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

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

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

Causas de incumplimiento de los pacientes que acuden a una farmacia comunitaria de Granada

Este trabajo fue presentado como comunicación- póster en el II Congreso Nacional de la SEFaC en A Coruña el 17-19 de noviembre de 2006.Objetivo: Determinar si los pacientes que acuden a una oficina de farmacia de Granada incumplen el tratamiento terapéutico e identificar su causa. Diseño: Estudio descriptivo, observacional, transversal. Emplazamiento: Farmacia comunitaria de Granada. Participantes: Pacientes mayores de 12 años y sin ninguna dificultad cognitiva, que acudieron a la farmacia en septiembre de 2005. Mediciones principales: Se midió el cumplimiento farmacoterapéutico mediante el cuestionario de Morisky-Green1. Se pasó un segundo cuestionario a los pacientes incumplidores preparado ad hoc para determinar las posibles causas de incumplimiento. Resultados: Participaron y concluyeron el estudio 139 pacientes. De ellos, 108 (77,7%) incumplían el tratamiento; el 62% eran mujeres y el resto, varones, con una mayoría en el rango de edad de 19-45 años (76%) y el 64,8% tenía un nivel cultural medio

Efecto de una intervención farmacéutica sobre el control de la presión arterial y la adherencia farmacológica en pacientes hipertensos tratados farmacológicamente que acuden a farmacias comunitarias: estudio AFenPA

Tesis Univ. Granada. Departamento de Química Física. Leída el 27 de abril de 201

Efecto de la intervención farmacéutica en adherencia de la medicación y del control de la presión arterial en pacientes hipertensos tratados: Análisis razonado, diseño y métodos del estudio experimental de AFenPA

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.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 deforma 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.The project was partially funded by Almirall S.A. and Roche Diagnostics, S.L. Financial support was provided by Almirall S.A. in the form of an unrestricted grant for a project researcher, Narjis Fikri Benbrahim. Financial support was provided by Roche Diagnostics Laboratories, S.L. through the supply at no cost of half of the blood pressure monitors used in the study and funding of the statistical analysis of the data

Burnout in the staff of a chronic care hospital

ABSTRACT 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

Burnout y factores de riesgo psicosocial en el personal de un hospital de larga estancia

Nuestro objetivo fue evaluar la relación entre los riesgos psicosociales y el burnout en un hospital español de media-larga estancia. Se realizó un estudio transversal en 2017, aplicando la versión española del MBI-HSS y el cuestionario F-Psico 3.1 del Instituto Nacional de Seguridad e Higiene en el Trabajo. Variables predictoras: características sociodemográficas, moduladoras y factores de riesgo psicosocial. Variables resultado: prevalencia de burnout y afectación de sus subescalas. La asociación entre variables se cuantificó con odds ratio. El cansancio emocional se asoció positivamente a los riesgos psicosociales vinculados a carga de trabajo, demandas psicológicas, participación/supervisión, desempeño de rol, relaciones/apoyo social y al consumo de ansiolíticos; fueron factores protectores los hijos, sentirse valorado por pacientes y compañeros, satisfacción laboral, optimismo y apoyo social. Las asociaciones halladas para la despersonalización fueron similares, pero más débiles. La baja realización personal se asoció positivamente a los riesgos psicosociales vinculados al tiempo trabajado, autonomía, variedad/contenido del trabajo, desempeño de rol y apoyo social; fue la subescala que mostró mayor número de variables sociodemográficas/moduladoras protectoras: estado civil, tener hijos, trabajar de noche, sentirse valorado por pacientes y familiares, ilusión por el trabajo, apoyo social, autoeficacia y optimismo. Según nuestros resultados, existe asociación entre los riesgos psicosociales y el burnout. Los individuos con mayor satisfacción laboral, autoeficacia y optimismo, afrontan mejor el estrés y son menos vulnerables a los riesgos psicosociales y al burnoutThe aim of this study was to assess the relationship between psychosocial risks and burnout syndrome in a long-stay hospital in Spain. A cross-sectional study was conducted in 2017, applying the Spanish version of the MBI-HSS and the F-Psico 3.1 questionnaire of Spain’s National Institute of Work Safety and Health. The predictive variables were sociodemographic characteristics, modulators, and psychosocial risk factors. The outcome variables were prevalence of burnout and the effects on his subscales. Associations between variables were measured by odds ratio. Burnout was directly associated with psychosocial risks related to workload, psychological demands, participation/supervision, role performance and social support, and consumption of anxiolytics. Meanwhile, protective factors were having children, feeling valued by patients and coworkers, satisfaction at work, optimism, and social support. The associations found on depersonalization were similar but weaker. Low personal fulfillment was directly associated with the psychosocial risks related to length of workweek, limited autonomy and variety/content of work, and role performance and social support. Low personal fulfillment was the subscale with the most modulating and protective sociodemographic variables included marital status, children, night shift, feeling valued by patients and family members, social support, self-efficacy, and optimism. According to our results, there is an association between psychosocial risks and burnout syndrome. Individuals with greater work satisfaction, self-efficacy, and optimism cope better with stress and are less vulnerable to psychosocial risks and burnout