Effect of pharmaceutical intervention on medication adherence and blood pressure control in treated hypertensive patients: Rationale, design and methods of the AFenPA pilot study.

Objetivo: Evaluar el efecto de una intervención farmacéutica protocolizada sobre el control de la presión arterial y la adherencia al tratamiento farmacológico en pacientes usuarios de farmacias comunitarias.Material y métodos: Estudio cuasi-experimental con grupo control en el que se comparará el efecto de una intervención farmacéutica (grupo intervención) con el proceso de atención habitual (grupo control), sobre la presión arterial y la adherencia al tratamiento de pacientes hipertensos tratados farmacológicamente en farmacias comunitarias. Los pacientes serán distribuidos de forma equitativa en ambos grupos (n control = n intervención) y serán seguido durante 6 meses. El programa de la intervención farmacéutica constará de tres partes fundamentales: 1) educación/información al paciente sobre aspectos relacionados con la hipertensión y adherencia al tratamiento farmacológico, 2) automonitorización de la presión arterial y, 3) interacción con el médico mediante informes personalizados cuando la media de las cifras de presión arterial realizadas en el domicilio superen el objetivo terapéutico acorde con la situación clínica del paciente. Para evaluar el efecto de la intervención farmacéutica sobre la adherencia terapéutica y la presión arterial se obtendrán medidas de presión arterial en la farmacia y porcentaje de cumplimiento terapéutico mediante recuento de comprimidos en ambos grupos al principio y al final del estudio.Discusión: Según nuestros conocimientos, éste es el primer estudio que se realiza en farmacia comunitaria en España para probar la efectividad de una intervención farmacéutica conjuntamente con la automedida de la presión arterial sobre el control de la presión arterial. Además, la intervención farmacéutica se ha diseñado de forma que pueda integrase como práctica habitual enmarcada dentro de la Atención Farmacéutica.Objective: To assess the effect of a protocol-based pharmacist intervention on blood pressure control and medication adherence among treated hypertensive patients who are users of community pharmacies.Methods: A quasi experimental study design with control group has been designed to compare the effect of pharmaceutical intervention (intervention group) versus the standard healthcare procedure (control group) on blood pressure and medication adherence among hypertensive patients receiving drug therapy in community pharmacies. The patients will be allocated evenly between the two groups (ncontrol = nintervention), with a 6-month follow-up. The pharmaceutical intervention program will comprise three main parts: 1) patient education / information on issues relating to hypertension and medication adherence; 2) self-monitoring of blood pressure; and 3) interaction with the physician through personalized reports when the mean blood pressure values recorded at home exceed the treatment goal according to the clinical condition of the patient. In order to evaluate the effect of the pharmaceutical intervention upon medication adherence and blood pressure, blood pressure recordings will be made in the pharmacy, while percent medication adherence will be established based on pill count in both groups at the start and end of the study.Discussion: To our knowledge, this is the first study in the community pharmacy setting in Spain to evaluate the effectiveness of pharmaceutical intervention in combination with home blood pressure monitoring on blood pressure control. In addition, the pharmaceutical intervention has been designed for inclusion as standard practice in the context of Pharmaceutical Care

Métodos de medida de la presión arterial disponibles en la farmacia comunitaria para el cribado y seguimiento de la hipertensión arterial

La medida de la presión arterial (PA) en la consulta médica (PAC) ha sido durante muchos años el método de referencia para realizar el diagnóstico, seguimiento y tomar las decisiones clínicas en el manejo de la hipertensión arterial (HTA). Por otra parte, la medida de la PA en la farmacia comunitaria es un método poco estudiado y su utilidad en la práctica clínica es, cuando menos, desconocida. La aparición de la automedida domiciliariade la PA (AMPA) y de la monitorización ambulatoria de la PA (MAPA) ha permitido superar muchas de las limitaciones inherentes a la medida de la PAC, principalmente al proporcionar múltiples medidas de PA exentas del efecto de bata blanca. Además, estos métodos han demostrado relacionarse más estrechamente que la medida de la PAC con el pronóstico cardiovascular y la lesión de órganos diana. En definitiva, la AMPA y la MAPA proporcionan una evaluación más precisa (p. ej., del riesgocardiovascular o del efecto de los tratamientos antihipertensivos) y un mejor manejo del paciente con HTA. El presente artículo ofrece una visión actualizada sobre el interés de los distintos métodos de medida de la PA disponibles en la farmacia para el cribado y seguimiento del paciente hipertenso

