Problemas relacionados con los medicamentos en pacientes de Santiago de Cuba hospitalizados / Drug related problems in inpatients of Santiago de Cuba

Introducción: Los problemas relacionados con los medicamentos constituyen una gran preocupación sanitaria por su elevado impacto en la morbilidad de pacientes hospitalizados.Método: Estudio observacional, descriptivo y transversal en los servicios clínicos de cinco instituciones de salud de Santiago de Cuba, durante el primer trimestre de 2020. Se revisaron los perfiles de 329 pacientes que recibieron seguimiento farmacoterapéutico. La muestra fue caracterizada según variables biosociales, clínicas y farmacoterapéuticas, la identificación de los problemas relacionados a la medicación fue realizada utilizando los criterios de Cipolle, Stramd y Morley, determinándose además los medicamentos implicados en los problemas relacionados a la medicación. Los datos fueron procesados a través de frecuencias absolutas y relativas representadas por medio de tablas y figuras.Resultados: Predominaron los pacientes mayores o iguales de 60 años representando un 38,6 %; respecto al género un 61,4 % perteneció al femenino. La mayoría de los pacientes presentaron hasta dos enfermedades (76,3 %), las infecciones respiratorias complicadas (35,6 %) fueron el motivo de ingreso más frecuente. El 36,5 % consumió entre cuatro y seis medicamentos, siendo los antibacterianos de usos sistémicos los más prescritos. Se identificaron 598 Problemas Relacionados con los Medicamentos para una proporción de 1,8 PRM/paciente, de estos un 42,8 % corresponde a los problemas de Seguridad, un 31,1 % de Indicación, seguido de 24,9 % de Efectividad y finalmente el 1,2 % de Adherencia.Conclusiones: Los antimicrobianos resultaron los más implicados en la aparición de los problemas relacionados a la medicación. La atención farmacéutica ofrece servicios que garantizan el uso adecuado de los medicamentos. (AU)

Introduction: Drug-related problems are a major health concern because of their high impact on inpatient morbidity. Method: Descriptive and cross-sectional observational, study in the clinical services of five health institutions of Santiago de Cuba, during the first quarter of 2020. The profiles of 329 patients who received pharmacotherapeutic follow-up were reviewed. The sample was characterized according to biosocials, clinical and pharmacotherapeutic variables, the identification of medication-related problems was performed using the criteria of Cipolle, Stramd and Morley, also determining the drugs involved in medication-related problems. The data were processed through absolute and relative frequencies represented by means of tables and figures. Results: Patients over or equal to 60 years of age predominated, representing 38.6 %; 61.4 % of the patients were female. Most of the patients had up to two diseases (76.3 %); complicated respiratory infections (35.6 %) were the most frequent reason for admission. Between four and six medications were consumed by 36.5 %, with antibacterials for systemic use being the most prescribed. A total of 598 drug-related problems were identified for a ratio of 1.8 DRP/patient, of which 42.8 % corresponded to safety problems, 31.1 % to indication, followed by 24.9 % to effectiveness and finally 1.2 % to adherence. Conclusions: Antimicrobials were the most implicated in the occurrence of medication-related problems. Pharmaceutical care offers services that ensure the appropriate use of medications. (AU)

Problemas relacionados con medicamentos en adultos mayores hipertensos / Drugs related problems in hypertensive elderlypatients

Introducción: Los problemas relacionados con medicamentos en los adultos mayores son causantes de admisiones hospitalarias y se asocian con estadías hospitalarias prolongadas, reducen la calidad de vida e incrementan la mortalidad y los costos asociados a los sistemas de salud. Objetivo: Identificar los problemas relacionados con medicamentos en adultos mayores hipertensos. Método: Se realizó un estudio descriptivo y transversal desde enero a marzo del 2017, en el cual participaron 50 adultos mayores hipertensos registrados en la Farmacia Principal Municipal Santiago de Cuba. Losproblemas relacionados con medicamentos se clasificaron según el procedimiento normalizado de trabajo diseñado por otros autores. Resultados: Se identificaron 232 problemas relacionados con medicamentos. Predominaron los errores en la prescripción con un 40,52 %, seguido de los errores en la administración con 36,64 % y las reacciones adversas medicamentosas con 14,22%. Entre los errores de prescripción prevalecieron los relacionados con la interacción fármaco-fármaco con 13,79 % y la medicación potencialmente inapropiada con 11,21 %. Los errores de administración más frecuentes fueron la interacción alimento-medicamento con el 15,95 % y la no adherencia al tratamiento con el 11,64 %. La sequedad bucal, tos seca y poliuria fueron las reacciones adversas más frecuentes. Conclusión: Existe una alta incidencia de problemas relacionados con medicamentos en los adultos mayores hipertensos dispensarizados en la Farmacia Principal Municipal Hospitalaria Santiago de Cuba, con predominio de las interacciones fármaco-fármaco entre los errores de prescripción.(AU)

