Estudio para la calculadora de edad vascular como herramienta para reducir el riesgo cardiovascular de la farmacia comunitaria

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, leída el 29-11-2021Background: Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality in Spain. According to the World Health Organization (WHO), 80% of these premature deaths are avoidable by reducing the modifiable risk factors of CVD. Research indicates that patients better understand their true risk when information is presented to them in vascular age (VA). Community pharmacists (CP) are well situated to assess patientsVA, provide professional educational advice, and implement interventions for reducing cardiovascular risk (CVR).Aim: The explicit objective of this thesis was to create a patient-centred, accurate and accessible tool that allows the CPs in Spain to estimate the VA and design a personalized intervention aimed at reducing the patient’s VA.Method: A website was created and included an original questionnaire, the vascular age calculator (VAC), detailed protocols for the pharmacist’s intervention and the patient’s information leaflets on CVR factors. The webpage user’s perceptions were analysed via a 26-item self-completion online survey distributed among CPs using a Google forum. Informed consent was taken from the CPs to participate in the study. The responses to the survey were collected anonymously. Open and closed questions were used to gain a wide range of replies and an in-depth understanding. The questionnaire from the pilot study was available online from the 1st August 2020 to the 31st of February 2021. The results were analysed using the STATA package version 12.0 (StataCorp LP, College Station, TX, USA). The NVivo software was used for assessing the descriptive findings...Antecedentes: La enfermedad cardiovascular (ECV) es una de las principales causas de morbilidad y mortalidad en España. Según la Organización Mundial de la Salud, el 80% de estas muertes prematuras se podrían evitar reduciendo los factores de riesgo cardiovascular modificables. Diversos estudios indican que los pacientes entienden mejor su riesgo real cuando se les presenta la información en forma de edad vascular. Los farmacéuticoscomunitarios (FC) están bien posicionados para evaluar la edad vascular de los pacientes, proporcionar asesoramiento educativo profesional y aplicar intervenciones para reducir el riesgo cardiovascular (RCV).Objetivo: El objetivo explícito de esta tesis fue crear una herramienta centrada en el paciente, precisa y accesible que permita a los FC de España estimar la edad vascular y diseñar un plan de intervención personalizado encaminado a reducirla. Método: Se creó una página web que incluía un cuestionario original, la calculadora de la edad vascular, protocolos detallados para la intervención del farmacéutico y folletos informativos para el paciente sobre factores de RCV. Se analizó la percepción de los usuarios sobre la página web a través de una encuesta online de veintiséis preguntas distribuida entre los FC mediante un formulario de Google. Se obtuvo el consentimiento informado de los FC para participar en el estudio. Las respuestas a la encuesta se recogieron de forma anónima. Se utilizaron preguntas abiertas y cerradas para obtener una amplia gama de respuestas y de mayor profundidad. El cuestionario del estudio piloto estuvo disponible en línea desde el 1de agosto de 2020 hasta el 31 de febrero de 2021. Los resultados se analizaron con el paquete STATA versión 12.0 (StataCorp LP, College Station, TX, USA). Para evaluar los resultados descriptivos se utilizó el programa informático NVivo...Fac. de FarmaciaTRUEunpu

Implementación del aprendizaje-servicio en “Farmacología General” como estrategia para fomentar el conocimiento significativo.

Depto. de Farmacología, Farmacognosia y BotánicaFac. de FarmaciaFALSEsubmitte

Identificación de problemas relacionados con el medicamento y estrategias de mejora en personas mayores

Depto. de Farmacología, Farmacognosia y BotánicaDepto. de Salud Pública y Materno - InfantilFac. de FarmaciaFac. de MedicinaUniversidad Complutense de Madrid. Proyectos ApSsubmitte

The real impact of COVID-19 on community pharmacy professionals as part of the primary health care frontier workforce in Spain

Context: Spain was at the epicentre of the pandemic. Health centres across Spanish territory refused to respond to non-emergency enquiries, leaving community pharmacies as the first point of patient’s contact. Aims: To investigate the impact of COVID-19 on the mental and physical health of community pharmacy teams across Spain. Methods: A cross-sectional observational study was performed with community pharmacy professionals throughout Spain. A questionnaire designed by our collaborator from the United Kingdom was adapted to the Spanish population and launched between October 2020 and February 2021. Results: A total of 98 participants responded to the questionnaire. The survey showed an 80% increase in workload. The pandemic had negatively impacted the well-being of community pharmacy professionals. The survey indicated a national shortage of medicines and personal protective equipment across Spain, particularly during the first peak. To adapt to this pandora's box of COVID-19, 96% of the pharmacies changed their settings to improve patients and staff's safety. Most of these changes were self-financed by the pharmacy owner. The pharmacists kept up to date with information released from the pharmacists' college, General Pharmaceutical Council and the Spanish Society of Community Pharmacists. The Public domain purchased more (79%) immune booster supplements. Conclusions: Community pharmacy team have faced tremendous mental, physical and professional pressure in providing adequate personal protective equipment and medication supply to their communities. They have resisted delivering more pharmaceutical services during the crisis, because they have not been recognised as essential healthcare workers by the healthcare system

