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1.
Farm Hosp ; 44(4): 135-140, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-660916

ABSTRACT

OBJECTIVE: To analyze the status of the implementation and development of  telepharmacy as applied to the pharmaceutical care of outpatients treated at  hospital pharmacy services in Spain during the COVID-19 pandemic. METHOD: Six weeks after the beginning of the confinement period, an online 10- question survey was sent to all members of the Spanish Society of Hospital  Pharmacists. A single response per hospital was requested. The survey included  questions on the provision of remote pharmaceutical care prior to the onset of  the health crisis, patient selection criteria, procedures for home delivery of  medications and the means used to deliver them, the number of patients who  benefited from telepharmacy, and the number of referrals made. Finally,  respondents were asked whether a teleconsultation was carried out before  sending patients their medication and whether these deliveries were recorded. RESULTS: A total of 39.3% (n = 185) of all the hospitals in the National Health  System (covering all of Spain's autonomous regions) responded to the survey.  Before the beginning of the crisis, 83.2% (n = 154) of hospital pharmacy  services did not carry out remote pharmaceutical care activities that included  telepharmacy with remote delivery of medication. During the study period,  119,972 patients were treated, with 134,142 deliveries of medication being  completed. Most hospitals did not use patient selection criteria. A total of 30.2%  of hospitals selected patients based on their personal circumstances. Home  delivery and informed delivery (87%; 116,129 deliveries) was the option used in most cases. The means used to deliver the medication mainly included the use  of external courier services (47.0%; 87 hospitals) or the hospital's own transport services (38.4%; 71 hospitals). As many as 87.6% of hospitals carried out  teleconsultations prior to sending out medications and 59.6% recorded their  telepharmacy activities in the hospital pharmacy appointments record. CONCLUSIONS: The rate of implementation of telepharmacy in outpatient care in  Spain during the study period in the pandemic was high. This made it possible to guarantee the continuity of care for a large number of patients.


Subject(s)
Ambulatory Care/statistics & numerical data , Betacoronavirus , Coronavirus Infections , Pandemics , Pharmacy Service, Hospital/statistics & numerical data , Pneumonia, Viral , Telemedicine/statistics & numerical data , Health Care Surveys , Home Care Services/organization & administration , Hospital Bed Capacity , Humans , Medication Systems/organization & administration , Medication Systems/statistics & numerical data , Patient Selection , Pharmacy Service, Hospital/organization & administration , Referral and Consultation/statistics & numerical data , Spain , Telemedicine/organization & administration , Workload
2.
Farm Hosp ; 44(4): 135-140, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-640386

ABSTRACT

OBJECTIVE: To analyze the status of the implementation and development of  telepharmacy as applied to the pharmaceutical care of outpatients treated at  hospital pharmacy services in Spain during the COVID-19 pandemic. METHOD: Six weeks after the beginning of the confinement period, an online 10- question survey was sent to all members of the Spanish Society of Hospital  Pharmacists. A single response per hospital was requested. The survey included  questions on the provision of remote pharmaceutical care prior to the onset of  the health crisis, patient selection criteria, procedures for home delivery of  medications and the means used to deliver them, the number of patients who  benefited from telepharmacy, and the number of referrals made. Finally,  respondents were asked whether a teleconsultation was carried out before  sending patients their medication and whether these deliveries were recorded. RESULTS: A total of 39.3% (n = 185) of all the hospitals in the National Health  System (covering all of Spain's autonomous regions) responded to the survey.  Before the beginning of the crisis, 83.2% (n = 154) of hospital pharmacy  services did not carry out remote pharmaceutical care activities that included  telepharmacy with remote delivery of medication. During the study period,  119,972 patients were treated, with 134,142 deliveries of medication being  completed. Most hospitals did not use patient selection criteria. A total of 30.2%  of hospitals selected patients based on their personal circumstances. Home  delivery and informed delivery (87%; 116,129 deliveries) was the option used in most cases. The means used to deliver the medication mainly included the use  of external courier services (47.0%; 87 hospitals) or the hospital's own transport services (38.4%; 71 hospitals). As many as 87.6% of hospitals carried out  teleconsultations prior to sending out medications and 59.6% recorded their  telepharmacy activities in the hospital pharmacy appointments record. CONCLUSIONS: The rate of implementation of telepharmacy in outpatient care in  Spain during the study period in the pandemic was high. This made it possible to guarantee the continuity of care for a large number of patients.


