Impact of a pharmaceutical intervention on influenza vaccination in patients receiving treatment with biological medicines.

OBJECTIVE: The aims of this study were twofold - to determine the impact of a health education intervention led by a hospital pharmacy department on influenza vaccination take-up in patients diagnosed with immune-mediated diseases. Patients were receiving treatment with biological medicines. Secondly, to compare those rates with the vaccination percentages of another hospital pharmacy with similar characteristics in which no educational intervention was conducted. METHODS: This was a retrospective cohort study of adult patients with immune-mediated diseases receiving treatment with biological medicines. The medicines were dispensed by the hospital pharmacy departments of two hospitals between 1 January 2019 and 31 December 2020. In Cohort A (intervention group), a health education strategy was implemented with regards to influenza vaccination. Cohort B acted as a control group. The influenza vaccination rates obtained in both cohorts during 2019 and 2020 were compared. RESULT: A total of 355 patients took part in the study - 148 (41.7%) in Cohort A and 207 (58.3%) in Cohort B. The hospital pharmacy department in Cohort A implemented a health education strategy after which the vaccination percentage during the 2020 campaign increased by 38 patients (45.7%), compared with a 10 patient (5.8%) increase in Cohort B (p<0.001). CONCLUSIONS: The health intervention by the pharmacy department had a positive impact. This included an opportunity to improve vaccination take-up and is a strategy to consider when implementing a vaccination programme. Health education is a fundamental objective of healthcare. In our case it led to an increase in vaccination and had a positive impact on public health. It also provides opportunities for pharmacists to work in a multidisciplinary way with other healthcare professionals.

Evaluación de la técnica inhalatoria y valoración de la necesidad de intervención farmacéutica en pacientes con patología respiratoria / Inhalation technique assessment and evaluation for the need of pharmaceutical intervention in respiratory pathologies patients

Objetivo: Analizar la tasa y los tipos de errores en la técnica de inhalación de pacientes atendidos a nivel hospitalario en el área de observación del servicio de urgencias y a nivel ambulatorio en la consulta farmacéutica de atención primaria y en la farmacia comunitaria. Método: Estudio observacional de tipo descriptivo realizado por un farmacéutico hospitalario en colaboración con un farmacéutico de atención primaria y un farmacéutico comunitario. Se realizó una entrevista anónima para registrar los distintos datos analizados y se solicitó a cada paciente que ejecutara una demostración completa de cómo utilizaba su inhalador habitualmente para comprobar de forma activa la técnica de inhalación. Para evaluar dicha técnica se establecieron dos checklist en función del tipo de inhalador. Los resultados fueron tabulados mediante el software Microsoft Excel(R) 2010 y analizados mediante el programa estadístico R 3.5. Resultados: Se reclutaron 66 pacientes (42 varones y 24 mujeres; edad media 67 años). El 48,5% usaban más de un inhalador, de ellos el 34,4% utilizaban distintos tipos de inhalador y el 65,6% diferentes sistemas. Un total de 39 pacientes estaban en tratamiento con inhaladores de polvo seco y 38 con inhaladores de cartucho presurizado. Los errores más frecuentes, tanto con inhaladores de polvo seco como con inhaladores de cartucho presurizado, fueron: no realizar la apnea de 10 segundos y no expulsar lentamente el aire de los pulmones. En torno al 50% precisaron nuevo aprendizaje tras la evaluación de la técnica de inhalación, a pesar de que el 88,5% ya habían recibido formación previa. Los pacientes de edad más avanzada realizaban peor la técnica inhalatoria. Conclusiones: Existe una elevada tasa de errores en el empleo de la terapia inhalada, siendo mayor en los pacientes de edad más avanzada. La instrucción en la técnica inhalatoria por parte del personal sanitario parece inadecuada, por lo que es preciso sensibilizar al mismo sobre la importancia de la educación sanitaria a los pacientes en el empleo de los inhaladores, realizando un seguimiento programado y una evaluación de la técnica y del feedback obtenido por el paciente

