[Design, implementation and evaluation of a service for Medication compliance aids (MCAs) in an institutional Pharmacy in the city of Córdoba]. / Diseño, implantación y evaluación de un servicio de Sistemas Personalizados de Dosificación en una farmacia institucional de la ciudad de Córdoba.

Introduction: The Pharmaceutical Service (PS) for the provision of Medication compliance aids (MCAs) consists of reconditioning and unifying, in a protocolized manner and in multi-compartment devices, the medications used by a patient, ordering them according to their dosage guideline. The objective was to design, implement and evaluate an PS of MCAs in an institutional pharmacy in the city of Córdoba. Methods: Observational, descriptive and longitudinal study. A Standard Operating Procedure (SOP) was developed from for PS of MCAs and applied to a sample of 20 patients. Adherence was analyzed by: tablet count and Morisky-Green test. A validated service satisfaction questionnaire was applied and a cost analysis was performed considering the initial investment and the times involved. Results: A 98.0% adherence was obtained by counting the tablets and by the Morisky-Green test: 5.0% at the start of the service and 55.0% at 3 months. The patients expressed in the satisfaction questionnaire: 90.0% very satisfied and 10.0% satisfied. Regarding the cost analysis, the initial investment was USD 1,670.44. A value of US $ 4.29 was calculated for the first interview, and the monthly cost of preparation ranged from US $ 16.02, for 7-30 weekly takings, to US $ 28.73 for more than 121 takings. Conclusion: It was possible to develop and implement an SOP for the PS of SPD, with significant improvements in adherence. A high degree of patient satisfaction was observed and were obtained minimal operating costs to achieve sustainability.

Introducción: El Servicio Profesional Farmacéutico Asistencial (SPFA) de provisión de Sistemas Personalizados de Dosificación (SPD) consiste en reacondicionar y unificar, de manera protocolizada y en dispositivos multicompartimentales, los medicamentos que emplea un paciente, ordenándolos según su pauta posológica. El objetivo fue diseñar, implantar y evaluar un SPFA de SPD en una farmacia institucional de la ciudad de Córdoba. Métodos: Estudio observacional, descriptivo y longitudinal. Se desarrolló de un Procedimiento Normalizado de Trabajo (PNT) para el SPFA de SPD y se aplicó a una muestra de 20 pacientes. Se analizó la adherencia mediante: recuento de comprimidos y test de Morisky-Green. Se aplicó un cuestionario validado de satisfacción del servicio y se realizó un análisis de costos considerando la inversión inicial y los tiempos involucrados. Resultados: Se obtuvo un 98,0% de adherencia por recuento de comprimidos y por Test de Morisky-Green, 5,0% al inicio del servicio y 55,0% a los 3 meses.  Los pacientes expresaron en el cuestionario de satisfacción:  90,0% muy satisfecho y 10,0% satisfecho.  Respecto al análisis de costos, la inversión inicial fue de USD 1.670,44. Se calculó un valor de U$4,29 para la primera entrevista y el costo mensual de preparación, desde USD 16,02 para 7-30 tomas semanales hasta USD 28,73 para más de 121 tomas. Conclusión: Fue posible desarrollar e implantar un PNT para el SPFA de SPD, con mejoras significativas en la adherencia. Se observó un elevado grado de satisfacción del paciente y se obtuvieron los costos operativos mínimos para conseguir su sostenibilidad.

[Characterization of the problem of the therapeutic use of Cannabis Oil in Córdoba, Argentina]. / Caracterización de la problemática del uso terapéutico del Aceite de Cannabis en Córdoba, Argentina.

Introduction: The therapeutic use of the "cannabis" oil is a social problem that puts legal, health, scientific and cultural aspects under stress. Difficulty in access generates an emptiness exploited by the illegal market, to which patients and relatives resort to improve their health and quality of life. These oils, with unknown chemical composition, are used without therapeutic follow-up. An interdisciplinary team from the Universidad Nacional de Córdoba (UNC) started the study of this problem with the aim of characterizing the socio-therapeutic use of "cannabis" oil in Córdoba and establishing a relationship with the real content of cannabinoids. Methodology: Observational-descriptive and cross-sectional study approved by the Comité Institucional de Ética de las Investigaciones en Salud, Hospital Nacional de Clínicas from UNC (CIEIS-HNC-UNC): interviews with patients/caregivers of legal age who used the "cannabis" oil (year 2019). Experimental study: analysis of oil samples obtained from interviewees to determine their cannabinoid content, specifically delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), by High Performance Liquid Chromatography analysis (HPLC). Results: thirty-seven interviews were conducted, and 48 samples were analysed. The 73% were adults and older adults. The 92% started using the oil without prescription or medical suggestion, mainly due to the lack of effectiveness of other therapies (54%) and in the search for therapeutic alternatives (33%). The 84% perceived it to be effective (moderate to highly effective), and 78% reported no adverse events. Main uses: refractory epilepsy 27% and arthritis/arthrosis 24%. Fifteen percent of the samples showed no quantifiable content of CBD and THC, and 67% had only THC. The quantifiable content of cannabinoids was very low. Conclusions: This work allowed carrying out a preliminary information-gathering on several aspects (social and therapeutic) about the use of "cannabis" oil in Córdoba, and to analyze the chemical quality of the oils consumed. An important finding was the discrepancy between the effectiveness perceived by users and the low cannabinoid content detected.

