Stakeholder analysis in health innovation planning processes: A systematic scoping review.

Integrating health innovations into the health system is a complex endeavour that requires a well-designed planning process engaging key stakeholders. Stakeholder analyses lay the foundations to inform appropriate planning processes and undertake strategic actions. A systematic scoping review was performed to explore how stakeholder analyses are applied in health innovation planning processes and a guideline to report stakeholder analyses was developed. The literature search was conducted in PubMed, Scopus and DOAJ; grey literature was sought using Google. Articles reporting stakeholder analyses during the planning process of health policies, systems, products and technologies, and services and delivery methods were included. Fifty-one records were incorporated in the qualitative synthesis. Stakeholder analyses were conducted worldwide, used in all types of health innovations, applied in all phases of the planning process and conducted both prospectively and retrospectively. The steps followed to perform stakeholder analysis, the methods used, the stakeholder attributes analysed and how authors reported the analyses were heterogeneous. Forty-one studies reported the identification of stakeholders, 50 differentiated/categorised them and 25 analysed stakeholder relationships. Only some authors proposed future actions based on the results obtained in their stakeholder analysis. A list of Reporting Items for Stakeholder Analysis (i.e., the RISA tool) is proposed to contribute to the reporting guidelines to enhancing the quality and transparency of health research.

Collaborative health service planning: A stakeholder analysis with social network analysis to develop a community pharmacy service.

BACKGROUND: Stakeholder participation optimizes health planning, fostering the acceptability and integration of new health services. Collaborative approaches may help overcome existing challenges in the development, implementation and evaluation of community pharmacy services (CPSs). Stakeholder analyses lay the foundation for building collaboration in the integrated delivery of health care. OBJECTIVES: This stakeholder analysis was performed to organize a collaborative initiative to develop a CPS aimed at preventing cardiovascular diseases in Andalucía (Spain). It aimed to identify stakeholders, differentiate/categorize them, and analyze stakeholder relationships. METHOD: Stakeholders were identified using the snowballing technique. To differentiate/categorize stakeholders and analyze the relationships (i.e., collaboration) an online web-based questionnaire was sent to 186 stakeholders. Stakeholders were asked for: (1) their influence, interest and attitude toward the initiative; (2) stakes/interests; (3) capacity to contribute to the initiative; (4) desire for involvement; (5) concerns; (6) whom they considered a key stakeholder; and (7) the level of collaboration they had with other stakeholders. Data analysis combined descriptive qualitative content analysis, descriptive quantitative analysis and social network analysis. RESULTS: Of the 186 stakeholders approached, 96 (51.6%) participated. The identification process yielded 217 stakeholders (individuals, organizations or collectives), classified into 10 groups. Fifty-seven stakeholders were considered critical to the intended initiative. Most participant stakeholders supported the initiative and were willing to collaborate in the development of the CPS. Public health and science were the main driving interests. A collaboration network existed between the 96 stakeholders. CONCLUSION: This study revealed the magnitude of the social system surrounding the development of a CPS aimed at preventing cardiovascular disease. A large array of stakeholders was identified and analyzed, and a group of critical stakeholders selected. Stakeholder characteristics such as attitude toward the initiative, potential contribution, desire for involvement, and the existing collaboration network, provided complementary information that was helpful for planning the process and stakeholder engagement.

A stakeholder visioning exercise to enhance chronic care and the integration of community pharmacy services.

BACKGROUND: Collaboration between relevant stakeholders in health service planning enables service contextualization and facilitates its success and integration into practice. Although community pharmacy services (CPSs) aim to improve patients' health and quality of life, their integration in primary care is far from ideal. Key stakeholders for the development of a CPS intended at preventing cardiovascular disease were identified in a previous stakeholder analysis. Engaging these stakeholders to create a shared vision is the subsequent step to focus planning directions and lay sound foundations for future work. OBJECTIVES: This study aims to develop a stakeholder-shared vision of a cardiovascular care model which integrates community pharmacists and to identify initiatives to achieve this vision. METHODS: A participatory visioning exercise involving 13 stakeholders across the healthcare system was performed. A facilitated workshop, structured in three parts (i.e., introduction; developing the vision; defining the initiatives towards the vision), was designed. The Chronic Care Model inspired the questions that guided the development of the vision. Workshop transcripts, researchers' notes and materials produced by participants were analyzed using qualitative content analysis. RESULTS: Stakeholders broadened the objective of the vision to focus on the management of chronic diseases. Their vision yielded 7 principles for advanced chronic care: patient-centered care; multidisciplinary team approach; shared goals; long-term care relationships; evidence-based practice; ease of access to healthcare settings and services by patients; and good communication and coordination. Stakeholders also delineated six environmental factors that can influence their implementation. Twenty-four initiatives to achieve the developed vision were defined. CONCLUSIONS: The principles and factors identified as part of the stakeholder shared-vision were combined in a preliminary model for chronic care. This model and initiatives can guide policy makers as well as healthcare planners and researchers to develop and integrate chronic disease services, namely CPSs, in real-world settings.

