[Effect of pharmacist involvement in adherence to medications in patients with high to moderate cardiovascular risk (Study EMDADER-CV-INCUMPLIMIENTO)]. / Efecto de la actuación farmacéutica en la adherencia del tratamiento farmacológico de pacientes ambulatorios con riesgo cardiovascular (Estudio EMDADER-CV-INCUMPLIMIENTO).

OBJECTIVE: To evaluate the effect of pharmacist involvement, by means of Pharmacotherapy Follow-Up (PFU) in the improvement of medication adherence and therapeutic outcomes. DESIGN: An experimental, controlled, and randomised clinical study comparing a PFU program with the routine process in Spanish community pharmacies improved with health education during 8 months. SETTING: Nine Spanish community pharmacies. PARTICIPANTS: Patients between 25 and 74 years with a moderate-high cardiovascular risk (CVR), who arrived with a prescription, in their name, for drugs for at least one CVR factor. INTERVENTIONS: The patients were randomly assigned to the intervention group (IG), and received PFU and health education, or the control group (CG), who received health education only. MAIN MEASUREMENTS: Adherence to treatment, and blood pressure (BP) and total cholesterol (TC) levels at the beginning and end of the study. RESULTS: Of the 87 patients enrolled, 85 finished the study: 41 from the CG and 44 from the IG. Both groups increased adherence at the end of the [CG: 26.9%; 95% CI: 12.7- 41; IG: 27.3%; 95% CI: 13.6 - 41]. Although the IG showed better results in the variation of BP and TC levels, the differences compared to the CG were not statistically significant. CONCLUSIONS: PFU and health education improves adherence to treatment. To be a patient who completes the study is also associated with improvement in the blood pressure and blood pressure/total cholesterol objectives.

[Adherence to codes of conduct for biomedical information on the internet in useful websites for pharmacotherapy follow-up]. / Adecuación a los códigos de conducta para información biomédica en internet de sitios web útiles para el seguimiento farmacoterapéutico.

OBJECTIVES: To assess adherence to four codes of conduct in websites providing information useful for pharmacotherapy follow-up. METHODS: We performed a descriptive study of adherence to quality criteria in 19 websites. These sites had been identified in a previous study as being those most frequently used by pharmacists. A descriptive analysis was performed and the kappa coefficient was calculated to evaluate interrater concordance (Fleiss' criteria for evaluation of the kappa index). RESULTS: The most highly rated source of clinical practice guidelines and that which adhered most closely to the 4 codes of conduct was Fisterra. The websites most highly rated in reviews and secondary sources were the Cochrane Library and PubMed. The most highly rated journals were JAMA and the BMJ, followed by Atención Primaria and Medicina Clínica. Among drug information guides, the highest scores were obtained by BOT and Martindale's. The highest rated drug bulletins were the Boletín Terapéutico Andaluz and Butlletí Groc. The most highly rated agency was the World Health Organization. The journals with the lowest scores were Pharmaceutical Care and Seguimiento Farmacoterapéutico followed by the Spanish Internacional Vademecum MediMedia-Medicom. According to Fleiss's criteria, interrater concordance was acceptable for the 4 codes. CONCLUSIONS: The quality of the web sites evaluated varied widely, although most received scores of more than 60 points (out of 100) in the 4 codes of conduct used for evaluation.