Farmaceuticos Comunitarios最新文献

Introduction: The medicines aid kits revision services is a Clinical Professional Pharmacy Service that aims to increase patients' knowledge about their medication, (What it is for, how to take it, how to preserve…). It also promotes proper management of expired and/or unused medicines, (disposal at punto SIGRE in pharmacies) to reduce their environmental impact.

Objective: To review the medicines, medical devices, and/or self-care products that the patient has at home, to record any incidents detected, and any pharmaceutical interventions carried out.

Material and methods: The campaign was open to all pharmacies in Alava. Participating pharmacies, after completing specific training, reviewed medicines aid kits and filled in an electronic form with the collected data. Finally, the data were analysed.

Results: The main pharmaceutical interventions were to dispose of expired medicines at point SIGRE, inform about appropriate use and storage at home.

Discussion: This study reinforces the role of the pharmacist within the health system as an indispensable agent in improving patient health.

Anticholinergic drugs are widely used for very common diseases such as Parkinson's disease, depression or allergies, but it has been observed in previous studies that high anticholinergic burden can lead to physical and cognitive dysfunctions in polymedicated elderly people. The objective of this project is to review these hypotheses and study the possible relationship between high anticholinergic burden and cognitive and physical dysfunctions.In terms of methodology, a bibliographic review has been carried out of the information that exists to date on the hypothesis that high anticholinergic burden can lead to both physical and cognitive dysfunctions in elderly people taking multiple medications, and a cross-sectional study has been designed that included patients over 70 years and taking multiple medications to calculate the anticholinergic burden of their medication and determine whether high levels of it could have any influence on the deterioration of the patients.At the end of the study, it was observed high prevalence of prescriptions of medications with high anticholinergic burden in elderly patients, with its consequences in terms of adverse effects. These results lead us to the conclusion of the need to take into account the anticholinergic burden of medications when prescribing.

If we want community pharmacy to be care-giving and integrated into the health system as a fundamental resource, we must demonstrate the evolution of professional pharmaceutical services and to do so, initiatives such as the Observatory of Professional Pharmaceutical Services (OBSERVAFARMA) that SEFAC has launched are necessary. It is underway and will see the light of day in 2025. This Observatory was born with the vocation to add and is open to the collaboration and participation of all agents in the health ecosystem.

Objective: To review and validate a questionnaire on knowledge of injectable insulin management (JH-SEFAC) by patients with diabetes for use in community pharmacies.

Methods: Study design: cross-sectional observational in Spanish community pharmacies during the first half of 2023. Inclusion criteria: patients with diabetes, of legal age, on insulin treatment. Questionnaire design: a nominal group of community pharmacists reviewed and piloted the initial questionnaire to determine its feasibility. It was approved by the CEIC of Aragón (PI22/375). Content validation: by a multidisciplinary group of experts in diabetes, using an ad hoc evaluation questionnaire of 10 questions (Likert scale of 1-5). Reliability: by means of the internal consistency index (Cronbach's alpha) and the intraclass correlation coefficient (ICC). Reproducibility (test/retest): the results of the questionnaire administered twice 2-3 weeks apart to the group of patients were compared. Pharmacists members of the SEFAC Diabetes Working Group collaborated. Sample: calculated in 127 subjects (95% CI and precision of 10%).

Results: 20 community pharmacies from 13 autonomous communities included 131 patients. The expert assessment was 4.52 out of 5 (90.4%). The Keiser-Meyer-Olkin test was 0.626 and Bartlett's test was significant (p<0.001). The Cronbach's alpha of the global questionnaire was 0.804 and the ICC was 0.902. The mean score of the questionnaire was 15.98 out of 31 points.

Conclusions: The JH-SEFAC questionnaire was validated to evaluate the management of insulin injectables, providing community pharmacists with a valuable tool for therapeutic education.

Case presentation: A 73-year-old woman, independent, with a medical history of psychopathology under treatment and non-compliant. After a fall, he suffered a forearm fracture and, in this context, abuse of psychoactive drugs and non-steroidal antiinflammatory drugs was suspected.

Study and evaluation of the case: The state of the patient's situation was evaluated, and an abuse of the hypnotic-anxiolytic treatment was observed, which could be related to her recent forearm fracture. His poor therapeutic adherence led to poor control of his health problems and the appearance of possible Negative Outcomes Associated with Medication (NOM).

Intervention: He was referred to his primary care physician with a pharmacist consultation report, indicating the possible NMRs and therapeutic alternatives in antihypertensive and antidepressant treatment.

Results: The family physician related the fall and subsequent forearm fracture, as well as the decompensation of his basal pathology, with therapeutic noncompliance. The proposal for pharmaceutical intervention was accepted, monitoring blood pressure for its corresponding dosage readjustment, bupropion was withdrawn, a gradual deprescription of benzodiazepine doses began, and the antiinflammatory was replaced by analgesics. Consequently, the patient significantly improved her cardiovascular health and her quality of life, in addition to increasing her personal autonomy.

Conclusions: Multidisciplinary communication between health professionals allows better control of cardiovascular disease and optimization of pharmacotherapy and health resources, contributing to improving their state of health.

Introduction: Drug Information Services (DIS) act as a source of technical and scientific information of drugs and medical devices, promoting their rational use.

Objective: To analyze and classify, according to standardized criteria, the pharmacotherapeutic queries, therapeutic groups, and drugs most frequently consulted at the DIS of the Muy Ilustre Colegio Oficial de Farmacéuticos de Valencia (MICOF).

