ABSTRACT
Introducción: Una técnica de inhalación incorrecta contribuye de forma importante a la falta de efectividad de los medicamentos antiasmáticos y provoca frecuentes efectos adversos a nivel orofaringeo. Estudios anteriores han evidenciado altos niveles de desconocimiento de la técnica inhalatoria adecuada por parte de pacientes y profesionales sanitarios. Objetivo: Analizar el conocimiento de la técnica de inhalación por parte de farmacéuticos comunitarios. Material y métodos: Se analizó mediante 3 cuestionarios (checklist) para 3 dispositivos (Aerosol Presurizado, Turbuhaler y Accuhaler) el conocimiento de los diferentes pasos necesarios para inhalar correctamente, en una muestra de 28 farmacéuticos comunitarios. Resultados: El porcentaje medio de pasos correctos fue de 55,9% en Turbuhaler, 49,4% en Accuhaler y 47,4% en Aerosol Presurizado (AU)
Background: A correct inhalation technique contributes significantly to the lack of effectiveness of asthma medications, and causes frequent adverse effects at the pharynx level. Previous studies have showed poor knowledge of the correct inhalation technique by both patients and health professionals. Objective: To analyse the knowledge of the inhalation technique by community pharmacists. Methods: 3 checklists for 3 devices (Metered-Dose inhaler, Turbuhaler and Accuhaler) were used to analyse the knowledge of the different steps needed to inhale correct/y, in a sample of 28 community pharmacists. Results: The mean percentage of correct steps was 55.9% with Turbuhaler, 49,4% with Accuhaler, and 47,4% with Metered-Dose Inhaler. Conclusions: There is an alarming lack of knowledge (55,9% with Turbuhaler, 49,4% with Accuhaler, and 47,4% with Metered-Dose Inhaler) about the correct sequence of steps for the administration of inhaled asthma medications, by the community pharmacist included in the sample (AU)
Subject(s)
Humans , Administration, Inhalation , Metered Dose Inhalers , Asthma/drug therapy , Anti-Asthmatic Agents/administration & dosage , Health Knowledge, Attitudes, Practice , Dry Powder Inhalers/methods , Behind-the-Counter Drugs/administration & dosage , Community Pharmacy ServicesABSTRACT
Introducción: A pesar de las mejoras terapéuticas conseguidas en los últimos años, existe un bajo nivel de seguimiento de las recomendaciones internacionales sobre manejo del asma, así como un insuficiente control del asma en general. Se han descrito problemas de educación de los pacientes, falta de adherencia y técnica de inhalación incorrecta. Objetivo: Describirlos PRM que se presentan con mayor frecuencia en pacientes asmáticos atendidos en un programa de seguimiento farmacoterapéutico en farmacia comunitaria, y medir el grado de resolución de dichos PRM. Material y métodos: Se analizan los PRM identificados en 96 pacientes captados en 20 farmacias. Se utilizaron entrevistas de inicio/cierre, y registros de visita, en los que se tuvieron en cuenta las siguientes variables: sexo, edad, causa, categoría, PRM, consecuencia, medicación responsable, intervención farmacéutica y resolución. Resultados: Se identificaron 116 PRM en 65 pacientes. La mayoría pertenecían a la categoría de efectividad (60,3%), seguida de seguridad (21,6%), e indicación (18,1%). La intervención farmacéutica se realizó fundamentalmente con el paciente (30,2 % explicación sobre utilización, y 24,1% ayuda al cumplimiento), y en un 45,7% se produjo derivación al médico. Se resolvió el PRM en un 75,9% de las ocasiones. Conclusiones: Los PRM más frecuentes en asmáticos pertenecen a la categoría de efectividad (60,3%). La intervención farmacéutica consigue resolver los PRM identificados en una elevada proporción (75,9%) (AU)
Background: Despite the therapeutic improvements achieved in last years, there is a low level of use of the international asthma management guides, and a wide poorly asthma control. Problems with patient education, lack of adherence and bad inhalation technique have been described. Objective: To describe the most common drug related problems in patients with asthma following a pharmaceutical care program in community pharmacy, and to measure the solution of such problems. Methods: Drug related problems identified in 96 patients from 20 pharmacies were analysed. Initial/Final interviews, and visit registers were used, including the next variables: sex, age, cause, category, drug related problem, consequence, medication, pharmaceutical intervention, and solution. ResuIts: 116 drug related problems were identified in 65 patients, in most cases included in the effectiveness category (60,3%), followed by safety (21,6%), and indication (18,1%). Pharmaceutical interventions were developed with the patient for the most part (30,2% explanation about use, 24,1% compliance aid), and derivation to doctor was needed in 45,7% of cases. 75,9% of drug related problems were solved. Conclusions: The most common drug related problems in patients with asthma belong to the effectiveness category (60,3%). Pharmaceutical interventions salve drug related problems in a high proportion of cases (75,9%) (AU)
Subject(s)
Humans , Asthma/drug therapy , Anti-Asthmatic Agents/administration & dosage , Drug-Related Side Effects and Adverse Reactions/epidemiology , Behind-the-Counter Drugs/administration & dosage , Community Pharmacy Services , Administration, Inhalation , Medication Adherence , Evaluation of the Efficacy-Effectiveness of InterventionsABSTRACT
BACKGROUND: At present, there are a lot of drugs for the therapeutic approach of all the severity levels of asthma in developed countries. However, there are big difficulties in the correct use of inhalation devices, and usually there are drug related problems causing poorly controlled asthma. The objective of the study is to prove if the community-based pharmaceutical care service improves health outcomes in patients with asthma. METHODS: Community intervention trial, with a controlled multicenter quasi-experimental design, measuring the response variables before and after an observation period of 9 months. 96 patients were recruited in the Intervention group and 69 in the Control group, in 37 pharmacies. The measurement instruments used were the specific quality of life questionnaires AQLQ (adults) and PAQLQ (pediatric) of Juniper, and initial and final interviews containing a scale of 10 signs of poorly controlled asthma and data about health services utilization. RESULTS: Quality of life measures in the Intervention group achieved a mean increase of 0.82 points in adults and 0.81 in children, both clinically significant because they exceed the established clinical thresholds (0.5 and 0.42 respectively). Also there was a statistically significant difference in the final comparason between groups. The signs of poorly controlled asthma decreased significantly in the Intervention group from an initial mean of 2.72 into 1.15. Also a significant difference was found in the final comparason between groups. CONCLUSIONS: The community-based pharmaceutical care service had a beneficial effect in health related quality of life in asthma patients, and in the signs of poorly controlled asthma. It was not found a significant improvement in health services utilization.