Stakeholder analysis for the development of a community pharmacy service aimed at preventing cardiovascular disease.

BACKGROUND: Participatory approaches involving stakeholders across the health care system can help enhance the development, implementation and evaluation of health services. These approaches may be particularly useful in planning community pharmacy services and so overcome challenges in their implementation into practice. Conducting a stakeholder analysis is a key first step since it allows relevant stakeholders to be identified, as well as providing planners a better understanding of the complexity of the health care system. OBJECTIVES: The main aim of this study was to conduct a stakeholder analysis to identify those individuals and organizations that could be part of a leading planning group for the development of a community pharmacy service (CPS) to prevent cardiovascular disease (CVD) in Australia. METHODS: An experienced facilitator conducted a workshop with 8 key informants of the Australian health care system. Two structured activities were undertaken. The first explored current needs and gaps in cardiovascular care and the role of community pharmacists. The second was a stakeholder analysis, using both ex-ante and ad-hoc approaches. Identified stakeholders were then classified into three groups according to their relative influence on the development of the pharmacy service. The information gathered was analyzed using qualitative content analysis. RESULTS: The key informants identified 46 stakeholders, including (1) patient/consumers and their representative organizations, (2) health care providers and their professional organizations and (3) institutions and organizations that do not directly interact with patients but organize and manage the health care system, develop and implement health policies, pay for health care, influence funding for health service research or promote new health initiatives. From the 46 stakeholders, a core group of 12 stakeholders was defined. These were considered crucial to the service's development because they held positions that could drive or inhibit progress. Secondary results of the workshop included: a list of needs and gaps in cardiovascular care (n = 6), a list of roles for community pharmacists in cardiovascular prevention (n = 12) and a list of potential factors (n = 7) that can hinder the integration of community pharmacy services into practice. CONCLUSIONS: This stakeholder analysis provided a detailed picture of the wide range of stakeholders across the entire health care system that have a stake in the development of a community pharmacy service aimed at preventing CVD. Of these, a core group of key stakeholders, with complementary roles, can then be approached for further planning of the service. The results of this analysis highlight the relevance of establishing multilevel stakeholder groups for CPS planning.

Investigación y conocimiento en Atención Farmacéutica: un binomio inseparable / No disponible

No disponible

Estudio de adecuación a la ficha técnica de las prescripciones de trastuzumab en un hospital de tercer nivel / Study of compliance with prescription information sheet of trastuzumab prescriptions in a tertiary level hospital

Introducción El presente estudio comparó las condiciones reales de uso de trastuzumab en la práctica clínica con las descritas oficialmente en ficha técnica. Además, se midió el gasto asociado a su uso. Métodos Estudio observacional de prescripción-indicación de trastuzumab en un hospital de tercer nivel desde enero de 2006 hasta el 31 de diciembre de 2007. Se analizó si el uso de trastuzumab en la práctica clínica se adecuaba a ficha técnica en lo referente a: sobreexpresión del HER2, indicación (cáncer de mama), esquema de tratamiento, línea de tratamiento, dosis, frecuencia y número de ciclos. Para medir el gasto, se calculó el número total de miligramos utilizados y posteriormente se multiplicó por el precio por miligramo de venta del laboratorio más IVA. Resultados Todos los pacientes (n=77) usaron trastuzumab para cáncer de mama. El 62,6% de los pacientes presentó sobreexpresión del HER2+++. Se utilizaron 29 esquemas no autorizados en ficha técnica. El gasto total de trastuzumab durante el periodo de estudio fue de 1.537.622,73 euros. Conclusiones: Aunque el trastuzumab se utiliza siempre en cáncer de mama, se usa en condiciones distintas a las autorizadas en ficha técnica, tanto en lo referente a la sobreexpresión de HER2, como en los esquemas de tratamiento (AU)

