Biosimilars and access to biologic therapy in immune-mediated diseases.

BACKGROUND: The rise of biologic agents has been a major breakthrough in treating immune-mediated inflammatory diseases (IMIDs). However, their high cost underscores the need for strategies to optimize treatment efficiency. Biosimilars offer cost-effective alternatives to biologics. This study aimed to assess biosimilar drug availability's impact on biologic therapy access for IMIDs. RESEARCH DESIGN AND METHODS: A retrospective observational study in 15 Spanish hospitals analyzed IMID patients (arthropathies, inflammatory bowel disease and psoriasis) initiating biologic therapy with originator or biosimilar drugs (infliximab, etanercept, adalimumab). Time to availability and initiation of biologic therapy were assessed. RESULTS: 267 patients were included, with 58.4% starting on biosimilars. The mean time to availability of the biologic drugs in the hospitals was 15.9 ± 6.7 months, (20.0 ± 12.4 for originator and 11.8 ± 5.2 for biosimilars). Mean time to biologic treatment was 7.7 ± 9.0 years (8.6 ± 8.9 for originators and 7.0 ± 9.0 for biosimilars). Showing statistically significant differences among conditions. CONCLUSION: The emergence of biosimilar drugs has enhanced market competition and accelerated their adoption into hospitals' therapeutic regimens over original reference drugs. This has significantly improved access to biologic therapy for patients with IMIDs, evidenced by a notable 1.6-year reduction in access time for biosimilar drugs.

Long-term changes in macroinvertebrate communities across high-latitude streams.

Long-term records of benthic macroinvertebrates in high-latitude streams are essential for understanding climatic changes, including extreme events (e.g. floods). Data extending over multiple decades are typically scarce. Here, we investigated macroinvertebrate community structural change (including alpha and beta diversity and gain and loss of species) over 22 years (1994-2016) in 10 stream systems across Denali National Park (Alaska, USA) in relation to climatological and meteorological drivers (e.g. air temperature, snowpack depth, precipitation). We hypothesised that increases in air temperature and reduced snowpack depth, due to climatic change, would reduce beta and gamma diversity but increase alpha diversity. Findings showed temporal trends in alpha diversity were variable across streams, with oscillating patterns in many snowmelt- and rainfall runoff-fed streams linked to climatic variation (temperature and precipitation), but increased over time in several streams supported by a mixture of water sources, including more stable groundwater-fed streams. Beta-diversity over the time series was highly variable, yet marked transitions were observed in response to extreme snowpack accumulation (1999-2000), where species loss drove turnover. Gamma diversity did not significantly increase or decrease over time. Investigating trends in individual taxa, several taxa were lost and gained during a relative constrained time period (2000-2006), likely in response to climatic variability and significant shifts in instream environmental conditions. Findings demonstrate the importance of long-term biological studies in stream ecosystems and highlight the vulnerability of high-latitude streams to climate change.

Outpatient pharmaceutical care satisfaction survey through Telepharmacy during COVID-19 pandemic in Spain.

OBJECTIVE: To present the results of a survey about the Telemedicine outpatients experience and satisfaction of a pharmaceutical care  program through Telepharmacy, carried out from hospital pharmacy  departments in Spain during COVID-19 Pandemic (ENOPEX survey), and  identify differences across regions in Spain. METHOD: An analysis of results of the national survey ENOPEX on outpatient Telepharmacy services during the lockdown due to the COVID­19 pandemic, analyzed by autonomous community in Spain. Data was collected in relation to point of delivery; pharmacotherapeutic follow-up; patient's opinion and satisfaction with Telemedicine; confidentiality; future development of pharmaceutical care, through Telepharmacy services;  and coordination with the patient care team. Four multilevel regressions were performed to evaluate the differences between Spanish regions on the most relevant variables of the study, using the R version 4.0.3 software. RESULTS: A total of 8,079 interviews were valid, 52.8% of respondents were  female, age was 41-65 years in 54.3% of participants; 42.7% had been  receiving treatment for more than 5 years; 42.8% lived 10-50 km  from the  hospital; the journey to hospital took more than one hour for 60.2% of  participants. Globally, 85.7% received medicines at home. However, medicines  were delivered at a community pharmacy in some communities, such as  Cantabria (95.8%), or at primary care centers as in Castile La Mancha  (16.5%). In total, 96.7% of participants were satisfied or very satisfied with  Telemedicine pharmaceutical care, through Telepharmacy services, with  differences across communities, with users in Andalusia reporting the highest  satisfaction (OR = 1.58), and users in Castile-León being less satisfied with  Telepharmacy services (OR = 0.66). Users in Catalonia are the ones more  clearly in favor of Telemedicine pharmaceutical care, through Telepharmacy  services as a complementary service, with an OR = 5.85 with respect to other  users. The Telemedicine most frequently mentioned advantage was that  Telepharmacy services avoided visits, especially in Cantabria (92.5%) and  Extremadura (88.4%). Most patients prefer informed delivery of medicines at  home when they do not have an appointment at the hospital: total of 75.6 %,  from 50.1% of users in Cantabria to 96.3% in Catalonia (p < 0.001). The users  less willing to pay for Telepharmacy services were the ones from Castile- León and Galicia, with users in Catalonia and Navarra showing higher  willingness. CONCLUSIONS: In general terms, patients were satisfied with Telemedicine pharmaceutical care, through Telepharmacy services during the COVID­19 pandemic, being mostly in favor of maintaining these services to avoid travels.

