RESUMO
Objetivo: Valorar si un programa de atención farmacéutica integrada (PAFI) en pacientes crónicos mejora la evolución clínica, la calidad de vida de los pacientes y disminuye el consumo de recursos sanitarios. Material y métodos Ensayo clínico, paralelo, abierto y multicéntrico de un PAFI en pacientes con insuficiencia cardiaca (IC) y/o enfermedad pulmonar obstructiva crónica (EPOC) en 8 áreas de salud de Cataluña. Al paciente en intervención le realizaban seguimiento farmacoterapéutico los farmacéuticos de hospital, atención primaria y farmacia comunitaria. Al control, seguimiento habitual. Todos los pacientes fueron seguidos 12 meses y se les realizó un test de calidad de vida al inicio y final del seguimiento. Resultados Participaron 8 hospitales, 8 centros de atención primaria y 109 farmacias comunitarias. Finalizaron el estudio 238 pacientes con un porcentaje de pérdidas del 2,9%. No hubo diferencias significativas en reingresos, visitas al médico o urgencias. Se detectaron 50 problemas relacionados con medicamentos (PRM) en 37 pacientes, siendo estadísticamente significativa la diferencia de PRM entre el grupo intervención y control en pacientes con IC y casi significativa en pacientes con EPOC. El 36% de los PRM fueron moderados-graves. El 94% PRM fueron evitables y el farmacéutico los resolvió en el 90% de los casos. No hubo diferencias entre la calidad de vida al inicio y final del estudio ni en el consumo de recursos sanitarios. Conclusiones Los programas de atención farmacéutica integrada permiten la mejora de la calidad asistencial al paciente, no obstante es necesaria la utilización de registros electrónicos que faciliten la comunicación entre niveles asistenciales (AU)
Objectives: To assess whether an integrated pharmaceutical care programme (IPCP) improvesclinical evolution, patient quality of life, and reduces health costs in chronic patients. Material and methods: A parallel, open, and multi-centre clinical trial of an IPCP in patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD) in 8 different health areas in Cataluña. The intervened patient was monitored for pharmacotherapeutic evolution by hospital pharmacists, primary care physicians, and community pharmacists. Controls received normal follow-up. All patients were monitored for 12 months, with quality of life tests administered at the beginning and end of follow-up. Results: We had the participation of 8 different hospitals, 8 primary care centres, and109 community pharmacies. 238 patients completed the study, with 2.9% of participants lost during the study period. There were no significant differences in terms of readmissions, visits to the doctors, or to emergency services. We detected 50 different medication-related problems(MRP) in 37 patients, with a statistically significant difference in terms of MRP between the control and treatment groups of patients with HF, and almost significant differences in COPD patients. MRP were moderate-severe in 36% of cases. MRP were avoidable in 94% of cases, and the pharmacist resolved the issue in 90% of cases. There were no differences in terms of patient quality of life or health costs between the start and end of the study. Conclusions: Integrated pharmaceutical care programs facilitate an improvement in the quality of patient care, but electronic registries are necessary to promote communication between sections of the health care network (AU)
Assuntos
Humanos , Doença Crônica/tratamento farmacológico , Polimedicação , Assistência Farmacêutica , Prescrição Eletrônica , Continuidade da Assistência ao Paciente/organização & administração , Quimioterapia Assistida por Computador/métodosRESUMO
OBJECTIVES: To assess whether an integrated pharmaceutical care programme (IPCP) improves clinical evolution, patient quality of life, and reduces health costs in chronic patients. MATERIAL AND METHODS: A parallel, open, and multi-centre clinical trial of an IPCP in patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD) in 8 different health areas in Cataluña. The intervened patient was monitored for pharmacotherapeutic evolution by hospital pharmacists, primary care physicians, and community pharmacists. Controls received normal follow-up. All patients were monitored for 12 months, with quality of life tests administered at the beginning and end of follow-up. RESULTS: We had the participation of 8 different hospitals, 8 primary care centres, and 109 community pharmacies. 238 patients completed the study, with 2.9% of participants lost during the study period. There were no significant differences in terms of readmissions, visits to the doctors, or to emergency services. We detected 50 different medication-related problems (MRP) in 37 patients, with a statistically significant difference in terms of MRP between the control and treatment groups of patients with HF, and almost significant differences in COPD patients. MRP were moderate-severe in 36% of cases. MRP were avoidable in 94% of cases, and the pharmacist resolved the issue in 90% of cases. There were no differences in terms of patient quality of life or health costs between the start and end of the study. CONCLUSIONS: Integrated pharmaceutical care programs facilitate an improvement in the quality of patient care, but electronic registries are necessary to promote communication between sections of the health care network.