Introduction This study compares trastuzumab's actual conditions of use in clinical practice with those officially described on its summary of product characteristics. We also measure the cost associated with its use. Methods Observational study of the prescription/indication of trastuzumab in a tertiary hospital from January 2006 to 31 December 2007. We analysed whether trastuzumab use in clinical practice complied with its summary of product characteristics, concerning the following: HER2 over expression, indication (breast cancer), treatment plan, line of treatment, dosage, frequency and number of cycles. To measure cost, we calculated the total number of milligrams used and then multiplied it by the laboratory's sale price per milligram plus VAT. Results All patients (n=77) used trastuzumab for breast cancer. Sixty-two point two percent of patients presented with HER2+++ over expression. Twenty-nine treatment plans were used, that were not authorised on the summary of product characteristics. The total trastuzumab cost during the study period was €1537 622.73. ConclusionsAlthough trastuzumab is always used for breast cancer, it is used in conditions other than those described on its summary of product characteristics, both for HER2 over expression and treatment plans (AU)

Study of compliance with prescription information sheet of trastuzumab prescriptions in a tertiary level hospital.

INTRODUCTION: This study compares trastuzumab's actual conditions of use in clinical practice with those officially described on its summary of product characteristics. We also measure the cost associated with its use. METHODS: Observational study of the prescription/indication of trastuzumab in a tertiary hospital from January 2006 to 31 December 2007. We analysed whether trastuzumab use in clinical practice complied with its summary of product characteristics, concerning the following: HER2 over expression, indication (breast cancer), treatment plan, line of treatment, dosage, frequency and number of cycles. To measure cost, we calculated the total number of milligrams used and then multiplied it by the laboratory's sale price per milligram plus VAT. RESULTS: All patients (n=77) used trastuzumab for breast cancer. Sixty-two point two percent of patients presented with HER2+++ over expression. Twenty-nine treatment plans were used, that were not authorised on the summary of product characteristics. The total trastuzumab cost during the study period was €1537 622.73. CONCLUSIONS: Although trastuzumab is always used for breast cancer, it is used in conditions other than those described on its summary of product characteristics, both for HER2 over expression and treatment plans.

Effect of pharmaceutical intervention on medication adherence and blood pressure control in treated hypertensive patients: Rationale, design and methods of the AFenPA pilot study

Objective: To assess the effect of a protocol-based pharmacist intervention on blood pressure control and medication adherence among treated hypertensive patients who are users of community pharmacies.Methods: A quasi experimental study design with control group has been designed to compare the effect of pharmaceutical intervention (intervention group) versus the standard healthcare procedure (control group) on blood pressure and medication adherence among hypertensive patients receiving drug therapy in community pharmacies. The patients will be allocated evenly between the two groups (ncontrol = nintervention), with a 6-month follow-up. The pharmaceutical intervention program will comprise three main parts: 1) patient education / information on issues relating to hypertension and medication adherence; 2) self-monitoring of blood pressure; and 3) interaction with the physician through personalized reports when the mean blood pressure values recorded at home exceed the treatment goal according to the clinical condition of the patient. In order to evaluate the effect of the pharmaceutical intervention upon medication adherence and blood pressure, blood pressure recordings will be made in the pharmacy, while percent medication adherence will be established based on pill count in both groups at the start and end of the study.Discussion: To our knowledge, this is the first study in the community pharmacy setting in Spain to evaluate the effectiveness of pharmaceutical intervention in combination with home blood pressure monitoring on blood pressure control. In addition, the pharmaceutical intervention has been designed for inclusion as standard practice in the context of Pharmaceutical Care(AU)