Subject(s)
Ambulatory Care/statistics & numerical data , Betacoronavirus , Coronavirus Infections , Pandemics , Pharmacy Service, Hospital/statistics & numerical data , Pneumonia, Viral , Telemedicine/statistics & numerical data , Health Care Surveys , Home Care Services/organization & administration , Hospital Bed Capacity , Humans , Medication Systems/organization & administration , Medication Systems/statistics & numerical data , Patient Selection , Pharmacy Service, Hospital/organization & administration , Referral and Consultation/statistics & numerical data , Spain , Telemedicine/organization & administration , Workload
4.
Farm Hosp ; 44(7): 49-52, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-603418

ABSTRACT

As in other areas of the health system, COVID-19 has had a dramatic impact on  hospital compounding. This area has faced numerous challenges, including the  shortage of frequent-use products (hydroalcoholic solutions, lopinavir/ritonavir  suspension), the use of new preparations for SARS-CoV-2 (tocilizumab,  remdesivir), or requests from overwhelmed wards unable to assume the safe  preparation of a high volume of medications (intravenous solutions). The  demand for all types of preparations (topic and oral medications, intravenous  solutions) has increased dramatically. This increase has highlighted the shortage of resources allocated to this area, which has made it difficult to meet the high  demand for preparations. In addition, the pandemic has revealed the scarcity of  research on such basic aspects as agent stability and drug compatibility. One of  the most relevant conclusions drawn from the COVID-19 pandemic is that the  basic areas of hospital pharmacy, along with other, must be maintained and  reinforced, as these are the areas that make us essential.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Drug Compounding , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Administration, Oral , Antiviral Agents/supply & distribution , Antiviral Agents/therapeutic use , Blood Component Transfusion , Disinfection , Drug Administration Routes , Drug Interactions , Drug Stability , Equipment Contamination/prevention & control , Excipients , Forecasting , Home Care Services , Humans , Hydroxychloroquine/administration & dosage , Hydroxychloroquine/chemistry , Infusions, Intravenous , Lopinavir/administration & dosage , Personal Protective Equipment/supply & distribution , Platelet-Rich Plasma , Ritonavir/administration & dosage , Solutions
5.
Farm Hosp ; 44(7): 49-52, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599578

ABSTRACT

As in other areas of the health system, COVID-19 has had a dramatic impact on  hospital compounding. This area has faced numerous challenges, including the  shortage of frequent-use products (hydroalcoholic solutions, lopinavir/ritonavir  suspension), the use of new preparations for SARS-CoV-2 (tocilizumab,  remdesivir), or requests from overwhelmed wards unable to assume the safe  preparation of a high volume of medications (intravenous solutions). The  demand for all types of preparations (topic and oral medications, intravenous  solutions) has increased dramatically. This increase has highlighted the shortage of resources allocated to this area, which has made it difficult to meet the high  demand for preparations. In addition, the pandemic has revealed the scarcity of  research on such basic aspects as agent stability and drug compatibility. One of  the most relevant conclusions drawn from the COVID-19 pandemic is that the  basic areas of hospital pharmacy, along with other, must be maintained and  reinforced, as these are the areas that make us essential.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Drug Compounding , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Administration, Oral , Antiviral Agents/supply & distribution , Antiviral Agents/therapeutic use , Blood Component Transfusion , Disinfection , Drug Administration Routes , Drug Interactions , Drug Stability , Equipment Contamination/prevention & control , Excipients , Forecasting , Home Care Services , Humans , Hydroxychloroquine/administration & dosage , Hydroxychloroquine/chemistry , Infusions, Intravenous , Lopinavir/administration & dosage , Personal Protective Equipment/supply & distribution , Platelet-Rich Plasma , Ritonavir/administration & dosage , Solutions
7.
Farm Hosp ; 44(7): 66-70, 2020 06 13.
Article in English | MEDLINE | ID: covidwho-599574

