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Publications (26)1.12 Total impact

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    ABSTRACT: Objetive: The primary objective of this study was to evaluate the adherence level in chronic conditions patients during "The Adherence Day" celebrated on November 15, 2013. We performed a transversal, observational and multicenter study at 43 Spanish hospitals, in order to estimate adherence in chronic treatments. We used the validated questionnaires Haynes- Sackett and Morisky- Green to measure medication adherence; but also a visual analogue scale and questions related with treatment complexity and selective adherence were applied. We performed a descriptive analysis and the closeness of agreement between questionnaires results. A total of 723 surveys were collected especially among outpatients. 43% of the participants were women, with a median age of 51 and taking 3 drugs per day. 10.8% of the patients reported to have difficulty taking their pills according to Haynes- Sackett test. However, depending on Morisky- Green questionnaire, 56.4% of the participants were totally compliant; but considering only the question about forgetfulness, more were adherents (77%). 71% of the patients considered their compliance level as good (more than 8) according to visual analogue scale. And 11% presented a selective adherence, no taking equally well all the medications. The closeness of agreement between questionnaires and Morisky- Green test, as gold standard, was poor for Haynes- Sackett and weak for visual analogue scale. In our study only 56% of the patients with chronic treatment had a perfect adherence. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
    No preview · Article · Mar 2015 · Revista de la Sociedad Espanola de Farmacia Hospitalaria

  • No preview · Article · Apr 2014
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    ABSTRACT: Objectives: To describe the structure, process and outcomes with which hospital pharmacist performs health care activity, teaching and research about Pharmaceutical Care (PC) in HIV patients in Spain. Methods: Observational, cross-sectional and multicenter study carried out between November 2011-February 2012 in spanish hospitals. The inclusion criteria were: hospitals pharmacy services that dispensed antiretroviral medication to HIV patients. The questionnaire had 41 questions structured in 9 groups: hospital type and person conducting the survey, structure and resources, health care activities, interventions, communication with the rest of the multidisciplinary team, adherence, and quality records, management and pharmacoeconomy and teaching and research. Descriptive analysis was performed. To analyze the existence of statistically significant relationships, we applied fisher test, chi-square or logistic regression. Results: 86 hospitals completed the survey. In 93%, PC consultation was not classified by pathologies. 27.9% provided continuing PC to all patients. Adherence was determined regularly or when pharmacist suspected poor adherence (57.5 %). 20% of hospital s teaching had a program that allowed a high level of training in PC to HIV patient. 52,3% of participating centers had published scientific articles related to HIV. Conclusions: Pharmaceutical care to HIV patients in Spain need to adapt to a new situation. For this, hospital pharmacists have to consider several issues such as chronicity, comorbidity, incorporation of new technologies and the stratification of patients in order to make it more efficient.
    No preview · Article · Mar 2014 · Revista de la Sociedad Espanola de Farmacia Hospitalaria

  • No preview · Article · Mar 2013 · European Journal of Hospital Pharmacy
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    ABSTRACT: Objective To develop and validate a prediction model for the detection of drug-related problems (DRP) in patients on antiretroviral treatment during their regular monitoring in Pharmaceutical Care Clinics before dispensing drugs.MehodOpen multicentre prospective study. HIV patients with and without DRP were included. Demographic, clinical and pharmacotherapy variables (related and unrelated to antiretroviral treatment) were included in the model design.To find prognostic factors for DRP, a binary logistic regression model was created after performing a univariate analysis that identified independent variables related to DRP these variables were introduced in the multivariate model for the final selection. Model validity was determined by the shrinkage method and the discriminatory power by Harrell's C-index.Results733 patients were included. The variables “adherence”, “prescription of drugs needing dosage adjustment”, and “total number of drugs prescribed (apart from the antiretroviral treatment)” were independently related to the appearance of DRP. Probabilities predicted by the model, customising the coefficients using the uniform shrinkage method, showed a R2 = 0.962 for the construction sample and a R2 = 0.872 for the validation sample. The discriminatory capacity of the model was 0.816 for the construction sample and 0.779 for the validation sample.Conclusions The developed and validated model enables detection of patients on antiretroviral treatment who are at a higher risk for experiencing a DRP. The prediction variables employed are commonly used in patient's pharmacotherapy record, allowing the model to be used in routine clinical practice.
    No preview · Article · Sep 2012
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    ABSTRACT: OBJECTIVE: To develop and validate a prediction model for the detection of drug-related problems (DRP) in patients on antiretroviral treatment during their regular monitoring in Pharmaceutical Care Clinics before dispensing drugs. MEHOD: Open multicentre prospective study. HIV patients with and without DRP were included. Demographic, clinical and pharmacotherapy variables (related and unrelated to antiretroviral treatment) were included in the model design. To find prognostic factors for DRP, a binary logistic regression model was created after performing a univariate analysis that identified independent variables related to DRP these variables were introduced in the multivariate model for the final selection. Model validity was determined by the shrinkage method and the discriminatory power by Harrell's C-index. RESULTS: 733 patients were included. The variables "adherence", "prescription of drugs needing dosage adjustment", and "total number of drugs prescribed (apart from the antiretroviral treatment)" were independently related to the appearance of DRP. Probabilities predicted by the model, customising the coefficients using the uniform shrinkage method, showed a R(2)=0.962 for the construction sample and a R(2)=0.872 for the validation sample. The discriminatory capacity of the model was 0.816 for the construction sample and 0.779 for the validation sample. CONCLUSIONS: The developed and validated model enables detection of patients on antiretroviral treatment who are at a higher risk for experiencing a DRP. The prediction variables employed are commonly used in patient's pharmacotherapy record, allowing the model to be used in routine clinical practice.
    No preview · Article · Aug 2012 · Revista de la Sociedad Espanola de Farmacia Hospitalaria