Introducción: El uso terapéutico del aceite de "cannabis" es una problemática social que pone en tensión aspectos legales, sanitarios, científicos y culturales. La dificultad en el acceso genera un vacío aprovechado por el mercado ilegal, al que recurren pacientes y familiares para mejorar su salud y calidad de vida. Estos aceites, de composición química desconocida, se emplean sin un seguimiento terapéutico. Un equipo interdisciplinario de la UNC se involucró en esta problemática con el objetivo de aportar elementos para su caracterización en nuestro medio. Metodología: Estudio observacional-descriptivo y transversal (aprobado por el CIEIS-HNC-UNC): entrevistas a pacientes/cuidadores mayores de edad que usaban el aceite (2019). Estudio experimental: análisis de muestras de aceites de los entrevistados para determinar su contenido de cannabinoides (THC y CBD), mediante HPLC. Resultados: Se realizaron 37 entrevistas y analizaron 48 muestras. El 73% fueron adultos y adultos-mayores. El 79% empiezan a usar el aceite por recomendación de parientes/amigos o por iniciativa propia, principalmente por falta de efectividad de otras terapias (54%) y por búsqueda de alternativas (33%). El 84% lo percibe efectivo (moderado-muy efectivo) y el 78% no manifestó eventos adversos. Usos principales: epilepsia refractaria 27% y artritis/artrosis 24%. El 15% de las muestras no presentaron contenidos cuantificables de CBD y THC, y el 67% presentó THC sin CBD. El contenido de cannabinoides cuantificables fue muy bajo. Conclusiones: Se obtuvo una aproximación sobre el uso terapéutico del aceite de "cannabis" en Córdoba y su calidad. Se observó discrepancia entre la efectividad percibida y el bajo contenido de cannabinoides detectados.

Integration of Community pharmacy and pharmacists in primary health care policies in Argentina

Argentina is a federal republic with approximately 44 million people, divided into 23 provinces and an autonomous city, Buenos Aires. The health system is segmented into public, social security and private subsystems. The social security and private sectors cover more than 60% of the population. Total health expenditure in 2017 was 9.4% of gross domestic product. Primary health care (PHC) was considered as the principal strategy for universal coverage policy for health system reform in Latin America at the end of 20th century. The most remarkable characteristics of the Argentinian health system are its fragmentation and disorganization. An increase of public sector demands, due to a socioeconomic crisis, led to the subsequent collapse of the system, caused primarily by a sustained lack of investment. First care level decentralization to the Integral Health Service Delivery Networks (IHSDN) becomes the cornerstone of a PHC-based system. Pharmacists and community pharmacies are not formally mentioned in PHC policies or IHSDN. However, pharmacies are recognized as healthcare establishments as part of the first care level. Community pharmacists are the only health care professional whose profit comes from the margin on product sales. Contracts with social security and private insurances provide small margins which reduce the viability of community pharmacies. There is a preference by community pharmacies to diversify product sales instead of providing professional services. This is driven by marketing and economic pressures rather than patient care and health policies. Dispensing is the main professional activity followed by management of minor illness and associated product recommendations. Currently, there are no national practice guidelines or standard operating procedures for the provision of pharmaceutical services and there is no nationally agreed portfolio of services. National pharmacy organizations appear to have no official strategic statements or plans which would guide community pharmacies. There are some isolated experiences in community pharmacies and in public first care level pharmacies that demonstrate the possibilities and opportunities for implementing pharmaceutical services under the PHC approach. There is a real lack of integration of community pharmacies and pharmacists in the healthcare system

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Integration of Community pharmacy and pharmacists in primary health care policies in Argentina.