Métodos de medida de la presión arterial disponibles en la farmacia comunitaria para el cribado y seguimiento de la hipertensión arterial

La medida de la presión arterial (PA) en la consulta médica (PAC) ha sido durante muchos años el método de referencia para realizar el diagnóstico, seguimiento y tomar las decisiones clínicas en el manejo de la hipertensión arterial (HTA). Por otra parte, la medida de la PA en la farmacia comunitaria es un método poco estudiado y su utilidad en la práctica clínica es, cuando menos, desconocida. La aparición de la automedida domiciliariade la PA (AMPA) y de la monitorización ambulatoria de la PA (MAPA) ha permitido superar muchas de las limitaciones inherentes a la medida de la PAC, principalmente al proporcionar múltiples medidas de PA exentas del efecto de bata blanca. Además, estos métodos han demostrado relacionarse más estrechamente que la medida de la PAC con el pronóstico cardiovascular y la lesión de órganos diana. En definitiva, la AMPA y la MAPA proporcionan una evaluación más precisa (p. ej., del riesgocardiovascular o del efecto de los tratamientos antihipertensivos) y un mejor manejo del paciente con HTA. El presente artículo ofrece una visión actualizada sobre el interés de los distintos métodos de medida de la PA disponibles en la farmacia para el cribado y seguimiento del paciente hipertenso

Available measurement methods of blood pressure at the community pharmacy for the screening and follow up of hypertension

The blood pressure (BP) measurement in the physician's office has been for many years the gold standard for diagnosis, monitoring and making clinical decisions in the management of hypertension. On the other hand, few studies analyze the usefulness of the community pharmacy BP measurement method, which remains unknown in clinical practice. Home and ambulatory BP monitoring (HBPM and ABPM, respectively) have overcome many of the inherent limitations of the BP measurement at the physician's office, mainly providing multiple BP readings exempt from the white coat effect. Additionally, these methods have shown to be better predictors of end-organ damage and cardiovascular outcome than BP measured in the physician's office. Finally, the use of HBPM or ABPM enables a more accurate assessment and an improved management of hypertension. This article provides an overview update on the interest of the different BP measurement methods available in the community pharmacy for the screening and monitoring of hypertensive patients

ESSENTIAL OILS ANALYSIS AND ANTIBACTERIAL ACTIVITY OF THE LEAVES OF ROSMARINUS OFFICINALIS, SALVIA OFFICINALIS AND MENTHA PIPERITA CULTIVATED IN AGADIR (MOROCCO)

Objective: This study was designed to determine the chemical composition and the antibacterial activity of hydro-distillated essential oils (EOs) extracted from leaves of three aromatic and medicinal plants cultivated in Agadir (Morocco): Rosmarinus officinalis, Mentha piperita and Salvia officinalis. Methods: EOs chemical composition was determined by GC and GC/MS. Disc diffusion method and agar dilution technique were used to evaluate their antibacterial activity against eight microbial strains. Moreover, a statistical study, consisting in a student test, was conducted.Results: The most important constituents identified were α-pinene (34.83%), a-thujone (24.05%) and Menthol (41, 23%) respectively in the Rosemary, the Sage and Mint. All tested EOs exhibited an antibacterial activity at different levels against the studied strains. Micrococcus luteus was the most sensitive to the tested EOs with Minimum Inhibitory Concentration values of 5.8, 2.35 and 20 mg/ml for Rosemary, Sage and Mint EOs respectively. Thus, these EOs can be used as antibacterial supplement in the developing countries to develop new therapeutic agents.Conclusions: Additional in vivo studies and clinical trials would be needed to justify and further evaluate their potential.Â