OBJETIVO: Describir los resultados de la encuesta sobre experiencia y  atisfacción de la Telemedicina en pacientes externos relativo a un programa de  atención farmacéutica a través de la Telefarmacia, realizado desde los servicios de farmacia durante la pandemia COVID-19 (encuesta ENOPEX) e identificar  las diferencias entre las comunidades autónomas de España.Método: Se analizaron los resultados de la encuesta nacional ENOPEX sobre  Telefarmacia en pacientes externos durante el confinamiento debido a la  pandemia COVID-19, realizado en las diferentes comunidades autónomas de  España. Se recogieron datos relativos a lugar de entrega, seguimiento farmacoterapéutico, opinión y satisfacción del paciente con la  Telefarmacia, confidencialidad, desarrollo futuro de la atención farmacéutica a  través de los servicios de Telefarmacia, y coordinación con el equipo de atención al paciente. Se realizaron cuatro regresiones multinivel para  evaluar las diferencias entre comunidades autónomas sobre las variables más relevantes del estudio por medio del software R versión 4.0.3. RESULTADOS: Un total de 8.079 entrevistas fueron válidas: el 52,8% eran mujeres, el 54,3% tenía entre 41-65 años, el 42,9% estaban en  tratamiento  prodesde hacía más de 5 años, el 42,8% vivía a 10-50 km del  hospital y el 60,2%  tardaba más de una hora en acudir al hospital.  globalmente, el 85,7% recibieron medicación a domicilio, aunque hubo  comunidades autónomas en las que se optó también por las oficinas de  farmacia, como en Cantabria (95,8%), o los centros de atención primaria,  como en Castilla­La Mancha (16,5%). El 96,7% de los pacientes refirieron estar satisfechos o muy satisfechos con la Telemedicina en la atención farmacéutica  mediante el uso de la Telefarmacia, detectándose variabilidad en cuanto a la  opinión entre comunidades, desde la mejor opinión en Andalucía (odds ratio  =1,58) y la menos favorable en Castilla y León (odds ratio = 0,66). Por su  parte, Cataluña es la comunidad que estaría más claramente a favor de la  Telemedicina en la atención farmacéutica de usar la Telefarmacia como  actividad complementaria, con una odds ratio de 5,85 respecto al resto. Las  ventajas más mencionadas de la Telemedicina fue que los servicios de  Telefarmacia evitaban desplazamientos, especialmente en Cantabria (92,5%) y Extremadura (88,4%). Los pacientes mayoritariamente prefieren el  acercamiento y entrega informada de la medicación a domicilio cuando no  tienen que acudir al hospital, el 75,6% globalmente, desde el 50,1% de  pacientes de Cantabria al 96,3% en Cataluña (p < 0,001). Las comunidades  autónomas menos dispuestas a pagar por el servicio de Telefarmacia fueron  Castilla y León y Galicia, y las que más, Cataluña y Navarra. CONCLUSIONES: En líneas generales, los pacientes están satisfechos con la  Telemedicina aplicada a la atención farmacéutica a través de los servicios de  Telefarmacia durante la pandemia COVID-19, estando mayoritariamente a  favor de mantenerla para evitar desplazamientos.

Encuesta de satisfacción en pacientes externosde la atención farmacéutica mediante Telefarmaciadurante la pandemia COVID-19 en España / Outpatient pharmaceutical care satisfaction survey through Telepharmacy during COVID-19 pandemic in Spain

Objetivo: Describir los resultados de la encuesta sobre experiencia y satisfacción de la Telemedicina en pacientes externos relativo a un programade atención farmacéutica a través de la Telefarmacia, realizado desde losservicios de farmacia durante la pandemia COVID-19 (encuesta ENOPEX)e identificar las diferencias entre las comunidades autónomas de España.Método: Se analizaron los resultados de la encuesta nacional ENOPEXsobre Telefarmacia en pacientes externos durante el confinamiento debidoa la pandemia COVID-19, realizado en las diferentes comunidades autónomas de España. Se recogieron datos relativos a lugar de entrega, seguimiento farmacoterapéutico, opinión y satisfacción del paciente con la Telefarmacia, confidencialidad, desarrollo futuro de la atención farmacéuticaa través de los servicios de Telefarmacia, y coordinación con el equipo deatención al paciente. Se realizaron cuatro regresiones multinivel para evaluar las diferencias entre comunidades autónomas sobre las variables másrelevantes del estudio por medio del software R versión 4.0.3.Resultados: Un total de 8.079 entrevistas fueron válidas: el 52,8% eranmujeres, el 54,3% tenía entre 41-65 años, el 42,9% estaban en tratamiento desde hacía más de 5 años, el 42,8% vivía a 10-50 km del hospital y el 60,2%tardaba más de una hora en acudir al hospital. Globalmente, el 85,7% recibieron medicación a domicilio, aunque hubo comunidades autónomas en lasque se optó también por las oficinas de farmacia, como en Cantabria (95,8%),o los centros de atención primaria, como en Castilla-La Mancha (16,5%). El96,7% de los pacientes refirieron estar satisfechos o muy satisfechos con laTelemedicina en la atención farmacéutica mediante el uso de la Telefarmacia,detectándose variabilidad en cuanto a la opinión entre comunidades, desde lamejor opinión en Andalucía (odds ratio =1,58) y la menos favorable en Castillay León (odds ratio = 0,66). (AU)

Objective: To present the results of a survey about the Telemedicineoutpatients experience and satisfaction of a pharmaceutical care programthrough Telepharmacy, carried out from hospital pharmacy departments inSpain during COVID-19 Pandemic (ENOPEX survey), and identify differences across regions in Spain.Method: An analysis of results of the national survey ENOPEX on outpatient Telepharmacy services during the lockdown due to the COVID-19pandemic, analyzed by autonomous community in Spain. Data wascollected in relation to point of delivery; pharmacotherapeutic follow-up;patient’s opinion and satisfaction with Telemedicine; confidentiality; futuredevelopment of pharmaceutical care, through Telepharmacy services; andcoordination with the patient care team. Four multilevel regressions wereperformed to evaluate the differences between Spanish regions on themost relevant variables of the study, using the R version 4.0.3 software.Results: A total of 8,079 interviews were valid, 52.8% of respondentswere female, age was 41-65 years in 54.3% of participants; 42.7% hadbeen receiving treatment for more than 5 years; 42.8% lived 10-50 km from the hospital; the journey to hospital took more than one hour for60.2% of participants. Globally, 85.7% received medicines at home.However, medicines were delivered at a community pharmacy in somecommunities, such as Cantabria (95.8%), or at primary care centers as inCastile La Mancha (16.5%). In total, 96.7% of participants were satisfiedor very satisfied with Telemedicine pharmaceutical care, through Telepharmacy services, with differences across communities, with users in Andalusia reporting the highest satisfaction (OR = 1.58), and users in CastileLeón being less satisfied with Telepharmacy services (OR = 0.66). (AU)

Situación actual, inquietudes y necesidades de los tutores de formación especializada de farmacia hospitalaria / Specialized training in hospital pharmacy: an overview of the concerns, needs and current situation of resident tutors