Argentina is a federal republic with approximately 44 million people, divided into 23 provinces and an autonomous city, Buenos Aires. The health system is segmented into public, social security and private subsystems. The social security and private sectors cover more than 60% of the population. Total health expenditure in 2017 was 9.4% of gross domestic product. Primary health care (PHC) was considered as the principal strategy for universal coverage policy for health system reform in Latin America at the end of 20th century. The most remarkable characteristics of the Argentinian health system are its fragmentation and disorganization. An increase of public sector demands, due to a socioeconomic crisis, led to the subsequent collapse of the system, caused primarily by a sustained lack of investment. First care level decentralization to the Integral Health Service Delivery Networks (IHSDN) becomes the cornerstone of a PHC-based system. Pharmacists and community pharmacies are not formally mentioned in PHC policies or IHSDN. However, pharmacies are recognized as healthcare establishments as part of the first care level. Community pharmacists are the only health care professional whose profit comes from the margin on product sales. Contracts with social security and private insurances provide small margins which reduce the viability of community pharmacies. There is a preference by community pharmacies to diversify product sales instead of providing professional services. This is driven by marketing and economic pressures rather than patient care and health policies. Dispensing is the main professional activity followed by management of minor illness and associated product recommendations. Currently, there are no national practice guidelines or standard operating procedures for the provision of pharmaceutical services and there is no nationally agreed portfolio of services. National pharmacy organizations appear to have no official strategic statements or plans which would guide community pharmacies. There are some isolated experiences in community pharmacies and in public first care level pharmacies that demonstrate the possibilities and opportunities for implementing pharmaceutical services under the PHC approach. There is a real lack of integration of community pharmacies and pharmacists in the healthcare system.

[Strategies to foster an adequate compromise of the pharmacist with respect to over the counter medicines' advertisement.] / Estrategias para fomentar un adecuado compromiso del farmacéutico con respecto a la publicidad de medicamentos de venta libre.

The advertisement has a great influence on the public and, in over the counter medicines (OTC), it can generate health risks on the population if it is misregulated. The aim of this work is to analyze and disclose strategic viable actions emerged from a forum debate during an online course for fostering the pharmacist's compromise related to OTC advertisement. Methods: A content analysis was carried on, grouping by themes and categories the opinions of community pharmacists participating in a forum debate about OTC advertisement. Two audiovisual advertisement pieces were analyzed as triggers of discussion. Results: Sixty-five professionals participated in 3 groups of debate, and 103 opinions were collected. Among individual strategies, to guarantee the attention by a pharmacist was highlighted when health conditions or the use of medicines are consulted about. Other strategies include denouncing to the ANMAT the advertisements that do not comply with the norms, procuring a better regulation and assuming a critical posture. Within the collective strategies, including pharmacists in the evaluation committee of advertisement of ANMAT and furthering norms to reassess the role of the pharmacist and the community pharmacy in minor illnesses were stressed. Conclusion: The contribution of the community pharmacists allows disposing a set of professional strategies, both individuals and collectives, to promote a rational use of OTC for the patients and the community.

INTRODUCCIÓN: la publicidad ejerce una influencia muy importante sobre el público y, en el caso de los medicamentos de venta libre (MVL), puede generar riesgos en la salud de la población si no es adecuadamente fiscalizada. OBJETIVO: El objetivo de este trabajo es analizar y divulgar acciones estratégicas viables surgidas de la discusión en un foro de debate de un curso online, para fomentar el compromiso del farmacéutico ante la publicidad de MVL. MÉTODO: se realizó un análisis de contenido, agrupando por temas y categorías los aportes de los farmacéuticos comunitarios participantes en un foro de debate sobre publicidad de MVL. Como elemento disparador del debate, se analizaron 2 piezas publicitarias audiovisuales. RESULTADOS: participaron 65 profesionales en 3 grupos de debate y se efectuaron 103 aportes. Dentro de las estrategias individuales se destacan la de garantizar la atención por un farmacéutico ante consultas sobre problemas de salud o sobre el uso de estos medicamentos. Otras estrategias incluyen denunciar ante la ANMAT las publicidades que no cumplan con las normativas vigentes, solicitar mejor fiscalización y asumir una postura crítica. Dentro de las estrategias colectivas se destacan: incluir a farmacéuticos en la comisión evaluadora de publicidad de la ANMAT e impulsar normativas para revalorizar el rol del farmacéutico y la farmacia comunitaria frente a los trastornos menores.C CONCLUSIONES: la contribución de los farmacéuticos comunitarios permite disponer de un set de estrategias profesionales individuales y colectivas para promover un uso más racional de los MVL por parte de los pacientes y la comunidad.