Objetivo: Evaluar el efecto de una intervención farmacéutica protocolizada sobre el control de la presión arterial y la adherencia al tratamiento farmacológico en pacientes usuarios de farmacias comunitarias.Material y métodos: Estudio cuasi-experimental con grupo control en el que se comparará el efecto de una intervención farmacéutica (grupo intervención) con el proceso de atención habitual (grupo control), sobre la presión arterial y la adherencia al tratamiento de pacientes hipertensos tratados farmacológicamente en farmacias comunitarias. Los pacientes serán distribuidos de forma equitativa en ambos grupos (n control = n intervención) y serán seguido durante 6 meses. El programa de la intervención farmacéutica constará de tres partes fundamentales: 1) educación/información al paciente sobre aspectos relacionados con la hipertensión y adherencia al tratamiento farmacológico, 2) automonitorización de la presión arterial y, 3) interacción con el médico mediante informes personalizados cuando la media de las cifras de presión arterial realizadas en el domicilio superen el objetivo terapéutico acorde con la situación clínica del paciente. Para evaluar el efecto de la intervención farmacéutica sobre la adherencia terapéutica y la presión arterial se obtendrán medidas de presión arterial en la farmacia y porcentaje de cumplimiento terapéutico mediante recuento de comprimidos en ambos grupos al principio y al final del estudio.Discusión: Según nuestros conocimientos, éste es el primer estudio que se realiza en farmacia comunitaria en España para probar la efectividad de una intervención farmacéutica conjuntamente con la automedida de la presión arterial sobre el control de la presión arterial. Además, la intervención farmacéutica se ha diseñado de forma que pueda integrase como práctica habitual enmarcada dentro de la Atención Farmacéutica(AU)

Uso de monitorización ambulatoria de la presión arterial en el cribado de la hipertensión arterial: una oportunidad para el farmacéutico comunitario / No disponible

No disponible

Guía de actuación para el farmacéutico comunitario en pacientes con hipertensión arterial y riesgo cardiovascular. Documento de Consenso (versión extendida) / No disponible

La hipertensión arterial (HTA) es un problema de salud estrechamente relacionado con un aumento del riesgo de padecer una enfermedad cardiovascular. Además, la HTA puede producir o empeorar la lesión de ciertos órganos diana, lo que también puede influir negativamente en el pronóstico cardiovascular del paciente. En España, la HTA es una condición muy frecuente, afectando a unos 10 millones de sujetos adultos.Por su accesibilidad y formación especializada en materia de medicamentos, el farmacéutico comunitario puede jugar un papel clave en la detección y seguimiento del paciente con HTA. Hasta la fecha, se han publicado numerosas guías clínicas sobre la atención a pacientes con HTA, dirigidas principalmente a médicos. Sin embargo, cada vez es más evidente la necesidad de que todos los profesionales de la salud participen en la atención integral a los pacientes con HTA y riesgo cardiovascular (RCV). La cooperación entre farmacéutico, médico, personal de enfermería y otros profesionales sanitarios es imprescindible para conseguir resultados que optimicen la prevención cardiovascular y mejoren la calidad de vida del paciente. Así, a fin de promover la gestión compartida de los pacientes con HTA y RCV se publica este documento, cuyo principal destinatario es el farmacéutico comunitario.El presente documento pretende ser una herramienta de referencia que dé soporte a los programas de Atención Farmacéutica al paciente con HTA y RCV que se están desarrollando actualmente en las oficinas de farmacia. El texto ha sido desarrollado de forma consensuada entre expertos de la Sociedad Española de Hipertensión- Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), la Sociedad Española de Farmacia Comunitaria (SEFAC) y el Grupo de Investigación en Atención Farmacéutica de la Universidad de Granada (GIAF-UGR)(AU)

Arterial hypertension (AH) is an important health-related problem, as responsible for an important part of cardiovascular disorders. Moreover, AH is related to the development and progression of organ damage, which has indeed a negative influence in the cardiovascular prognosis of the individual. In Spain, AH is a frequent condition, affecting about 10 millions of the adult population.Due to their accessibility and specific background on drug management, the community pharmacist could play a key role in the detection and follow-up of the hypertensive patient. To date, several guidelines on hypertension management have been released, although almost invariably have been addressed to the medical community. However, it has become more evident the need for a global management of hypertension and cardiovascular risk with the participation of several health-care providers, such as pharmacists and nurses, with the aim of improving cardiovascular prevention and the quality of life of subjects affected. The present document, particularly addressed to the community pharmacist, is intended to provide current knowledge with the aim of a better shared management of patients with hypertension and cardiovascular risk.The present document pretends to serve as a tool for currently developed programs supporting the involvement of the community pharmacy in the care of patients with hypertension and cardiovascular risk. The document has been developed after a consensus between members from the Spanish Society of Hypertension, the Spanish Society of Community Pharmacy and the Research Group on Pharmaceutical Care from the University of Granada(AU)

