or transplant) when eGF falls under 15 mL/min/1.73m2. Screening in at risk populations has been proven to be cost-effective. The aim of this work is to perform CKD screening in the community pharmacy. In this publication we report and justify the methodology in detail. Methodology: Pharmacists from the community pharmacies taking part selected patients who complied with inclusion and not exclusion criteria. Creatinine was measured by means of a finger prick and eGF calculated with the formula CKD-EPI. If this is lower than a set value, which depends on age, referral to the general practitioner takes place. Results: A total of 141 out of 200 pharmacies took part in the study. In all 2116 patients were recruited and 116 patients were lost. The final sample size was 2000 patients. Discussion: The protocol was successfully implemented by community pharmacists and was extremely well received by community pharmacy users. The age adjustment for eGF thresholds provides a novel additional filter. The aim is not to overburden primary care centres with potential referrals of false positives. Confirmation of the diagnosis is subject to voluntary communication by the patient to the pharmacist.
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AIM OF THIS STUDY: The aim of this study is to calculate smoking prevalence among first, third and fifth-year pharmacy students in Spain, and to describe their attitude towards giving up smoking. METHODS: Cross-sectional multi-center study using an ad hoc self-administered questionnaire in first, third and fifth-year pharmacy students at seven Spanish universities. Bivariate analysis with chi-square and Student's t-test, statistical significance p<0.05. RESULTS: Smoking prevalence: 34.92%. The smokers smoke 31.04 (SD=43.182) cigarettes/week on average. Pharmacy students have a positive attitude towards giving up smoking, with differences between year groups (p=0.036). CONCLUSIONS: Four in ten pharmacy students in Spain smoke every day by the time they finish their degree. Smoking prevalence is lower in the first few years of the degree and increases over time. Students also have a positive attitude towards giving up smoking, and are in favor of measures that can be taken to try to stop people smoking.
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Atitude do Pessoal de Saúde , Abandono do Hábito de Fumar/psicologia , Fumar/epidemiologia , Estudantes de Farmácia/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fumar/psicologia , Espanha/epidemiologia , Inquéritos e Questionários , Universidades , Adulto JovemRESUMO
OBJECTIVE: Our aim was to estimate the prevalence of Pharmacotherapy negative outcomes in Primary Care Emergency visits in a rural environment, and to determine their preventability and severity. DESIGN: Descriptive study with an analytical component. SITE: Primary Care Emergency Service (SUAP), Mula. Murcia. PATIENTS: The study consisted of 330 patients over a 33 week period. METHOD: Number and type of Pharmacotherapy negative outcomes: Pharmacist through the data, a validated questionnaire and medical history, assessing whether there was a relationship between the medications and the patient, and the reason for going to the Primary Care Emergency. In case of suspicion of Pharmacotherapy negative outcomes the patient is reassessed by the doctor, and the Pharmacotherapy negative outcomes confirmed or not identified. RESULTS: Of the 330 patients, 317 were evaluable. The mean age of patients was 39.63 years and 51.42% were women. The mean number of drugs used was 1.38, and 26.50% (95% CI, 21.94% -31.62%) patients were detected with Pharmacotherapy negative outcomes as a cause of visiting the Primary Care Emergency. 53.57% of the detected Pharmacotherapy negative outcomes detected as regards efficacy was 53.75%, 40.48% as regards need. More than three-quarters (77.41%; 95% CI, 67.35% -85.01%) of emergency visits caused by Pharmacotherapy negative outcomes were avoidable. In terms of severity, 92.86% of the Pharmacotherapy negative outcomes were mild. CONCLUSIONS: One in four Mula SUAP visits are due to a Pharmacotherapy negative outcomes, and 77.41% of them are preventable.