RADICAL SCAVENGING AND DISINFECTANT EFFECT OF ESSENTIAL OIL FROM MOROCCAN MENTHA PULEGIUM

Objective: As part of the valorization of medicinal and aromatic plants in Morocco, this study aims to investigate the chemical composition, the antimicrobial and the antioxidant activities of Mentha pulegium essential oil.Methods: Essential oil of M. pulegium from Oued Laou region (Morocco) was screened for its antimicrobial activity against seven bacteria and two fungi using broth microdilution method. The radical scavenging effect was used to assess in vitro antioxidant capacity of this oil.Results: The tested essential oil exhibited strong inhibitory effect against all tested microorganisms with minimum inhibitory concentrations ranging from 0.003% to 1% (v/v) except for Pseudomonas aeruginosa. Moreover, the studied essential oil exhibited radical scavenging power with the half maximal inhibitory concentration of 2 mg/ml.Conclusion: These findings showed that the studied essential oil has both an antimicrobial and antioxidant potential, which is very rare. Thus, it reinforces its use as an effective, eco-friendly preservative agent in food and cosmetic field.Â

Effect of Pharmaceutical Intervention in Pharmacologically Treated Hypertensive Patients—A Cluster-Randomized Clinical Trial: AFPRES-CLM Study

Background: Evaluate the effect of a community pharmaceutical intervention on the control of blood pressure in hypertensive patients treated pharmacologically.Methods: A cluster-randomized clinical trial of 6 months was carried out. It was conducted in the Autonomous Community of Castilla-La Mancha (Spain). Sixty-three community pharmacies and 347 patients completed the study. Intervention patients received the community pharmaceutical intervention based on a protocol that addresses the individual needs of each patient related to the control of their blood pressure, which included Health Education, Pharmacotherapy Follow-up and 24 h Ambulatory Blood Pressure Measurement. Control patients received usual care in the community pharmacy.Results: The pharmaceutical intervention resulted in better control of blood pressure (85.8% vs. 66.3% p < 0.001), lower use of emergencies (p = 0.002) and improvement trends in the physical components of quality of life, measured by SF-36 questionnaire, after 6 months of pharmaceutical intervention. No significant changes were observed for any of these variables in the control group. There were also detected 354 negative medication-related outcomes that were satisfactorily resolved in a 74.9% of the cases and 330 healthcare education interventions and 29 Ambulatory Blood Pressure Monitorings were performed in order to increase adherence to pharmacological treatment and minimize Negative Outcomes associated with Medication and prevent medication-related problems.Conclusions: Community pharmaceutical intervention can increase hypertensive patients with controlled blood pressure, after 6 months, compared with usual care.General Council of Official Associations of Pharmacist

Burnout in the staff of a chronic care hospital

OBJECTIVE: To estimate the prevalence of Burnout in a medium or long-stay hospital, to monitor its evolution and to highlight the importance of cut-off points used to avoid distortions in the interpretation of the results. METHODS: Two cross-sectional studies (2013–2016) were carried out, applying the Spanish version of the Maslach Burnout Inventory to the staff of a chronic care hospital (n = 323). Result variables were: Burnout prevalence and a high degree of affectation of the subscales and predictor variables: sociodemographic characteristics and factors that trigger and modulate the syndrome. The association between variables was quantified using odds ratio. RESULTS: The participation rate went from 31.5% to 39.3%. The professionals presented a mean level of Burnout in both moments, observing a lower degree of affectation of the depersonalization subscales and personal accomplishment in the 2016 cut-off. The average score of the subscales in 2016 was 21.5 for emotional fatigue, 4.7 for depersonalization and 41.7 for personal fulfillment, compared to the values of emotional fatigue = 21.6, depersonalization = 6.9 and personal fulfillment = 36.3 obtained in 2013. The emotional fatigue score was slightly higher than the mean value of the national studies (19.9), while the rest of the values were similar to the mean values of the studies considered. The prevalence of Burnout and the interpretation of the results varied significantly according to the cut-off points considered. In both studies, sociodemographic variables showed little significance, while social support and interpersonal relationships were associated with the degree of burnout among professionals. CONCLUSIONS: Our prevalence of Burnout was similar to that of other studies consulted, although the emotional component is more marked in our environment. The interpretation of the results varied significantly according to the cut-off points applied, due to the cross-cultural differences

Overall results of the Dader Pharmacotherapeutic Follow-Up Program data base: 2008

Se recogen los resultados globales de la aplicación web desarrollada por el Programa Dáder de Seguimiento Farmacoterapéutico del Grupo de Investigación en Atención Farmacéutica de la Universidad de Granada en el primer año de funcionamiento