Métodos de medida de la presión arterial disponibles en la farmacia comunitaria para el cribado y seguimiento de la hipertensión arterial / Available measurement methods of blood pressure at the community pharmacy for the screening and follow up of hypertension

La medida de la presión arterial (PA) en la consulta médica (PAC) ha sido durante muchos años el método de referencia para realizar el diagnóstico, seguimiento y tomar las decisiones clínicas en el manejo de la hipertensión arterial (HTA). Por otra parte, la medida de la PA en la farmacia comunitaria es un método poco estudiado y su utilidad en la práctica clínica es, cuando menos, desconocida. La aparición de la automedida domiciliaria de la PA (AMPA) y de la monitorización ambulatoria de la PA (MAPA) ha permitido superar muchas de las limitaciones inherentes a la medida de la PAC, principalmente al proporcionar múltiples medidas de PA exentas del efecto de bata blanca. Además, estos métodos han demostrado relacionarse más estrechamente que la medida de la PAC con el pronóstico cardiovascular y la lesión de órganos diana. En defi nitiva, la AMPA y la MAPA proporcionan una evaluación más precisa (p. ej., del riesgo cardiovascular o del efecto de los tratamientos antihipertensivos) y un mejor manejo del paciente con HTA. El presente artículo ofrece una visión actualizada sobre el interés de los distintos métodos de medida de la PA disponibles en la farmacia para el cribado y seguimiento del paciente hipertenso(AU)

The blood pressure (BP) measurement in the physician’s office has been for many years the gold standard for diagnosis, monitoring and making clinical decisions in the management of hypertension. On the other hand, few studies analyze the usefulness of the community pharmacy BP measurement method, which remains unknown in clinical practice. Home and ambulatory BP monitoring (HBPM and ABPM, respectively) have overcome many of the inherent limitations of the BP measurement at the physician’s office, mainly providing multiple BP readings exempt from the white coat effect. Additionally, these methods have shown to be better predictors of end-organ damage and cardiovascular outcome than BP measured in the physician’s offi ce. Finally, the use of HBPM or ABPM enables a more accurate assessment and an improved management of hypertension. This article provides an overview update on the interest of the different BP measurement methods available in the community pharmacy for the screening and monitoring of hypertensive patients(AU)

Guía de actuación para el farmacéutico comunitario en pacientes con hipertensión arterial y riesgo cardiovascular. Documento de consenso (versión resumida) / Action guide for community pharmacist in patients with hypertension and cardiovascular risk. Consensus document (condensed version)

La hipertensión arterial (HTA) es un problema de salud estrechamente relacionado con un aumento del riesgo de padecer una enfermedad cardiovascular. Además, la HTA es capaz de producir o empeorar la lesión de ciertos órganos diana, lo que también puede infl uir negativamente en el pronóstico cardiovascular del paciente. En España, la HTA es una condición muy frecuente, que afecta a unos 10 millones de sujetos adultos. Por su accesibilidad y formación especializada en materia de medicamentos, el farmacéutico comunitario puede desempeñar un papel clave en la detección y seguimiento del paciente con HTA. Hasta la fecha, se han publicado numerosas guías clínicas sobre la atención a pacientes con HTA, dirigidas principalmente a médicos. Sin embargo, cada vez es más evidente la necesidad de que todos los profesionales de la salud participen en la atención integral a los pacientes con HTA y riesgo cardiovascular (RCV). La cooperación entre farmacéutico, médico, personal de enfermería y otros profesionales sanitarios es imprescindible para conseguir resultados que optimicen la prevención cardiovascular y mejoren la calidad de vida del paciente. Por ello, y a fin de promover la gestión compartida de los pacientes con HTA y RCV, se publica este documento, cuyo principal destinatario es el farmacéutico comunitario. El presente documento pretende ser una herramienta de referencia que dé soporte a los programas de atención farmacéutica al paciente con HTA y RCV que se están llevando a cabo actualmente en las oficinas de farmacia. El texto ha sido desarrollado de forma consensuada entre expertos de la Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), la Sociedad Española de Farmacia Comunitaria (SEFAC) y el Grupo de Investigación en Atención Farmacéutica de la Universidad de Granada (GIAF-UGR)(AU)