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Emergências , Serviço Hospitalar de Emergência , Atenção Primária à Saúde , Adulto , Estudos Transversais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Saúde da População Rural , Índice de Gravidade de DoençaRESUMO
Objetivo: validar un cuestionario de conocimiento de medicación en la población adolescente estudiante de bachillerato.Material y métodos: emplazamiento y muestra: para la citada validación se han usado los datos obtenidos en el estudio ConóceMe. Concretamente, la respuesta al cuestionario en el primer seguimiento en el total de los alumnos (n= 12.030). Para la prueba de fiabilidad test-retest se han usado la línea base y el primer seguimiento solo del grupo control (n= 6.228).Análisis de los datos: se han evaluado la fiabilidad (consistencia interna, test de dos mitades y test-retest), la validez (análisis factorial) y el funcionamiento de los ítems (dificultad, discriminación y correlación respecto al total del cuestionario). Resultados: las pruebas de fiabilidad arrojan unos resultados con índices todos ellos superiores a 0,7. Así el alfa de Cronbach tiene un valor de 0,80 y el test de dos mitades 0,81.La validez muestra un análisis factorial que obtiene su óptimo en una solución de tres factores, todos ellos con valores propios superiores a 0,9 y explicando entre los tres una variancia del 70 % del total.En cuanto a los ítems, todos presentan valores aceptables de funcionamiento en cuanto a dificultad y discriminación y una buena correlación respecto al total de puntuación del cuestionario.Conclusiones: el cuestionario de conocimiento valorado en el presente estudio presenta unas propiedades métricas adecuadas, siendo de utilidad para el fin que se pretendía, evaluar conocimientos generales sobre medicamentos en la población de estudiantes de bachillerato.
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Humanos , Preparações Farmacêuticas , Análise de Dados , Inquéritos e QuestionáriosRESUMO
INTRODUCCIÓN: en la farmacia comunitaria se realizan determinaciones de parámetros analíticos cada vez con más frecuencia. Los valores obtenidos son muy útiles en el trabajo de atención farmacéutica. Uno de ellos, la creatinina en sangre, puede ser especialmente útil para la detección y seguimiento de la enfermedad renal crónica. Además, permitiría sugerir al clínico la desprescripción o ajuste de dosis de determinados medicamentos nefrotóxicos o de eliminación renal en función del filtrado glomerular calculado. Se plantea valorar la utilidad de un nuevo aparato, el StatSensor Xpress Creatinine® de Nova Biomedical como paso previo a la realización de un estudio sobre la posibilidad de implantar un servicio con estas características. MATERIAL Y MÉTODOS: a partir de una muestra de sangre proporcionada por uno de los investigadores y una solución control de creatinina se preparan 35 muestras que son analizadas con el aparato problema. Otras 35 muestras alícuotas de las primeras son analizadas por un laboratorio de referencia. Se evalúan la exactitud, rendimiento diagnóstico y precisión mediante las pruebas Passing Bablock, coeficiente de correlación de Lin, Bland Altman, sensibilidad y especificidad diagnóstica y coeficiente de variación. RESULTADOS: la prueba de Passing Bablock y el coeficiente de Lin son correctos. Bland Altman es estadísticamente significativa en valores superiores a 5 mg/dl. La sensibilidad y especificidad diagnósticas son del 100 % y el coeficiente de variación es menor del 5 %. CONCLUSIÓN: el analizador de mano StatSensor Xpress Creatinine® es válido en el rango de valores habituales en farmacia comunitaria
INTRODUCTION: At community pharmacy, determinations of analytical parameters are made more and more frequently. The values obtained are particularly useful in Pharmaceutical Care work. One of them, blood creatinine, can be especially useful for the detection and monitoring of chronic renal disease. In addition, it would allow to suggest to the clinician the deprescription or dose adjustment of certain nephrotoxic or renal elimination drugs according to the calculated glomerular filtrate. The usefulness of a new device, the StatSensor Xpress Creatinine® by Nova Biomedical, is being considered as a preliminary step to carrying out a study on the possibility of implementing a professional service with these characteristics. MATERIAL AND METHODS: From a blood sample provided by one of the researchers and a creatinine control solution, 35 samples are prepared and analyzed with the test device. Another 35 aliquots of the former are analyzed by a reference laboratory. Accuracy, diagnostic performance and precision are evaluated using the Passing Bablock, Lin correlation coefficient, Bland Altman, diagnostic sensitivity and specificity, and coefficient of variation tests. RESULTS: The Passing Bablock test and the Lin coefficient are correct. Bland Altman is statistically significant at values greater than 5 mg/dL. Diagnostic sensitivity and specificity are 100% and the coefficient of variation is less than 5%. CONCLUSION: The StatSensor Xpress Creatinine® Handheld Analyzer is valid in the range of common community pharmacy values
