ABSTRACT
No disponible
Subject(s)
Humans , Therapeutic Equivalency , Drugs, Generic/pharmacology , Drugs, Generic/administration & dosage , Drug Design , Treatment Outcome , Biological AvailabilityABSTRACT
No disponible
Subject(s)
Humans , Cyclooxygenase Inhibitors/pharmacokinetics , Anti-Inflammatory Agents, Non-Steroidal/pharmacokinetics , Gastritis/chemically induced , Risk FactorsABSTRACT
OBJECTIVE: To evaluate the efficacy of an educational intervention to minimise the prescription of those new medicines whose therapeutic effects are of little benefit. DESIGN: Controlled and randomised experimental study. SETTING: 27 health centres in the province of Sevilla, Spain. PARTICIPANTS: 376 general practitioners. The 264 who worked in the same posts were randomised for the 6 pre-intervention months. 10 of them did not complete the post-intervention period. INTERVENTIONS: Four 45-minute training sessions in a 2-month period, given by health team doctors, with a critical reading of the studies available on recently marketed drugs, plus personal feed-back on prescription and bulletins on therapeutic novelties. The control group received only the feed-back and bulletins. MAIN MEASUREMENTS: Prescription of new medication of little benefit, measured as the number of packages out of the total. Second, the amount of coxib and eprosartan measured as defined daily doses. RESULTS: In the 6 months after the educational sessions, the doctors in the intervention group prescribed proportionately fewer therapeutic novelties of little benefit than those allocated to the control group (1.34% vs 1.62%; P<.001). The coxib and eprosartan prescribed showed only a non-significant trend towards less prescription by the intervention group. CONCLUSIONS: The group educational sessions, run by doctors trained in aspects of evidence-based medicine and prepared jointly with the pharmacy unit, reduced discreetly the prescription of new medicines that were not very innovative.
Subject(s)
Drug Prescriptions/standards , Family Practice/education , Humans , SpainABSTRACT
Fundamento. Determinar si las actividades de seguimiento farmacoterapéutico a pacientes crónicos polimedicados,como parte de la atención farmacéutica realizada por farmacéuticos comunitarios, modifica las distintas dimensiones de la calidad de vida percibida. Métodos. 110 pacientes polimedicados fueron aleatorizados ofertándosele a la mitad el seguimiento farmacotera-péutico en la farmacia comunitaria, y a la otra mitad atención habitual. La oferta de seguimiento farmacoterapéutico se hizo en 8 farmacias de la provincia de Sevilla durante 6 meses, cuyos titulares son farmacéuticos específicamente entrenados en actividades de atención farmacéutica. La variable resultado principal es la calidad de vida percibida, medida según el cuestionario SF-36 (versión española). La evaluación se hizo por investigadores independientes.Resultados. A los 6 meses, no se observan diferencias estadísticamente significativas en ninguno de los ochocomponentes de la calidad de vida (función física, rol físico, dolor corporal, salud general, vitalidad, funciónsocial, rol emocional y salud mental). Comparativamente con los valores nacionales de referencia, los pacientescrónicos polimedicados tienden a manifestar peor calidad de vida que la media nacional de referencia,especialmente las mujeres en las dimensiones de rol físico, dolor corporal, vitalidad, función social y saludmental (p<0,05).Conclusiones. La calidad de vida de los pacientes polimedicados es peor que la media nacional. El seguimiento farmacoterapéutico desde las oficinas de farmacia no demuestra mejoría
Objective. To determine whether pharmacotherapeutic follow-up activities in chronic patients on multidrugtherapy, as part of the pharmaceutical care provided by community pharmacists, modifies the dimensionsof perceived quality of life.Methods. The study involved 110 patients on multidrug therapy. Half of them were randomized to undergopharmacotherapeutic follow-up in the community pharmacy and the other half to regular care. The offer ofpharmatherapeutic follow-up involved eight pharmacies in the province of Seville over a six-month period.The proprietors were pharmacists specifically trained in pharmaceutical care activities. The main outcomevariable was the perceived quality of life, measured according to the Spanish version of the SF-36 questionnaire. The evaluation was carried out by independent investigators.Results. After six months of study, no statistically significant differences were observed in any of the eightquality of life components (physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role and mental health). When compared with the national reference values, chronicpatients on multidrug therapy tended to present a lower quality of life than the national average. The mostmarked differences were found in women with respect to physical role, bodily pain, vitality, social functioningand mental health (p<0.05).Conclusions. The quality of life in patients on multidrug therapy is lower than the national average. Pharmacotherapeutic follow-up carried out in pharmacies is not associated with an improvement
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Polypharmacy , Quality of Life , Pharmaceutical Services , Chronic Disease/drug therapy , Case-Control Studies , Sickness Impact ProfileABSTRACT
BACKGROUND: In our country, there are two types of infectious mumps vaccines available. In recent times, doubts have been raised regarding the overall effectiveness of these vaccines and the comparative effectiveness of the two strains (Rubini strain and Jeryl Lynn strain). In the "East Seville" Primary Care district, 245 cases were reported in 1997 (90.1 cases per 100,000 inhabitants). This study is aimed at taking advantage of the outbreak of cases of mumps to evaluate affected populations and comparative incidence according to type of vaccines given during childhood. METHODS: Descriptive analysis of the cases (age, territorial spread, inoculation history') and trend analysis (annual incident rates) within this health care district and the surrounding area. The overall effectiveness of the mumps vaccines. The case incidence rates among those inoculated with Rubini strain and those inoculated with Jeryl Lynn strain are also estimated. RESULTS: The highest rates of incidence are found among children in the 1-4 age range. Overall effectiveness rates for these vaccines have been estimated. A significantly higher rate of infection has been found among the children inoculated with Rubini strain than those inoculated with the Jeryl Lynn strain (relative risk of 6.5 with a Confidence Interval of 95% 3.6-11.8). CONCLUSIONS: The effectiveness which follows from this study does not seem as good as the theoretical effectiveness anticipated for the mumps vaccines. It thus seems advisable for other case studies to be conducted by types of vaccines used. The data to be furnished by means of sero-epidemiological studies are also of major interest.