ABSTRACT

The health crisis resulting from the rapid spread of SARS-CoV-2 worlwide, added to the low evidence of currently used treatments has led to the development of a large number of clinical trials (CT) and observational studies. Likewise,  important measures have been adopted in healthcare and research centers  aimed at halting the pandemic as soon as possible. The objective of this study is  to gather the main aspects of the clinical research studies undertaken by the  Departments of Hospital Pharmacy (DHP) of Spain during the COVID-19 crisis. The decision of the Spanish Society of Hospital Pharmacy (SEFH) to sponsor CTs made it possible that 13% of DHP had been led at least one CT.  The Spanish Agency for Medicines and Medical Devices (AEMPS), in coordination  with Institutional Review Boards, has adopted a fast-track review procedure to  accelerate authorizations for CTs related to the treatment or prevention of  COVID-19. There have also been numerous public and private calls for financing  research projects aimed at contributing to the fight against this virus. Despite  the pandemic, actions have been taken to continue ongoing CTs and studies  while the safety and well-being of patients are guaranteed. More specifically, the AEMPS and the European Medicines Agency (EMA) have issued guidelines that  incorporate changes to CT protocols that will have to be applied until the  pandemic is over. In this health emergency, the scientific community has found  itself in a race against time to generate evidence. It is at this moment that  hospital pharmacists emerge as key players in clinical research and are  contributing to a rational, effective and safe healthcare decision-making.


Subject(s)
Betacoronavirus , Clinical Trials as Topic , Coronavirus Infections/drug therapy , Infection Control/organization & administration , Multicenter Studies as Topic , Observational Studies as Topic , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Antiviral Agents/therapeutic use , Clinical Trials as Topic/economics , Clinical Trials as Topic/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Decision Making , Drugs, Investigational/therapeutic use , Forecasting , Humans , Multicenter Studies as Topic/economics , Multicenter Studies as Topic/statistics & numerical data , Observational Studies as Topic/economics , Observational Studies as Topic/statistics & numerical data , Pandemics/prevention & control , Patient Safety , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Research Design , Research Support as Topic , Role , Spain
9.
Farm Hosp ; 44(7): 21-23, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599572

ABSTRACT

Medical devices have become essential to the prevention and control of the  COVID-19 pandemic, being crucial for health professionals and patients in  particular, and the population in general. It is important to be aware of the laws  that regulate the management, distribution, and control of medical devices.  Article 82 of the Spanish Law 29/2006 on Guarantees and Rational Use of  Medicines and Medical Devices establishes that it is the responsibility of Hospital  Pharmacy Services "to participate in and coordinate the purchase of medicines and medical devices in the hospital to ensure an efficient acquisition  and rational use of medical devices". For this reason, working groups of the Spanish Society of Hospital Pharmacy and other scientific societies have issued technical guidelines and consensus statements to provide technical support and updated information on the use of masks, individual  protection equipments and other medical devices. In addition, the shortage of  medical devices caused by the high demand has resulted in the uncontrolled  production and distribution of medical devices. This phenomenon, added to the  fraudulent selling of medical devices, highlights the need for a closer surveillance of the market to guarantee the efficacy and safety of available medical devices. A rational use of medical devices is necessary to ensure the availability and safety of these products, which requires the involvement of  different stakeholders, including hospital pharmacists. Thus, it is essential that  hospital pharmacists receive specific training in technical aspects concerning the possession and use of medical devices. This will help guarantee an effective and safe use of medical products. The acquisition and use of medical  devices requires a keen understanding of the technical and legal aspects  concerning these products, which makes hospital pharmacists essential for the  integral management of medical devices.


Subject(s)
Betacoronavirus , Coronavirus Infections , Equipment and Supplies , Pandemics , Pharmacy Service, Hospital , Pneumonia, Viral , Protective Devices , Certification , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Device Approval , Equipment and Supplies/standards , Equipment and Supplies/supply & distribution , Forecasting , Fraud , Health Services Needs and Demand , Humans , Infection Control/instrumentation , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Pandemics/prevention & control , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Protective Devices/supply & distribution , Ventilators, Mechanical/supply & distribution
10.
Farm Hosp ; 44(7): 11-16, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599571

