Prioritization of initiatives 2024-2027 of the strategic map of pharmaceutical outpatient care of the Spanish Society of Hospital Pharmacy. / Priorización de iniciativas 2024­2027 del mapa estratégico de atención farmacéutica al paciente externo de la Sociedad Española de Farmacia Hospitalaria.

OBJECTIVE: To prioritize the initiatives to be developed for the development of the Strategic Map of Outpatient Care (MAPEX) project to improve the quality of care and Pharmaceutical Care for patients seen in Hospital Pharmacy outpatient clinics in the period 2024-2027 in Spain. METHOD: The study was carried out in 4 phases between January and December 2023. For phase 1, a literature review of the evolution of the project was carried out by the coordinating committee with the aim of establishing a basis on which to define a new proposal for initiatives. In addition, an analysis was made of the health trends that will have an impact in the coming years. In phase 2, a working group of 19 specialists from all the autonomous communities was created, who were called regional ambassadors. They all made a preliminary proposal of initiatives and established revisions for their adjustment and final version both online and in telematic meetings. In phase 3, a consensus was established based on the Delphi-Rand/UCLA methodology with two rounds of online voting to select the initiatives classified as: priority and key or breakthrough. Between the first and second round of voting, a face-to-face "Consensus Conference" was held, where the results of the first round were presented. In phase 4, a public presentation was made in scientific forums and through the web. RESULTS: Ten trends in the health sector were identified. A list of 34 initiatives grouped into five lines of work was established. A total of 103 panelists participated in the first round and 76 in the second. Finally, five initiatives were established as priority and 29 as key. Among those prioritized were external visibility, adaptations to the CMO methodology, strengthening certification and improving training. CONCLUSIONS: The initiatives agreed upon as priorities were aimed at improving professional visibility, broadening the methodology of care work, expanding the quality of care, enhancing the training of professionals and the voice of patients.

Análisis 2016-2021 del desarrollo del proyecto de atención farmacéutica al paciente externo MAPEX por Comunidades Autónomas / Analysis 2016-2021 of the development of the MAPEX outpatient pharmaceutical care Project by regions in Spain

Objetivo: analizar la evolución del proyecto «Mapa Estratégico de Atención Farmacéutica al Paciente Externo» (MAPEX) por comunidades autónomas en España, a través del análisis de los resultados de la encuesta de situación comparativa entre los años 2016 y 2021. Métodos: un comité de expertos nacionales pertenecientes a la Sociedad Española de Farmacia Hospitalaria elaboró la Encuesta MAPEX sobre la situación de las unidades de pacientes externos, que constó de 43 preguntas específicas de aspectos relacionados con estructura, contexto, integración, procesos, resultados y formación, docencia e investigación. Se llevó a cabo en 2 periodos, uno en 2016 y otro en 2021 (con 3 preguntas adicionales en 2021, relacionadas con los avances de la iniciativa MAPEX y las líneas prioritarias a seguir). Se realizó un análisis comparativo de resultados a nivel nacional y por comunidad autónoma. Resultados: participaron 141 hospitales en 2016 y 138 en 2021, con representación de las 17 comunidades autónomas. El análisis de los resultados mostró mejoras significativas en todas las dimensiones de la encuesta, con variabilidad entre las diferentes regiones. De entre las mejoras más importantes, destacó el desarrollo y consolidación de la telefarmacia, la mayor especialización del farmacéutico por áreas de conocimiento y su integración en equipos multidisciplinares. La mejora del modelo asistencial se consideró el mayor avance a nivel general (65%) y la atención farmacéutica no presencial a nivel de centro (48,2%). Se consideraron líneas prioritarias de trabajo la expansión y aplicación práctica de la metodología de atención farmacéutica (66,4%), la investigación (58,4%) y la formación en todas las iniciativas MAPEX (53,3%). Conclusiones: la implantación y desarrollo de las iniciativas MAPEX ha supuesto un impacto positivo en la evolución en todos los ámbitos asistenciales de la atención farmacéutica al paciente externo. La encuesta permite identificar...(AU)

Objective: Analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between the years 2016 and 2021. Methods: A committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching and investigation. It was carried out in two periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. Results: 141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialization of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). Conclusions: The implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement...(AU)

Analysis 2016-2021 of the development of the MAPEX outpatient pharmaceutical care Project by Regions in Spain / Análisis 2016-2021 del desarrollo del Proyecto de atención farmacéutica al paciente externo MAPEX por Comunidades Autónomas en España