Introduction: Drug-related problems in elderly adults cause hospital admissions and are associated with prolonged hospital stays. Objective:To describe the problems related to drugs identified in an office of pharmaceutical care for elderly adults, in the Main Municipal Pharmacy of Santiago de Cuba. Method: A retrospective study was carried out through the review of an intentional sample of pharmacotherapeutical profiles registered in the community pharmacy in the period (January to March 2017), corresponding to 50 hypertensive elderly adults. The Problems Related to medications were classified according to the Standardized Pharmacotherapeutical Follow-up Work Procedure and Medication Criteria potentially inappropriate for the elderly, validated for the Cuban context. Results: 232 problems related to medications were identified. Prescription errors (40.6%) predominated, followed by administration errors (36.6%) and adverse drug reactions (14.2%). Among prescription errors, drug-drug interaction (13.8%) and potentially inappropriate medication (11.2%) predominated. The most frequent administration errors were food-drug interaction (16.0%) and non-adherence to treatment (11.6%). Dry mouth and dry cough were the most frequent adverse reactions. Conclusion: There is a high incidence of drug-related problems in hypertensive elderly adults treated at the Santiago de Cuba Hospital Municipal Main Pharmacy, with a predominance of drug-drug interactions among prescription errors, which shows the need for responsible optimization ofpharmacotherapy from the community pharmaceutical service.(AU)

Criterios de medicación potencialmente inapropiada para el anciano: una propuesta cubana / Medication approaches potentially inappropriate for the elderly: a Cuban proposal

Introducción: El impacto de la prescripción inapropiada de fármacos en el anciano ha llevado al desarrollo de métodos para su reducción en varias partes del mundo. Objetivo: Diseñar y validar los criterios de medicación potencialmente inapropiada en el anciano, adaptados al entorno sociosanitario de Cuba. Métodos: Se realizó una investigación cualitativa, en la cual los criterios fueron validados por medio de la metodología Delphi, por un comité de expertos (especialistas en medicina geriátrica y clínica de diferentes zonas geográficas del país), y se les calculó la consistencia interna mediante el coeficiente alfa de Cronbach. Resultados: Los criterios quedaron estructurados en tres listas: 1) medicación potencialmente inapropiada, medicamento indicado no prescripto, cuando no existe contraindicación para su uso; 2) medicación potencialmente inapropiada independiente del diagnóstico o la condición clínica; 3) medicación potencialmente inapropiada dependiente del diagnóstico o la condición clínica. Conclusiones: Se demostró la validez del contenido y la adecuada consistencia interna de los criterios diseñados para la identificación de medicación potencialmente inapropiada en el anciano.

Introduction: The impact of inappropriate prescription of medication in the elderly has led to the development of methods for its reduction in several parts of the world. Objective: To design and validate the medication approaches potentially inappropriate in the elderly, adapted to the socio-sanitary environment of Cuba. Methods: A qualitative investigation was carried out, in which the approaches were validated by means of the Delphi methodology, by an experts committee (specialists in geriatrics medicine and clinic from different geographical areas of the country), and the internal consistency was calculated by means of the alpha coefficient of Cronbach. Results: The approaches were structured in three lists: 1) potentially inappropriate medication, advised medication non prescribed, when contraindication doesn't exist for its use; 2) medication potentially inappropriate, independent from the diagnosis or clinical condition; 3) potentially inappropriate medication, depending on the diagnosis or clinical condition. Conclusions: The validity of the content and the appropriate internal consistency of the designed approaches for the medication identification potentially inappropriate in the elderly were demonstrated.