  • No preview · Article · Mar 2012 · European Journal of Hospital Pharmacy

  • No preview · Article · Mar 2012 · Farmacia Hospitalaria

  • No preview · Article · Oct 2011 · Revista de la Sociedad Espanola de Farmacia Hospitalaria
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    ABSTRACT: To evaluate antiretroviral treatment adherence in the HIV patient cohort of our hospital and observe their evolution over a 9-year period; also to determine the individual pattern of adherence over time. Descriptive study of the evolution of average annual adherence and the annual percentage of adherent patients greater than 95% from 2000 to 2008. We analysed the individual pattern of adherence over time and patients were classified into consistently adherent, consistently non-adherent, and fluctuating. In the analysis of 577 patients, baseline adherence was significantly greater in naïve patients with respect to those who were pre-treated. Average annual adherence increased slightly and stayed at values around 95%. As with the percentage of patients with adherence greater than 95%, which increased from 64% in 2000 to 79% in 2008. In terms of the individual pattern of adherence over time, of the 468 patients analysed, the majority (59%) were consistently adherent, 4% non-adherent, and the rest (37%) fluctuated in their adherence. In our cohort the overall adherence values maintained themselves over time and even show a positive trend, likely the result of systematic monitoring of adherence and implementation strategies to maintain adherence.
    Preview · Article · Dec 2010 · Farmacia Hospitalaria
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    ABSTRACT: At present, the side effects associated with antiretroviral treatment are the main reasons for discontinuation of this kind of therapy, both in clinical trials and in regular clinical practise.On the other hand, due to the change of direction that our profession has suffered in recent years, we face the need to establish a different relationship with the patient, achieving direct and effective Pharmaceutical Care within a framework of shared responsibility for therapeutic results.Pharmacist interventions should be aimed at improving the quality of life of patients, which can only be achieved with a multidisciplinary approach and individualised and adjusted to new patterns of toxicity of the drugs currently used.The pharmacist who does this work must know how to interpret these side effects, giving accurate information to the patient about both pharmacological and non-pharmacological treatment and correct pharmaceutical follow-up which clearly sets forth the criteria for referral to medical appointments.The aim of this paper is to establish baselines so that the hospital pharmacist can perform clearly and uniformly in the prevention, identification and management of major side effects: gastrointestinal, cardiovascular, dermatological, at the central nervous system and kidney level, associated with antiretroviral therapy.
    Full-text · Article · Sep 2010
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    Full-text · Article · Apr 2009 · Farmacia Hospitalaria
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    ABSTRACT: This study wants to improve the pharmaceutical follow-up of HIV patients by applying criteria for selecting patients with a higher risk of therapeutic morbidity that are candidate for pharmaceutical care (PC). Method: In July 2007, we selected patients with adherence problems, virologic failure, prior drug-related problems (DRP), beginnings or changes in treatment, other concomitant treatments or requesting PC. Results: 42.5% of 193 patients were selected for PC. 77 of them had any of the criteria, mainly due to adherence problems and treatment for hepatitis C, and 5 on demand. Thirteen selected patients did not receive any PC because another person was the one picking up the medication. We identified 82 chances for improvement and 30 real DRPs, mainly related to safety and adherence. 47% of the stated interventions were of educational nature with the purpose of improving adherence. Conclusion: Patient selection produces PC optimization by ensuring the pharmaceutical follow-up for those patients in need.
    No preview · Article · Mar 2009 · Atencion Farmaceutica
  • O Ibarra Barrueta · L Ortega Valín