Arterial hypertension (AH) is an important health-related problem, as responsible for an important part of cardiovascular disorders. Moreover, AH is related to the development and progression of organ damage, which has indeed a negative infl uence in the cardiovascular prognosis of the individual. In Spain, AH is a frequent condition, affecting about 10 millions of the adult population. Due to their accessibility and specific background on drug management, the community pharmacist could play a key role in the detection and follow-up of the hypertensive patient. To date, several guidelines on hypertension management have been released, although almost invariably have been addressed to the medical community. However, it has become more evident the need for a global management of hypertension and cardiovascular risk with the participation of several health-care providers, such as pharmacists and nurses, with the aim of improving cardiovascular prevention and the quality of life of subjects affected. The present document, particularly addressed to the community pharmacist, is intended to provide current knowledge with the aim of a better shared management of patients with hypertension and cardiovascular risk. The present document pretends to serve as a tool for currently developed programs supporting the involvement of the community pharmacy in the care of patients with hypertension and cardiovascular risk. The document has been developed after a consensus between members from the Spanish Society of Hypertension, the Spanish Society of Community Pharmacy and the Research Group on Pharmaceutical Care from the University of Granada(AU)

DaderWeb: una nueva herramienta del Programa Dáder para efectuar un seguimiento farmacoterapéutico / DaderWeb: a new Pharmaceutical Care tool from the Dader Program

El Programa Dáder de seguimiento farmacoterapéutico (SFT) es un programa docente desarrollado para farmacéuticos en ejercicio que pretende enseñar a hacer SFT a sus pacientes de forma práctica. El Programa Dáder cuenta con una base de datos que actualmente tiene más de 16.000 intervenciones farmacéuticas, en el que están implicados 1.200 servicios de farmacia. En el marco del programa se desarrolla el Método Dáder para realizar SFT, que ha evolucionado y se ha adecuado a los requerimientos de esta actividad clínica en continuo desarrollo. Las actualizaciones del método se han elaborado atendiendo a la experiencia acumulada por los farmacéuticos que lo utilizan, las investigaciones realizadas con los datos del Programa Dáder, y las aportaciones del trabajo asistencial, docente e investigador de muchos profesionales. Para conseguir nuevos objetivos dentro del programa se está desarrollando una nueva herramienta de trabajo para efectuar SFT: DaderWeb. Ésta es una estrategia innovadora que aprovecha las nuevas tecnologías para apoyar, prestar servicios y favorecer la comunicación de los farmacéuticos cuando realizan SFT. Este sistema está pensado para proporcionar la información necesaria con el fin de evaluar la actividad existente. DaderWeb consta de las siguientes utilidades para facilitar el SFT de los pacientes: seguimiento farmacoterapéutico, sesiones clínicas, búsqueda de información basada en la evidencia, envío de intervenciones farmacéuticas, informes, documentación, noticias, mensajería, agenda personal y contactos. Los requisitos para utilizar esta herramienta son un ordenador con conexión a internet, un navegador www y la aceptación de la solicitud de alta por parte de la coordinación del Programa Dáder (AU)