Objetivo: analizar la evolución del proyecto «Mapa Estratégico de Atención Farmacéutica al Paciente Externo» (MAPEX) por comunidades autónomas en España, a través del análisis de los resultados de la encuesta de situación comparativa entre los años 2016 y 2021. Métodos: un comité de expertos nacionales pertenecientes a la Sociedad Española de Farmacia Hospitalaria elaboró la Encuesta MAPEX sobre la situación de las unidades de pacientes externos, que constó de 43 preguntas específicas de aspectos relacionados con estructura, contexto, integración, procesos, resultados y formación, docencia e investigación. Se llevó a cabo en 2 periodos, uno en 2016 y otro en 2021 (con 3 preguntas adicionales en 2021, relacionadas con los avances de la iniciativa MAPEX y las líneas prioritarias a seguir). Se realizó un análisis comparativo de resultados a nivel nacional y por comunidad autónoma. Resultados: participaron 141 hospitales en 2016 y 138 en 2021, con representación de las 17 comunidades autónomas. El análisis de los resultados mostró mejoras significativas en todas las dimensiones de la encuesta, con variabilidad entre las diferentes regiones. De entre las mejoras más importantes, destacó el desarrollo y consolidación de la telefarmacia, la mayor especialización del farmacéutico por áreas de conocimiento y su integración en equipos multidisciplinares. La mejora del modelo asistencial se consideró el mayor avance a nivel general (65%) y la atención farmacéutica no presencial a nivel de centro (48,2%). Se consideraron líneas prioritarias de trabajo la expansión y aplicación práctica de la metodología de atención farmacéutica (66,4%), la investigación (58,4%) y la formación en todas las iniciativas MAPEX (53,3%). Conclusiones: la implantación y desarrollo de las iniciativas MAPEX ha supuesto un impacto positivo en la evolución en todos los ámbitos asistenciales de la atención farmacéutica al paciente externo. La encuesta permite identificar...(AU)

Objective: Analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between the years 2016 and 2021. Methods: A committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching and investigation. It was carried out in two periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. Results: 141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialization of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). Conclusions: The implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement...(AU)

Analysis 2016-2021 of the development of the MAPEX outpatient pharmaceutical care Project by regions in Spain. / Análisis 2016-2021 del desarrollo del proyecto de atención farmacéutica al paciente externo MAPEX por Comunidades Autónomas.

OBJECTIVE: Analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between the years 2016 and 2021. METHODS: A committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching and investigation. It was carried out in two periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. RESULTS: 141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialization of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). CONCLUSIONS: The implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement, as well as those areas to be developed through strengthening and corrective actions. The expansion of the project in the coming years will mean progress towards excellence in care and in the improvement of health results.

[Translated article] Analysis 2016-2021 of the development of the MAPEX outpatient pharmaceutical care Project by Regions in Spain.

OBJECTIVE: To analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between 2016 and 2021. METHODS: A committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching, and investigation. It was carried out in 2 periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. RESULTS: 141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialisation of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). CONCLUSIONS: The implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement, as well as those areas to be developed through strengthening and corrective actions. The expansion of the project in the coming years will mean progress toward excellence in care and in the improvement of health results.

Developing a telepharmacy programme with home medication dispensing and informed delivery in a tertiary hospital: description of the model and analysis of the results.

OBJECTIVES: This study aimed to describe the actions taken to implement a telepharmacy programme with home medication dispensing and informed delivery in an outpatient pharmaceutical care unit of a tertiary hospital, where approximately 5000 patients are treated per year. It also aimed to substantiate the applicability and benefits of the programme through analysing the findings and measuring patient satisfaction. METHODS: We identified the operational, logistical, technological and legal needs, as well as the need for training, information and coordination with the care team and patient associations. A standard operating procedure was developed which described the home dispensing model and the profile of patients eligible for telepharmacy. Care activity was evaluated, between the months of July 2020 and January 2021; and a survey was conducted to measure patient satisfaction based on the Enopex project, a cross-sectional observational study of patients who used telepharmacy services during the COVID-19 lockdown period in Spain. RESULTS: A total of 2536 medication deliveries were made over 144 working days, with a mean of 18 (standard deviation (SD): 6) deliveries per day, and a total of 2854 dispensings (1.1 drugs per delivery). In total, 197 different types of pharmaceutical formulations were delivered, corresponding to 123 active ingredients. The distance and time avoided during the study period totalled 1 05 624 km and 1 09 452 min (76 days), whereby the median distance and time saved per patient were 66 (interquartile range (IQR):122 km and 90 (IQR:90) minutes, which represents an approximate carbon footprint reduction of 25 kg of CO2 per patient and 16.5 tonnes in total. The satisfaction survey conducted, completed by 134 patients, revealed high satisfaction with the pharmacy service of 9.88 points out of 10. CONCLUSIONS: The SARS-CoV-2 pandemic (COVID-19) has provided the pharmacy service with an opportunity to develop and implement a telepharmacy programme that benefits patients, which has enabled better organisation of the unit and greater accessibility for patients attending in person. It is a replicable method that is applicable in other pharmacy services with similar characteristics and requirements.