Objective: To evaluate rate and type of errors in inhalation technique of patients seen in hospitals at the observation area in the emergency department, as well as patients seen in the outpatients clinic at the primary care pharmaceutical consultation, and at the community pharmacy. Method: Descriptive observational study carried out by a hospital pharmacist, along with a primary care pharmacist and a community pharmacist. An anonymous survey was performed in order to collect different analyzed data. Each patient was asked to execute a complete demonstration on how they used their inhalers, to actively check the inhalation technique. Two checklists regarding the type of inhaler were established in order to assess said technique. Results were tabulated through Microsoft Excel(R) 2010 software and analyzed through R 3.5 statistical program. Results: A total of 66 patients (42 male, 24 female; mean age 67) were recruited. Out of all patients, 48.5% used more than one inhaler, which 34.4% used different types of inhaler, and 65.6% used different systems. A total of 39 patients were under dry powder inhaler therapy, and 38 were using pressurized metered dose inhalers. The most frequent errors -both in dry powder inhalers and pressurized metered dose inhalers- were: not performing a 10 second apnea and not slowly expelling air from the lungs. Around 50% of patients needed new learning after assessing their inhalation technique, even though 88.5% had already received previous training. Older aged patients performed a worse inhalation technique. Conclusions: There is a high rate of errors in the use of inhaled therapy, being even higher among older aged patients. The inhalation technique training by the medical staff seems inadequate, as it is crucial to raise awareness about the importance of health education for patients and their use of inhalers, to which a scheduled follow up and a technical and feedback obtained from the patient assessment is required

Inhalation technique assessment and evaluation for the need of pharmaceutical intervention in respiratory pathologies patients.

OBJECTIVE: To evaluate rate and type of errors in inhalation technique of patients seen in hospitals at the observation area in the  emergency department, as well as patients seen in the outpatients clinic  at the primary care pharmaceutical consultation, and at the  community pharmacy. METHOD: Descriptive observational study carried out by a hospital  pharmacist, along with a primary care pharmacist and a community  pharmacist. An anonymous survey was performed in order to collect  different analyzed data. Each patient was asked to execute a complete  demonstration on how they used their inhalers, to actively check the  inhalation technique. Two checklists regarding the type of inhaler were  established in order to assess said technique. Results were tabulated  through Microsoft Excel® 2010 software and analyzed through R 3.5  statistical program. RESULTS: A total of 66 patients (42 male, 24 female; mean age 67) were  recruited. Out of all patients, 48.5% used more than one  inhaler, which 34.4% used different types of inhaler, and 65.6% used  different systems. A total of 39 patients were under dry powder inhaler  therapy, and 38 were using pressurized metered dose inhalers. The  most frequent errors -both in dry powder inhalers and pressurized  metered dose inhalers-were: not performing a 10 second apnea and not  slowly expelling air from the lungs. Around 50% of patients needed  new learning after assessing their inhalation technique, even though  88.5% had already received previous training. Older aged patients  performed a worse inhalation technique. CONCLUSIONS: There is a high rate of errors in the use of inhaled  therapy, being even higher among older aged patients. The inhalation  technique training by the medical staff seems inadequate, as it is crucial  to raise awareness about the importance of health education for  patients and their use of inhalers, to which a scheduled follow up and a  technical and feedback obtained from the patient assessment is  required.

Objetivo: Analizar la tasa y los tipos de errores en la técnica de  inhalación de pacientes atendidos a nivel hospitalario en el área de  observación del servicio de urgencias y a nivel ambulatorio en la  consulta farmacéutica de atención primaria y en la farmacia  comunitaria.Método: Estudio observacional de tipo descriptivo realizado por un farmacéutico hospitalario en colaboración con un farmacéutico de  atención primaria y un farmacéutico comunitario. Se realizó una  entrevista anónima para registrar los distintos datos analizados y se  solicitó a cada paciente que ejecutara una demostración completa de  cómo utilizaba su inhalador habitualmente para comprobar de forma  activa la técnica de inhalación. Para evaluar dicha técnica se  establecieron dos checklist en función del tipo de inhalador. Los  resultados fueron tabulados mediante el software Microsoft Excel® 2010  y analizados mediante el programa estadístico R 3.5. Resultados: Se reclutaron 66 pacientes (42 varones y 24 mujeres; edad media 67 años). El 48,5% usaban más de un inhalador,  de ellos el 34,4% utilizaban distintos tipos de inhalador y el 65,6%  diferentes sistemas. Un total de 39 pacientes estaban en tratamiento  con inhaladores de polvo seco y 38 con inhaladores de cartucho  presurizado. Los errores más frecuentes, tanto con inhaladores de polvo  seco como con inhaladores de cartucho presurizado, fueron: no  realizar la apnea de 10 segundos y no expulsar lentamente el aire de los  pulmones. En torno al 50% precisaron nuevo aprendizaje tras la  evaluación de la técnica de inhalación, a pesar de que el 88,5% ya  habían recibido formación previa. Los pacientes de edad más avanzada  realizaban peor la técnica inhalatoria.Conclusiones: Existe una elevada tasa de errores en el empleo de la terapia inhalada, siendo mayor en los pacientes de edad más  avanzada. La instrucción en la técnica inhalatoria por parte del personal  sanitario parece inadecuada, por lo que es preciso sensibilizar al mismo  sobre la importancia de la educación sanitaria a los pacientes en el  empleo de los inhaladores, realizando un seguimiento programado y una  evaluación de la técnica y del feedback obtenido por el paciente.