Methodology: An ambispective and cross-sectional observational study was conducted from June 1, 2021, to June 1, 2022. A total of 445 inquiries made by pharmacists from the province of Valencia were registered and analyzed, collecting the following data: drug, ATC-4 therapeutic group, and pharmacotherapeutic category of the query.

Results: The most frequently consulted categories were commercialization and safety, with Proton Pump Inhibitors (PPIs, A02BC) and Vitamin K Antagonists (VKAs, B01AA) being the most consulted pharmacological groups, accounting for 2.7% and 2.3% of the total inquiries respectively. Regarding classification, 90,0% of the inquiries about acenocoumarol were about drug interactions, while 33.3% of the inquiries about PPIs were related to commercialization.

Conclusions: The analysis of the inquiries received has made possible to identify the therapeutic groups, drugs and pharmacotherapeutic categories that generate the highest number of inquiries. This information is valuable for improving the efficiency of responses at the DIS, providing uniformity, and reducing errors. Additionally, it provides a comprehensive database that facilitates the standardized integration of information.

Aging is a global reality that is accompanied by an increase in polypharmacy. In this vital stage, caregivers emerge as relevant actors since their intervention impacts on the safety of the medication use process and on the quality of life of the patient they assist. As the knowledge about the treatments that caregivers supervise for the patient under their care conditions the health outcomes of the medications, the main objective of this study is to characterize the caregivers of patients who use opioid analgesics and to identify factors that increase the risk of the appearance of Medication Related Problems (DRP).The results reveal that the caregiver profile affects the health outcomes of this therapeutic group in both the prevalence and type of DRP. Of the 63 patients using opioid analgesics under pharmacotherapeutic follow-up during this study, 17 (27%) had caregivers. The caregiver in this study was predominantly female (61.1%).Considering DRP and kinship, a higher prevalence of DRP was observed when the caregivers were children or external personnel.Analyzing the pharmacotherapy of these caregivers, 4.8% have started antidepressant treatment, 3.2% hypnotic treatment after becoming caregivers of these patients. The Zarit Test reveals that 29.4% of the caregivers of these patients manifest overload.We conclude that Pharmaceutical Care should consider the opportunity and relevance of designing and implementing intervention and education protocols focused on caregivers.

Case description: Patient (29 years old) with palmo-plantar erythema, goes to the community pharmacy (FC) requesting a cream to treat atopy.

Evaluation: The patient accessed the Pharmaceutical Indication Service (SPIF), showing that the manifestations appeared 24 hours after the start of dental treatment with amoxicillin 1g/12h and ibuprofen 600 mg/8h without any concomitant medication.

Intervention: After explaining the possible relationship of the symptoms with their medication, patient was derived to the doctor with the referral report completed by SEFAC-eXPERT.

Results: The patient went to the emergency where she was treated with intravenous corticosteroid and a prescription for cetirizine 10 mg. The dentist changed the beta-lactam to a macrolide (azithromycin) and the ibuprofen to paracetamol. From the FC, the evolution of the symptoms was monitored, which took 72 hours to disappear. Allergy tests suggested avoiding beta-lactams, cephalosporins, and arylpropionics without being conclusive. Months later, the patient suffered similar symptoms after inhaling a disinfectant spray and the allergy diagnosis was confirmed.

Conclusions: The FC identified and immediately referred using SPIF a case of hypersensitivity in a patient susceptible to RNM and the SPIF helps to record the intervention and follow-up, increasing patient safety.

Introduction: The Medication Review in the Pharmacotherapeutic Follow-up Service (PFS) seems to be an effective method to study long-term drug safety in the outpatient setting. The adverse drug reactions (ADRs) that are not immediately obvious are difficult to identify and sometimes can be confused with a more common condition. Misdiagnosis by not associating the symptoms of AMR to its pharmacological cause causes its masking and hinders its detection.

Objective: Detect in the SFT service the diagnostic errors related to the non-detection of adverse reactions to statins.

Material and methods: The data obtained from the medication review at the Pharmacotherapeutic Follow-up Service (PFS) were pooled for analysis. The patients who received the service were selected with the "DLGM screening" tool, an acronym "Diagnosis load Generated by Medications", that allows us to describe adverse drug reactions (ADRs), when their symptoms are attributed to a pathology, without considering medication as a possible underlying cause.Only the results of patients over 60 years of age, who after a prolonged period of statin use gradually presented musculoskeletal disorders (MSD) and other symptoms theoretically described as possible ADRs, are shown.

Results: In 66 % of the cases, corresponding to 14 patients out of a total of 21 studied, the physician modified the treatment and in 92% of these cases there was improvement and a decrease of the consumption of analgesics drug, anti-inflammatory and other drugs used to treat ADR symptoms.

Conclusion: DLGM screening identified hidden AMRs in 62 % of patients.

Regulatory agencies such as the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) recognize pharmacogenetics as a key tool in their pharmacological guidelines for pharmaceutical counseling. In this context, community pharmacies play a crucial role in addressing this healthcare need, which could lead to a significant improvement in patients' quality of life by preventing ineffective or contraindicated treatments.In this work, we conducted a systematic review of the available scientific evidence regarding druggene interactions relevant to community pharmacy. We identified the main genes and polymorphisms associated with treatment response and adverse effects in primary care. Finally, we propose a model for implementing pharmacogenetic services in community pharmacies.