The Telepharmacy patient prioritisation model of the Spanish Society of Hospital Pharmacy.

The Spanish Society of Hospital Pharmacy Position Paper on Telepharmacy states that the inclusion of patients should take into account  ethical considerations and, therefore, be based on the concept of equity. Thus, it establishes that Telepharmacy should not be limited to specific  pathologies or medicines, but should be based on the individual needs of each patient: it also highlights the need to rely on selection or prioritisation models to help identify patients who can benefit from  Telepharmacy. The aim of this article is to present the Spanish Society of  Hospital Pharmacy Telepharmacy Patient Prioritisation Model, which establishes  key recommendations and a reference prioritisation model to guide  hospital pharmacists in the identification and prioritisation of patients  who are candidates for inclusion in Telepharmacy programmes. This model was  developed based on the experience of a group of experts in their clinical  practice as well as on a review of the main reference documents available in  this field. It comprises 25 criteria, grouped into 8 minimum inclusion criteria, 5 continuity criteria, and 12 recommended criteria. The latter criteria are divided  into high, medium, and low priority criteria. Patients are prioritised according  to their scores on meeting the recommended criteria, such that those with the  highest scores are given the highest priority. As stated in the Spanish Society  of Hospital Pharmacy Position Paper on Telepharmacy, pharmacotherapeutic  monitoring can be conducted via remote consultation without sending  medication, but not vice versa; thus, the 25 criteria defined apply to  Telepharmacy programmes in the area of the remote dispensing and informed  delivery of medicines, but only 19 of them apply to pharmacotherapeutic  monitoring programmes. The model presented is intended to be a reference  guide and should be adapted to the particular characteristics and  circumstances of each pharmacy service, depending on demand and available  resources.

La Sociedad Española de Farmacia Hospitalaria, en su Documento de  osicionamiento sobre Telefarmacia, establece que la inclusión de pacientes debe tener en cuenta consideraciones éticas y, por tanto, estar  basada en el concepto de equidad. Por ello, establece que la Telefarmacia no  debe restringirse por patologías ni medicamentos, sino en función de las  necesidades individuales de cada paciente, y destaca la necesidad de apoyarse en modelos de selección o priorización que ayuden en la  identificación de los pacientes que puedan beneficiarse de la Telefarmacia. El  objetivo de este artículo es presentar el "Modelo de priorización de pacientes  en Telefarmacia de la Sociedad Española de Farmacia Hospitalaria", que pretende establecer recomendaciones clave y un modelo de priorización de referencia que sirva de orientación a los farmacéuticos especialistas en farmacia hospitalaria para la identificación y priorización de pacientes candidatos a ser incluidos en programas de Telefarmacia. El modelo  a sido desarrollado en base a la experiencia de un grupo de expertos en su práctica clínica y a la revisión de los principales documentos de referencia disponibles en este ámbito y está conformado por un total de 25  criterios, agrupados en 8 criterios mínimos de inclusión, 5 criterios de  continuidad y 12 criterios recomendables. Estos últimos se dividen en criterios  de alta, media y baja prioridad. En función de las puntuaciones obtenidas del  cumplimiento de los criterios recomendables, se establece el orden de  prioridad de pacientes, de modo que aquellos que mayor puntuación obtengan  serán los más prioritarios. Tal como recoge el "Documento de Posicionamiento sobre Telefarmacia de la Sociedad Española de Farmacia Hospitalaria", puede  haber seguimiento farmacoterapéutico por teleconsulta sin envío de medicación, pero no al contrario, por lo que los 25 criterios definidos aplican a  programas de Telefarmacia en el ámbito de la dispensación y entrega informada de medicamentos a distancia, pero solamente 19 de ellos aplican para los programas de seguimiento farmacoterapéutico. El modelo que se  presenta ha sido concebido como un marco de referencia y deberá adaptarse a las características y circunstancias particulares de cada servicio de farmacia,  en función de la demanda y de los recursos disponibles.