ABSTRACT

The purpose of this article is to report the experience of the Department of Hospital Pharmacy of a mid-size hospital during the peak of the COVID-19 pandemic. The human and material resources available in a mid-size hospital were more limited than in larger hospitals of the region. In this article, we describe how this Department of Hospital Pharmacy was reorganized to meet the increase in activity, the strategies developed and the  lessons learned for future pandemics. The COVID-19 pandemic had a higher  impact in Leganes, a city in the south of Madrid, with a population of 190,000.  In the face of the dramatic increase in the proportion of patients attending our  hospital between March and April 2020, the Severo Ochoa University Hospital  increased the number of beds by 24.5% and fitted out new premises inside and  outside the hospital (sports centers). The mean number of patients seen in our  Emergency Department every day passed from 70-80 to a peak of 286 patients, with 652 hospitalized patients. The situation of emergency created by  this infectious disease, with management protocols changing constantly, had a  dramatic impact on the activity of hospital pharmacies. Thus, the pandemic has  affected areas of economic management, magistral preparation, dispensing of  medication to inpatients, ambulatory patients, patients monitored at home,  institutionalized patients, and patients from private hospitals and field hospitals.  Other areas affected include training, clinical trials, pharmacovigilance, and  counseling boards. Two strategies were adopted to overcome these problems: a  strategy centered on human resources (staff reinforcement, reallocation of  responsibilities), and a strategy centered on processes (some processes were  reinforced to meet the increase in activity, whereas other were temporarily suspended or reduced to the minimum).Conclusions: The Department of Hospital Pharmacy plays a key role  in hospitals and has been significantly reinforced to meet the dramatic impact of  the pandemic on this service. This Department has been able to reorganize its  processes and take over new responsibilities such as telepharmacy and home  dispensing. Hospital pharmacies play a crucial role in  pharmacotherapeutic decisions in hospitals. As in other Departments, training is  the area more significantly affected by the pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Clinical Trials as Topic , Disaster Planning , Drug Compounding , Drug Prescriptions/statistics & numerical data , Forecasting , Health Services Needs and Demand , Hospital Bed Capacity , Hospitals, University/organization & administration , Hospitals, Urban/organization & administration , Humans , Inpatients/statistics & numerical data , Medication Systems, Hospital/organization & administration , Spain , Staff Development
11.
Farm Hosp ; 44(7): 24-27, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599570

ABSTRACT

Type 2 coronavirus pandemics that is plaguing almost all the world has caused  qualitative and quantitative strains in health systems that have had to be responded to. The lack of known vaccines and effective treatments has generated the need to  use drugs with very little evidence for their incorporation into pharmacotherapeutic  protocols agreed by the clinical team. The hospital pharmacist, within the  multidisciplinary team, has been responsible for critically evaluating the alternatives and positioning them in these protocols. Finally, some ethical and legal questions  that should be considered in this scenario are analyzed in this article.


Subject(s)
Betacoronavirus , Coronavirus Infections , Evidence-Based Medicine , Pandemics , Pharmacists , Pharmacy Service, Hospital/organization & administration , Pharmacy and Therapeutics Committee/organization & administration , Pneumonia, Viral , Clinical Protocols , Coronavirus Infections/drug therapy , Drug Therapy/standards , Humans , Interdisciplinary Communication , Off-Label Use/ethics , Off-Label Use/legislation & jurisprudence , Patient Care Team , Pharmacy Service, Hospital/legislation & jurisprudence , Pneumonia, Viral/drug therapy , Practice Guidelines as Topic , Propaganda , Role
12.
Farm Hosp ; 44(7): 32-35, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599569

ABSTRACT

The Intensive Care Unit (ICU) of the University Hospital of Fuenlabrada was  forced to critically increase its capacity in the COVID-19 pandemic. The objective of this work is to describe the activities promoted by the pharmacist in the care  of the critically ill patient in this context. A new organizational structure was  designed, analyzing the tasks necessary to make the processes profitable. Two  pharmacists joined the critical patient care to help the pharmacist who was  already integrated in the ICU team. The development of the operational  structure was carried out on three levels. The healthcare activity highlights the  daily participation of pharmacists in the two clinical sessions in which the ICU  teams evaluated all cases and made decisions. This in turn facilitated the  pharmaceutical validation that was carried out in the critical units themselves. In addition, one of the pharmacists created the Immuno-COVID Committee, in  which they participated together with different specialists for therapeutic  decision-making in the most complex cases. On the other hand, the availability  of human and material resources allowed the implantation of centralized  elaboration in the Pharmacy Service of many intravenous mixtures, including  antibiotics elastomers Pumps for continuous infusion, and non-sterile  elaborations. In logistics management, in addition to the acquisition of COVID- 19 therapies, the reconciliation with nursing activity stands out. The physical presence of the pharmacist favored the detection of needs, the  availability in time of medications in the unit, including sterile and non-sterile  preparations, and coordination with the central pharmacy. In knowledge  management, the participation of the pharmacist in the working group for the  development of the hospital management protocol COVID-19 stands out. The  daily presence in the unit and the joint work with the entire multidisciplinary team demonstrate the value that the pharmacist can bring. In addition to  efficient resource management, support for clinical decision-making and  improvement actions, it provides the climate of inter-professional trust necessary to respond to the complexity of the critical patient and promote joint  projects.


