Valoración desde la dispensación activa de la efectividad y seguridad del uso de medicamentos antihipertensivos / Assessment from the perspective of the community pharmacy of the effectiveness and safety of the use of antihypertensive drugs

Introducción y objetivos: Este estudio pone de manifiesto la situación actual del uso de medicamentos antihipertensivos en pacientes ambulatorios, y valora la efectividad y seguridad de éstos desde la oficina de farmacia. El tema tiene un gran alcance debido a la elevada prevalencia de la hipertensión arterial (HTA) en nuestra sociedad. El objetivo del estudio fue determinar el grado de cumplimiento que tienen los pacientes en el uso de los medicamentos antihipertensivos para así poder valorar la efectividad y seguridad de estos tratamientos. Método: Estudio cualitativo, descriptivo, transversal, multicéntrico y prospectivo, realizado a 335 pacientes ambulatorios atendidos en 12 oficinas de farmacia del Baix Llobregat (Barcelona). Resultados: En el estudio se pudo detectar y prevenir un gran número de problemas relacionados con los medicamentos (PRM) (un total de 131). El grado de control de la HTA en el grupo de pacientes estudiados fue moderado (62% de los casos) y el grado de cumplimiento de la población estudiada según el test de Morisky-Green fue del 72 ± 4,8%. Conclusiones: Se observó la relación existente entre el cumplimiento terapéutico según el test de Morisky-Green y los valores de presión arterial medidos. Las intervenciones farmacéuticas mejoraron la implicación del paciente en el tratamiento en relación con la adherencia e incidieron en la modificación de sus hábitos. El estudio concluye que los datos y los resultados recogidos permiten afirmar que los tratamientos estudiados para la HTA son moderadamente efectivos y mayoritariamente seguros (AU)

Background: This study illustrates the current situation in terms of the use of antihypertensive drugs by ambulatory patients and assesses the effectiveness and safety of these medications from the perspective of the community pharmacy. The problem is of utmost importance owing to the high prevalence of hypertension in our society. The objective of this study was to determine the degree of patient compliance in terms of the use of antihypertensive drugs for the purpose of assessing the effectiveness and safety of these treatments. Methods: A prospective, qualitative, descriptive, cross-sectional, multicenter study involving 335 patients was carried out in 12 community pharmacies in Baix Llobregat, Barcelona, Spain. Results: This study has enabled the detection of a large number of drug-related problems (n= 131). The degree of hypertension control in the group of patients studied was moderate (62% of the cases) and the degree of compliance among the study population, according to the Morisky-Green test, was 72% ± 4.8%. Conclusions: From the perspective of the community pharmacy, there is a direct relationship between treatment compliance, according to Morisky-Green’s test, and the arterial blood pressure values. Pharmaceutical interventions improve the involvement of the patients in their treatment in relation to adherence to the treatment, and influence the modification of their habits. The study concludes that the data and the results gathered demonstrate that the treatments for hypertension studied are reasonably effective and, for the most part, safe (AU)

[Review of the interference between the most commonly prescribed drugs and clinical analyses at the Primary Health Care Centre of L'Hospitalet de Llobregat]. / Revisión de las interferencias entre los medicamentos más prescritos en el servicio de atención primaria de L'Hospitalet de Llobregat (ICS) y los análisis clínicos.

OBJECTIVE: To analyse the concordance of published information on probable drug interactions and the results of clinical analyses. DESIGN: Bibliographical review of the 50 most commonly prescribed drug products at the Primary Health Centre of L'Hospitalet de Llobregat, Barcelona, Spain, in 2002 and 2003. DATA SOURCE: Six bibliographical sources consisting of drug product catalogues and reference books. MEASUREMENTS: Interference with the 56 drug products studied. RESULTS: Most theoretical interference belonged to the therapeutic group of anti-inflammatory drugs. The drug products with most interference were hydrochlorothiazide (diuretic) and gliclazide (lipid lowering). The most frequent interference was in the increase of transaminases, thrombocytopaenia, leukopaenia, hyperglycaemia, and hyperuricaemia. Only in 12% of the points of interference analysed was the rate of concordance among the various bibliographical sources reviewed higher than 50%. The highest rate of concordance was found in the diuretics. CONCLUSIONS: Consultation of a single bibliographical source does not necessarily ensure the obtaining of reliable data on possible drug interference. This study demonstrates the need to standardize information on drug interference and to include the medication that the patient follows on the analysis application form.

