Navigating the journey as a peer reviewer: a roadmap to success.

Peer review is an essential step in scientific progress and clinical improvement, providing opportunity for research to be critically evaluated and improved by one's colleagues. Pharmacists from all job settings are called to serve as peer reviewers in the ever-growing publication landscape of the profession. Despite challenges to engagement such as time and compensation, peer review provides considerable professional development for both authors and reviewers alike. This article will serve as a practical guide for peer reviewers, discussing best practices as well as the handling of different situations that may arise during the process.

Evaluation of Clinical Communication in Pharmacy Undergraduates in Brazil: A Multicentric Study.

OBJECTIVE: To assess the clinical communication characteristics of pharmacy undergraduates, estimate differences in this specific competency, and produce recommendations for further education and training. METHODS: Analysis of communication competence between 110 pharmacy students in the last graduation year from each of the 5 Brazilian regions and a simulated patient with complaints of mild allergic rhinitis passive of resolution with non-prescription medicines. The simulated appointment was recorded, and the video was analyzed using the 2 main elements: biomedical/task-focused and socio-emotional exchange of the Roter Interaction Analysis System. RESULTS: The total of utterances/speech from the pharmacist to the patient was 183.4; there was a statistically significant difference according to the Brazilian region. In the consultation, the frequency with which pharmacy students returned to the segment was evaluated, with a total mean clinical history segment 2 of mean 5.60; in segment 4, which is the counseling phase, an average of 4.80. In the task codes and the socio-emotional codes, there was a statistically significant difference between the codes when compared by region. We compare by sex because it is said that women talk more than men. There was a statistically significant difference in socio-emotional code and biomedical/focused and task being higher for women. CONCLUSION: The level of communication competence of students should be that desired for graduation, in all regions. There seems to be a difference between training and level of competence. Considering gender, although the consultation time is similar, it appears that the quality of communication is higher for women.

Are images worth a thousand words? A preliminary study testing a video for owner education in canine atopic dermatitis.

BACKGROUND: Successful management of canine atopic dermatitis (cAD) is challenging and effective pet owner education is crucial to successful outcomes. However, there are limited proven educational strategies in this area. Our goal was to create an effective and engaging educational tool for owners of dogs with cAD. HYPOTHESIS: Video-based education efficacy would be comparable to traditional verbal delivery. Secondary objectives included assessing client perception of the intervention, and determining if there were clinical benefits for the dogs and improved client adherence to treatment. SUBJECTS: Twenty-nine dogs with cAD and their owners were recruited from a teaching hospital of a European veterinary medicine faculty. MATERIALS AND METHODS: In this 8 week, prospective, randomised controlled study, clients in the control group (CG, n = 13) received verbal education and those in the intervention group (IG, n = 16) watched a video. Client knowledge was assessed at Day (D)0 and D56. Treatment adherence and perceived utility and appeal ratings were measured at D56. Clinical progress was assessed at D0 and D56 using CADESI-04 and PVAS10. RESULTS: The differences found in the means of cAD knowledge score, clinical outcomes, utility and appeal ratings and owners' adherence score between groups were not statistically significant. A significant association between the outcome and the intervention group concerning education success [CG, six of 13 (46.15%); IG, 15 of 16 (93.75%)] was found (p = 0.01). CONCLUSIONS AND CLINICAL RELEVANCE: Video-based instructions positively impacted owners' education and demonstrated their potential as a valuable tool. The authors believe that video-based education could be a time-efficient alternative for initial cAD education in veterinary clinics.

Documentation and classification of hospital pharmacist interventions: A scoping review.

The practice of documenting pharmacist interventions (PIs) has been endorsed by many hospital pharmacists' societies and organizations worldwide. Current systems for recording PIs have been developed to generate data on better patient and healthcare outcomes, but harmonization and transferability are apparently minimal. The present work aims to provide a descriptive and comprehensive overview of the currently utilized PI documentation and classification tools contributing to increased evidence systematization. A systematic literature search was conducted in PubMed, Scopus, Web of Science and the Cumulative Index to Nursing and Allied Health Literature. Studies from 2008, after the release of the Basel Statements, were included if interventions were made by hospital or clinical pharmacists in a global hospital setting. Publications quality assessment was accomplished using the Mixed Methods Appraisal Tool. A total of 26 studies were included. Three studies did not refer to the documentation/classification method, 10 used an in-house developed documentation/classification method, seven used externally developed documentation/classification tools and six described method validation or translation. Evidence confirmed that most documentation/classification systems are designed in-house, but external development and validation of PI systems to be used in hospital practice is gradually increasing. Reports on validated PI documentation/classification tools that are being used in hospital clinical practice are limited, including in countries with advanced hospital pharmacy practice. Needs and gaps in practice were identified. Further research should be conducted to understand why using validated documentation/classification methods is not a disseminated practice, knowing patients' and organizational advantages.

