Aceptación de recomendaciones en el paciente con oportunidades de mejora farmacoterapéutica

Soria, M.A. López-Montenegro; Climente‐Martí, Mónica; Torres, Nicolás

doi:10.1016/j.farma.2010.04.001

Cited by 4 publications

(2 citation statements)

References 14 publications

(14 reference statements)

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“…The treatment of many patients due to their NCDs added to their associated comorbidities has become more complex. In most cases, the consequent progression of pathologies occurs, increasing the risks of hospitalization and mortality 4 . These concomitant pathologies confuse diagnoses, aggravate symptoms, and interfere with treatments.…”

Section: Introductionmentioning

confidence: 99%

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Impact of a comprehensive medication management program on ambulatory care patients with noncommunicable diseases in a Latin American hospital: A retrospective study

Sancho‐Vargas

Zavaleta‐Monestel

Arguedas-Chacón

2023

J Am Coll Clin Pharm

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Background: Noncommunicable diseases are the leading causes of death and disability in the world, harming life conditions and increasing expenditures within the health care system. Comprehensive Medication Management (CMM) may improve patient safety, adherence, and clinical outcomes by preventing or intervening in drug-related problems (DRPs). Methods: Retrospective, cross-sectional study conducted between October 2017 and July 2022 in a CMM of a hospital in Costa Rica. Patients 3-106 years old diagnosed with at least one chronic disease and had risk factors for DRP were included. A clinical pharmacist (CP) identified DRPs and proposed interventions to resolve them. DRPs were classified into four categories: indication, effectiveness, safety, and adherence. Additionally, the severity of the problem was determined by using a scale of potential clinical consequences avoided related to DRPs and medication errors (MEs). The adherence rate was determined by applying validated questionnaires and traceability control of dispensing medication dates. Clinical outcomes were classified as resolved, improved, stable, worsened, and therapeutic failure according to the condition of the DRP until the last appointment by the patient. Results: Pharmacotherapy interventions had an overall acceptance rate of 98.3%. Interventions made by the CP were related to effectiveness (38.9%, n = 253), safety (29.6%, n = 193), adherence (20.90%, n = 136), and therapy indications (10.60%, n = 69). The patient adherence rate improved, with a mean value of 74% on the first appointment compared with 88% as the last value calculated after the pharmacist's interventions. Predominant determinants of medication nonadherence were therapyrelated factors (30.88%) and patient-related factors (30.15%). In the clinical status assessment of 651 DRPs, 490 (75.3%) resolved, 105 (16.1%) improved, 43 (6.6%) remained stable, 5 (0.8%) worsened, and 8 (1.2%) patients presented with therapeutic failure. Conclusions: CPs can help resolve DRPs/MEs which enable patients to achieve medication-related therapeutic goals. The clinical interventions made were

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Section: Introductionmentioning

confidence: 99%

“…In most cases, the consequent progression of pathologies occurs, increasing the risks of hospitalization and mortality. 4 These concomitant pathologies confuse diagnoses, aggravate symptoms, and interfere with treatments.…”

Section: Introductionmentioning

confidence: 99%

Impact of a comprehensive medication management program on ambulatory care patients with noncommunicable diseases in a Latin American hospital: A retrospective study

Sancho‐Vargas

Zavaleta‐Monestel

Arguedas-Chacón

2023

J Am Coll Clin Pharm

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Role and impact of pharmacists in Spain: a scoping review

et al. 2018

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Medication Counselling: Physicians' Perspective

Bonnerup

Lisby

Eskildsen

et al. 2013

Basic Clin Pharma Tox

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Medication reviews have the potential to lower the incidence of prescribing errors. To benefit from a medication review, the prescriber must adhere to medication counselling. Adherence rates vary from 39 to 100%. The aim of this study was to examine counselling-naive hospital physicians' perspectives and demands to medication counselling as well as study factors that might increase adherence to the counselling. The study was conducted as a questionnaire survey among physicians at Aarhus University Hospital, Denmark. The questionnaire was developed based on focus group interviews and literature search, and was pilot-tested among 30 physicians before being sent to 669 physicians. The questionnaire consisted of 35 items divided into four categories: attitudes (19 items), behaviours (3 items), assessment (8 items) and demographics (5 items). The response rate was 60% (400/669). Respondents were employed at psychiatric, medical or surgical departments. Eighty-five per cent of respondents agreed that patients would benefit of an extra medication review, and 72% agreed that there was a need for external medication counselling. The most important factor that could increase adherence was the clinical relevance of the counselling as 78% rated it of major importance. The most favoured method for receiving counselling was via the electronic patient record.Prescribing errors are considered a major problem in healthcare systems [1]. A review reported prescribing errors in approximately 15% of handwritten prescriptions and in 8% of electronic prescriptions [2]. One method to lower the prevalence of prescribing errors is to review the medicine charts and prescriptions. In UK hospitals, pharmacists have, since the 1980s, been reviewing medicine charts and have made recommendations to prescribers [3]. In medication reviews, there is an underlying assumption that if evidence-based medication counselling is provided, the prescriber will, in turn, implement these recommendations [4]. Adherence to pharmacists' medication counselling varies in studies between 39 and 100% [5][6][7][8][9][10][11]. Similar challenges in adherence have been noticed in, for example, geriatric consultation where recommendations are implemented in approximately half of the cases [12]. Furthermore, a review on adherence to treatment recommendations from consulting psychiatrists showed that medication advice was followed in 68-98% of cases [13].Facilitators in collaboration in medication counselling seem to be related to trustworthiness, role specification and routine face-to-face interaction [14]. Factors that seem to enhance adherence to medication counselling are as follows: feedback by personal contact, the education of the medication counselling provider, ward type and time spent at the ward [15][16][17]. Previous studies of pharmaceutical interventions have revealed that physicians are satisfied with the intervention [18,19]. All of the aforementioned studies are performed retrospectively after implementation of medication counselling or after ...

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Aceptación de recomendaciones en el paciente con oportunidades de mejora farmacoterapéutica

Cited by 4 publications

References 14 publications

Impact of a comprehensive medication management program on ambulatory care patients with noncommunicable diseases in a Latin American hospital: A retrospective study

Impact of a comprehensive medication management program on ambulatory care patients with noncommunicable diseases in a Latin American hospital: A retrospective study

Role and impact of pharmacists in Spain: a scoping review

Medication Counselling: Physicians' Perspective

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