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Humanos , Serviços Comunitários de Farmácia , Nefropatias/sangue , Nefropatias/diagnóstico , Creatinina/sangue , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Valores de ReferênciaRESUMO
OBJETIVO: Evaluar la efectividad de la intervención educativa en la adherencia al tratamiento con antibióticos y en la evolución de los síntomas referidos por el paciente. DISEÑO: Estudio experimental controlado con asignación sistemática. Emplazamiento: farmacia comunitaria en Murcia. Participantes: pacientes que acudieron a la farmacia con una receta de antibiótico. Intervención: Aportar información sobre las características del tratamiento (duración, pauta y forma de utilización) y la correcta adherencia. En el grupo Control se procedió a una venta habitual. Mediciones principales: se evaluaron la «adherencia al tratamiento» y la «percepción de salud» a la semana de la dispensación mediante entrevista telefónica. RESULTADOS: Finalizaron el estudio 126 pacientes: 62 en el Grupo Control (GC) y 64 en el Grupo Intervención (GI). No hubo diferencias entre grupos en las características basales, incluido el nivel de conocimientos previo a la intervención. Tras la intervención, la adherencia al tratamiento en el GC fue del 48,4% (IC 95%: 36,4-60,6) frente al 67,2% (IC 95%: 55,0-77,4) del GI, siendo esta diferencia del 18,8% (p = 0,033; IC 95%: 15,8-34,6;). La falta de adherencia fue de más de una toma en el 81,2% GC vs el 38,1% GI, diferencia del 43,1% (p = 0,001; IC 95%: 16,4-63,1%). En la percepción de salud del paciente no se encontraron diferencias. La regresión logística mostró como predictor de adherencia el conocimiento de la medicación y la coincidencia entre la duración del tratamiento indicado por el médico y la duración del envase prescrito en la receta. CONCLUSIONES: Una intervención educativa durante la dispensación del antibiótico mejora la adherencia al tratamiento frente a una atención habitual
OBJECTIVE: To assess the effectiveness of an educational intervention on antibiotic adherence and patient-reported resolution of symptoms. DESIGN: A controlled experimental study with systematic assignment to groups. Setting: A pharmacy in Murcia. Participants were patients who came to the pharmacy with a prescription for antibiotics. Intervention provided information on treatment characteristics (duration, dose and method of use) and correct compliance. A control group received routine care. Main variables "treatment adherence" and "perceived health" were evaluated one week after dispensation by telephone interview. RESULTS: A total of 126 patients completed the study, 62 in the Control Group (CG) and 64 in the Intervention Group (IG). There were no differences between the groups in baseline characteristics, including the level of knowledge before the intervention. At the end of the study, treatment adherence in the CG was 48.4% (CI: 36.4-60.6), compared with 67.2% (CI: 55.0-77.4) in the IG. The difference of 18.8% was statistically significant (p = 0.033; 95% CI = 15.8-34.6). Non-compliance through missing more than one dose was 81.2% in the CG versus 38.1% in the IG, which is a statistically significant difference of 43.1% (p = 0.001; 95% CI = 16.4-63.1%). No significant differences were found in patient-perceived health. Logistic regression showed as predictor of adherence, the medication knowledge and the coincidence between duration of treatment indicated by physician and duration of treatment written in the prescription. CONCLUSIONS: An educational intervention during antibiotic dispensation improves treatment adherence versus routine care
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Humanos , Masculino , Feminino , Adesão à Medicação , Cooperação do Paciente/psicologia , Farmácias/organização & administração , Farmácias/provisão & distribuição , Farmácias/tendências , Educação de Pacientes como Assunto/métodos , Antibacterianos/uso terapêutico , Ensaio Clínico , Recusa em Tratar/ética , Recusa do Paciente ao Tratamento/ética , Recusa do Paciente ao Tratamento/psicologia , Assistência ao Paciente/tendências , TelefoneRESUMO