Defining and supporting a professional role for pharmacists associated with traditional and complementary medicines: a cross-country survey of pharmacists.

Introduction: An estimated 80% of the world's population use traditional and complementary medicine (T&CM) products as part of their healthcare, with many accessed through pharmacy. This cross-cultural study posed a set of professional practice responsibilities and actions to pharmacists related to T&CM products, with a view toward developing consensus, safeguarding, and promoting the health of the public. Methods: Data were collected from 2,810 pharmacists across nine countries during 2022 via a cross-sectional online survey reported in accordance with the guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) and the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Of the 2,810 participants from nine countries, 2,341 completed all sections of the survey. Of these, most agreed (69%) that T&CM product use was common in the community they served, but most did not have adequate training to support consumer needs. Over 75% acknowledged that there were known and unknown safety risks associated with T&CM use. Of 18 professional responsibilities posed, 92% agreed that pharmacists should be able to inform consumers about potential risks, including T&CM side effects and drug-herb interactions. The provision of accurate scientific information on the effectiveness of T&CM products, skills to guide consumers in making informed decisions, and communication with other healthcare professionals to support appropriate and safe T&CM product use were all ranked with high levels of agreement. In order to effectively fulfill these responsibilities, pharmacists agreed that regulatory reforms, development of T&CM education and training, and access to quality products supported by high-quality evidence were needed. Conclusion: General agreement from across nine countries on eighteen professional responsibilities and several stakeholder actions serve as a foundation for the discussion and development of international T&CM guidelines for pharmacists.

Older people, medication usage and long-term care pharmacists: a retrospective cohort study.

OBJECTIVE: To investigate the impact of the presence of a pharmacist on medication usage in long-term care facilities. METHODS: The study followed a retrospective cohort design, with a sample of patients aged ≥65 years admitted to three long-term care facilities over 30 months. Data on age, gender, type of stay, the presence or absence of a pharmacist and pharmacotherapeutic profile at admission and discharge were obtained for study patients. Variations in the number of medicines, anticholinergic burden and potentially inappropriate medications at admission and discharge were assessed as outcome variables. Anticholinergic burden and potentially inappropriate medications were assessed using the Anticholinergic Cognitive Burden scale and the EU(7)-PIM List, respectively. One-sample t-tests were used to compare the mean values of the outcome variables. A four-way ANOVA was used to test the association between background and outcome variables. Partial eta squared (η2) was used to measure the effect size. RESULTS: A total of 1366 patients were studied. All outcome variables showed a statistically significant increase at discharge compared with admission. The presence of a pharmacist was statistically significant in improving the number of medicines (p<0.001) and the anticholinergic burden score (p<0.001), while no statistically significant value was reached on potentially inappropriate medications (p=0.642). Small effect size values were obtained for the impact of the pharmacist on the number of medicines and anticholinergic burden scores (η2=0.021 and η2=0.011, respectively). CONCLUSION: These findings suggest that the presence of a long-term care pharmacist can positively impact the use of medication associated with poor health outcomes. An integrated interprofessional approach is needed to address potentially inappropriate medications, anticholinergic burden and polypharmacy in long-term care settings, particularly at the time of discharge.

A qualitative study on female executive pharmacists with convergent roles.

