Farmaceuticos Comunitarios最新文献

Introduction: In 2012, a Professional Pharmaceutical Nutrition Service was implemented in a Lanzarote Pharmacy. This service offers nutritional and dietary advice and follow-up to study the evolution. After the 12 years, an analysis has been carried out including all the patients who have been part of the service.

Method: With the information from the successive interviews, a quasi-experimental study has been developed in which different variables are studied, both qualitative (sex, age, diseases suffered) and quantitative (weight, height, BMI, % body fat, blood pressure values, blood glucose values, number of visits). The time frame is from March 2012 to March 2024. The study population is all the patients who attended the consultation after the implementation of the service.

Results: The sample consisted of 1,638 patients. It is observed that most of the patients are women. The main objective is to lose weight in 98.7% of cases, increase weight in 0.5% and control biochemical parameters in 0.8%. After inclusion in the service, the obesity rate was reduced from 70.1% before the first intervention to 20.3% after the last consultation. Normal weight rates increased from the initial 3.1 to the final 30.2. There are statistically significant differences between the number of visits and the weight loss obtained, with more weight loss the more appointments there are. In addition, the number of symptoms and pathologies present in overweight or obese patients decreases with weight loss.

Conclusions: The community pharmacy can be a key center to combat the high numbers of overweight and obesity in the population.

Abstract: 71-year-old man with multiple pathologies. He goes to the pharmacy and a frequent throat clearing and cough is detected. He says it has been going on for a couple of months. He has tried mucolytics, cough suppressants and flu medications, and nothing calms him down. As a patient with COPD, you are invited to go to the PCA.During the initial consultation, we provided health education and a spirometry test with the Vitalograph® COPD-6 (unable). We performed validated tests, reviewed the inhalation technique, device care, and cleaning, as well as the patient's medications.The patient was instructed on proper inhalation technique, as two critical errors were detected.After 6 days, he was given an appointment and the same tests were performed, obtaining acceptable FEV1/FEV6 values, COPD grade = 2, BODEX = 3 (moderate), and corrected inhalation technique, but he did not improve his sintoms.After 7 days, we performed spirometry again, COPD grade = 1, BODEX = 3. The technique still showed no critical errors, so we used the InCheckDial® to detect whether the inspiratory flow was correct, and we detected that the inspiration was too forceful (≥90 L/min).The patient was referred to the PCP for treatment assessment with a detailed report suggesting a change of inhalation device. The PCP changed the device to an Ellipta® and requested a follow-up with your pulmonologist.

Abstract: Medicines are made up of one or more active ingredients and excipients. Active ingredients have pharmacological action and cause adverse reactions to medications, but what about excipients? They are necessary to achieve the appropriate properties of the medication, but they are not always harmless and can also cause adverse reactions.In order to provide community pharmacists with quick reference material during dispensing services, thus ensuring safe use of medicines, a bibliographic review of the available literature has been carried out, focusing on the identification of possible adverse reactions associated with excipients present in medicines and vaccines in both the pediatric and adult populations. A series of reference tables have been developed indicating potentially dangerous excipients, the adverse reactions they make produce, and the precautions to be taken into account in certain pathologies or if they are intended for the pediatric population.

Introduction: Chronic pain, affecting 20-26% of adults, has a profound impact on quality of life and generates substantial socioeconomic costs. Patient profiling enables the individualization of treatment, the identification of patient subgroups, and the design of personalized therapeutic strategies, ultimately improving outcomes and healthcare efficiency. The main objective of this study is to establish patient clusters based on pain characteristics and to develop a screening tool capable of identifying patients according to the resulting clustering model.

Materials and methods: A descriptive, cross-sectional, multicenter study was conducted in patients experiencing pain who visited community pharmacies. Unsupervised clustering techniques were employed to identify patterns among patients with acute and chronic pain. These were followed by statistical analyses and supervised algorithms for the prediction and evaluation of the questionnaire. Based on these findings, a tool was developed to predict patient group membership according to the identified clusters.

Results: The analysis identified four acute pain profiles and five chronic pain profiles, with subgroup 1 exhibiting the poorest outcomes in both cases. The classification model used to predict new data achieved an accuracy of 64.52% for acute pain and 85.56% for chronic pain based on the available data.