Objetivo: Conocer las necesidades formativas y de recursos de lostutores de formación especializada de farmacia hospitalaria de España,así como su motivación y satisfacción con la docencia.Método: Se realizó, mediante Google-forms®, una encuesta dirigida atutores de farmacia hospitalaria durante enero-marzo de 2019 con preguntas generales (tutor, hospital, servicio) y específicas (medios disponibles,actividades docentes, satisfacción con la docencia, necesidades formativas). Se realizó un análisis exploratorio univariante para estudiar posiblesfactores relacionados con la satisfacción y la motivación docente.Resultados: Respondieron 83 tutores (tasa de respuesta: 52,8%),de 15/17 comunidades autónomas. El número de residentes/año-tutorresultó 4 (rango intercuartílico = 2-4). El 96,4% realizan entrevistas (trimestrales [65,1%]-ninguna [3,6%]. También se ocupan principalmente dela gestión de rotaciones externas [97,6%], planificación de rotaciones [97,6%] y la evaluación anual [96,4%]). El 17,1% dispone de horas parala docencia insuficientes para el 71,4%. Un 70,7% de los tutores deocho comunidades autónomas con normativa sobre el tiempo de liberación carecen de dicho tiempo. Los tutores se declararon mayoritariamentesatisfechos con la docencia (66,7%) y motivados (63,0%). (AU)

Objective: To provide new insight into the training needs and resourcesrequired by hospital pharmacy resident tutors in Spain, as well as into theirlevel of motivation and satisfaction with their teaching.Method: Google Forms® was used to design a survey addressed to hospital pharmacy resident tutors between January and March 2019. Theysurvey consisted of generic (tutor, hospital, service) and specific questions(available resources, teaching activities, teaching satisfaction, trainingneeds). A univariate exploratory analysis was conducted to study possiblefactors related to teaching satisfaction and motivation.Results: Replies were received from 83 tutors (rate of response:52.8%), from 15/17 Spanish regions. The annual resident/tutor ratio was4 (IQR = 2-4). A total of 96.4% of tutors conducted interviews, of whom65.1% did so quarterly. Other activities included the management of external training rotations (97.6%), planning of rotations (97.6%) and annual appraisals (96.4%). Only 17.1% of respondents were given time off theirregular duties for their tutorship work, with 71.4% stating that the time theywere allowed was insufficient. A total of 70.7% of tutors from eight Spanish regions where the granting of protected time was regulated said werenot given any time off for their teaching endeavors. Most tutors declaredto be satisfied (66.7%) and motivated (63%) with their teaching work. (AU)

Specialized training in hospital pharmacy: an overview of the concerns, needs and current situation of resident tutors.

OBJECTIVE: To provide new insight into the training needs and resources required by hospital pharmacy resident tutors in Spain, as well as  into their level of motivation and satisfaction with their teaching. Method: Google Forms® was used to design a survey addressed to hospital pharmacy resident tutors between January and March 2019. They survey consisted of generic (tutor, hospital, service) and specific  questions (available resources, teaching activities, teaching satisfaction,  training needs). A univariate exploratory analysis was conducted to study  possible factors related to teaching satisfaction and motivation. Results: Replies were received from 83 tutors (rate of response: 52.8%), from  15/17 Spanish regions. The annual resident/tutor ratio was 4 (IQR = 2- 4). A total of 96.4% of tutors conducted interviews, of whom 65.1% did so  quarterly. Other activities included the management of external training  rotations (97.6%), planning of rotations (97.6%) and annual  appraisals  (96.4%). Only 17.1% of respondents were given time off their regular duties  for their tutorship work, with 71.4% stating that the time they were allowed  was insufficient. A total of 70.7% of tutors from eight Spanish regions where  the granting of protected time was regulated said were not given any time off  for their teaching endeavors. Most tutors declared to be satisfied (66.7%) and  motivated (63%) with their teaching work. Motivation appeared to fall with  age, and both motivation and satisfaction decreased as a function of the tutors'  years of professional experience and when they were given no time off  for their tutorship work or when the remuneration was low, without any  relationship being identified between these factors. Tutors pointed out that work should be done to increase the number of hours assigned to tutorships  (78%), preparing SEFH-validated training plans (76.8%), improving teaching  techniques (65.9%), and decreasing the clinical workload (62.2%). Over the  past 3 years, 69.1% of tutors had received training. This training was arranged  by educational committees (63.3%), the Spanish regional authorities  (42.4%) and SEFH (13.6%). All the training in clinical, teaching, and communicative competencies enjoyed wide acceptance (> 90%). The  preferred delivery method was hybrid (partly on-line and partly onsite)  (64.6%). CONCLUSIONS: SEFH's tutors' group conducted its first national survey  addressed to hospital pharmacy resident tutors. The survey showed that, although tutors are highly satisfied with their teaching activities, they  ould like more training and to be able to devote more time to their tutorship work. It was also shown that a regulatory framework needs to be  implemented in various Spanish regions and that compliance with existing  regional regulations must be improved.