Subject(s)
Betacoronavirus , Coronavirus Infections , Intensive Care Units , Pandemics , Pharmacists , Pneumonia, Viral , Coronavirus Infections/epidemiology , Coronavirus Infections/nursing , Coronavirus Infections/therapy , Critical Care , Decision Making , Disease Management , Equipment and Supplies, Hospital/supply & distribution , Health Services Needs and Demand , Hospitals, University , Humans , Intensive Care Units/organization & administration , Intensive Care Units/statistics & numerical data , Interdisciplinary Communication , Patient Care Team , Pharmaceutical Preparations/supply & distribution , Pharmacy Service, Hospital/organization & administration , Pharmacy and Therapeutics Committee/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/nursing , Pneumonia, Viral/therapy , Professional Role , Spain/epidemiology
13.
Farm Hosp ; 44(7): 40-42, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599568

ABSTRACT

Since the implementation of the Antimicrobial Therapy Optimization Programme, hospital pharmacy specialists have collaborated with infectious disease specialists on a regular basis in most hospitals in Spain.  Cooperation between these professionals ensures the integrated management of patients with infectious diseases and the appropriate use of antimicrobials in  hospitals. The COVID-19 pandemic forced hospital pharmacists to abruptly  suspend all their structured activities and concentrate on the health crisis.  Realtime information sharing between different medicine specialties is an  effective strategy to generate and maintain treatment protocols adapted to each center, with continuous evidence-based modifications as new publications appear. Hospital pharmacies had to reorganize their activities to  respond to the pandemic. On the one side were patients with COVID-19, and on  the other were routine hospital pharmacy tasks, with the added difficulty of  adapting to individual protection measures. New communication and  collaboration strategies were adopted. Protocols were established for the  management of COVID-19 patients, with continuous changes; special  medications had to be prepared and distributed; circuits were designed for the  home- or institution-based care of patients; internal circuits were created to  minimize the movements of hospital staff and professionals caring for COVID-19  patients. The most effective antiviral drug and anti inflammatory therapy  remains elusive. In this scenario, hospital pharmacists emerge as a key player,  as they have a deep understanding of the mechanisms of action of drugs and  potential interactions. In a setting where experimental drugs preferably tested in clinical trials are being used, the role of hospital pharmacists in interdisciplinary  teams has become essential for the optimization of clinical outcomes.


Subject(s)
Betacoronavirus , Coronavirus Infections , Hospital Units , Interdisciplinary Communication , Pandemics , Patient Care Team , Pharmacists , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Critical Care , Decision Making , Disease Management , Health Services Needs and Demand , Hospitals, University , Humans , Infection Control/methods , Infection Control/organization & administration , Infectious Disease Medicine/organization & administration , Inpatients , Intensive Care Units/organization & administration , Pharmaceutical Preparations/supply & distribution , Pharmacy and Therapeutics Committee/organization & administration , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Spain/epidemiology
14.
Farm Hosp ; 44(7): 5-10, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599567