Objetivos: Los estudiantes generalmente no reconocen al tabaco como una de las principales causas de enfermedades, por lo que se plantea estudiar el conocimiento del tabaco y los métodos de deshabituación tabáquica del alumno de 1º, 3º y 5º curso de la licenciatura de Farmacia en España. Pacientes y método: Estudio multicéntrico observacional descriptivo transversal con componente analítico desarrollado mediante un cuestionario "ad hoc" y autocumplimentado por los alumnos de 1º, 3º y 5º de Farmacia de siete Facultades de Farmacia españolas. Resultados: Se totalizaron 922 cuestionarios, observándose que el grado de conocimiento de tabaco del alumno de 1º y 3º de Farmacia de España está en su mayoría en un percentil medio-bajo, mientras que el mayor porcentaje de 5º tiene un percentil alto (p<0,001). Al aumentar el curso aumenta también el conocimiento del tabaco y disminuye ser extranjero y ser fumador (p<0,001). En el grado de conocimiento sobre métodos de deshabituación tabáquica, el alumno de 5º obtiene su mayor porcentaje en percentil alto (p<0,001). Influyen positivamente el curso académico y ser extranjero. Ser fumador influye de forma negativa, sabiendo menos cuanto más se fuma. No se encontraron diferencias en el conocimiento del tabaco (p=0,528) y en el conocimiento sobre métodos de deshabituación tabáquica (p=0,508) según el género. Conclusiones: Cuatro de cada diez alumnos de Farmacia al terminar su licenciatura consigue un buen nivel de conocimientos sobre tabaco y tres de cada diez conocen los métodos de deshabituación tabáquica(AU)
Aim: Students generally do not recognize the snuff as a major cause of disease, so it is to study the knowledge of tobacco and methods of smoking cessation student's 1 st, 3 rd and 5 th year of the undergraduate of Pharmacy in Spain. Patients and methods: Cross-sectional observational multicenter study with an analytical component developed through a questionnaire "ad hoc" and self-completed by the students of 1, 3 and 5 of Pharmacy Faculty of Pharmacy of seven selected Spanish. Results: He totaled 922 questionnaires, showing that the degree of knowledge of tobacco the student of 1 and 3 of Pharmacy of Spain is mostly on a percentile medium-low, while the highest percentage of 5 ° has a percentile higher (p <0.001) . By increasing the current also increases the knowledge of being a foreigner and decreases snuff and smoking (p <0.001). The degree of knowledge about smoking cessation methods, the student gets 5 th percentile for the most high percentage (p <0.001). Positively influence the academic year and a foreigner. Being a smoker has a negative influence, knowing the more you smoke less. There were no differences in knowledge of snuff (p = 0.528) and knowledge about methods of smoking cessation (p = 0.508) according to gender. Conclusions: Four out of ten students complete their undergraduate Pharmacy achieved a good level of knowledge of snuff and only three in ten know the methods to quit smoking(AU)
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Humanos , Adolescente , Adulto Jovem , Fumar/terapia , Estudantes de Farmácia/estatística & dados numéricos , Estudos Multicêntricos como Assunto , Estudos TransversaisRESUMO
Objetivo: Analizar la prevalencia de los resultados negativos asociados a la medicación (RNM) que son causa de consulta en un servicio de urgencias de atención primaria (SUAP) en un entorno rural. Determinar la evitabilidad y la gravedad de los mismos. Diseño: Estudio observacional descriptivo transversal. Emplazamiento: SUAP de Mula. Murcia. Participantes: Un total de 330 pacientes, en un periodo de 33 semanas. Mediciones principales: Número y tipo de RNM: el farmacéutico, a través de los datos obtenidos de un cuestionario validado y la historia clínica, evaluó si existía relación entre los medicamentos que toma el paciente y el motivo de acudir a urgencias. En caso de sospecha de RNM se reevaluaba con el médico y se confirmaban o no los RNM identificados. Resultados: De los 330 pacientes fueron evaluables 317. La media de edad de los pacientes era de 39,63 años y el 51,42% eran mujeres. La media de medicamentos que utilizaban fue de 1,38. Se detectaron un 26,50% (IC 95% 21,94-31,62) de pacientes con RNM como causa de visita a urgencias. El 53,57% de los RNM detectados fue de la categoría de efectividad y el 40,48% de necesidad. El 77,41% (IC-95% 67,35-85,01) de las visitas causadas por RNM fueron evitables. En cuanto a la gravedad, el 92,986% de los RNM eran leves. Conclusiones: Una de cada 4 visitas al SUAP de Mula está causada por un RNM y, de ellas, el 77,41% son evitables(AU()
Objective: Our aim was to estimate the prevalence of Pharmacotherapy negative outcomes in Primary Care Emergency visits in a rural environment, and to determine their preventability and severity. Design: Descriptive study with an analytical component. Site: Primary Care Emergency Service (SUAP), Mula Murcia. Patients: The study consisted of 330 patients over a 33 week period. Method: Number and type of Pharmacotherapy negative outcomes: Pharmacist through the data, a validated questionnaire and medical history, assessing whether there was a relationship between the medications and the patient, and the reason for going to the Primary Care Emergency. In case of suspicion of Pharmacotherapy negative outcomes the patient is reassessed by the doctor, and the Pharmacotherapy negative outcomes confirmed or not identified. Results: Of the 330 patients, 317 were evaluable. The mean age of patients was 39.63 years and 51.42% were women. The mean number of drugs used was 1.38, and 26.50% (95% CI, 21.94% -31.62%) patients were detected with Pharmacotherapy negative outcomes as a cause of visiting the Primary Care Emergency. 53.57% of the detected Pharmacotherapy negative outcomes detected as regards efficacy was 53.75%, 40.48% as regards need. More than three-quarters (77.41%; 95% CI, 67.35% -85.01%) of emergency visits caused by Pharmacotherapy negative outcomes were avoidable. In terms of severity, 92.86% of the Pharmacotherapy negative outcomes were mild. Conclusions: One in four Mula SUAP visits are due to a Pharmacotherapy negative outcomes, and 77.41% of them are preventable(AU)