Objetivo: Conocer las necesidades formativas y de recursos de los tutores de  formación especializada de farmacia hospitalaria de España, así como su  motivación y satisfacción con la docencia.Método: Se realizó, mediante Google-forms®, una encuesta dirigida a tutores  de farmacia hospitalaria durante enero-marzo de 2019 con preguntas generales (tutor, hospital, servicio) y específicas (medios  disponibles, actividades docentes, satisfacción con la docencia, necesidades  formativas). Se realizó un análisis exploratorio univariante para estudiar  posibles factores relacionados con la satisfacción y la motivación docente. Resultados: Respondieron 83 tutores (tasa de respuesta: 52,8%), de 15/17  comunidades autónomas. El número de residentes/año-tutor resultó 4 (rango  intercuartílico = 2-4). El 96,4% realizan entrevistas (trimestrales [65,1%]- ninguna [3,6%]. También se ocupan principalmente de la gestión de rotaciones  externas [97,6%], planificación de rotaciones  [97,6%] y la  evaluación anual [96,4%]). El 17,1% dispone de horas para la docencia  insuficientes para el 71,4%. Un 70,7% de los tutores de ocho comunidades  autónomas con normativa sobre el tiempo de liberación carecen de dicho  tiempo. Los tutores se declararon mayoritariamente satisfechos con la docencia  (66,7%) y motivados (63,0%). Parece que la motivación desciende  con la edad, y que motivación y satisfacción disminuyen con los años como  tutor y como especialista, también son menores en ausencia de liberación o  retribución económica, sin haberse podido demostrar asociación. Los tutores  seleccionaron como acciones de mejora: aumento de dedicación horaria  (78%), planes formativos validados por la Sociedad Española de Farmacia  Hospitalaria (76,8%), mejorar técnicas pedagógicas (65,9%) y menor carga  asistencial (62,2%). En los últimos 3 años el 69,1% recibió formación. La  formación fue organizada por la Comisión de Docencia (63,3%), comunidades  autónomas (42,4%) y Sociedad Española de Farmacia Hospitalaria (13,6%). La  formación propuesta en competencias clínicas, docentes y de comunicación  fue ampliamente aceptada (> 90%). El formato docente  preferido fue semipresencial (64,6%).Conclusiones: El Grupo de Tutores de la Sociedad Española de Farmacia Hospitalaria ha realizado la primera encuesta nacional dirigida a  tutores de farmacia hospitalaria. La encuesta muestra que, aunque la satisfacción con la actividad docente es elevada, los tutores demandan más tiempo de dedicación y una mayor formación. Además, pone de  manifiesto que es preciso desarrollar el marco normativo en varias  comunidades autónomas y mejorar el cumplimiento de la normativa  autonómica vigente.

Outpatients' Opinion And Experience Regarding Telepharmacy During The COVID-19 Pandemic: The Enopex Project.

BACKGROUND: Telepharmacy, as a remote pharmaceutical care procedure, is being used worldwide during the COVID-19 pandemic, with the aim of preserving the health of patients and professionals. Its future development should incorporate the assessment of patient perception, but no research study has investigated it. OBJECTIVE: The objective was to poll the opinions and experiences of outpatients with telepharmacy through a purpose-developed questionnaire and to assess it's quality through an internal validity and reliability analysis. METHODS: Cross-sectional observational study of adult patients who used telepharmacy services during the COVID-19 lockdown period in Spain. The subjects answered a 24-item questionnaire, after giving their informed consent. Place of delivery, informed pharmacotherapeutic follow-up, opinion about telepharmacy, future development, ethics/satisfaction, and coordination constituted the six questionnaire categories. After assessing the adequate sample size with the Kaiser-Meyer-Olkin test, the Bartlett sphericity test analyzed the validity of the questionnaire. The intraclass correlation coefficient and Cronbach's α coefficient calculations verified the reliability and internal consistency. RESULTS: A total of 9442 interviews were administered to patients from 81 hospitals, of which 8079 were valid (52.8% female). A 54.1% were aged between 41-65 years; 42.7% had been in treatment for more than 5 years; 42.8% lived between 6-31 miles from the hospital. As many as 96.7% of patients were "satisfied" or "very satisfied" with telepharmacy, 97.5% considering it complementary to their usual follow-up; 55.9% expressed a preference for being followed up face to face when visiting the hospital. 75.6% said they had rather receive their medication at home. The sample size obtained was deemed appropriate [the Kaiser-Meyer-Olkin test (0.789) and Bartlett's sphericity test (p<0.005)]. The reliability analysis resulted in a Cronbach α = 0.7. CONCLUSION: Patients have shown high satisfaction with telepharmacy and the ENOPEX questionnaire is a tool with sufficient validity and reliability to be used in the evaluation of the care that patients receive through telepharmacy.

Evaluación de la formación especializada en farmacia hospitalaria / Evaluation of specialized training in hospital pharmacy

OBJETIVO: Analizar el grado de satisfacción de los residentes de la especialidad de farmacia hospitalaria e identificar áreas de mejora en su formación. MÉTODO: Cuestionario on line con 51 preguntas dirigido a residentes de cuarto año en Farmacia Hospitalaria que finalizaban su formación en 2018. Se realizó un análisis bivariante y multivariante para identificar la asociación de cada una de las variables independientes con respecto a la satisfacción global y delimitar en qué medida las asociaciones pudieran explicarse por el efecto del resto de variables recogidas en el estudio. RESULTADOS: Un total de 91 (67,4%) residentes cumplimentaron el cuestionario. La media de satisfacción global fue aceptable-buena (3,52 ± 0,92). El 86,8% disponía de un Plan Individualizado de Formación y el 50% valoraron su adaptación al programa de la especialidad como buena o muy buena. El 63,7% valoró positivamente la labor del tutor principal y un 72,5% la del resto de adjuntos. El 15,4% contestó que su servicio disponía de un protocolo de supervisión y responsabilidad progresiva. El 81% consideró adecuado el nivel de responsabilidad en as guardias y el 69,2% su supervisión. El 96,7% disponía de menos de 10 horas semanales para actividades docentes o de investigación. Un 35,2% tenía cinco o menos publicaciones o comunicaciones a congresos como primer autor y un 45,1% participaba en algún proyecto de investigación. Un 89% valoró positivamente la formación recibida en su centro y un 75,8% de los residentes volvería a elegir el mismo hospital. El análisis estadístico mostró una asociación respecto a la satisfacción global con significación estadística de varias variables, siendo la labor del tutor principal la que se relacionó de forma independiente con la satisfacción global. CONCLUSIONES: La satisfacción global con la formación recibida es aceptable, siendo la tutorización del tutor principal y la del resto de farmacéuticos de los servicios de farmacia los factores que afectan a la satisfacción global, si bien sólo la del tutor de un modo estadísticamente significativo. Como áreas de mejora se han detectado la supervisión de la formación, la labor del colaborador docente farmacéutico en las rotaciones clínicas y la investigación