Nutritional knowledge, practice, and dietary habits among school children and adolescents

Background: Although nutritional status of children and adolescents is of great concern various interventions and modifications aiming at promotion of healthy eating behaviors have limited impact due to insufficient understanding of dietary habits between different age groups and genders. The aim of this study in not only evaluation of nutritional knowledge, practice, and dietary habits of primary school and junior high school students in Isfahan province, but also this research explore crucial differences regarding gender and living area of the above-mentioned population in Iran. Methods: This cross-sectional study was conducted on 4700 primary school and junior high school pupils in Isfahan province. Data were collected through standard 24-h recall food frequency questionnaire and researcher-designed questionnaire. Independent t-test was applied for comparison of mean values of total units of consumed food materials. Qualitative variables were compared by using the Chi-square test. Data were analyzed by ACCESS 2010 and SPSS 18 software. Results: Nutritional knowledge of female pupils and junior high school students was higher than their male and elementary school students respectively; still, theses superiorities did not lead to higher practice score. Bread and cereals group received daily intakes in accordance with food and drug administration (FDA) recommendations. Indeed, vegetables, milk, and dairy products, as well as meat daily intakes, were lower than the FDA recommendation, whereas fats, oils, and sugars intakes were higher. In comparison to females, male participants had significantly lower consumption of vegetables and fruits whilst they had a higher intake of carbohydrates, fats, and meats. Conclusions: Our results showed that adolescents failed to meet sufficient nutritional requirements, and they had an imbalanced diet, which was considerably low in several essential nutrients and high in some food materials

Heterogeneity in the association between prediabetes categories and reduction on glomerular filtration rate in a 5-year follow-up

Prediabetes and not just diabetes can cause kidney damage. This study assess the association of prediabetes with development of impaired renal function (IRF). We used data from PREDAPS prospective study a cohort of 1072 subjects with prediabetes and another cohort of 772 subjects without prediabetes were follow-up from 2012 to 2017. Prediabetes was defined according to American Association of Diabetes criteria. IRF was defined as having a glomerular filtration rate < 60 mL/min/1.73 m2. Incidence rates of IRF in both cohorts and in different categories of prediabetes, based on impaired glycosylated hemoglobin (HbA1c) and/or fasting plasma glucose (FPG), were calculated. Hazard ratios (HR) for the association of the prediabetes with IRF, adjusting for potential confounders, were estimated by Cox regression models. Incidence rates of IRF per 100 person-years were 1.72 (95% confidence interval [CI]: 1.34-2.21) and 1.79 (95%CI: 1.45-2.20) for those without and with prediabetes, respectively .The HR of IRF in subjects with prediabetes with respect to subjects without prediabetes was 0.76 (95% CI: 0. 54-1.07). Corresponding HRs for type of prediabetes was 0.68 (95%CI: 0.40-1.15) for those with both altered parameters, 0.68 (95%CI: 00.40-1.15) for those with only impaired HbA1c and 1.12 (95%CI: 0.68-1.85) for those with only impaired FPG. The present study reflects an overall trend towards a slightly decreased risk of IRF onset associated to prediabetes except for individuals with only isolated impaired FPG. Further studies are warranted to fully assess the renal progression of each group

Medical device regulation in vascular ageing assessment:a VascAgeNet survey exploring knowledge and perception

BACKGROUND: Regulation has a key role for medical devices throughout their lifecycle aiming to guarantee effectiveness and safety for users. Requirements of Regulation (EU) 2017/745 (MDR) have an impact on novel and previously approved systems. Identification of key stakeholders' needs can support effective implementation of MDR improving the translation to clinical practice of vascular ageing assessment. The aim of this work is to explore knowledge and perception of medical device regulatory framework in vascular ageing field.RESEARCH DESIGN AND METHODS: A survey was developed within VascAgeNet and distributed in the community by means of the EUSurvey platform.RESULTS: Results were derived from 94 participants (27% clinicians, 62% researchers, 11% companies) and evidenced mostly a fair knowledge of MDR (despite self-judged as poor by 51%). Safety (83%), validation (56%), risk management (50%) were considered relevant and associated with the regulatory process. Structured support and regulatory procedures connected with medical devices in daily practice at the institutional level are lacking (only 33% report availability of a regulatory department).CONCLUSIONS: Regulation was recognized relevant by the VascAgeNet community and specific support and training in medical device regulatory science was considered important. A direct link with the regulatory sector is not yet easily available.</p