ObjectivesThis study aimed to describe the actions taken to implement a telepharmacy programme with home medication dispensing and informed delivery in an outpatient pharmaceutical care unit of a tertiary hospital, where approximately 5000 patients are treated per year. It also aimed to substantiate the applicability and benefits of the programme through analysing the findings and measuring patient satisfaction.MethodsWe identified the operational, logistical, technological and legal needs, as well as the need for training, information and coordination with the care team and patient associations. A standard operating procedure was developed which described the home dispensing model and the profile of patients eligible for telepharmacy. Care activity was evaluated, between the months of July 2020 and January 2021; and a survey was conducted to measure patient satisfaction based on the Enopex project, a cross-sectional observational study of patients who used telepharmacy services during the COVID-19 lockdown period in Spain.ResultsA total of 2536 medication deliveries were made over 144 working days, with a mean of 18 (standard deviation (SD): 6) deliveries per day, and a total of 2854 dispensings (1.1 drugs per delivery). In total, 197 different types of pharmaceutical formulations were delivered, corresponding to 123 active ingredients. The distance and time avoided during the study period totalled 1 05 624 km and 1 09 452 min (76 days), whereby the median distance and time saved per patient were 66 (interquartile range (IQR):122 km and 90 (IQR:90) minutes, which represents an approximate carbon footprint reduction of 25 kg of CO2 per patient and 16.5 tonnes in total. The satisfaction survey conducted, completed by 134 patients, revealed high satisfaction with the pharmacy service of 9.88 points out of 10.ConclusionsThe SARS-CoV-2 pandemic (COVID-19) has provided the pharmacy service with an opportunity to develop and implement a telepharmacy programme that benefits patients, which has enabled better organisation of the unit and greater accessibility for patients attending in person. It is a replicable method that is applicable in other pharmacy services with similar characteristics and requirements.
The greatest cost and percentage of adherent patients associated with the combos composed of Tenovovir/Emtricitabine(TDF/FTC) and ABC/3TC, and the least cost and effectiveness of those composed of AZT/#TC and ABC/AZT/3TC, does not allow us to identify any option as significantly dominant. The regimens with ABC/3TC were shown to be the most favourable from the combined point of view of cost and adherence.
questionnaire before and after the information sessions. The score of their satisfaction with the information received before and after the sessions was also collected.Fifteen days after discharge, the patients were telephoned and a further survey was carried out.The reasons for unscheduled readmissions in the period were mainly worsening of the respiratory function test and fever. Results Of the 129 lung transplanted patients in the period studied, 114 completed both questionnaires. 70 were men and the average age was 55 years. The causes of transplantation were: diffuse interstitial pulmonary disease: 58, chronic obstructive pulmonary disease: 29; bronchiectasis/ cystic fibrosis: 17; other causes: 7; pulmonary hypertension: 3.99 transplants were double-lung, 20 left single-lung and 10 right single-lung.The percentage of correct answers varied from 70% in the pre-questionnaire to 85% in the post-questionnaire (p=0.000).The score of the patients' satisfaction with the information received was 6.6 points in the pre-questionnaire and 9.3 in the post-questionnaire (p=0.000).114 telephone calls were made to patients' homes in order to complete the post-questionnaire.In the first 90 days after transplantation, 27% of the transplanted patients were readmitted unscheduled in 2020 compared with 38.2% in 2016 (control group) (p=0.225).
Conclusion and relevancePharmaceutical care for lung transplant patients statistically significantly improved their knowledge about medicines and healthy lifestyles as well as their degree of satisfaction with the information received, and statistically significantly improved the unscheduled readmissions in the first 90 days after transplantation.
What Is Known and Objective: The study aimed to assess acceptability and patient experience of Certolizumab (CZP) self-injection with AVA ® and clarify patient device preference after switching CZP from the syringe or auto-injection pen to AVA ® in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients.
Method:A multicentre open-label, cross-sectional and prospective study among four Spanish hospitals was performed. Adult RA, PsA, axSpA patients treated for at least 6 months with the CZP syringe or pen were recruited. At the first visit, patients completed Pre-AVA ® questionnaire. Patients were instructed on proper administration of CZP by AVA ® . After 2 and 6 months of CZP self-injections using the AVA ® , patient experience, adherence, preference and safety of each administration was assessed using post-AVA ® questionnaire.Results and Discussion: Thirty four patients were included (28 women). All patients self-administered CZP AVA ® the full dose of CZP was injected. Patients reported >90% adherence to CZP AVA ® assessed with the injection log. Pain at the injection site was reduced after switching to AVA ® . Twenty nine patients preferred CZP AVA ® and five patients preferred the CZP pen. No safety-related findings related to AVA ® CZP administration were identified.
What Is New and Conclusion:The AVA ® is an advantageous delivery option for CZP in patients with RA, PsA, axSpA.
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