[Analysis of over-the-counter medicines' information and strategies oriented to the community for improving its access and quality.] / Análisis de la información de medicamentos de venta libre y estrategias dirigidas a la población para mejorar su acceso y calidad.

Introduction: The Disposición ANMAT 753/2012 states definitions and guidelines about the information that inserts and labels must include in nonprescription drugs (also known as over-the-counter or OTC drugs). aim: Aims: to analyze the adequacy to the norm in a sample of OTC drugs; promote and disseminate strategic viable actions for being developed by pharmacists to improve the patient's information. formulated. Methods: During a course destined to community pharmacists, a practical activity and an on-line forum about the adequacy to the Disposición ANMAT 753/2012 were developed. The compliance of 17 requirements of the norm, in a sample of 66 OTC drugs, was registered. Forum duration: 2 weeks. A content analysis related to the strategies proposed by the participants was conducted. Results: From the sample, 87.9% of the medicines do not accomplish to at least 1 of the requirements. The major noncompliances were: inappropriately described composition, lack of telephone number for consultations, uncomprehensible therapeutic action, and package requirements. Strategies to develop by pharmacies individually, grouped, or through professional associations were Conclusions: A high level of noncompliance in the analyzed aspects of the norm was observed. The strategies proposed are oriented to patient empowerment by health education about OTC drugs and access to reliable information resources, comprehensible for consumers. It is necessary to reinforce the control procedures for the information the OTC drugs must include, and to encourage both the participation and commitment of the pharmacist.

Introducción: La Disposición ANMAT 753/2012: establece definiciones y lineamientos generales sobre la información que deben contener prospectos, etiquetas y rótulos de medicamentos de venta libre (MVL). Objetivos: analizar la adecuación a la normativa de una muestra de MVL; promover y divulgar acciones estratégicas viables a desarrollar por los farmacéuticos a fin de mejorar la información para los pacientes. Métodos: En un curso, dirigido a farmacéuticos comunitarios, se desarrollaron una actividad práctica y un foro de debate sobre la adecuación a la Disposición ANMAT 753/2012. Se registró el cumplimiento de 17 pautas de la normativa en una muestra de 66 MVL. Duración del foro: 2 semanas. Se realizó un análisis de contenido sobre las estrategias aportadas por los participantes. Resultados: El 87,9% de los medicamentos de la muestra incumple con al menos 1 de las pautas analizadas. Los mayores incumplimientos se relacionaron a composición inadecuadamente descripta, ausencia de número telefónico para consultas, acción terapéutica incomprensible y requerimientos del envase. Se plantearon estrategias a desarrollar en farmacias individualmente, agrupadas o a través de los colegios profesionales. Conclusión: Se observó un alto incumplimiento en las pautas analizadas de la normativa. Las estrategias planteadas se encaminan a conseguir el empoderamiento del paciente a través de educación sanitaria sobre el uso de MVL y el acceso a fuentes de información confiables que sean comprensibles para el usuario. Es necesario fortalecer los circuitos de control de la información que deben contener los MVL y promover la participación y el compromiso del farmacéutico.

Pacientes diabéticos sin cobertura de salud: Utilización de medicamentos, adherencia y complicaciones derivadas de su patología de base / Diabetic patients without health coverage: drug use, adherence and complications arising from their underlying disease

Objetivo: realizar un Estudio de Utilización de Medicamentos de los pacientes diabéticos atendidos en el Hospital Josefina Prieur (HJP) de la ciudad de Villa Allende (Córdoba, Argentina), determinar consumo de medicamentos antidiabéticos, grado de adherencia al tratamiento y pacientes afectados por complicaciones derivadas de la diabetes.Método: Estudio observacional, descriptivo y transversal, sobre pacientes diabéticos atendidos en el HJP que pertenecen al Programa Córdoba Diabetes (ProCorDia) durante los meses de Mayo a Diciembre de 2011.Conclusiones: Del total de medicamentos antidiabéticos dispensados, el 40,50% correspondió al subgrupo A10B (hipoglucemiantes orales) y el 59,50% al subgrupo A10A (Insulinas). Se observó una buena adherencia al tratamiento Pacientes diabéticos sin cobeRtuRa de salud: utilización de medicamentos, adheRencia y comPlicaciones deRivadas de su Patología de base Recibido: 23 de enero de 2013. Aprobado: 23 de mayo de 2013.(AU)