BACKGROUND: Although women's participation is relatively high in the pharmacist workforce, women remain underrepresented in executive positions. The rate of executive female pharmacists in diversified pharmaceutical areas, from education and research to politics, is recognized as being disproportionately low. OBJECTIVES: In this study, we aimed to explore female executive pharmacists' roles and identify reasons for their being underrepresented in such executive positions in Turkey. METHODS: Semistructured in-depth interviews were conducted from a feminist standpoint with female executive delegates working in the Grand National Assembly of Turkey, pharmacy chambers, and public pharmacy faculties. A thematic data analysis of transcriptions was conducted using MAXQDA 2020 software and was reported according to Consolidated Criteria for Reporting Qualitative Research. RESULTS: The researchers interviewed 19 participants. Three primary themes emerged: gender roles, being an executive, and being a pharmacist. Eight roles came to the surface: mother, child, wife, pharmacist, manager, homemaker, cook, and planner. Taking the responsibility for an executive position involves a continued and simultaneous performance of all other roles as well. CONCLUSION: In this context, female pharmacists' views on gender roles in relation to motherhood, inequalities, and their dedication to their profession came to the fore. This study can be considered as a starting point for studying the underlying causes of the limited representation of female pharmacists in executive positions.

Clinical Communication Within Hospital Pharmacy Practice: Exploring Pharmaceutical Oncological Consultations.

This exploratory study aimed to identify communication trends typical of pharmacists' clinical communication in the context of hospital consultations. A cross-sectional design was used to investigate the pharmacist-patient exchange, applying the Roter Interaction Analysis System (RIAS). Communication variables and RIAS composites were assessed, including therapeutic information complexity, estimated through the ad-hoc score CTICS (Cancer Therapy Information Complexity Score). The study comprised 13 consultations of cancer patients with one female pharmacist, of which 6 included a patient family member, lasting on average 22.74 minutes and presenting repeated or overlapping consultation phases. The pharmacist's talk dominance reached 53.49%, slightly higher in dyadic consultations (U = 6.0, p = .032), and with an overall predominance of closed-ended questioning (W = 81.0, p = .013). Patients' questioning on biomedical issues was higher in dyadic consultations. The level of the pharmacist's rapport-building with the relative was higher when the patient's age was ≥80 years. Several strong correlations, both positive and negative, were found between composites, including between patient positive rapport-building and relative lifestyle/psychosocial information giving (Rho = -0.971, p = .001). Pharmaceutical consultations seem to be lengthier than other hospital practitioners' interviews, indicating a lack of  clear organization and flow, thus challenging their efficiency regarding therapy management. Still, several positive communication features were found regarding the pharmaceutical care of older cancer patients. Further studies are needed, involving larger samples and other hospital consultation settings.

Long-term care professionals' views on pharmacists: a qualitative study using Role Theory.

BACKGROUND: Qualitative research investigating pharmacists' participation in Long-Term Care (LTC) within interdisciplinary teams is scarce. AIM: To characterize how pharmacists' participation in a national network of LTC is perceived by healthcare professionals and other key stakeholders. METHOD: Individual, in-depth, semi-structured interviews of participants (nurses, physicians, pharmacists, and LTC researchers) enrolled purposively or through snowballing sampling techniques, with the final sample being comprised of fourteen participants. Data analysis followed a deductive coding approach framed by Role Theory and supplemented with an inductive coding for additional themes. RESULTS: Four Role Theory constructs were identified from the primary data-role identity, overqualification, ambiguity, underqualification. Clinical pharmacy services, logistics and educational activities were pointed out as representing the identity of pharmacists' interventions. Despite the clear identification of LTC pharmacists' interventions, pharmacist expertise on medicine optimization seemed to be underused (role overqualification), as a result of lack of time, lower proactivity in healthcare teams' integration, and the absence of a legal framework targeted to LTC pharmacy practice (role ambiguity). Additional clinical training, including in the management of older people's health conditions, nutrition, and palliative care were missing (role underqualification). CONCLUSION: LTC pharmacists can provide essential services (e.g., clinical pharmacy, logistics, educational interventions), although additional training and a clearer legal framework are missing to better define pharmacists' roles in LTC pharmacy practice.

Long-Term Care medicines formularies: any reasons for pharmacists' concern?