Atención Farmacéutica en adultos mayores hipertensos. Una experiencia en la atención primaria de salud en Cuba / Pharmaceutical care in hypertensive elderly. An experience in primary health care in Cuba

Introducción: Los adultos mayores constituyen un grupo poblacional con predominio de enfermedades crónicas, entre estas la hipertensión arterial. Esto implica un incremento en el consumo de medicamentos y de los problemas relacionados con los mismos. De ahí que en estos resulte útil el desarrollo de la atención farmacéutica para optimizar la farmacoterapia que reciben. Objetivo: Evaluar el impacto de un servicio de atención farmacéutica en pacientes adultos mayores hipertensos. Métodos: Se realizó un estudio prospectivo y de intervención desde enero a junio del 2017, en el que participaron 50 adultos mayores hipertensos. Para su desarrollo se empleó un procedimiento normalizado de trabajo. Se evaluó el impacto de las intervenciones en la adherencia terapéutica, la satisfacción de los pacientes y en la resolución o prevención de los resultados negativos asociados a la medicación. Resultados: Predominaron los pacientes del sexo femenino (62 %) y nivel de escolaridad preuniversitario (40 %). El 54 % de los pacientes estuvo sometido a la polifarmacia. Se detectaron 232 resultados negativos asociados a la medicación, predominando los de seguridad (75,4 %), seguidos de los de efectividad (17,7 %). Se realizaron 237 intervenciones farmacéuticas que incrementaron a un 84 % el porcentaje de pacientes adheridos totalmente. Se resolvieron 82,76 % de los resultados negativos asociados a la medicación y el 100 % de los pacientes estuvo satisfecho. Conclusiones: El servicio desarrollado tuvo un alto impacto al incrementar la adherencia terapéutica, solucionar la mayoría de los resultados negativos asociados a la medicación y lograr la satisfacción de pacientes y cuidadores

Introduction: Elderly constitute a population group with a predominance of chronic diseases, among them arterial hypertension. This implies an increase in drugs consumption and the problems related to them. Hence, in these the development of pharmaceutical care is useful for optimize the pharmacotherapy that they receive. Objective: To evaluate the impact of a pharmaceutical care service in hypertensive elderly patients. Methods: A prospective and intervention study was conducted from January to June 2017, with the participation of 50 hypertensive elderly patients. For the development of the service, a standard operating procedure was used. The impact of the service on therapeutic adherence, patient satisfaction and the resolution or prevention of negative outcomes associated with medication was evaluated. Results: Female patients predominated (62%) and pre-university level of education (40%). 54% of the patients were subjected to polypharmacy. 232 negative outcomes associated with medication were detected, predominantly safety (75.4%), followed by those of effectiveness (17.7%). There were 237 pharmaceutical interventions that increased the percentage of patients totally adherent to 84%. We resolved 82.76% of the negative outcomes associated with medication and 100% of the patients were satisfied with the service. Conclusions: The service developed had a high impact by increasing therapeutic adherence, solving most of the negative outcomes associated with medication and achieving the satisfaction of patients and caregivers

Content design and validation of a Standard Operating Procedure to provide pharmacotherapy follow-up for the elderly in Cuba

ABSTRACT Incorporating methodological tools that allow uniform and standardized development from the clinical pharmacy services to the Pharmaceutical Care practice, is nowadays a necessity. Considering the importance of pharmaceutical care provision to elderly patients, this manuscript introduces the design and content validation of a standard operating procedure to provide pharmacotherapy follow-up to the elderly in nursing homes in Cuba. The procedure was designed based on a deep analysis of documents relative to experiences focused on holistic care to elderly patients, criteria for the identification and assessment of potentially inappropriate prescriptions and the relationship between functional geriatric evaluation and the use of drugs. The content validation was conducted by a panel of experts, using the Delphi methodology, through two working sessions. In addition, we used Likert-type scale to evaluate the procedure by experts, in line with the indicators described. In general, the criteria issued by the experts were very appropriate and allowed us to modify, add or keep several elements of the instrument for the final version. The findings demonstrated that the instrument can be used at any level of health care.

Perfil profesional del Licenciado en Farmacia de la Universidad de Oriente, Cuba / Professional profile of the Bachelor of Pharmacy in Universidad de Oriente, Cuba

Teniendo en cuenta la necesidad de un currículo que garantice una formación universitaria universal, contextual, flexible y comprometida con la realidad social y profesional, en el presente trabajo se diseñó el perfil profesional que caracterizará al egresado de la Licenciatura en Ciencias Farmacéuticas de la Universidad de Oriente, Cuba. Se utilizó para ello el Modelo de Actuación Profesional; se precisó el problema profesional, el objeto de la profesión y el objetivo profesional, y sobre la base del sentido articulador entre estas configuraciones se definieron los campos, esferas y modos de actuación, dejando explícito, además, los objetivos educativos e instructivos que se aspiran alcanzar(AU)