ABSTRACT

The WHO declared the SARS- CoV-2 outbreak a pandemic in March 11, 2020.  Spain has been the third country with the highest number of reported cases of  COVID-19. In the face of the pandemic, the authorities of the Autonomous  Community of Madrid led an unprecedented transformation of hospital services  by increasing the number of beds available, setting up temporary field hospitals  in fairgrounds, and transforming hotels into support centers for patients with  mild symptoms of COVID-19. In the light that this crisis will continue to be a real threat for the years to come, our hospital pharmacies need to be better prepared for similar outbreaks in the future. During the COVID-19 pandemic, the  Department of Hospital Pharmacy of Hospital General Universitario Gregorio  Marañón has faced four challenges: an exponential increase in the demand for  resources, constant changes to therapeutic protocols and approaches, regulatory changes, and a dramatic impact on hospital staff (strain on human resources  and psychological impact). This article is aimed at describing the main  organizational changes implemented to the Department of Hospital Pharmacy of  Hospital GU Gregorio Marañón and its relationship with other hospital  pharmacies of the Community of Madrid. An account is provided of the strategies to be adopted for reorganizing a Department of Hospital Pharmacy and achieve a safe and effective use of medications. Strategies range from the creation of  integral hospital task groups (COVID-crisis task group, protocolization task  group, research task group) to the adaptation of the internal organization of the  Department of Hospital Pharmacy, which encompasses aspects related to  management and leadership; a communication plan (internal and external);  staff management, and the reorganization and adaptation of processes. People,  patients and professionals are at the core of these strategies. This paper is a  reflection on key factors of "humanization in COVID times".


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pharmacy Service, Hospital , Pneumonia, Viral , Antiviral Agents/supply & distribution , Antiviral Agents/therapeutic use , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Disaster Planning , Health Resources , Health Services Needs and Demand , Hospitals, General/organization & administration , Humans , Infection Control/organization & administration , Pandemics/prevention & control , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Pneumonia, Viral/prevention & control , Professional-Patient Relations , Protective Devices , Quality Assurance, Health Care , Spain , Telemedicine
15.
Farm Hosp ; 44(7): 61-65, 2020 06 13.
Article in English | MEDLINE | ID: covidwho-599566

ABSTRACT

Hospital Pharmacy Service (HPS) in Spain have been impacted by the health  crisis caused by the COVID-19 pandemic. Thus, the outbreak has forced HPSs to adapt their outpatient consultation services to Telepharmacy to optimize clinical  outcomes and reduce the risk of contagion. The purpose of this article is to  describe and analyze the experience of HPSs with outpatient Telepharmacy  during the COVID-19 pandemic and expose the lessons learned. Measures have  been adopted in on-site outpatient pharmacy clinics to prevent exposure of  patients and professionals to the virus. These measures are based on national  and international recommendations on social distancing and hygiene. With  regard to remote outpatient pharmacy services, teleconsultation with drug  dispensing has been promoted based on five basic procedures, each with its  advantages and limitations: home drug delivery from HPSs, with the advantage  of universal access and the limitation of entailing a substantial investment in  resources; HPS coordination with primary care pharmacists, which requires no  investments but with limited access to some geographic areas; HPS coordination with community pharmacists based on a large network of pharmacies, which  requires the patient to go to the pharmacy, without confidentiality being  guaranteed for any patient; geolocation and hospital-based medication  dispensing, which provides universal access and direct traceability, but entails  investment in human resources; and HPS coordination with associations of  patients, which does not entail any additional cost but limits the information  available on the diseases of society members. Three main lessons have been learned during the pandemic: the satisfactory capacity of HPS to provide outpatient pharmacy consultation services in the setting of a public health crisis; the usefulness of Telepharmacy for the clinical follow-up, healthcare coordination, outpatient counseling, and informed dispensing and delivery of  medication (with a high level of satisfaction among patients); and the need to  foster Telepharmacy as a complementary tool through a mixed model of  outpatient pharmacy consultation service that incorporates the advantages of  each procedure and adapts to the individual needs of each patient in a context of humanized healthcare.