Revisión de las interferencias entre los medicamentos más prescritos en el servicio de atención primaria de L'Hospitalet de Llobregat (ICS) y los análisis clínicos / Review of the interference between the most commonly prescribed drugs and clinical analyses at the primary health care centre of L’Hospitalet de Llobregat (ICS)

Objetivo. Analizar la concordancia de la información publicada sobre probables interacciones medicamentosas con los resultados de las pruebas analíticas. Diseño. Revisión bibliográfica sobre los 50 medicamentos más prescritos en el servicio de atención primaria (SAP) de L'Hospitalet de Llobregat (Barcelona) durante los años 2002 y 2003. Fuente de datos. Seis fuentes bibliográficas consistentes en catálogos de especialidades farmacéuticas y libros de referencia. Selección de estudios. Interferencias que corresponden a los 56 medicamentos estudiados. Resultados. El mayor número de interferencias teóricas correspondió al grupo terapéutico de los antiinflamatorios. Los medicamentos con más interferencias fueron la hidroclorotiacida (diurético) y la gliclacida (hipoglucemiante). Las interferencias más frecuentes correspondieron al aumento de las transaminasas, la trombopenia, la leucopenia, la hiperglucemia y la hiperuricemia. Sólo en el 12% de las interferencias analizadas el grado de coincidencia entre las distintas fuentes bibliográficas consultadas fue superior al 50%. El mayor grado de coincidencia se dio en los diuréticos. Conclusiones. La consulta de una sola fuente bibliográfica no garantiza la obtención de una información fiable acerca de las posibles interferencias medicamentosas. El estudio pone de manifiesto la necesidad de uniformizar la información sobre las interferencias medicamentosas y de incluir en la solicitud analítica la medicación que utiliza el paciente

Objective. To analyse the concordance of published information on probable drug interactions and the results of clinical analyses. Design. Bibliographical review of the 50 most commonly prescribed drug products at the Primary Health Centre of L'Hospitalet de Llobregat, Barcelona, Spain, in 2002 and 2003. Data source. Six bibliographical sources consisting of drug product catalogues and reference books. Measurements. Interference with the 56 drug products studied. Results. Most theoretical interference belonged to the therapeutic group of anti-inflammatory drugs. The drug products with most interference were hydrochlorothiazide (diuretic) and gliclazide (lipid lowering). The most frequent interference was in the increase of transaminases, thrombocytopaenia, leukopaenia, hyperglycaemia, and hyperuricaemia. Only in 12% of the points of interference analysed was the rate of concordance among the various bibliographical sources reviewed higher than 50%. The highest rate of concordance was found in the diuretics. Conclusions. Consultation of a single bibliographical source does not necessarily ensure the obtaining of reliable data on possible drug interference. This study demonstrates the need to standardize information on drug interference and to include the medication that the patient follows on the analysis application form

Hipolipemiantes: estudio de la dispensación activa en Oficinas de Farmacia de la región sanitaria "Costa de Ponent" / No disponible

Este estudio contempla la dispensación activa a pacientes con hipercolesterolemia en el ámbito de la oficina de farmacia. Su diseño es descriptivo, multicéntrico y transversal. Han participado 19 oficinas de farmacia ubicadas en la Región Sanitaria "Costa de Ponent" del Servicio Catalán de la Salud (SCS). Se han entrevistado a pacientes que utilizan hipolipemiantes, recogiendo información sobre los datos demográficos del paciente, los relacionados con la hipercolesterolemia y su tratamiento, así como la detección de posibles problemas relacionados con los medicamentos (PRM’s) y el registro de las intervenciones farmacéuticas llevadas a cabo (AU)

This study consists of the development of pharmaceutical care in those patients affected by hypercholesteremia from the perspective of pharmacies. To that end, a descriptive, multicentrical and transversal trial has taken place in nineteen pharmacies from the "Costa de Ponent" Health Region of the Catalan Health Service. Such study inludes patient interviews focused on a questionnaire involvingd demographic data related to the patient, the pathology and their pharmacological treatment, as well as the detection of possible drug-related problems and the register of the pharmaceutical interventions carried out (AU)

[The enzymatic hydrolysis of cell wall applied to yeasts classification (author's transl)]. / L'hydrolyse enzymatique de la paroi appliquée à la classification des levures

The rigid structure of yeast cell wall may be a taxonomic criterion. Using the Helix pomatia juice (with mercaptoethylamine hydrochloride) as a polyenzymatic system, we have always obtained protoplasts from ascomycetous yeasts and never from basidiomycetous yeasts tested. Then, we have applied this enzymatic analysis to the Fungi imperfecti yeasts and, according to this test, separated genus looking like basidiomycetous behaviour: Trichosporon, Pityrosporum, Rhodotorula, Cryptococcus and non fermentative Candida (group II). Oppositely, we have put together the Fungi imperfecti yeasts looking like ascomycetous behaviour: Kloeckera, Trigonopsis, Brettanomyces and fermentative Candida (group I). With the second lytic system made of mercaptoethylamine-HCl and beta-(1-3)-D-glucanase, we have selected ascomycetous yeasts giving protoplasts: Saccharomycoidea with genus Saccharomyces, Kluyveromyces, Pichia, Hansenula, Citeromyces, Debaryomyces; we have joined Saccharomycodes and Hanseniaspora to this second group. The other ascomycetous yeasts studied did not give protoplasts with the definite lytic system made of purified beta-(1-3)-D-glucanase and thiol. These results seem to demonstrate that the structure of cell wall can act as an important taxonomic criterion.