OBJECTIVE: To analyze the degree of satisfaction of hospital pharmacy residents and identify areas of improvement in their training. METHOD: A survey (5-point Likert scale) was administered among fourth-year hospital pharmacy residents due to complete their residency in 2018. Bivariate and multivariate logistic regression analyses was performed to identify the association of each independent variable with overall satisfaction. RESULTS: 67.4% (91/135) of residents filled out the questionnaire. The mean overall satisfaction rate was acceptable-good (3.52 ± 0.92); 86.8% of residents had received an individualized training program, with 50% of them considering their individualized training program to be very well attuned to their day-to-day professional practice. The work of the tutor and other staff members involved in resident education was rated as positive by 63.7% and 72.5% of residents, respectively. A total of 15.4% of residents said that their units had a supervision and progressive empowerment pr-tocol in place. With respect to the level of on-call responsibility bestowed on them, 81% of residents considered it to be adequate; 69.2% considered the supervision they received to be adequate. As many as 96.7% of residents dedicated less than 10 hours per week to teaching or research activities; 35.2% of residents had produced five or less articles or congress presentations as first authors. Residents that had defended or were in the process of writing their PhD dissertation were 30.8%; 45.1% were involved in an Research project. Finally, 89% of residents rated the training received as positive, with 75.8% of them stating that they would select the same hospital again. In the statistical analysis, an association was found between overall satisfaction and several variables, with the work done by the main tutor being independently related to overall satisfaction. CONCLUSIONS: Overall satisfaction with the training received by fourth-year residents was acceptable. The work of the tutor and other staff members involved in resident education were the variables with the greatest influence on overall satisfaction, albeit only the tutor ́s work achieved statistical significance. The supervision of residents' progress, the coaching provided by other staff members during clinical rotations, and research were identified as areas for improvement

Evaluation of specialized training in hospital pharmacy.

OBJECTIVE: To analyze the degree of satisfaction of hospital pharmacy residents and identify areas of improvement in their training. METHOD: A survey (5-point Likert scale) was administered among  fourthyear hospital pharmacy residents due to complete their residency  in 2018. Bivariate and multivariate logistic regression analyses was  performed to identify the association of each independent variable with  overall satisfaction. RESULTS: 67.4% (91/135) of residents filled out the questionnaire. The  mean overall satisfaction rate was acceptable-good (3.52 ± 0.92);  86.8% of residents had received an individualized training program, with  50% of them considering their individualized training program to be very  well attuned to their day-to-day professional practice. The work of the  tutor and other staff members involved in resident education was rated  as positive by 63.7% and 72.5% of residents, respectively. A total of  15.4% of residents said that their units had a supervision and  progressive empowerment protocol in place. With respect to the level of  on-call responsibility bestowed on them, 81% of residents considered it  to be adequate; 69.2% considered the supervision they received to be  adequate. As many as 96.7% of residents dedicated less than 10 hours  per week to teaching or research activities; 35.2% of residents had  produced five or less articles or congress presentations as first authors.  Residents that had defended or were in the process of writing their PhD  dissertation were 30.8%; 45.1% were involved in an Research project.  Finally, 89% of residents rated the training received as positive, with  75.8% of them stating that they would select the same hospital again. In the statistical analysis, an association was found between overall  satisfaction and several variables, with the work done by the main tutor  being independently related to overall satisfaction. CONCLUSIONS: Overall satisfaction with the training received by  fourthyear residents was acceptable. The work of the tutor and other  staff members involved in resident education were the variables with the  greatest influence on overall satisfaction, albeit only the tutor´s work  achieved statistical significance. The supervision of residents' progress,  the coaching provided by other staff members during clinical rotations,  and research were identified as areas for improvement.

Objetivo: Analizar el grado de satisfacción de los residentes de la especialidad de farmacia hospitalaria e identificar áreas de mejora en su formación.Método: Cuestionario on line con 51 preguntas dirigido a residentes de  cuarto año en Farmacia Hospitalaria que finalizaban su formación en  2018. Se realizó un análisis bivariante y multivariante para identificar la  asociación de cada una de las variables independientes con respecto a la  satisfacción global y delimitar en qué medida las asociaciones pudieran  explicarse por el efecto del resto de variables recogidas en el estudio.Resultados: Un total de 91 (67,4%) residentes cumplimentaron el cuestionario. La media de satisfacción global fue aceptable-buena (3,52 ± 0,92). El 86,8% disponía de un Plan Individualizado de  Formación y el 50% valoraron su adaptación al programa de la  especialidad como buena o muy buena. El 63,7% valoró positivamente la labor del tutor principal y un 72,5% la del resto de adjuntos. El 15,4%  contestó que su servicio disponía de un protocolo de supervisión y  responsabilidad progresiva. El 81% consideró adecuado el nivel de  responsabilidad en las guardias y el 69,2% su supervisión. El 96,7%  disponía de menos de 10 horas semanales para actividades docentes o  de investigación. Un 35,2% tenía cinco o menos publicaciones o  comunicaciones a congresos como primer autor y un 45,1% participaba  en algún proyecto de investigación. Un 89% valoró positivamente la  formación recibida en su centro y un 75,8% de los residentes volvería a  elegir el mismo hospital. El análisis estadístico mostró una asociación  respecto a la satisfacción global con significación estadística de varias  variables, siendo la labor del tutor principal la que se relacionó de forma  independiente con la satisfacción global.Conclusiones: La satisfacción global con la formación recibida es aceptable, siendo la tutorización del tutor principal y la del resto de farmacéuticos de los servicios de farmacia los factores que afectan a  la satisfacción global, si bien sólo la del tutor de un modo  estadísticamente significativo. Como áreas de mejora se han detectado la supervisión de la formación, la labor del colaborador docente  farmacéutico en las rotaciones clínicas y la investigación.

