Farmaceuticos Comunitarios最新文献

Introduction: Diabetes mellitus (DM) is a heterogeneous metabolic disease with multiple pathophysiological mechanisms. The traditional classification into type 1 diabetes (T1D) and type 2 diabetes (T2D) does not fully capture the diversity of clinical and metabolic profiles among patients. Recently, Ahlqvist et al. proposed a model based on five phenotypic subtypes, enabling a more precise stratification of the disease and a personalized therapeutic approach.

Methods: Through cluster analysis in cohorts of diabetic patients, five subgroups were identified: Severe Autoimmune Diabetes (SAID), Severe Insulin Deficient Diabetes (SIDD), Severe Insulin Resistant Diabetes (SIRD), Mild Obesity-related Diabetes (MOD), and Mild Age-related Diabetes (MARD). These phenotypes differ in pathophysiology, disease progression, and treatment response.

Results and discussion: Phenotypic stratification allows better prediction of microvascular and macrovascular complications, optimizes pharmacotherapy, and enhances personalized interventions. In community pharmacy, this classification could improve subtype identification, facilitate more precise therapeutic recommendations, and promote treatment adherence. However, its implementation faces challenges, such as limited access to key biomarkers.

Conclusions: The phenotypic classification of DM represents a step toward personalized medicine. As key healthcare professionals in chronic disease management, community pharmacists can play a crucial role in its application, improving patient education and therapeutic monitoring to enhance clinical outcomes.

Abstract: A 58-year-old woman diagnosed with diabetes and hypercholesterolemia and undergoing treatment for breast cancer. Take metformin, rosuvastatin, and anastrozole. She goes to the community pharmacy to pick up a treatment for flatulence that has been prescribed to her in primary care. The prescribed medications are dispensed: Clebopride/Simeticone and paracetamol in addition to asking the pharmacy for a shower gel without detergent for back irritations. After 5 days of treatment, the patient returns requesting a more powerful analgesic since the pain has worsened.The patient was referred to the emergency department upon detection of an MRI of Necessity related to an untreated health problem. In the emergency department, he undergoes an ultrasound and intravenous analgesics that relieve the pain, diagnoses nephritic colic and prescribes metamizole and tramadol/paracetamol. The next day the patient goes to her primary care doctor and he tells her to continue with the prescribed treatment in the emergency room.The patient goes to the community pharmacy again requesting something for the rashes on her back since the gel does not calm her. The pharmacist makes a second referral to the doctor, with a written communication of suspicion of Herpes Zoster, the doctor accepts the intervention and changes the treatment by putting Valacyclovir, paracetamol/codeine and capsaicin cream. The patient returns to the pharmacy reporting that the doctor was surprised that it was a pharmacist who gave the correct diagnosis.

Abstract: It is possible that traffic accidents caused by medication use are among the most underestimated compared with other types of accidents.This issue stems from human factors that affect driving even before it begins, increasing the likelihood of accidents. Therefore, it is a predictable and avoidable factor.In this context, it is essential to gain a deeper understanding of the medications that pose the greatest risks and how they influence driving.To do this, we will study the groups of drugs marketed in the European Union that can affect driving, analyzing the DRUID classification of medicines to determine which group of drugs can have the most influence on driving.To this end, the DRUID classification has been reviewed, the technical data sheets of medications marketed in Spain have been analyzed, focusing on the sections regarding "Effects on driving" and "Adverse effects," and the frequency of these effects has been evaluated to identify the medications with the greatest impact.

Abstract: A 42-year-old patient with obesity and psychological problems comes to the Community Pharmacy seeking nutritional advice to lose weight, since in the last 4 months there has been an increase of 19 kilograms of body weight.From the CF we offer specific nutritional help and, in addition, we propose to make a comparison of the medication she is using in the current situation and compare it with the one she was using before the weight gain. The patient accepts and, indeed, we observe certain changes that may be causing the weight gain.Therefore, we refer the case to the Primary Care Physician providing information regarding changes in medication, latest medical tests and other indicators that could be contributing to the weight gain. Simultaneously, we establish dietary follow-up with one session per week to monitor her diet and eating habits.

Introduction: The high prevalence of problems related to invalid or erroneous prescriptions causes numerous patient referrals from community pharmacy, as well as problems related to patients' adherence to their treatments and underscores the importance of effective review and validation systems in pharmacies.

Objective: To identify and quantify the causes of patient referral from community pharmacies to physicians.

Methods: Observational, cross-sectional, non-interventional and analytical study. The possible causes of patient referral from community pharmacies were defined and these causes were quantified by means of an online questionnaire.

Results: A total of 3530 referrals were recorded from 165 community pharmacists in 114 pharmacies. The most frequent cause of referral was lack of a valid prescription (57.7%). Health problems requiring a prescription (18.4%) and problems with the prescribed medication, such as shortages or incorrect dosage (17.2%) were also identified.The study highlights the importance of implementing Complementary Dispensing (CD) and Independent Dispensing (ID) to reduce referrals and improve adherence to treatment. Thirty-two percent of referrals could have been avoided through these professional pharmaceutical actions, reducing the pressure on primary care, specialized and emergency care centers, allowing pharmacists to adjust or advance prescriptions under consensus with physicians or to dispense certain drugs without prescription. The previously defined referrals were collected by means of a validated questionnaire.

Conclusion: Expanding the competencies of community pharmacists would improve the efficiency of the health care system, reducing referrals and improving adherence to treatment.

Background: Community pharmacy has been promoted internationally for the management of minor ailments with positive results for patients and health care systems. This study evaluates the clinical impact and implementation of a minor ailment service in community pharmacies' daily practice.