Subject(s)
Ambulatory Care/organization & administration , Betacoronavirus , Coronavirus Infections , Delivery of Health Care/organization & administration , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral , Telemedicine/organization & administration , Delivery of Health Care/statistics & numerical data , Directive Counseling/organization & administration , Distance Counseling/organization & administration , Forecasting , Geography, Medical , Health Services Needs and Demand , Home Care Services/organization & administration , Hospitals, University/organization & administration , Humans , Medication Systems, Hospital/organization & administration , Outpatients , Patient Education as Topic/organization & administration , Pharmacy Service, Hospital/statistics & numerical data , Spain
16.
Farm Hosp ; 44(7): 17-20, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599565

ABSTRACT

COVID crisis has abruptly broken into our hospitals, and many difficulties have  emerged, including those related to supply logistics. A huge number of new  patients, a fast internal reorganization process and many other changes were  suddenly established. These circumstances revealed the need to increase stocks  of drugs, both for basic treatment as well as for specific SARS-CoV-2 infection  management. At the same time, other problems (shortages, new and complex  purchasing procedures, etc.) surfaced, so they could risk safety along the  pharmacotherapeutic process. The main objective was to develop and implement all the necessary measures within the logistics circuit in order to ensure the  availability of medicines for patients, as safely and effectively as possible, during the Coronavirus crisis. Firstly, two pharmacists were appointed to coordinate the whole process, and a preliminary analysis of the following aspects was carried  out an estimation of needs to make an initial drug provisioning, a storage  feasibility study and a global analysis of the logistics process to detect critical  points. Three different circuits for medicines supply were established as some  drugs were operated by Agencia Española de Medicamentos y Productos  Sanitarios (AEMPS) or Servicio Madrileño de Salud (SERMAS), and others were  under no restrictions. For stocks control, inventory was frequently reviewed and  monitoring of prescription trends was implemented. For all new medicinal  products, compliance with security standards was reviewed and relabeling was  carried out if necessary. Criteria were defined for the storage of overstocks and  it was placed an isolated area for quarantined drugs. Shortages inevitably  occurred but their effects were partly mitigated by AEMPS and SERMAS. After  all, we consider that the implemented procedure for logistics management may  be reproducible, and the key points we have identified are the following: to  enhance our quality management system, to develop an Action Plan for  Healthcare Emergencies and to ensure the adequate training for all pharmacy  staff. Furthermore, we also should address other aspects: to establish storage  optimization strategies, to focus on a more advanced logistics management  model, as well as to take advantage of the extraordinary multidisciplinary  network, which has been consolidated during this COVID pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pharmaceutical Preparations/supply & distribution , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral , Antiviral Agents/supply & distribution , Antiviral Agents/therapeutic use , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Disaster Planning , Drug Labeling , Drug Prescriptions/statistics & numerical data , Drug Storage , Education, Pharmacy, Continuing , Health Services Needs and Demand , Humans , Interdisciplinary Communication , Inventories, Hospital , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Total Quality Management
17.
Farm Hosp ; 44(7): 43-48, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599564

ABSTRACT

The COVID-19 pandemic is having a devastating effect on the nursing homes for dependent older people. The difficulty of management of this crisis is aggravated by the frailty of the people served and by the specific characteristics of the care  area, mainly the fact of not being integrated into the health system. The  objective of this work is to describe the pharmaceutical care developed by a  hospital pharmacy service established in a nursing home and, from a more  global perspective, analyze the strengths and weaknesses found from the  various experiences of hospital pharmacy in all spanish autonomous  communities to deal with this pandemic. Specialized pharmaceutical care has  provided rigor in the validation and treatments review processes from a  comprehensive perspective, maximizing safety and collaborating in the  establishment of the therapeutic intensity degree most appropriate to the  individual situation, has ensured the availability of all necessary medications,  has collaborated in the acquisition and management of personal protective equipment, has been able to adapt the dispensation processes to the internal  nursing homes sectorization and has facilitated the coordination between the  nursing home and the health system. It is clear that the crisis casued by COVID- 19 has put relevance of the need to integrate the social-health level into the  health system. And also, the contribution of specialized pharmaceutical care in  improving healthcare coverage and coordination with health services has  highlighted the urgency of developing the current legislation, prioritizing the  establishment of pharmacy services able to provid specialized and specific care  for this area, so that it meets healthcare needs and is integrated into the health  system.