Posicionamiento de la Sociedad Española de Farmacia Hospitalaria sobre Telefarmacia. Recomendaciones para su implantación y desarrollo / Spanish Society of Hospital Pharmacy Position Statement on Telepharmacy: Recommendations for its implementation and development

En la práctica asistencial de los farmacéuticos de hospital resulta imprescindible la utilización de las tecnologías de la información y comunicación en el ámbito de la Telefarmacia. Por lo tanto, la Sociedad Española de Farmacia Hospitalaria considera oportuno definir el término y condiciones de Telefarmacia y comunicar su posicionamiento institucional a través de este documento de posicionamiento: "La Telefarmacia es la práctica farmacéutica a distancia a través del uso de las tecnologías de la información y comunicación". La Telefarmacia incluye como principales actividades: validación terapéutica, documentación clínica, consulta de atención farmacéutica, monitorización terapéutica, seguimiento de la adherencia, formación/información sobre medicamentos, coordinación con profesionales sanitarios y evaluación de resultados en salud. Los procedimientos asistenciales en el ámbito de la Telefarmacia deben regirse por un Procedimiento Normalizado de Trabajo, con documentación en la historia clínica y sin discriminación de acceso a pacientes candidatos. Se consideran cuatro procedimientos principales de Telefarmacia: seguimiento farmacoterapéutico; información y/o formación a pacientes y cuidadores; coordinación con el equipo multidisciplinar a nivel intra y extrahospitalario; dispensación y entrega informada de medicamentos a distancia. La implantación de la Telefarmacia requiere adecuación de medios humanos (formación, capacitación) y tecnológicos (validación, interoperatividad, confidencialidad). Asimismo, debe dar cumplimiento a la legalidad y normativa vigente, tanto a nivel autonómico como estatal. Los procedimientos de Telefarmacia deben también ajustarse a las consideraciones éticas y los códigos deontológicos pertinentes. Debe fomentarse la evaluación de la Telefarmacia a través del uso de indicadores y de la investigación de su repercusión sobre los resultados en salud. Por tanto, la Sociedad Española de Farmacia Hospitalaria considera que la Telefarmacia es una herramienta complementaria y necesaria para la provisión de una Atención Farmacéutica Especializada con el objetivo final de mejorar los resultados en salud y maximizar la seguridad y satisfacción de los pacientes

The use of information and communication technologies have nowadays become part and parcel of hospital pharmacy practice. Against this background, it is hardly surprising that Telepharmacy has sparked the interest of a large number of stakeholders. In this respect, the Spanish Society of Hospital Pharmacy has developed a definition of the concept and outlined the conditions under which Telepharmacy should operate. It has also shared its institutional stance on the subject through a position statement that states that Telepharmacy is the provision of pharmaceutical care at a distance through information and communication technologies. Telepharmacy practice includes activities such as therapeutic validation, drafting of clinical documents, provision of pharmaceutical care, therapeutic follow-up, adherence monitoring, drug education and information, coordination between healthcare providers and evaluation of health outcomes. The clinical tasks performed as part of Telepharmacy practice must adhere to a standardized procedure and revolve around the patient's clinical record. Access to Telepharmacy must be provided without discrimination. The service comprises four main activities: pharmacotherapeutic follow-up; patient and caregiver-directed education and information-dissemination; coordination with healthcare providers from the same or different hospitals; and remote informed home drug delivery. Implementation of Telepharmacy requires an adjustment of human (training and capacity-building) and technological resources (validation, interoperability, confidentiality). It must also comply with the laws and regulations in force both at a regional and a national level. Telepharmacy procedures must also be adapted to the relevant ethical standards and codes of good practice. Appropriate indicators must be used to evaluate the performance of Telepharmacy and its impact on health outcomes. According to Spanish Society of Hospital Pharmacy Telepharmacy is a necessary complemetary tool to provide specialized pharmaceutical care and thereby improve health outcomes and maximize patient safety and satisfaction

Spanish Society of Hospital Pharmacy Position Statement on Telepharmacy: Recommendations for its implementation and development.

The use of information and communication technologies have nowadays become  part and parcel of hospital pharmacy practice. Against this background, it is  hardly surprising that Telepharmacy has sparked the interest of a large number  of stakeholders. In this respect, the Spanish Society of Hospital Pharmacy has  developed a definition of the concept and outlined the conditions under which  Telepharmacy should operate. It has also shared its institutional stance on the  subject through a position statement that states that Telepharmacy is the  provision of pharmaceutical care at a distance through information and  communication technologies. Telepharmacy practice includes activities such as  therapeutic validation, drafting of clinical documents, provision of  pharmaceutical care, therapeutic follow-up, adherence monitoring, drug  education and information, coordination between healthcare providers and  evaluation of health outcomes. The clinical tasks performed as part of  Telepharmacy practice must adhere to a standardized procedure and revolve  around the patient's clinical record. Access to Telepharmacy must be provided without discrimination. The service comprises four main activities:  pharmacotherapeutic follow-up; patient and caregiver-directed education and information-dissemination; coordination with healthcare providers from the  same or different hospitals; and remote informed home drug delivery. Implementation of Telepharmacy requires an adjustment of human (training and capacity-building) and technological resources (validation, interoperability, confidentiality). It must also comply with the laws and regulations in force both  at a regional and a national level. Telepharmacy procedures must also be  adapted to the relevant ethical standards and codes of good practice.  Appropriate indicators must be used to evaluate the performance of  Telepharmacy and its impact on health outcomes. According to Spanish Society  of Hospital Pharmacy Telepharmacy is a necessary complementary tool to  provide specialized pharmaceutical care and thereby improve health outcomes  and maximize patient safety and satisfaction.

En la práctica asistencial de los farmacéuticos de hospital resulta imprescindible la utilización de las tecnologías de la información y comunicación en el ámbito de la Telefarmacia. Por lo tanto, la Sociedad Española e Farmacia Hospitalaria considera oportuno definir el término y condiciones de  Telefarmacia y comunicar su posicionamiento institucional a través de este  documento de posicionamiento: "La Telefarmacia es la práctica farmacéutica a  distancia a través del uso de las tecnologías de la información y comunicación".  La Telefarmacia incluye como principales actividades: validación terapéutica,  documentación clínica, consulta de atención farmacéutica, monitorización  terapéutica, seguimiento de la adherencia, formación/información sobre  medicamentos, coordinación con profesionales sanitarios y evaluación de  resultados en salud. Los procedimientos asistenciales en el ámbito de la  Telefarmacia deben regirse por un Procedimiento Normalizado de Trabajo, con  documentación en la historia clínica y sin discriminación de acceso a pacientes  candidatos. Se consideran cuatro procedimientos principales de Telefarmacia:  seguimiento farmacoterapéutico; información y/o formación a pacientes y  cuidadores; coordinación con el equipo multidisciplinar a nivel intra y  extrahospitalario; dispensación y entrega informada de medicamentos a  distancia. La implantación de la Telefarmacia requiere adecuación de medios  humanos (formación, capacitación) y tecnológicos (validación, interoperatividad, confidencialidad). Asimismo, debe dar cumplimiento a la legalidad y normativa  vigente, tanto a nivel autonómico como estatal. Los procedimientos de  Telefarmacia deben también ajustarse a las consideraciones éticas y los códigos  deontológicos pertinentes. Debe fomentarse la evaluación de la Telefarmacia a  través del uso de indicadores y de la investigación de su repercusión sobre los  resultados en salud. Por tanto, la Sociedad Española de Farmacia Hospitalaria  considera que la Telefarmacia es una herramienta complementaria y necesaria  para la provisión de una Atención Farmacéutica Especializada con el objetivo  final de mejorar los resultados en salud y maximizar la seguridad y satisfacción  de los pacientes.