Taking into account the need of a curriculum assuring universal, contextual and flexible university formation that is committed to the social and professional realities of the country, the present paper designed the professional profile of the Pharmaceutical Sciences graduate in the University of Oriente, Cuba. To this end, the Professional Performance Model was used; the professional problem, the object of the profession and the professional objectives were defined. On the basis of the articulation of these configurations, the various fields, spheres and modes of performance were established, thus clearly stating the educational and learning objectives that are expected to be attained(AU)

Perfil profesional del Licenciado en Farmacia de la Universidad de Oriente, Cuba / Professional profile of the Bachelor of Pharmacy in Universidad de Oriente, Cuba

Teniendo en cuenta la necesidad de un currículo que garantice una formación universitaria universal, contextual, flexible y comprometida con la realidad social y profesional, en el presente trabajo se diseñó el perfil profesional que caracterizará al egresado de la Licenciatura en Ciencias Farmacéuticas de la Universidad de Oriente, Cuba. Se utilizó para ello el Modelo de Actuación Profesional; se precisó el problema profesional, el objeto de la profesión y el objetivo profesional, y sobre la base del sentido articulador entre estas configuraciones se definieron los campos, esferas y modos de actuación, dejando explícito, además, los objetivos educativos e instructivos que se aspiran alcanzar

Taking into account the need of a curriculum assuring universal, contextual and flexible university formation that is committed to the social and professional realities of the country, the present paper designed the professional profile of the Pharmaceutical Sciences graduate in the University of Oriente, Cuba. To this end, the Professional Performance Model was used; the professional problem, the object of the profession and the professional objectives were defined. On the basis of the articulation of these configurations, the various fields, spheres and modes of performance were established, thus clearly stating the educational and learning objectives that are expected to be attained

What is the role of the pharmacist?: physicians' and nurses' perspectives in community and hospital settings of Santiago de Cuba

This study was carried out to understand the perceptions and expectations of the other health care professionals about pharmacists' role in primary health care centers and hospitals in Santiago de Cuba (Cuba). A cross-sectional descriptive study was conducted, applying a self-administered questionnaire to health care professionals. The sample included 763 professionals (40.9 percent physicians and 59.1 percent nurses) from hospitals and primary health care clinics, chosen by random stratified sampling,. The most common activity performed by pharmacists was the distribution of medications or the drug supply management (51.5 percent) and adverse drug reactions reporting (29.4 percent), activities performed daily by pharmacists. Pharmaceutical care practice was considered as poor by the professionals, and only 15.6 percent of them have collaborated in these programs in the past. For nurses and physicians, interprofessional communication occurs sometimes (56.9 percent) and never (25.8 percent). Pharmacists' integration into the health team was considered as fair (50.7 percent). A total of 70.1 percent perceived the pharmacist as a drug expert and 60.1 percent as a professional who provides medication counseling. The main expectations these health care professionals expressed were that pharmacists provide more education about medication (97.4 percent) and improve their interprofessional communication techniques in order to communicate more effectively with the other members of the health care team (96.6 percent).

O presente trabalho analisa o papel do farmacêutico na atenção primária de saúde e em hospitais, na percepção de profissionais da saúde na província de Santiago de Cuba. Um estudo descritivo transversal foi conduzido, através da aplicação de um questionário autoadministrado a uma amostra de 763 profissionais de atenção primária e hospitalar, 40,9 por cento de médicos e 59,1 por cento de enfermeiros. As funções farmacêuticas mais reconhecidas pelos profissionais desta amostra foram o fornecimento e distribuição de medicamentos (51,5 por cento) e o relato de reações adversas medicamentosas (29,4 por cento), funções desenvolvidas diariamente. A prática da atenção farmacêutica é limitada na percepção dos profissionais e apenas 15,6 por cento têm participado em programas desse tipo. Comunicação interprofissional ocorre às vezes (56,9 por cento) e nunca (25,8 por cento), com maiores dificuldades na atenção primária de saúde. A integração do farmacêutico na equipe de saúde foi considerada regular (50,7 por cento). Um total de 70,1 por cento dos profissionais percebeu o farmacêutico como especialista em medicamentos e 64,1 por cento como o profissional que aconselha sobre o uso de medicamentos. As principais expectativas colocam-se na necessidade de que o farmacêutico ofereça educação sobre o uso de medicamentos (97,4 por cento) e reforce as suas técnicas da comunicação na equipe multidisciplinar (96,6 por cento).