Objective: To carry out a drug usage study with diabetic patients treated at Josefina Prieur Hospital (HJP) Villa Allende city (Córdoba, Argentina) to determine anti-diabetic drug consumption, degree of treatment adherence, and amount of patients with complications arising from diabetes.Method: Observational, descriptive, cross-sectional study carried out on diabetic patients treated at the HJP belonging to the program ôPrograma Córdoba Diabetesö (ProCorDia), from May to December 2011. Drug consumption was determined in DDDs per 1000 inhabitants per day. Adherence was defined by the number of drug provisions for each patient during eight months. The presence of complications was obtained from records of drug delivery to patients receiving other medication besides anti-diabetic ones. Results: From 98 patients, 73 had some type of complication. The consumption of antidiabetic drugs in DDD per 1000 inhabitants per day was: Regular Insulin 1.990, NPH Insulin 6.244, Glibenclamide 2.826, Gliclazide 0.281, Metformin 2.497.Conclusions: From all anti-diabetic drugs dispensed, 40.50% belonged to subgroup A10B (oral hypoglycemic agents) and 59.50% to subgroup A10A (insulin). Good adherence to drug therapy was observed (mean = 81.63%, mode = 100%). A 74.49% of patients presented complications.(AU)

Pacientes diabéticos sin cobertura de salud: Utilización de medicamentos, adherencia y complicaciones derivadas de su patología de base / Diabetic patients without health coverage: drug use, adherence and complications arising from their underlying disease

Objetivo: realizar un Estudio de Utilización de Medicamentos de los pacientes diabéticos atendidos en el Hospital Josefina Prieur (HJP) de la ciudad de Villa Allende (Córdoba, Argentina), determinar consumo de medicamentos antidiabéticos, grado de adherencia al tratamiento y pacientes afectados por complicaciones derivadas de la diabetes.Método: Estudio observacional, descriptivo y transversal, sobre pacientes diabéticos atendidos en el HJP que pertenecen al Programa Córdoba Diabetes (ProCorDia) durante los meses de Mayo a Diciembre de 2011.Conclusiones: Del total de medicamentos antidiabéticos dispensados, el 40,50% correspondió al subgrupo A10B (hipoglucemiantes orales) y el 59,50% al subgrupo A10A (Insulinas). Se observó una buena adherencia al tratamiento Pacientes diabéticos sin cobeRtuRa de salud: utilización de medicamentos, adheRencia y comPlicaciones deRivadas de su Patología de base Recibido: 23 de enero de 2013. Aprobado: 23 de mayo de 2013.

Objective: To carry out a drug usage study with diabetic patients treated at Josefina Prieur Hospital (HJP) Villa Allende city (Córdoba, Argentina) to determine anti-diabetic drug consumption, degree of treatment adherence, and amount of patients with complications arising from diabetes.Method: Observational, descriptive, cross-sectional study carried out on diabetic patients treated at the HJP belonging to the program “Programa Córdoba Diabetes” (ProCorDia), from May to December 2011. Drug consumption was determined in DDDs per 1000 inhabitants per day. Adherence was defined by the number of drug provisions for each patient during eight months. The presence of complications was obtained from records of drug delivery to patients receiving other medication besides anti-diabetic ones. Results: From 98 patients, 73 had some type of complication. The consumption of antidiabetic drugs in DDD per 1000 inhabitants per day was: Regular Insulin 1.990, NPH Insulin 6.244, Glibenclamide 2.826, Gliclazide 0.281, Metformin 2.497.Conclusions: From all anti-diabetic drugs dispensed, 40.50% belonged to subgroup A10B (oral hypoglycemic agents) and 59.50% to subgroup A10A (insulin). Good adherence to drug therapy was observed (mean = 81.63%, mode = 100%). A 74.49% of patients presented complications.

[Community pharmacies' professional image: causes and improvement strategies by applying qualitative research techniques]. / Imagen profesional de farmacias comunitarias: causas y estrategias de mejora aplicando técnicas de investigación cualitativa.

OBJECTIVE: Ascertaining pharmacists' views related to factors explaining the lack of visibility of community pharmacies as being health facilities and proposing strategies for improving community pharmacy professional service accessibility using qualitative research techniques. METHODS: The nominal group technique (NGT) was used in two successive rounds using separate guidelines for factors and strategies. Framework analysis was then carried out. RESULTS: Thirty-four ideas related to "factors" and 32 related to "strategies" were obtained. Strategies were grouped into 14 topics, emphasising those prioritising patient-orientated professional services, ethical aspects and pharmacists' ongoing education. DISCUSSION: The techniques used led to identifying situations perceived by pharmacists which are not formally described in the literature. Raising awareness of professional services in community pharmacies implies agreeing on and developing strategies which should be based on joint participation by the pharmacists themselves, professional associations and universities.