Six months multicentre pilot open label single-arm study to evaluate patient experience, acceptability and satisfaction of switching certolizumab pegol from a prefilled syringe or autoinjection pen to an AVA® e-Device in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis patients.

WHAT IS KNOWN AND OBJECTIVE: The study aimed to assess acceptability and patient experience of Certolizumab (CZP) self-injection with AVA® and clarify patient device preference after switching CZP from the syringe or auto-injection pen to AVA® in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients. METHOD: A multicentre open-label, cross-sectional and prospective study among four Spanish hospitals was performed. Adult RA, PsA, axSpA patients treated for at least 6 months with the CZP syringe or pen were recruited. At the first visit, patients completed Pre-AVA® questionnaire. Patients were instructed on proper administration of CZP by AVA®. After 2 and 6 months of CZP self-injections using the AVA®, patient experience, adherence, preference and safety of each administration was assessed using post-AVA® questionnaire. RESULTS AND DISCUSSION: Thirty four patients were included (28 women). All patients self-administered CZP AVA® the full dose of CZP was injected. Patients reported >90% adherence to CZP AVA® assessed with the injection log. Pain at the injection site was reduced after switching to AVA®. Twenty nine patients preferred CZP AVA® and five patients preferred the CZP pen. No safety-related findings related to AVA® CZP administration were identified. WHAT IS NEW AND CONCLUSION: The AVA® is an advantageous delivery option for CZP in patients with RA, PsA, axSpA.

Modelo de priorización de pacientes en Telefarmacia de la Sociedad Española de Farmacia Hospitalaria / The Telepharmacy patient prioritisation model of the Spanish Society of Hospital Pharmacy

La Sociedad Española de Farmacia Hospitalaria, en su Documento de Posicionamiento sobre Telefarmacia, establece que la inclusión de pacientesdebe tener en cuenta consideraciones éticas y, por tanto, estar basada enel concepto de equidad. Por ello, establece que la Telefarmacia no deberestringirse por patologías ni medicamentos, sino en función de las necesidades individuales de cada paciente, y destaca la necesidad de apoyarseen modelos de selección o priorización que ayuden en la identificaciónde los pacientes que puedan beneficiarse de la Telefarmacia. El objetivode este artículo es presentar el “Modelo de priorización de pacientes enTelefarmacia de la Sociedad Española de Farmacia Hospitalaria”, quepretende establecer recomendaciones clave y un modelo de priorizaciónde referencia que sirva de orientación a los farmacéuticos especialistas enfarmacia hospitalaria para la identificación y priorización de pacientescandidatos a ser incluidos en programas de Telefarmacia. El modelo hasido desarrollado en base a la experiencia de un grupo de expertos en supráctica clínica y a la revisión de los principales documentos de referenciadisponibles en este ámbito y está conformado por un total de 25 criterios,agrupados en 8 criterios mínimos de inclusión, 5 criterios de continuidad y 12 criterios recomendables. Estos últimos se dividen en criterios de alta,media y baja prioridad. En función de las puntuaciones obtenidas del cumplimiento de los criterios recomendables, se establece el orden de prioridadde pacientes, de modo que aquellos que mayor puntuación obtengan seránlos más prioritarios. (AU)

The Spanish Society of Hospital Pharmacy Position Paper on Telepharmacy states that the inclusion of patients should take into account ethicalconsiderations and, therefore, be based on the concept of equity. Thus,it establishes that Telepharmacy should not be limited to specific pathologies or medicines, but should be based on the individual needs of eachpatient: it also highlights the need to rely on selection or prioritisationmodels to help identify patients who can benefit from Telepharmacy. Theaim of this article is to present the Spanish Society of Hospital PharmacyTelepharmacy Patient Prioritisation Model, which establishes key recommendations and a reference prioritisation model to guide hospital pharmacists in the identification and prioritisation of patients who are candidatesfor inclusion in Telepharmacy programmes. This model was developedbased on the experience of a group of experts in their clinical practiceas well as on a review of the main reference documents available in thisfield. It comprises 25 criteria, grouped into 8 minimum inclusion criteria,5 continuity criteria, and 12 recommended criteria. The latter criteria aredivided into high, medium, and low priority criteria. Patients are prioritisedaccording to their scores on meeting the recommended criteria, such that those with the highest scores are given the highest priority. (AU)