The Dader Program for Pharmacotherapy Follow-up is a teaching program developed for practicing pharmacists that intends to teach them how to provide Pharmacotherapy Follow-up (PTF) to their patients in a practical way. The Dader Program has a database that currently contains more than 16000 pharmacist interventions involving 1200 pharmacies. Within the framework of the program the Dader Method was developed for the provision of PTF, that has evolved and that has been adapted to the requirements of this clinical activity which is in continuous development. The Method was updated on the basis of the accumulated experience of the pharmacists who use it, the research carried out with the data of the Dader Program, and the contributions of the welfare, teaching and research work of many professionals. In order to achieve new aims within the Program a new working tool for the provision of PTF is being developed: DaderWeb. DaderWeb is an innovative strategy that uses the new technologies to support, provide services and enhance the communication of pharmacists when providing PTF. The system is designed to provide the information necessary for the assessment of the existing activity. DaderWeb consists of the following utilities to enable the provision of PTF: Pharmacotherapy Follow-up, Clinical sessions, Evidence based medicine information search, Submission of pharmacist interventions, Reports, Documents, News, Messaging, Personal Agenda, Contact. The requirements for the use of the tool are a computer with an Internet connection, a web browser and the acceptance of the registration request by coordinators of the Dader Program (AU)

Documentación de las actividades asistenciales del farmacéutico: la historia farmacoterapéutica / No disponible

No disponible

Efecto de una intervención farmacéutica en los parámetros clínicos de pacientes con síndrome metabólico: estudio piloto prospectivo «antes-después» / Effect of a pharmacist intervention on clinical parameters in metabolic syndrome patients: a prospective open-label pilot study

Objetivo: Evaluar la funcionalidad del seguimiento farmacoterapéutico en pacientes con síndrome metabólico como herramienta que permite identificar y resolver situaciones de descontrol de los factores de riesgo cardiovascular, o bien situaciones en las que la intervención farmacoterapéutica no se realiza con la intensidad debida según la situación clínica del paciente. Diseño: Estudio piloto prospectivo «antes-después». Emplazamiento: Centro de Salud Torcal de Antequera (Málaga). Participantes: Pacientes con síndrome metabólico de un cupo médico. Intervención: Se llevaron a cabo intervenciones farmacéuticas centradas, fundamentalmente, en acordar con el médico modificaciones en la farmacoterapia del paciente. Mediciones principales (método): Hemoglobina glucosilada (cromatografía de alta resolución), colesterol unido a lipoproteínas de alta densidad (homogéneo directo) y baja densidad (fórmula Friedewald), colesterol total (adaptación del enzimático de Stadtman), triglicéridos (enzimático lipasa/glicerolcinasa), índice de masa corporal, presión arterial, glucemia basal en sangre venosa (enzimático hexocinasa) y uso de ácido acetilsalicílico. Resultados: El número de pacientes que comenzaron a utilizar ácido acetilsalicílico aumentó de forma significativa. No hubo variaciones significativas del resto de los parámetros, ni del número de pacientes que alcanzaban los objetivos terapéuticos. Conclusiones: Detectar resultados negativos asociados a la medicación permite identificar situaciones de descontrol de los factores de riesgo cardiovascular y otras en las que la intervención farmacoterapéutica no se realiza con la intensidad debida según la situación clínica del paciente. La intervención farmacéutica aumentó de forma significativa el número de pacientes que requerían tomar ácido acetilsalicílico (AU)

Objectives: To evaluate the functionality of pharmacotherapy follow-up in patients with metabolic syndrome (MS) as a tool to identify and resolve situations in which there is lack of control of cardiovascular risk factors, as well as other situations in which the pharmacist intervention lacks the intensity necessary to successfully address the patient’s clinical condition. Design: Prospective pretest-posttest pilot study. Setting: Centro Salud Torcal de Antequera, Málaga, Spain. Participants: Patients with MS treated by the same physician. Intervention: Interventions were carried out focusing basically on modifying patient pharmacotherapy by mutual agreement with the physician. Main measurements (Method): Glycated hemoglobin (high-resolution gas chromatography), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels (Friedewald formula), total cholesterol level (adaptation of the Stadtman enzymatic method), triglycerides (enzymatic method using lipase/glycerol kinase), body mass index, arterial pressure, basal blood glucose (enzymatic method using hexokinase) and the use of acetylsalicylic acid (ASA). Results: The number of patients who began using acetyl ASA increased significantly. There were no significant changes in the remaining parameters or in the number of patients who achieved the therapeutic objectives. Conclusions: The detection of negative clinical outcomes of drug therapy makes it possible to identify those situations in which there is lack of control of cardiovascular risk factors, as well as other situations in which the pharmacist intervention lacks the intensity necessary to successfully address the patient’s clinical condition. The pharmacist intervention significantly increased the number of patients who required the use of ASA (AU)