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Humanos , /epidemiologia , Uso de Medicamentos/estatística & dados numéricos , Tratamento de Emergência/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Transversais , Distribuição por Idade e SexoRESUMO
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No disponible
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Humanos , Assistência Farmacêutica/organização & administração , Migrantes/estatística & dados numéricos , Educação de Pacientes como Assunto/tendênciasRESUMO
El AIE es una enfermedad consultancial al asma, que se manifiesta en el 12% de la población general cuando realiza un ejercicio intenso. Esta es una enfermedad infradiagnosticada e infratratada, fácilmente tratable o prevenible. Los resultados de la terapia son muy positivos a corto plazo, porque mejoran la calidad de vida en el niño, y a largo plazo, porque previene complicaciones pulmonares en la edad adulta (AU)
No disponible
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Humanos , Asma Induzida por Exercício/tratamento farmacológico , Antiasmáticos/administração & dosagem , Asma Induzida por Exercício/fisiopatologia , Assistência Farmacêutica/organização & administração , Assistência FarmacêuticaRESUMO
Introducción: El problema de los resistencias o antibióticos tiene su origen en unas pautas de utilización inadecuados. Objetivo: evaluar lo prescripción antibiótica a adultas en una farmacia comunitaria. Métodos: Estudio observacional prospectivo sobre los antibióticos prescritos paro tratamientos agudos a los pacientes mayores de 15 años, usuarios de una farmacia comunitaria de lo ciudad de Sevilla. A los que acceden a participar en el estudio se les realiza una encuesta en la que se recogen datos del paciente (edad, sexo, si tiene fiebre y si estaba tomando un antibiótico previamente), localización de la infección, datos del prescriptor (especialidad, si es su médico habitual, financiación de la receta, información sobre posología y duración del tratamiento), datos del medicamento (especialidad, dosis diaria, duración y precio) y datos del cuidador si no era el paciente quien acudía a la farmacia. Resultados: Quedaron incluidos 2 /4 pacientes o los que se les dispensaron 234 envases de antibióticos. Los penicilinas fueron las más prescritas, con 99 prescripciones y dentro de ellas lo amoxicilina, que únicamente no estuvo en 5 de éstos. Los siguientes grupos fueron macrólidos, con 48 y cefalosporinas con 37. La administración oral copó 212 de los 214 tratamientos, el número de tomas diarios fue de 2,5 (DE= 1,1) y fueron 6,2 DÍAS (DE= 2,5) los días de duración del tratamiento. Conclusiones: la utilización de antibióticos está tendiendo a seleccionar antibióticos de amplio espectro y de una mayor comodidad de uso para el paciente en cuanto a posología y duración, en detrimento de una política de uso racional del medicamento (AU)
Introduction: The problem of antibiotic resistances lies in the improper use of the guidelines. Objective: To evaluate antibiotic prescriptions for adults in a community pharmacy. Methods: Prospective observational study on prescribed antibiotics for acute treatment in patients older than fifteen, uses of a community pharmacy in Seville. A survey was carried out on those who agreed to take part in the study in which data of the patient was gathered (age, sex, if the person had a fever, and if he/she had been previously taking an antibiotic) the location of the infection, information about the prescriber (subspecialty, if he/she is the patient's usual physician, the funding of the prescription, information on dosage and length of treatment) data on the drug (brand name, daily doses, duration and price) and information on the person in charged of the prescription if it wasn 't the patient who visited the pharmacy. Results: 214 patients were included, to whom 234 antibiotic packages were dispensed. The most prescribed were penicillins, with 99 prescriptions and among those amoxycillin which was only absent in five cases. The next groups were macrolides with 48 and cephalosporins with 37. Oral administration took up 212 of the 214 treatments, the daily doses was 2.5 (SD= 1.1) and the duration of treatment was 6.2 days (SD=2.5). Conclusions: the use of antibiotics has the tendency of selecting antibiotics of an ample spectrum and a major convenience in use for the patient as far as dosage and duration, to the detriment of a rational drug use policy (AU)