Imagen profesional de farmacias comunitarias: causas y estrategias de mejora aplicando técnicas de investigación cualitativa / Community pharmacies' professional image: causes and improvement strategies by applying qualitative research techniques

Objetivo Conocer las opiniones de los farmacéuticos con relación a los factores que explican la falta de visibilidad de la farmacia comunitaria como establecimiento sanitario y proponer estrategias de desarrollo profesional a fin de lograr mejorar la accesibilidad a los servicios profesionales mediante técnicas de investigación cualitativa. Material y métodos Se utilizó una Técnica de Grupo Nominal (TGN) en 2 rondas sucesivas, respondiendo a 2 consignas guía sobre factores y estrategias. Posteriormente se realizó un Framework analysis. Resultados Se aportaron 34 ideas referidas a factores y 32 a estrategias. Las estrategias fueron agrupadas en 14 temas, destacándose las vinculadas a la priorización de los servicios profesionales orientados a los pacientes, al cumplimiento de la ética y a la formación continua del farmacéutico. Discusión Las técnicas utilizadas permitieron evidenciar situaciones percibidas por los farmacéuticos que no están formalmente descriptas en la literatura. Aumentar la visibilidad de los servicios profesionales en las farmacias comunitarias implica acordar y abordar estrategias que deben sustentarse en la participación conjunta de los propios farmacéuticos, las asociaciones profesionales y las universidades.

Objective Ascertaining pharmacists' views related to factors explaining the lack of visibility of community pharmacies as being health facilities and proposing strategies for improving community pharmacy professional service accessibility using qualitative research techniques. Methods The nominal group technique (NGT) was used in two successive rounds using separate guidelines for factors and strategies. Framework analysis was then carried out. Results Thirty-four ideas related to "factors" and 32 related to "strategies" were obtained. Strategies were grouped into 14 topics, emphasising those prioritising patient-orientated professional services, ethical aspects and pharmacists' ongoing education. Discussion The techniques used led to identifying situations perceived by pharmacists which are not formally described in the literature. Raising awareness of professional services in community pharmacies implies agreeing on and developing strategies which should be based on joint participation by the pharmacists themselves, professional associations and universities.

Validación de un cuestionario de satisfacción de pacientes con el servicio de indicación en farmacias comunitarias / Validating a patient-satisfaction questionnaire about professional advice received for minor illness in community pharmacies

Objetivo Analizar las evidencias de validez y fiabilidad de un cuestionario de satisfacción de pacientes con el servicio de indicación en las farmacias comunitarias argentinas. Material y Métodos Estudio descriptivo de corte transversal. Participaron todos los pacientes o sus cuidadores que concurrieron a las farmacias durante el período de estudio (marzo y abril de 2006) y que supieran leer y escribir. Resultados Se obtuvieron 289 cuestionarios. El análisis factorial reveló un único componente explicando el 52,2 por ciento de la varianza total. Se obtuvo un coeficiente alfa de Cronbach de 0,89. Los pacientes expresaron comentarios adicionales en 87 cuestionarios (30,1 por ciento) que se relacionaron con la calidad de la atención recibida y con otros aspectos de la asistencia. Discusión El cuestionario mostró evidencias de validez de contenido, validez como estructura interna y fiabilidad para valorar la satisfacción de pacientes con el servicio de indicación en las farmacias comunitarias argentinas.

Objective Analysing the evidence regarding the validity and reliability of a patient-satisfaction questionnaire about professional advice received for minor illness in Argentinean community pharmacies. Methods This was a descriptive, cross-sectional study. All patients or their caregivers who visited the pharmacies during the study period (March and April, 2006) and knew how to read and write were included. Results 289 questionnaires were completed. Factorial analysis revealed one single component explaining 52.2 percent of total variance. A 0.89 Cronbach's alpha coefficient was obtained. Patients made additional comments on 87 questionnaires (30.1 percent) concerning the quality of care received and other aspects. Discussion By presenting evidence of content validity, validity as internal structure and reliability the questionnaire could assess patient-satisfaction with the advice received for minor illness in Argentinean community pharmacies.

Relationship between cardiovascular risk factors and high blood pressure by community pharmacists in Spain.