Evaluar para formar / Evaluate to train

No disponible

Quality indicators for technologies applied to the hospital pharmacy / Indicadores de calidad de tecnologías aplicadas a la farmacia hospitalaria

The TECNO group of the Sociedad Española de Farmacia Hospitalaria (Spanish Society of Hospital Pharmacy) has addressed the definition of a catalogue of indicators for performance, quality and safety in the use of technologies applied to the logistic activity of Hospital Pharmacy Units. The project was developed with a methodology of qualitative techniques by consensus, with the members of the TECNO Group participating as experts. Once indicators had been defined, a validation phase was conducted, and standards were established based on the result of the sampling carried out in the hospitals of the group members. A total of 28 indicators were obtained, with their corresponding quality standards applied to the use of technologies in the processed for medication storage, dispensing and preparation. The definition of quality indicators and their standards for measuring technologies in the use of medication represents a step forward in the improvement of their safety (AU)

El grupo TECNO de la Sociedad Española de Farmacia Hospitalaria ha abordado la definición de un catálogo de indicadores de funcionamiento, calidad y seguridad del uso de tecnologías aplicadas a la actividad logística de los Servicios de Farmacia Hospitalaria. El proyecto se desarrolló con una metodología de técnicas cualitativas de consenso participando como expertos los miembros del grupo TECNO. Una vez definidos los indicadores, se realizó una fase de validación y se establecieron estándares en base al resultado del muestreo realizado en los hospitales de los miembros del grupo. Se han obtenido un total de 28 indicadores con sus correspondientes estándares de calidad aplicados a la utilización de tecnologías en los procesos de almacenamiento, dispensación y elaboración de medicamentos. La definición de los indicadores de calidad y los estándares de medida de las tecnologías en el uso de los medicamentos es un paso adelante para mejorar su seguridad (AU)

Quality indicators for technologies applied to the hospital pharmacy.

The TECNO group of the Sociedad Española de Farmacia Hospitalaria (Spanish Society of Hospital Pharmacy) has addressed the definition of a catalogue of indicators for performance, quality and safety in the use of technologies applied to the logistic activity of Hospital Pharmacy Units.The project was developed with a methodology of qualitative techniques by consensus, with the members of the TECNO Group participating as experts. Once indicators had been defined, a validation phase was conducted, and standards were established based on the result of the sampling carried out in the hospitals of the group members.A total of 28 indicators were obtained, with their corresponding quality standards applied to the use of technologies in the processed for medication storage, dispensing and preparation.The definition of quality indicators and their standards for measuring technologies in the use of medication represents a step forward in the improvement of their safety.

El grupo TECNO de la Sociedad Española de Farmacia Hospitalaria ha abordado la definición de un catálogo de indicadores de funcionamiento, calidad y seguridad del uso de tecnologías aplicadas a la actividad logística de los Servicios de Farmacia Hospitalaria.El proyecto se desarrolló con una metodología de técnicas cualitativas de consenso participando como expertos los miembros del grupo TECNO. Una vez definidos los indicadores, se realizó una fase de validación y se establecieron estándares en base al resultado del muestreo realizado en los hospitales de los miembros del grupo.Se han obtenido un total de 28 indicadores con sus correspondientes estándares de calidad aplicados a la utilización de tecnologías en los procesos de almacenamiento, dispensación y elaboración de medicamentos.La definición de los indicadores de calidad y los estándares de medida de las tecnologías en el uso de los medicamentos es un paso adelante para mejorar su seguridad.

Inmunoterapia alérgica desde Atención Primaria de Salud / Allergen immunotherapy from Primary Health Care

La vacuna o inmunoterapia es el único tratamiento etiológico y específico de las enfermedades alérgicas capaz de modificar su curso natural.El objetivo de este artículo es mostrar una actualización en la administración de la inmunoterapia alérgica (subcutánea y sublingual) en el ámbito de la Atención Primaria de Salud, así como en las recomendaciones generales para el paciente con alergia. Para ello se llevó a cabo una revisión de la literatura.No se han encontrado diferencias sobre la modificación de pautas y la actuación en caso de reacciones adversas. Además se ha de valorar la inmunoterapia sublingual, la cual se está posicionando como forma segura y eficaz en el tratamiento de la enfermedad alérgica. Esta vía de administración presenta una buena tolerancia, comodidad de administración y escasez de efectos secundarios en los pacientes alérgicos (AU)

Vaccines or immunotherapy is the only causal and specific treatment of allergic diseases able to modify the natural course of allergic disease.The aim of this paper is to show an update on the administration of allergenim munotherapy (subcutaneous and sublingual) in the field of PrimaryHealth Care, as well as general recommendations for patients with allergy. To this end a review of the literature was carried out.No differences were found on the modification of regimen patterns or actions to be taken in adverse reactions. In addition, sublingual immunotherapy has to be assessed, which is positioning it self as a safe and effective method in the treatment of allergic disease. This route of administration affords a good tolerance, ease of administration and lack of side effects in allergic patients (AU)

[Sexual transmission infections]. / Infecciones de transmisión sexual. Existencia de una red comunitaria.

The infections of sexual transmission (STI) have a great importance on the health of the world population. Especially its incidence, prevalence and consequence on the health. Sexually transmitted diseases may be contracted by people of any age, race and social standing. More than 20 different diseases are known as STI, they have all in common that they are transmitted during the sexual intercourse. The World Health Organization (WHO) estimates that each year there are 340 million new cases of STIs among the ages of 15 and 49 years. STI must be diagnosed and treated early in order to avoid its propagation. The sexual education is the fundamental tool of the prevention of STI.