Methods: A pragmatic study with a hybrid effectiveness-implementation design was conducted throughout Spain between 2020-2023. Patients who visited community pharmacies to consult or request a medicine for a minor ailment were included. The intervention consisted of a protocol for the minor ailment service and specific protocols for each ailment agreed with general medical practitioners through the SEFAC eXPERT® IT platform and after community pharmacists' training. Patients were followed up 10 days after the consultation.

Results: A total of 430 pharmacies registered 20,987 consultations. 85.2% (n=17,885) were consultations about minor ailments and 14.8% (n=3,102) were requests for specific medications. Minor ailments related to pain (18.7%, n=3,935) were the most frequently consulted. Pharmacists recommended pharmacological treatment to 81.3% (n=17,063) patients and referred 8.0% (n=1,682) patients to a general medical practitioner. 72.4% (n=15,192) of patients responded to follow-up with a symptom resolution of 9.0/10.0, a change in quality of life of +9.0 (0-100 scale) and a satisfaction with the service of 9.6/10.

Conclusions: SIF proved to be both operational and effective, yielding beneficial health outcomes. Its implementation enabled the evaluation of a substantial number of consultations and highlighted the need to encourage the routine documentation of services in community pharmacy practice.

Objective: A study is presented whose main objective is to describe pharmaceutical interventions in the assistance service in the dispensing of newly prescribed medications in patients of two community pharmacies.

Methodology: Descriptive observational study, carried out in two community pharmacies in the province of Malaga with patients who come for new medical prescriptions over 6 months (March 2022 - August 2022). Pharmaceutical interventions have been recorded, recording the following aspects: age, sex, new prescription, other medications, pharmaceutical intervention (posology-dose, indication), follow-up of the new medication. Regarding the follow-up of the new medication, the detection of a drug-related Problem (DRP) (possible adverse effects, interactions, lack adherence) and/or a Negative Outcome associated with Medication (NOM) has been recorded in the Dáder method intervention sheet.

Results: 251 records of new medication have been documented, which have totalled 258 new prescription medications. The average age of the patients was 58.6 years. The average number of medications used by the patients was 5.1 with a range between 1 and 15. In relation to the sex of the patients, 41.4% (n=104) were men and 58.6% (n=147) were women.The five therapeutic groups most studied have been: C10 Lipid-modifying agents (n=33), A10 Drugs used in diabetes (n=28), C09 Agents that act on the renin-angiotensin system (n=21), N06 Psychoanaleptics (n=19) and M01 Anti-inflammatory and antirheumatic products (n=13).A NOM was detected in 31.5% (n=79) of the patients, with non-quantitative safety problem being the most frequent (60.0% - n=48). 23 DRP of lack adherence have been documented.

Conclusions: The development of this service represents an opportunity for the team's assistant pharmacists to participate in a Clinical Professional Pharmacy Services in a homogeneous and systematized way, with the consequent documentation of their interventions and with a more active involvement in the patients' health processes. The need for greater integration of the two community pharmacies in the health system is evident.

The acceleration of climate change due to human activities demands urgent action at all levels. In the healthcare sector, the use of inhalers with high global warming potential represents a significant source of emissions, further exacerbated by low recycling rates. The transition to lower-impact devices and improved waste management are priority actions. In this context, community pharmacists play a key role-not only in optimizing inhalation therapy and educating patients, but also in reducing the associated carbon footprint-thus promoting a more sustainable healthcare practice.

Introduction: Compounding (FM) is a drug prepared according to the specific needs of a patient, under medical prescription, when the marketed medicines are not adequate according to the patient's pathology. This is why the FM is the last link in the Health System, in which the prescription is one of the critical elements of the FM preparation process. This study analyzes the distribution of FM, the most frequent errors and if there is any relation between the format used and the errors detected or where has it been prescribed.

Methodology: Human compounding prescriptions which were obtained from a third party manufacturing pharmacy from the 1st of September until the 30th of November of 2023. All mandatory data from RD 1718/2010 of 17th of December was collected, as well as the specialty of the drug, where has been prescribed and what the format used is. On these prescriptions, a descriptive analysis will be carried out as well as an analysis of the absence of legally mandatory data.

Results: a total of 6694 compounding prescriptions have been obtained, being the most frequent the ones from Madrid (4050), Castilla la Mancha (CLM) (1132) and Castilla y Léon (CyL) (1047) as the most common places of prescription.The most common format is paper (56,3 %), in which a lesser incidence of errors is observed in this format (5,9 (σ=2,889 SE=0,047)) rather than in electronic format (9,52 (σ=2,151 SE= 0,04)). On the other hand, significant difference were found among the number of errors per prescription and Autonomous Community (CCAA) (ANOVA p>0,001) and the number of errors per prescription and the format used (ANOVA p>0,001).

Discussion: The largest number of prescriptions come from Madrid, CLM and CyL, with a notable frequency of ophthalmology and dermatology prescriptions. The most commonly used format is paper in the public and private spheres, with the exception of the Madrid Health System, where electronic formats predominate. It is noteworthy that electronic formats have a much higher error rate than paper formats, posing a potential risk for the preparation of the prescription.

Conclusion: The results of frequency distribution by medical specialty may not be extrapolated due to overestimation of sterile pharmaceutical forms; however, format used and errors can be extrapolated.Despite what might be expected, electronic prescriptions are not the most commonly used format, possibly because they present a higher rate of errors per prescription. This higher rate can be caused by an incomplete prescription, deficient communication between the prescription system and the program used in pharmacies to access to this prescription or not knowing how to access the prescription data.