Encuesta de la SEFAP sobre la Farmacia de Atención Primaria y la Ley 29/2006 de garantías y uso racional del medicamento y productos sanitarios / No disponible

Transcurrido un año desde la publicación de la «Ley 29/2006 de garantías y uso racional de los medicamentos yproductos sanitarios», la Sociedad Española de Farmacéuticos de Atención Primaria (SEFAP) quiere conocer lasituación de los servicios de farmacia de atención primaria (SFAP) en el territorio nacional. Material y método.Estudio descriptivo transversal llevado a cabo mediante una encuesta con 128 ítems. Se distribuyó mediante envíoelectrónico desde la web de la SEFAP a todos los socios, especificando que se cumplimentara una encuesta por SFAP.Resultados. Se recibieron un total de 84 encuestas, desestimándose 5 por repetición del mismo SFAP o por no trabajaren un SFAP, lo que representa el 58,1% de los posibles SFAP. El 52% de las estructuras de gestión de atenciónprimaria encuestadas disponen de SFAP autorizados según la normativa vigente y el 59% son los responsables de lagestión de medicamentos. El 99% tienen establecidos sistemas de información sobre gestión de la farmacoterapia(aspectos clínicos, de efectividad, seguridad y eficiencia de la utilización de los medicamentos) y proporcionan unacorrecta información y formación sobre medicamentos y productos sanitarios a los profesionales. El 40% de los SFAPparticipa en la elaboración de criterios de selección de medicamentos para el desarrollo de protocolos y guías farmacoterapéuticasque garanticen la correcta asistencia a los pacientes, y el 27% asesora sobre el historial farmacoterapéuticode los pacientes. El 46% de las estructuras de atención primaria participa en investigación clínica en farmacoterapiade calidad, y el 42% de los SFAP participan en comités éticos y de investigación. El 99% participan confarmacovigilancia y con programas que potencian el uso seguro de los medicamentos. El 41% de los SFAP impulsanprogramas de educación a la población sobre medicamento. Y casi la mitad, el 45% de los SFAP, están participandoya en los planes estratégicos de calidad en las estructuras de gestión de atención primaria. Discusión. Los serviciosde salud deben impulsar y velar por el desarrollo de los SFAP, no sólo regularizando la situación administrativa deéstos conforme a la Ley, sino también promoviendo el desarrollo de las funciones establecidas, favoreciendo la integracióndel farmacéutico de atención primaria en todos los procesos de la cadena terapéutica, y retornando al sistemala corresponsabilidad en la calidad asistencial y la farmacoterapéutica de los pacientes

One year after the publication of Law 29/2006 on the guarantees and rational use of medicines and healthcareproducts the Spanish Society of Primary Care Pharmacists (SEFAP) wishes to know the situation of the PrimaryCare Pharmacy Services (SFAP) in Spain. Material and method: a cross-sectional descriptive study carried outby means of a survey with 128 items. It was distributed to all the members via e-mail from the SEFAP’s web,specifying that one survey should be filled out per Primary Care Pharmacy Service. Results: a total of 84 surveyswere received, 5 of which were rejected because of repetitions of the same SFAP or for not working in a SFAP,representing 58.1% of all possible SFAPs. Of the primary care management structures polled, 52% have SFAPsauthorised according to current legislation and 59% are responsible for the management of medicines. Of the total,99% have established information systems on pharmacotherapy management (clinical aspects, aspects regardingefficacy, safety and the efficiency of the use of the medicines) and provide correct information and training onmedicines and healthcare products to healthcare professionals. Of the SFAPs, 40% participate in the definition ofmedicine selection criteria for the development of protocols and pharmacotherapeutic guides that guarantee thecorrect pharmacotherapeutic care of patients, and 27% provide advice on the patients’ pharmacotherapeutic history.Of the Primary Care structures, 46% participate in clinical research on quality pharmacotherapy, and 42%of the SFAPs participate in Ethical and Research Committees. Moreover, 99% participate with Pharmacovigilanceand with programmes that promote the safe use of medicines. Of the SFAPs 41% promote educational programmesfor the population on medication. Nearly half of the SFAPs, namely 45%, already participate in strategic plans forquality in the primary care management structures. Discussion: the Health Services should promote and watchover the development of the SFAPs, not only through the regularisation of the administrative situation of the SFAPsaccording to the Law, but also through the promotion of the development of the established functions, encouragingthe involvement of the primary care pharmacist in all the processes of the therapeutic chain, returning to thesystem joint responsibility in the quality of the care and pharmacotherapy of the patients (AU)

Evidence based educational outreach visits: effects on prescriptions of non-steroidal anti-inflammatory drugs.

AIMS: To evaluate the effectiveness of an evidence based group educational outreach visit on prescription patterns of non-steroidal anti-inflammatory drugs (NSAIDs) in primary care. DESIGN: Randomised controlled simple blind trial, with randomisation into three groups: experimental (evidence based educational outreach visit), placebo (conventional education session), and control (without intervention). SETTING: The 24 primary care centres of the National Institute of Healthcare Network in a rural province of Aragon, Spain. PARTICIPANTS: The 24 primary health care teams of the network, with 158 general practitioners (GPs). The teams were randomised into the groups, experimental (8 teams, 48 GPs), placebo (8 teams, 54 GPs), and control (8 teams, 56 GPs). INTERVENTION: Experimental group: one group educational outreach visit, conveying data based on a systematic review of the literature that was reinforced with printed material; placebo group: one non-structured educational session; control group: no intervention. Both educational sessions emphasised that there are no differences in the effectiveness of the NSAIDs reviewed (diclofenac, piroxicam, and tenoxicam); a recommendation was made to prescribe diclofenac over tenoxicam because of price differences. MAIN OUTCOME MEASURES: Changes in the number of packages prescribed for each of the drugs and changes in the cost per package of NSAIDs prescribed during the six months before, and after the intervention. RESULTS: There were no differences in the basal characteristics of the three groups, except for the number of prescriptions during the six months before the intervention. Prescriptions for NSAIDs decreased homogeneously in the three groups. For tenoxicam, the experimental group reduced prescriptions by 22.5% (95%CI: 34.42 to -10.76), compared with a reduction of 9.78% (95%CI: -17.70 to -1.86) in the placebo group and an increase of 14.44% (95%CI: 5.22 to 23.66) in the control group. The average cost per prescription decreased by 1.91% (95%CI: -0.33% to -3.49%) in the experimental group, 0.16% (95%CI: -0.27% to -2.93%) in the placebo group, and rose by 1.76% (95%CI: 0.35% to 3.17%) in the control group. CONCLUSIONS: Evidence based educational outreach visits are more effective than no intervention at all. Results suggest that evidence based educational outreach visits are incrementally more effective than conventional educational sessions, which in turn are more effective than no intervention at all.