Conclusions: Four patient profiles were identified in acute pain and five in chronic pain, facilitating the personalization of treatment. Community pharmacy, due to its accessibility, enables continuous follow-up, improves adherence, allows for treatment adjustments, and enhances coordination of care. The classification tool will enable patient assessment through psychometric variables, thereby improving pain management.

Introduction: Within Good Pharmacy Practices, pharmaceutical indication is one of the most frequently requested pharmaceutical services in community pharmacies to address specific health problems as part of pharmaceutical care. This study aimed to explore the frequency and characteristics of pharmaceutical indication (PI), also known as pharmaceutical recommendation (PR), in Central American countries, specifically in private community pharmacies.

Materials and methods: This was an observational, exploratory, cross-sectional study using non-probabilistic convenience sampling. An electronic questionnaire consisting of 23 closed-ended and one open-ended question was distributed to community pharmacists working in private pharmacies, that is, privately owned, non-state establishments in the region. Data from Nicaragua were excluded due to the low number of responses. The survey explored general characteristics, professional perceptions, and clinical practice. Content validation was performed with one pharmacist from each country. No personal data was collected.

Results: Among the pharmacists who responded, PI/PR activities generally did not meet the common principles and reference frameworks supported by international organizations and national guidelines. Furthermore, there was considerable heterogeneity in the legislation and regulations governing this pharmaceutical service across Central America. The assessment of training received in this area revealed important opportunities for improvement.

Conclusions: Community pharmacy services in the study group should be redefined within a more patient-centered, clinical model to optimize pharmacotherapy and contribute to the maintenance and improvement of individual and public health.

Introduction: The survival of Community Pharmacy Services (CPS) within the community pharmacy (CP) model will depend on whether they are economically sustainable. Metabolic Syndrome (MS) is important for its high prevalence and significant associated morbidities. Its early detection is an excellent application of CPS with potential impact in patient outcomes.

Objetives: The aim of this study is to implement a CPS to control MS in a CP using a simple diagnostic method, and to analyze its impact using health and economics indices.

Materials and methods: Glucose, cholesterol, triglycerides, body mass index and blood pressure parameters were analyzed as they are the defining features of the MS. Anonymous follow-up cards were created with a total 5 sets of tests. The study results were correlated with economic indices of the CP to evaluate patient loyalty.

Results: From December 2019 to December 2022, 219 valid cards were analyzed (55% women; 45% men). 94.1% of the population started the first series of tests; 25.57% continued with at least two; and only 6.85% completed the follow-up for all 5 sets of the tests. Despite a decline in the number of tests completed over the study period, there was an increase in the loyalty of users in the pharmacy, verified by the standardized indicators with an increase in the number of operations and in overall billing.

Conclusions: The introduction of a CPS for self-monitoring of MS in the CP has, besides health benefits for patients, an impact on improving user loyalty and the economic results.

Objetives: To perform a medicines use review (MUR) service and apply a methodology to tailor the patients to more complex pharmacist-led clinical services.

Methods: A MUR consultation for revision with the patient of all medication to ensure the medicines are being taken properly was performed with participants from five community pharmacies. The 'Medication Adherence Universal Questionnaire' (MAUQ) and the 'Beliefs about Medicines Questionnaire' (BMQ) were added to the protocol. Medication Regimen Complexity Index (MRCI) was calculated for unintentional non-adherent patients. Then, a referral algorithm for more complex pharmacist-led clinical services - such as medication review, individualized medication preparation, or patient education - was applied to adapt a plan to each participant.

Results: From the 189 patients included, 100 (52.9%) were referred to a medication review service because they used at least one high-risk medicine, presented clinically significant complaints and/or used at least 10 medicines. From the remaining, MAUQ showed 46.1% non-adherent and BMQ revealed 26.8% intentionally non-adherent, indicating the need for education/health literacy services. Within the 73.2% unintentionally non-adherent, 46.7% presented MRCI below the median value, benefiting from memory strategies or referral to individualized medication preparation, while 53.3% needed medication review. MUR resolved medicines-use issues for 48 patients and potentially benefited an additional 25.