OBJECTIVES: The aim of this study is to determine the influence that different risk factors (age, gender, obesity, smoking, inactivity, diabetes mellitus and previous diagnosis of arterial hypertension) have on arterial pressure, and to determine the prevalence of patients that have high blood pressure and hypertension but have not received drug-treatment for arterial hypertension. SETTING: 42 Spanish community pharmacies. METHOD: Observational and descriptive study. Patients included in the study were over 18 years of age, not receiving pharmacological treatment for arterial hypertension and not pregnant. Two measurements of arterial pressure were taken from each patient on the first day of the study and two other measurements on a later day. The average of these four measurements was taken as the arterial pressure value for the patient. All measurements were taken in the participating community pharmacies, always by the pharmacist and following the same protocols. The measurements were noted in the patients' records along with data about the seven risk factors being studied, allowing them to be related with the patient's arterial pressure value. RESULTS: The number of patients invited to join the study was 3,760, of whom 2,574 agreed to participate, with 2,094 completing the study. It was found that an increase in the number of risk factors led to a corresponding rise in the percentage of patients with high blood pressure and arterial hypertension. The risk of having arterial hypertension was 4.23 times higher in patients aged 65 years and over. It was also 2.88 times greater in those who had been previously diagnosed with arterial hypertension, 2.79 times higher in overweight or obese patients, 2.69 times more in diabetics and 2.22 times higher in men compared with in women. Prevalence of high blood pressure in patients not receiving pharmacological treatment for arterial hypertension was 33.6%, and prevalence of arterial hypertension was 22.8%. CONCLUSIONS: Of the people studied, 22.8% had arterial hypertension. For the risk factors identified, those most related to the presence of arterial hypertension were, in descending order: being 65 years old or over, previous diagnosis of arterial hypertension, being overweight or obese, being diabetic and being male.

[Validating a patient-satisfaction questionnaire about professional advice received for minor illness in community pharmacies]. / Validación de un cuestionario de satisfacción de pacientes con el servicio de indicación en farmacias comunitarias.

OBJECTIVE: Analysing the evidence regarding the validity and reliability of a patient-satisfaction questionnaire about professional advice received for minor illness in Argentinean community pharmacies. METHODS: This was a descriptive, cross-sectional study. All patients or their caregivers who visited the pharmacies during the study period (March and April, 2006) and knew how to read and write were included. RESULTS: 289 questionnaires were completed. Factorial analysis revealed one single component explaining 52.2 % of total variance. A 0.89 Cronbach's alpha coefficient was obtained. Patients made additional comments on 87 questionnaires (30.1 %) concerning the quality of care received and other aspects. DISCUSSION: By presenting evidence of content validity, validity as internal structure and reliability the questionnaire could assess patient-satisfaction with the advice received for minor illness in Argentinean community pharmacies.

Barriers to pharmaceutical care in Argentina.

OBJECTIVE: To identify the perceived barriers to implementing pharmaceutical care in Argentina. METHOD: A semi-structured questionnaire was designed to carry out a cross-sectional descriptive study. The questionnaires were distributed in different continuing professional development events for pharmacists during November-December 2005. RESULTS: Ninety completed questionnaires were collected with the following distribution: 16.7% at the national congress of hospital pharmacy, 18.9% after a conference, 64.4% during two courses related to pharmaceutical care. The surveyed pharmacists work for community pharmacies (76.7%), hospital/institutional pharmacies (20.0%) and primary care centers (2.2%). The most important barriers mentioned were lack of time, lack of specific training and lack of communication skills. CONCLUSION: The opinions of Argentinian pharmacists from different places and professional practice settings were obtained. In all work settings, "lack of time" is the main barrier to overcome for implementing pharmaceutical care.

Development and validation of a Spanish language patient satisfaction questionnaire with drug dispensing.

OBJECTIVE: To develop and validate a specific questionnaire about patient satisfaction with drug dispensing at Spanish community pharmacies. METHOD: A self-administered semi-structured questionnaire was designed centered on the perception of the patients with the dispensing service. To validate this questionnaire, it was administered at Spanish community pharmacies, which voluntarily agreed to participate in the study for a period of 2 months (March and April 2006). Patients or caregivers who were able to read and write were included in the study. MAIN OUTCOME MEASURE: Scores of the items related to satisfaction with the dispensing service. RESULTS: The questionnaire consisted of: an introduction, 10 closed questions in an interval scale of five points, an open section to express comments, and finally demographic data of the patients. Twenty-seven community pharmacies participated in the validation, and 561 questionnaires were obtained with a response percentage of 56.5%. A Cronbach's alpha coefficient of 0.91 was obtained. The Kaiser-Meyer-Olkin coefficient was 0.92, and the extraction of the principal components revealed a unique component explaining 55.2% of the total variance. About 15.5% of patients made additional comments that praised the quality of attention received and other aspects of the service such as the amiability and friendliness shown by pharmacy staff. CONCLUSION: The questionnaire developed shows evidence of validity and reliability for evaluating patient satisfaction with the dispensing service in community Pharmacies in Spain.