Abstract This study aimed to characterize and compare medicines formularies (MFs) used in Long-Term Care (LTC) facilities in Portugal, and to identify the prevalence of Potentially Inappropriate Medicines (PIMs). A systematic contact with LTC facilities was undertaken in December 2021. MFs were systematized according to the Anatomical Therapeutical Chemical classification system (ATC), followed by descriptive content analysis. A structured comparison between MFs developed by public organizations and private LTC facilities was performed. After duplicate removal and exclusion of medicines not for systemic use, two explicit criteria - the Algorithm of medication review in frail older people and the EU(7)-PIM list - were employed for PIMs identification. Five MFs were obtained and assessed. The three MFs developed by private institutions covered 23% of the national LTC facilities and approximately 34% of the national total of beds. Heterogeneity was particularly high for the Alimentary tract and metabolism, Blood and blood-forming organs, Musculoskeletal system, and Respiratory system ATC groups. A PIM prevalence of 29,4% was identified. Medicines distribution between the MFs suggests the need to develop national guidelines towards harmonizing medicines usage in LTC. The prevalence of PIMs found highlights the importance of a particular optimized use of this health technology in aged sub-populations

Systematic literature review of adopting eHealth in pharmaceutical care during COVID-19 pandemic: recommendations for strengthening pharmacy services.

OBJECTIVES: The study aimed to determine how eHealth was adopted in pharmaceutical care (PC), the outcome reported and the contextual factors. DESIGN: Systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES: Literature was searched in six databases including PubMed, Scopus, Medline, Web of Science, Science Direct and China National Knowledge Infrastructure. ELIGIBILITY CRITERIA: Studies which reported the usage experiences of eHealth in any aspects of PC by pharmacists during the COVID-19 pandemic, written in English or Chinese, and published in peer-reviewed journals between December 2019 and March 2022 were included. Opinion articles, conference abstracts, correspondence, letters and editorials were excluded. DATA EXTRACTION AND SYNTHESIS: The literature search was completed on 15 April 2022. Two researchers independently conducted the literature search and extracted the data into an Excel table informed by the logic model with the key components of goals, input, activities, output and contextual factors. RESULTS: Forty-three studies were included in this review. During the COVID-19 pandemic, hospital pharmacists, community pharmacists and specialist pharmacists in 17 countries continued to educate, consult, monitor and manage the patients and the general public via phone calls, videoconferences, mobile applications, social media, websites and/or enhanced interoperability of electronic medical records. Assuring the continuity of pharmacy care, reduced need for hospital visits, and improved work accuracy and efficiency were the benefits of eHealth mostly reported. Contextual factors affecting the adoption of eHealth were multifaceted, prompting supporting actions at the levels of government, hospital/pharmacy, pharmacists and patients. CONCLUSION: This study revealed the wide adoption of eHealth in PC during the pandemic and the emerging evidence for its importance. Proper adoption of eHealth will help reshape the mode of pharmacy services to ensure continuity, quality and efficiency of care amid the challenges of the pandemic. PROSPERO REGISTRATION NUMBER: CRD42022299812.

Selenium and Redox Enzyme Activity in Pregnant Women Exposed to Methylmercury.

Selenium (Se) is a micronutrient with essential physiological functions achieved through the production of selenoproteins. Adequate Se intake has health benefits and reduces mercury (Hg) toxicity, which is important due to its neurotoxicity. This study determined the Se status and redox enzyme, including selenoproteins', activity in pregnant women highly exposed to Hg (between 1 to 54 µg Hg/L blood) via fish consumption. A cross-sectional study enrolling 513 women between the first and third trimester of pregnancy from Madeira, Portugal was conducted, encompassing collection of blood and plasma samples. Samples were analyzed for total Se and Hg levels in whole blood and plasma, and plasma activity of redox-active proteins, such as glutathione peroxidase (GPx), thioredoxin reductase (TrxR) and thioredoxin (Trx). Enzyme activities were related to Se and Hg levels in blood. Se levels in whole blood (65.0 ± 13.1 µg/L) indicated this population had a sub-optimal Se status, which translated to low plasma GPx activity (69.7 ± 28.4 U/L). The activity of TrxR (12.3 ± 5.60 ng/mL) was not affected by the low Se levels. On the other hand, the decrease in Trx activity with an increase in Hg might be a good indicator to prevent fetal susceptibility.

The principles of person-centredness in quality patient care-Evaluation of the Community Pharmacy Services Quality Guidelines in Estonia.

