ABSTRACT
Antecedentes: El uso inadecuado de los antibióticos es considerado como una de las principales causasde la aparición de resistencia microbiana. Este es considerado a su vez como un problema de salud pública,y los farmacéuticos tienen una importante oportunidad de intervención durante la dispensaciónde estos medicamentos. Objetivos: Identificar y resolver las incidencias relacionadas con el uso de antibióticosdurante la dispensación en una farmacia comunitaria, y caracterizar el perfil de paciente y tipode antibiótico solicitado. Métodos: Se realizó un estudio cuasi-experimental (sin grupo control), queincluyó a los pacientes que acudieron a la farmacia a retirar un antibiótico durante el periodo de estudio.La intervención en los pacientes que solicitaban el antibiótico por primera vez consistió en verificar siexistían criterios para la no dispensación e informar sobre el proceso de uso del medicamento. En dispensaciónrepetida se evaluó la efectividad y seguridad del antibiótico. En ambos casos se realizó la deteccióny resolución de incidencias, a través de un episodio de seguimiento. Cuando se solicitó el antibióticosin receta, se intervino para intentar evitarlo, ofreciendo al paciente otras alternativas. Resultados: El76,2% (64) de las solicitudes fueron con receta, con una media de edad de 44,5 (DE = 18,2) años, en sumayoría mujeres (65,6%), con estudios universitarios (68,8%). El grupo terapéutico más prescrito fue elde los beta-lactámicos (48,4%), y la infección más frecuente fue la respiratoria (45,3%). El 20,3% (13) delgrupo de población que demandó con receta tuvo un episodio de seguimiento; esta incidencia se resolvióen el 100% de los casos. El 23,8% (20) de las solicitudes fueron automedicación, la cual se evitó en un25% hablando con el paciente. El 58,3% (7) de los pacientes fueron remitidos al médico, mientras que el41,7% (5) no aceptó la propuesta...
Misuse of antibiotics is considered as one of the main drivers for the emergence of microbial resistance. This is in turn considered as a public health problem, and chemists have a fruitful opportunity in intervening the dispensation of these medicines.Objectives: To identify and resolve incidents regarding the use of antibiotics during the dispensation in a community pharmacy, as well as to classify the demand for antibiotics according to the patient ́s profile and the type of demanded antibiotic. Methods: A quasi-experimental study (without a control group) was carried out, including the patients who came to the chemist to withdraw an antibiotic during the period of study. The intervention in patients requesting the antibiotic for the first time consisted in verifying any possible criteria for its non-provision, and informing about the process of using the medicine. While supplying the product repeatedly, both its effectiveness and safety were tested together with incidents identification and resolution through a follow-up process. When the antibiotic was required without prescription, an action was taken in order to avoid it and offer to the patient other alternatives.
Subject(s)
Anti-Bacterial Agents , Self Medication , Good Dispensing Practices , Community Pharmacy ServicesABSTRACT
Background: Pharmacotherapy follow-up is a practice in which the pharmacist assumes responsibilityfor the patients drug-related Problems. Its goal is to achieve positive clinical outcomes. Methods toperform pharmacotherapy follow-up have centered principally on ambulatory patients. Objective: Thepurpose of this study is to propose and validate a methodology for inpatient pharmacotherapy follow-up.Methods: A systematic review was performed. This consisted in a comprehensive search of databasescontaining studies published in English or Spanish during 1998 - 2008, and that sought to improve thetransfer of accurate information about Pharmacotherapy follow-up in inpatients. The key terms used toconduct the search were identified in consultation with clinical experts and included: Pharmacotherapyfollow-up methods, pharmacotherapy follow-up, drug therapy problems, and validation. A comparativetable was elaborated to differentiate and evaluate the advantages of each of the proposed methodologies.The information gathered allowed to propose a sequence of general steps for inpatient Pharmacotherapyfollow-up. To validate the methodology, a descriptive study was carried out with 32 randomly selectedpatients and was independently followed up by two pharmacists to assess the reproducibility of the process.Results: Pharmaceutical Care Practice: The Clinicians Guide, proposed by Cipolle & Strand. AppliedTherapeutics: The Clinical Use of Drugs, the DÁDER method, and the IASER program, were selected.79 drug therapy problems (DTPs) were identified and resolved, where errors in necessity of medicationhad the highest incidence (46.6%), followed by effectiveness (24.5%) and safety (28.9%). The degree ofagreement among researchers in the identification and resolution of DTPs was quantified using the kappacoefficient, showing a high concordance (90% CI)...