La prevención de los PRM y el Segundo Consenso de Granada / No disponible

Con el objeto de evitar que se presenten los Problemas Relacionados con Medicamentos (PRM) se hace necesario implementar medidas de tipo preventivas en el ámbito dela salud pública. Es importante el papel que el farmacéutico puede desarrollar en esta área, para actuar antes de que los PRM se manifiesten y provoquen la morbimortalidad relacionada con medicamentos. Por ello, los PRM potenciales, no manifestados o riesgo de PRM deben ser considerados en las actividades cotidianas del farmacéutico. Se analiza el artículo sobre el Segundo Consenso de Granada, considerando los alcances teóricos del concepto de PRM, la utilidad práctica de los mismos y su clasificación. Se aconseja que, conjuntamente con la definición de PRM, se contemple el concepto de los PRM potenciales, no manifestados o riesgo de PRM como aquellos que «pueden conducir a la no consecución del objetivo terapéutico o a la aparición de efectos no deseados». Además, y dada su importancia, se debería presentar a cada uno de los PRM en forma potencial (AU)

Avoiding the appearance of Drug Related Problems (DRP) to implement preventive measures in the field of public health is necessary. The role of pharmacist acting beforethe DRP arise provoking drug related morbidity is important. Therefore the risk of DRP, also known as potential or not manifested DRP, should be considered between the daily activities of the pharmacist. The article about the Second Consensus of Granada is analyzed taking into account the theoretical scope of the concept of DRP as well as their practical usefulness and classification. The potential or not manifested DRP or the risk of DRP should be contemplated as those that «can conduct not to reach the therapeutic aim or to the appearance of undesirable effects». In addition and because of their importance, each one of the DRP should be introduced in the potential way too (AU)

Programa Dáder en Argentina: resultados del primer trimestre de actividades / Dáder Program in Argentina: results of the first trimester activities

La morbi-mortalidad relacionada a medicamentos constituye un problema sanitario de gran magnitud. Para optimizar el resultado de la farmacoterapia instaurada por el médico y lograr la máxima efectividad y seguridad de los medicamentos en el paciente se hace necesario el seguimiento de los tratamientos farmacológicos. Es mediante la atención farmacéutica (AF) como se logra una efectiva búsqueda, identificación y resolución de los problemas relacionados con los medicamentos (PRM). Con el propósito de brindar AF a todos los pacientes cualquiera fuese su enfermedad, se adopta el Programa Dáder de implantación del Seguimiento del Tratamiento Farmacológico, quien proporciona una metodología adaptada a nuestro medio para cumplir con este objetivo. Los farmacéuticos participantes (n=31) ejercen sus actividades en la Provincia de Cordoba. Para trabajar en forma eficiente. los farmacéuticos fueron organizados en grupos que se reunieron cada 3 semanas para desarrollar sesiones clínicas y totalizaron 129 pacientes asistidos. En el primer trimestre de actividades, el 58% de los farmacéuticos registraron intervenciones farmacéuticas (IF). La cantidad total de IF ascendió a 81, y correspondieron a 44 pacientes. En los pacientes en donde se encontraron PRM se identificaron 1.8 PRM/paciente, de los cuales se resolvieron el 80%. En los casos en que se comunicó con el médico (67% de los veces), los PRM se resolvieron en un 65%. La adopción el Programa Dáder llevó a una efectiva resolución de PRM en un eievado porcentaje (AU)

Drug-related morbidity and mortality constitute a large sanitary problem. To optimize the pharmacotherapy established by the physician and to obtain the maximum effectiveness and safety of medication used by the patient, pharmacological treatment follow-up is necessary Search, identification and resolution of drug related problems (DRP) succeed by implementing pharmaceutical care (PhC). In order to offer PhC to all patients whichever disease they have, the Dader Program implementation of Pharmacological Treatment Follow-up was adopted. This program provides a methodology according to our surrounding for that purpose. The participant pharmacists (n=31) are from community pharmacies -belonging to the College of Pharmacists- and they practice in the Province of Cordoba. To work efficiently, the pharmacists were organized in groups that met every 3 weeks for clinical sessions. Patients attended totaled 129. In the first trimester activities, 58% of the pharmacists registered pharmaceutical interventions (Phi).The total amount of Phl was 8i and it corresponded to 44 patients. In the patients with found DRP, I.8 DRP per patient were identified and 80% of them were solved. In 67% of the cases, there was a communication with physician; then, 65% of these DRP were solved. The adoption of Dader Program carried out to an effective resolution in a high percent of DRP (AU)