INTRODUCTION: Person-centredness is considered a key component of quality healthcare and the core competence of all healthcare professionals. However, person-centred care (PCC) is not often considered a priority for improving the quality of healthcare. This study aimed to evaluate to what extent the PCC principles are included in the Community Pharmacy Services Quality Guidelines (CPSQG) in Estonia. METHODS: The deductive content analysis was performed using the PCC framework developed by Santana et al. RESULTS: Approximately 2/3 (n = 78) of the CPSQG indicators (n = 126) in the practical guide used in Estonian community pharmacies support PCC principles. These results demonstrate that quality service itself includes some PCC components, as it forms an integral part of quality care and is directly related to its development. More than half (61.6%) of the CPSQG indicators were divided into process (covering the interaction of pharmacists and patients), one fourth into structure (mainly represented as environment and operation topics), and one tenth into outcome category (access to care). This result is in line with the situation of pharmacies in Estonia, where the current focus is on developing and implementing quality services (e.g., quality guidelines, e-tools supporting dispensing, restructuring of counselling area for private consultations) and finding the necessary resources for described activities. CONCLUSIONS: To support a more effective application of PCC principles in the community pharmacy practice, the CPSQG should be supplemented with indicators identifying patients' individual preferences, values, and needs. Additionally, interactions with other healthcare professionals should be encouraged, and they should be engaged in developing the CPSQG.

Exploring Muslims' Health-Related Behaviours in Portugal: Any Impact on Quotidian Community Pharmacy Practice?

Muslims are a growing community in European countries. General health habits, including therapy-related behaviours, have been described, though implications to pharmacy practice might vary with the local dominant culture and setting. This exploratory study aimed to describe Muslims' prevalent health and medication-related practices and possible implications for culturally competent community pharmacy practice. A descriptive cross-sectional survey was administered to a convenient sample of 100 participants at Lisbon Central Mosque, Portugal. Demographics, dietary, Traditional Arabic and Islamic Medicine (TAIM) and religious practices were examined, including health conditions and conventional biomedical treatments. Participant reported ailments (26%) were aligned with prevalent conditions in the general population. Ill participants were significantly associated with TAIM and Islamic dictates (p < 0.05), particularly Zam-Zam water and milk thistle usage. Participants' orientation to dietary options and Qur'an restrictions were observed regarding forbidden substances in medication, raising issues on medication adherence for some oral dosage forms. TAIM and religious beliefs supplement illness recovery and health improvement instead of replacing conventional healthcare in a religious minority well integrated within the dominant culture. Portuguese community pharmacists should not neglect religious specificities if seamless care is delivered, enhancing professionals' collaboration skills with multicultural patients.

Exploring the use of cognitive enhancement substances among Portuguese university students.

Background: Prescription drug use and the consumption of substances to enhance college students' cognitive performance, described as pharmacological cognitive enhancement (PCE), is a known phenomenon potentially impacting individuals' health. University and college students are two specific subpopulations noted to use PCE (up to 17%, on average). To our knowledge, no data have been published on the use of PCE drugs among university students at a national level in Portugal and the factors that might be associated with this usage. Objective: The main objective was to estimate the prevalence of PCE use by Portuguese university students and to identify the PCE substances commonly used by university students, i.e., those classified as prescription drugs and other legal and nonprescribed substances, including food supplements. Methods: The study followed a cross-sectional exploratory, descriptive design and pursued a convenience sample of students from Portuguese public and private universities (22 higher education institutions). Results: From a sample of 745 university students, 32% indicated the use of prescribed and nonprescribed substances. The most consumed substances were food supplements with CNS stimulants being the most frequent prescription-only drugs but not necessarily accessed through a medical prescription. A significant statistical association was found between substance consumption and the field of study. Health science students reported more food supplements and drug intake, allegedly under prescribed regimens, compared to humanities and exact sciences students. The study discusses the need to better understand the competitive societies that produce and support young students' outputs and the perceived 'need' for performance-enhancing substances. Conclusions: One-third of the university students aimed to improve their performance by pharmacological cognitive enhancement, with a preference for food supplements dispensed in pharmacies. PCE substance consumption in higher education is thus non-negligible. The study suggests the need to improve regulations on potential inequalities in academic rankings and success and an observant attitude concerning implications that negatively affect health in the long run.

Prescribing-Assessment Tools for Long-Term Care Pharmacy Practice: Reaching Consensus through a Modified RAND/UCLA Appropriateness Method.

Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a modified RAND/UCLA Appropriateness Method, 13 long-term care and hospital pharmacists assessed as 'appropriate', 'uncertain', or 'inappropriate' a collection of commonly used prescribing-assessment tools as to its suitability in assisting pharmacy practice in institutional long-term care settings. A qualitative analysis of written or transcribed comments of participants was pursued to identify relevant characteristics of prescribing-assessment tools and potential hinders in their use. From 24 different tools, pharmacists classified 9 as 'appropriate' for pharmacy practice targeted to long-term care patients, while 3 were classified as 'inappropriate'. The tools feature most appreciated by study participants was the indication of alternatives to potentially inappropriate medication. Lack of time and/or pharmacists and limited access to clinical information seems to be the most relevant hinders for prescribing-assessment tools used in daily practice.

Profession Driven Improvement of the Quality of Pharmacy Practice-Implementation of Community Pharmacy Services Quality Guidelines in Estonia.

Constant improvement of the quality of community pharmacy services is important in the development of contemporary patient care. A national and voluntary Community Pharmacy Services Quality Guidelines (CPSQG) was developed to formulate the principles of contemporary pharmacy services, including quality criteria for service provision. The purpose of this study was to identify the implementation of the CPSQG as a profession-driven initiative towards improving and harmonizing community pharmacy services in Estonia. Three cross-sectional electronic surveys were conducted among community pharmacies in Estonia in 2014 (N = 478 pharmacies), 2016 (N = 493), and 2019 (N = 494), and the CPSQG indicators were used for evaluation of the service quality. In this study, the aggregated data, collected in three study years were used to identify the implementation of guidelines into practice. For data analysis, the One-Way ANOVA test and Post-hoc multiple comparisons were used. The results demonstrated slow implementation of the CPSQG, but guidelines-based evaluation enabled a detailed overview of the community pharmacy activities and provided services. In order to develop community pharmacy services more efficiently, the use of implementation science principles, continuous introduction of the CPSQG to the pharmacists, and more active involvement of the state could be considered in the future.

Analysis of Medical Device Alerts Issued by the Portuguese Medicines Agency: Scoping the Purpose of New Regulatory Recommendations.

INTRODUCTION: Medical devices are healthcare technologies with a significantly growing market worldwide. This study aims to analyze medical device alerts issued by the Portuguese Medicines Agency, INFARMED, I.P. during 2017, as well as to identify the respective regulatory actions and to suggest additional recommendations. MATERIAL AND METHODS: All alerts on medical device alerts publicly available in the website of INFARMED, I.P. were identified and analyzed, including actions taken. Additionally, reports on medical devices from the Portuguese national competent authorities were compared with reports from other European Union member states such as Germany. RESULTS: A total of 32 safety alerts were identified: 18 (56%) related with devices without identified records of commercialization in Portugal, six (19%) related with devices voluntarily withdrawn from the market, such as counterfeit products, and eight (25%) categorized as 'other'. In both Portugal and Germany, 0.28 and 4.53 reports of national competent authorities per million inhabitants were identified, respectively. Diverse regulatory actions were taken, such as six compulsory indications to not acquire or use devices. DISCUSSION: Considering that the European Union is an open market where citizens should have equal access to medical devices, the Portuguese system of medical device safety alerts seems to be functioning normally. The identified safety alerts seemed relevant, with Portugal registering a proportionally slightly lower number of alerts when compared with higher sales volume markets, which may be explained by an underreporting of this type of problems. Further studies are needed to confirm these preliminary results, although the development of databases comprising data on patients using medical devices is recommended in order to generate automatic email and text message alerts. CONCLUSION: A limited number of safety alerts on medical devices was identified in Portugal, with few reported cases of counterfeit or falsified devices. The Portuguese Medicines Agency contributes to the citizens' access to quality medical devices, by issuing safety alerts, recommendations and mandatory market withdrawals for unsuitable or unsafe medical devices.