Infecciones de transmisión sexual. Existencia de una red comunitaria / Sexual transmission infections

Las infecciones de transmisión sexual (ITS) tienen una gran importancia sobre la salud de la población mundial, por su incidencia, prevalencia y repercusiones. Pueden contraerse por personas de cualquier edad, raza y medio social. Con este nombre se han agrupado más de 20 entidades patógenas diferentes que sólo tienen en común el hecho de poder transmitirse durante las relaciones sexuales. La Organización Mundial de la Salud (OMS) estima que cada año se producen 340 millones de casos nuevos de ITS entre las edades comprendidas de los 15 y 49 años. Las ITS se deben diagnosticar y tratar con prontitud, para erradicar su propagación y evitar complicaciones y secuelas. La prevención supone la herramienta fundamental y la metodología por excelencia es la educación sexual(AU)

The infections of sexual transmission (STI) have a great importance on the health of the world population. Especially its incidence, prevalence and consequence on the health. Sexually transmitted diseases may be contracted by people of any age, race and social standing. More than 20 different diseases are known as STI, they have all in common that they are transmitted during the sexual intercourse. The World Health Organization (WHO) estimates that each year there are 340 million new cases of STIs among the ages of 15 and 49 years. STI must be diagnosed and treated early in order to avoid its propagation. The sexual education is the fundamental tool of the prevention of STI(AU)

Developmental sperm contributions: fertilization and beyond.

The objective of this review was to examine the role of the various spermatozoal components suspected of actively participating in early human development. The contributions of the fertilizing spermatozoon to the oocyte include, as a minimum, the delivery of the DNA/chromatin, a putative oocyte-activating factor (OAF), and a centriole. Recent data indicate that spermatozoa may also provide the zygote with a unique suite of paternal mRNAs; some transcripts might be crucial for early and late embryonic development and deficient delivery, or aberrant transcription might contribute to abnormal development and arrest. Clinical evidence from assisted reproduction suggests that failure to complete the fertilization process, syngamy, or early cleavage might be the result of an early paternal effect. It is speculated that an abnormal release of a putative OAF and/or dysfunctions of the centrosome and cytoskeletal apparatus may mediate these effects. On the other hand, a later paternal effect resulting in embryonic failure to achieve implantation, pregnancy loss, and/or developmental abnormalities resulting from "carried over" sublethal effects may be associated with sperm nuclear/chromatin defects, including the presence of aneuploidy, genetic anomalies, DNA damage, and possibly other causes. These findings highlight the need for continuous monitoring of clinical results.

Tratamiento con radioyodo en el hipertiroidismo: resultados a largo plazo / Radioiodine in hyperthyroidism: long-term outcomes

Introducción: El 131I es una opción terapéutica eficaz para el tratamiento del hipertiroidismo, aunque en un alto porcentaje de pacientes se desarrolla hipotiroidismo definitivo. Objetivo: Evaluar la función tiroidea a largo plazo de pacientes con hipertiroidismo tras el tratamiento con 131I. Pacientes y método: Se estudió retrospectivamente a 128 pacientes hipertiroideos que recibieron 131I entre 1994 y 1999. Se excluyó a 32 por pérdida en el seguimiento y se clasificó a los 96 sujetos incluidos, según la afección tiroidea, en GB (Graves-Basedow, n = 46), BMN (bocio multinodular, n = 35) y AT (adenoma tóxico, n = 15). El tiempo de seguimiento fue 7,3 ± 0,2 años y la dosis media de 131I, 12,2 ± 0,3 mCi. Resultados: De los 96 pacientes, en el 58,3% se desarrolló hipotiroidismo, el 34,4% mantenía normofunción tiroidea y el 7,3% restante permanecía con hiperfunción clínica o subclínica. El 19,8% (n = 19) precisó más de una dosis de 131I. En el grupo GB, el 87% evolucionó a hipotiroidismo, el 10,9% persistía eutiroideo y el 2,1%, con hiperfunción; recibieron 2 dosis de 131I 10 (21,7%) pacientes. Del grupo BMN, el 28,6% quedó hipotiroideo; el 54,3%, eutiroideo y el 17,1%, con hiperfunción; 7 (20%) pacientes necesitaron 2 dosis y 2 (5,7%) pacientes, 3 dosis. En el grupo AT, el 40% desarrolló hipotiroidismo y el 60% mantenía normofunción tiroidea; 2 (13,3%) pacientes recibieron 2 dosis. Conclusiones: La tasa de hipotiroidismo definitivo en el grupo GB es superior a la de los otros 2 grupos. El alto porcentaje de pacientes con BMN que persisten hipertiroideos tras 131I indica que son necesarias dosis superiores en este grupo

Background: Radioiodine treatment is a safe and effective therapeutic option for hyperthyroidism, although the incidence of subsequent definitive hypothyroidism is high. Objective: To evaluate long-term thyroid function after radioiodine treatment in hyperthyroid patients. Patients and method: We performed a retrospective study of 128 hyperthyroid patients administered 131I between 1994 and 1999. We excluded 32 patients who were lost to follow-up. The 96 patients included were categorized into Graves' disease (GD), n = 46, toxic multinodular goiter (TMG), n = 35, and toxic adenoma (TA), n = 15. The mean time of follow-up was 7.3 ± 0.2 years and the mean 131I dose was 12.2 ± 0.3 mCi. Results: Among the 96 patients, hypothyroidism developed in 58.3%, normal thyroid function was achieved in 34.4% and some degree of hyperthyroidism persisted in 7.3%. More than one radioiodine dose was required in 19.8% (n = 19). In GD patients, hypothyroidism appeared in 87%, euthyroidism was achieved in 10.9%, and hyperthyroidism persisted in 2.1%. Ten patients required second 131I doses. In the TMG group, hypothyroidism developed in 28.6%, euthyroidism was achieved in 54.3% and hyperthyroidism was present in 17.1%. Seven patients (20%) were administered a second radioiodine dose and two patients (5.7%) received a third dose. In the TA group, hypothyroidism developed in 40% and euthyroidism was achieved in 60%. Two patients (13.3%) received a second 131I dose. Conclusions: The incidence of definitive hypothyroidism was higher in the GD group than in the TMG and TA groups. The high percentage of TMG patients with persistent hyperthyroidism suggests the need for higher radioiodine doses in this group