Subject(s)
Ambulatory Care/organization & administration , Betacoronavirus , Coronavirus Infections/drug therapy , Nursing Homes/organization & administration , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Aged , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Community-Acquired Infections/transmission , Comorbidity , Coronavirus Infections/nursing , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Disease Outbreaks , Drug Interactions , Female , Frail Elderly , Humans , Infection Control/organization & administration , Male , Medication Systems, Hospital/organization & administration , Pandemics/prevention & control , Personal Protective Equipment , Personnel Staffing and Scheduling , Pneumonia, Viral/nursing , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Polypharmacy , Spain/epidemiology
18.
Farm Hosp ; 44(7): 28-31, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599562

ABSTRACT

During the pandemic caused by the SARS-CoV-2 virus, pharmacy services have  had to adapt their service portfolio, and yet ensure efficient, equitable and  quality pharmaceutical care. Given the limited scientific evidence available, most drugs have been used off-label or in the context of clinical trials, which should be the preferred option in order to create new evidence. Among kind different  situations we have faced are the increase in workload, the expansion of  coverage to new wards and ICUs and shortages, which have caused the use of  alternative drugs and even other routes of administration. Given that covid-19  affects elderly population with greater severity and many of them are  polymedicated, great effort have been focused on monitoring interactions, both  pharmacokinetic and pharmacodynamic (specially prolongation of the QT  interval), monitoring correct concentrations of electrolytes, nutritional support,  adaptation of chemotherapy treatment protocols and anticoagulant  management, among others. The use of personal protective equipment added  difficulty for nursing work and some measures had been taken to minimize the  number of entries into the rooms. Eventually, team's split to guarantee care, the challenge of teleworking, remote validation, telemedicine and telepharmacy for  communication between professionals and patients, as well as training in this pandemic situation have been a challenge for our profession. These  difficulties have risen up new learning opportunities we hope will be useful to us  in the event we have to face similar situations in the future.


Subject(s)
Betacoronavirus , Coronavirus Infections/drug therapy , Inpatients , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Aftercare , Communication , Comorbidity , Cross Infection/prevention & control , Drug Administration Routes , Drug Interactions , Drug Monitoring , Forecasting , Health Personnel/education , Health Services Needs and Demand , Humans , Infection Control/methods , Infection Control/organization & administration , Off-Label Use , Patient Education as Topic , Patient Safety , Personal Protective Equipment , Pharmacovigilance , Professional-Patient Relations , Telemedicine
19.
Farm Hosp ; 44(7): 66-70, 2020 06 13.
Article in English | MEDLINE | ID: covidwho-597842

ABSTRACT

The health crisis resulting from the rapid spread of SARS-CoV-2 worlwide, added to the low evidence of currently used treatments has led to the development of a large number of clinical trials (CT) and observational studies. Likewise,  important measures have been adopted in healthcare and research centers  aimed at halting the pandemic as soon as possible. The objective of this study is  to gather the main aspects of the clinical research studies undertaken by the  Departments of Hospital Pharmacy (DHP) of Spain during the COVID-19 crisis. The decision of the Spanish Society of Hospital Pharmacy (SEFH) to sponsor CTs made it possible that 13% of DHP had been led at least one CT.  The Spanish Agency for Medicines and Medical Devices (AEMPS), in coordination  with Institutional Review Boards, has adopted a fast-track review procedure to  accelerate authorizations for CTs related to the treatment or prevention of  COVID-19. There have also been numerous public and private calls for financing  research projects aimed at contributing to the fight against this virus. Despite  the pandemic, actions have been taken to continue ongoing CTs and studies  while the safety and well-being of patients are guaranteed. More specifically, the AEMPS and the European Medicines Agency (EMA) have issued guidelines that  incorporate changes to CT protocols that will have to be applied until the  pandemic is over. In this health emergency, the scientific community has found  itself in a race against time to generate evidence. It is at this moment that  hospital pharmacists emerge as key players in clinical research and are  contributing to a rational, effective and safe healthcare decision-making.


Subject(s)
Betacoronavirus , Clinical Trials as Topic , Coronavirus Infections/drug therapy , Infection Control/organization & administration , Multicenter Studies as Topic , Observational Studies as Topic , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Antiviral Agents/therapeutic use , Clinical Trials as Topic/economics , Clinical Trials as Topic/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Decision Making , Drugs, Investigational/therapeutic use , Forecasting , Humans , Multicenter Studies as Topic/economics , Multicenter Studies as Topic/statistics & numerical data , Observational Studies as Topic/economics , Observational Studies as Topic/statistics & numerical data , Pandemics/prevention & control , Patient Safety , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Research Design , Research Support as Topic , Role , Spain
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