Introdução: Os dispositivos médicos são tecnologias de saúde com um significativo crescimento a nível mundial. Foi objetivo deste trabalho analisar os alertas sobre dispositivos médicos emitidos pela Agência Portuguesa do Medicamento: INFARMED, I.P. durante 2017, identificar as respetivas ações regulatórias e sugerir recomendações. Material e Métodos: Todos os alertas e ações sobre dispositivos médicos publicamente disponíveis no website do INFARMED, I.P. foram identificados e analisados. Adicionalmente, os relatórios da autoridade competente nacional sobre dispositivos médicos foram comparados com relatórios de outros países da União Europeia como a Alemanha. Resultados: Identificou-se um total de 32 alertas de segurança de dispositivos médicos: 18 (56%) sem registos de comercialização em Portugal, seis (19%) voluntariamente retirados do mercado, como produtos contrafeitos, e oito (25%) categorizados como 'outros'. Em Portugal e na Alemanha foram identificados 0,28 e 4,53 relatórios de autoridades competentes por milhão de habitantes, respetivamente. Diversas ações regulamentares foram tomadas, como seis indicações obrigatórias para não adquirir ou utilizar dispositivos médicos. Discussão: Considerando que a União Europeia é um mercado aberto no qual os cidadãos detêm igual acesso à utilização de dispositivos médicos, o sistema Português de alertas de segurança sobre estes dispositivos parece ter uma atividade normal. Os alertas de segurança identificados aparentam ser relevantes, com Portugal a registar um número ligeiramente inferior de alertas quando proporcionalmente comparado com outros mercados de maior volume de vendas, o que eventualmente pode ser explicado por uma subnotificação deste tipo de problemas. São necessários estudos adicionais para confirmar estes resultados preliminares, sendo o desenvolvimento de bases de dados sobre o uso de dispositivos médicos pelos doentes recomendado de forma a gerar emails e alertas telefónicos automáticos. Conclusão: Foi identificado um número limitado de alertas de segurança em dispositivos médicos em Portugal, com escassas notificações de contrafação ou falsificação. A Agência Portuguesa de Medicamentos contribui para o acesso dos cidadãos a dispositivos médicos de qualidade, através da emissão de alertas de segurança, recomendações e retirada obrigatória de dispositivos médicos inadequados ou inseguros do mercado.

Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease.

BACKGROUND: Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies. METHODS: The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases. RESULTS: Twenty-seven competency statements, were presented in Round 1 to the Delphi panel. Consensus was achieved for all statements. Based on comments, two statements were removed, one was added, and 14 were modified. All 15 statements subjected to Round 2 were consensus-approved, yielding a total of 12 foundational competencies for behaviour change in self-management of chronic disease and 14 behaviour change competencies. Four behaviour change competencies related to BCTs. Behavioural psychologists' feedback led to a core set of 21 BCTs deemed applicable to the five target behaviours across the seven chronic diseases. CONCLUSIONS: A behaviour change competency framework comprising 26 statements for European health and other professionals to support self-management of chronic disease was developed, linked with a core set of 21 BCTs from an established taxonomy.

Probing pharmacists' interventions in Long-Term Care: a systematic review.

PURPOSE: Long-Term Care (LTC) systems have experienced recent developments driven by changes in healthcare and demography (e.g. population ageing). As well, pharmacists are changing from traditional roles to more patient-oriented services. The present study aimed to identify and assess pharmacists' and/or pharmacy-based interventions in institutional LTC settings, also mapping relevant medications. METHODS: The review was undertaken in general accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using three main literature databases (PubMed, Scopus, and Web of Knowledge). A set of 16 keywords, divided into three domains (professional, type of care and type of setting), were combined into search equations. Selected studies were assessed through the Quality Assessment Tool for Quantitative Studies. RESULTS: Twenty-six studies met the inclusion criteria, out of 794 initial hits. Most studies (12) described pharmacist/pharmacy-driven interventions assessing Medication Management Reviews' impact in different endpoints or outcomes. Other studies (3) assessed pharmacists' interventions on specific medication groups. Good Administration Practices, new pharmaceutical care models, antibiotic stewardship programs, and studies assessing other pharmacists' interventions, such as pharmacy-managed informatics and education, were addressed by 11 other papers. Six studies were classified as Strong after quality assessment. CONCLUSION: LTC is a clinically complex type of care benefiting from interdisciplinary work. Despite the overall lower quality of the identified studies, pharmacists perform in a wide array of LTC areas. The broad implementation of pharmaceutical activities in institutional LTC settings opens opportunities to optimise medicines' use.