[The participation of the pharmacist in the design and follow-up of the drug treatment plan for patients with a cardiovascular condition]. / Diseño y seguimiento del plan farmacoterapéutico del paciente con enfermedad cardiovascular.

OBJECTIVES: To systemise the pharmaceutical care provided to patients with chronic diseases. To evaluate the pharmacist's participation in the drug treatment plan, studying their intervention in the reconciliation of the patient's habitual treatment and the detection and resolution of drug-related problems. METHOD: A multicentre study based on the comparison of two cohorts: one with the intervention of the pharmacist and one without. Inclusion criteria were as follows: patients over the age of 70 with chronic cardiovascular conditions being treated with more than 6 drugs. They were selected between 24-48 hours from admittance; a control patient was chosen for each patient in the intervention group. The pharmaceutical intervention consisted of medication reconciliation on admittance, drug treatment monitoring and reconciliation on discharge. Drug-related problems, their seriousness, the pharmaceutical intervention, the degree of resolution and the clinical outcomes on discharge were all recorded. A total of 24 hospitals participated, with a total of 356 patients: 180 in the intervention cohort and 176 in the control one. RESULTS: A total of 602 drug-related problems were identified: 66.9% belonging to the intervention group and 33% to the control group. Interventions were made in 359 (89%) patients belonging to the intervention group, 66% were resolved after the pharmaceutical intervention, producing a total or partial improvement in the patient in 36.3% of cases. CONCLUSIONS: Pharmaceutical care has been systematised, providing an instrument that enables all the hospitals to work in a standardised manner. The active participation of the pharmacist in the healthcare team contributes to preventing and resolving drug-related problems.

Diseño y seguimiento del plan farmacoterapéutico del paciente con enfermedad cardiovascular / The participation of the pharmacist in the design and follow-up of the drug treatment plan for patients with a cardiovascular condition

Objetivos: Sistematizar la atención farmacéutica al paciente con unaenfermedad crónica. Evaluar la participación del farmacéutico en elplan farmacoterapéutico mediante el estudio de su intervención enla conciliación del tratamiento habitual del paciente y en la deteccióny resolución de problemas relacionados con los medicamentos.Método: Estudio multicéntrico basado en la comparación de dos cohortes,una con intervención del farmacéutico y la otra no. Los criteriosde inclusión fueron: pacientes mayores de 70 años con enfermedadcardiovascular crónica y tratamiento con más de 6 fármacos. Seseleccionaban a las 24-48 h de su ingreso; por cada paciente del grupointervención se seleccionaba uno de control. La intervención farmacéuticaconsistía en la conciliación del tratamiento en el momentodel ingreso, el seguimiento farmacoterapéutico y la conciliación enel momento del alta. Se registraban los problemas relacionados conlos medicamentos, su gravedad, la intervención farmacéutica, el gradode resolución y los resultados clínicos en el momento del alta.Han participado 24 hospitales con un total de 356 pacientes: 180 dela cohorte de intervención y 176 de la de control.Resultados: Se ha identificado un total de 602 problemas relacionadoscon los medicamentos, el 66,9% perteneciente al grupo de intervencióny el 33% al de control. Se ha intervenido en 359 (89%) deellos pertenecientes al grupo intervención; un 66% se resolvió tras laintervención farmacéutica, que en el 36,3% de los casos produjo unamejoría total o parcial en el paciente.Conclusiones: Se ha sistematizado la atención farmacéutica y se haproporcionado un instrumento que permite trabajar de forma homogéneaen todos los hospitales. La participación activa del farmacéuticoen el equipo de salud contribuye a prevenir y resolver problemasrelacionados con los medicamentos

Objectives: To systemise the pharmaceutical care provided to patientswith chronic diseases. To evaluate the pharmacist’s participation inthe drug treatment plan, studying their intervention in the reconciliationof the patient’s habitual treatment and the detection and resolutionof drug-related problems.Method: A multicentre study based on the comparison of two cohorts:one with the intervention of the pharmacist and one without.Inclusion criteria were as follows: patients over the age of 70 withchronic cardiovascular conditions being treated with more than 6drugs. They were selected between 24-48 hours from admittance; acontrol patient was chosen for each patient in the intervention group.The pharmaceutical intervention consisted of medication reconciliationon admittance, drug treatment monitoring and reconciliation on discharge. Drug-related problems, their seriousness, the pharmaceuticalintervention, the degree of resolution and the clinical outcomeson discharge were all recorded. A total of 24 hospitals participated,with a total of 356 patients: 180 in the intervention cohort and 176 inthe control one.Results: A total of 602 drug-related problems were identified: 66.9%belonging to the intervention group and 33% to the control group.Interventions were made in 359 (89%) patients belonging to the interventiongroup, 66% were resolved after the pharmaceutical intervention,producing a total or partial improvement in the patient in36.3% of cases.Conclusions: Pharmaceutical care has been systematised, providingan instrument that enables all the hospitals to work in a standardisedmanner. The active participation of the pharmacist in the healthcareteam contributes to preventing and resolving drug-related problems