Conclusions: The MUR, combined with the assessment of medication adherence, and the subsequent application of a referral algorithm, identified patients with different needs' profiles, acting as an open door to more complex pharmacist-led services that best serve patients' needs in a community pharmacy.

Introduction: Poor access to community pharmacies has been associated with restricted accessibility to medicines. We aimed to compare the geographic distribution of community pharmacies and healthcare centers (HCCs) and identify sociodemographic variables associated with geographical discrepancies at the municipal level in Portugal.

Methods: Data on HCC, physicians, pharmacies, and pharmacists were collected at the municipality level in 2024. Municipality population and area per healthcare establishment and professional were compared, as well as pharmacies/HCC and physician/pharmacist ratios. Multivariate analyses were conducted between dependent variables and sociodemographic factors.

Results: Portugal municipalities had a mean 516 residents (SD 319) per physician and 1,021 (SD 450) per pharmacist (paired Cohen's d= 1.127 [0.76:1.277]), with a ratio physician/pharmacist of 2.55 (SD 1.55). The surface area covered by professionals was 22.0 km² (SD 35.8) per physician and 37.9 km² (SD 57.8) per pharmacist (d=0.449 [0.325:0.572]). However, population per HCC was 22,998 (SD 22,038) while 3,206 (SD 1,087) per pharmacy (d=0.924 [0.783:1.064]) and the area covered was 82.2 km² (SD 98.3) per pharmacy and 304.6 km² (SD 287.1) per HCC (d= 0.912 [0.771:1.051]). Positive associations were found between the ratio pharmacies/HCC and percentage of young population, higher educational level, or literacy.

Conclusion: Despite the greater number of physicians than pharmacists, community pharmacies showed a more intensive coverage of Portuguese mainland territory when compared to HCCs. The wider dispersion of pharmacies may facilitate the role of pharmacists as public health agents.

In a context of aging, chronicity, and polymedication, Personalized Dosage Systems (PDS) are an effective tool for improving therapeutic adherence and patient safety. However, they remain little known and underutilized. To reverse this situation, SEFAC has launched the INFO-SPD project, which reinforces the role of community pharmacists as key agents in improving health outcomes. The initiative offers materials adapted for professionals and patients and promotes a collaborative and normalized approach.

Introduction: Pain has a significant impact on quality of life. Personalized care emerges as a key strategy in pain management. Objectives: To identify the characteristics of patients with acute or chronic pain who visit the community pharmacy (CP) and to analyze the relationships between these characteristics in order to support future research.

Material and methods: A descriptive, observational, cross-sectional, multicenter study was conducted in patients experiencing pain who attended community pharmacies (CPs). The study took place from October 14 to 27, 2019, in 47 CPs across Spain. The variables analyzed included: pain intensity (VAS), type of pain based on duration and diagnosis, type of medication, quality of life (EuroQoL-5D questionnaire), functional capacity (Karnofsky Performance Status), sleep quality (Insomnia Severity Index - ISI), and satisfaction with treatment.

Results: A total of 403 participants were included: 28% were men and 72% women; 39% were over 70 years old, 45% between 40-69 years, and 16% between 18-39 years. Acute pain was reported by 25% of subjects, and chronic pain by 75%; 90% had non-oncological pain. The mean values observed were: VAS 6.1; EuroQoL 8.3; Karnofsky 78.1; and ISI 9.7. The correlational analysis between VAS, EuroQoL-5D, Karnofsky, and ISI, performed using Spearman's correlation coefficient (SC), showed statistically significant correlations: VAS and EuroQoL (SC=0.47; p<0.001), VAS and EuroQoL pain dimension (SC=0.52; p<0.001), VAS and ISI (SC=0.33; p<0.001), and a negative correlation between VAS and Karnofsky (SC=-0.33; p<0.001).

Conclusions: Correlations were identified between age and quality of life, as well as between sex and age with functional capacity. Finally, an association was observed between pain intensity (measured using the VAS scale) and indicators of quality of life, sleep quality, and functional capacity.