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    ABSTRACT: To understand the Pharmaceutical Care (PC) given to HIV+ patients in Spain. In the year 2004, a survey on PC provided to HIV+ patients was conducted among pharmacists. The survey, with 33 questions, aimed to determine the material and human resources used in this area, as well as specific aspects of PC, and finally the pharmacist's opinion. The survey was distributed through the SEFH (Spanish Society of Hospital Pharmacists) webpage and at HIV conferences. Data was collected from 68 hospitals, most of them public. The most important strengths included the availability of material resources, extensive consulting hours, and the intervention of the pharmacist at key moments (treatment initiation, changes in treatment and changes at the request of the patient). Verbal information was provided in most hospitals, accompanied by written information in 68% of cases. Although 81% of hospitals monitored compliance, less than half did it in a systematic manner, with the most widely used method being the dispensing records. Dispensing data was recorded, and to a lesser extent, the patients' drug treatment histories were available. Differences were seen among the hospitals depending on their size. The pharmacist considered that the PC was acceptable, but that there was room for improvement, and considered the measures available insufficient, highlighting the need for specific personnel and training. The PC situation of HIV patients is of a good standard, but there is still a lot to be done to achieve acceptable, quality PC.
    No preview · Article · Jun 2008 · Farmacia Hospitalaria
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    Olatz Ibarra Barrueta · Luis Ortega Valín
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    ABSTRACT: Objetivo: Conocer la situación de la atención farmacéutica (AF) al paciente con VIH en España. Método: En el año 2004 se realizó una encuesta sobre AF al paciente con VIH dirigida a farmacéuticos. La encuesta, de 33 preguntas, intentaba conocer los recursos materiales y humanos destinados a esta área, así como aspectos concretos de la AF y, finalmente, la opinión del farmacéutico. La encuesta se distribuyó a través de la página web de la SEFH y las jornadas de VIH. Resultados: Se recogieron datos de 68 hospitales, mayoritariamente públicos. Como puntos fuertes destacan la disponibilidad de recursos materiales, un horario de atención amplio y la intervención del farmacéutico en los momentos clave (inicios, cambios de tratamiento y a petición del paciente). En la mayoría de los hospitales se facilitaba información oral, acompañada de información escrita en el 68% de los casos. Aunque el 81% de los hospitales controlaban la adhesión, menos de la mitad lo hacían de forma sistemática; el método más empleado era el registro de dispensación. Se registraban datos de dispensación y, en menor medida, se disponía de una historia farmacoterapéutica del paciente. Se observaron diferencias entre los hospitales según su tamaño. El farmacéutico opinaba que la AF era aceptable pero mejorable y consideraba insuficientes los medios disponibles, destacando la necesidad de personal y formación específica. Conclusiones: La situación de la AF en el paciente con VIH tiene un buen nivel, pero queda mucho por hacer para alcanzar una AF aceptable y de calidad.
    Full-text · Article · Jun 2008 · Farmacia Hospitalaria
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    ABSTRACT: Objective: To describe the preparation process of intravitreous bevacizumab syringes, their use in treating age-related macular degeneration and related pathologies, and to estimate its economic impact. Method: Retrospective study. We analyzed data recorded for the period between 03/29/06 and 04/03/07. Results: Syringe preparation took place in a laminar flow cabinet (BIO-II-A) using an aseptic technique. They were assigned a three-month stability at 2-8°C. 170 syringes were individually prepared, and a total of 99 patients were treated. The number of administered doses per patient varied from 1 to 7 (median = 1, interquartile range = 1 to 2). 45% of patients received more than a dose, with a dose interval from 27 to 70 days. No treatment-related adverse reaction was recorded. The use of intravitreous bevacizumab produced net savings of 246,414 € with respect to the prior year. Conclusions: The results seem to point out that bevacizumab could be a cost-effective alternative in the treatment of pathologies with a proliferative component. The role of the pharmacy department is directed at individualized syringe preparation and therapy follow-up.
    No preview · Article · Mar 2008 · Atencion Farmaceutica
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    ABSTRACT: Objective To describe the ARPAS study and analyse the sociodemographic and clinical characteristics and patient preferences with regards the antiretroviral treatment (ART), as well as the relationship between compliance and satisfaction with the ART and quality of life.Method The ARPAS study has looked at adult patients diagnosed with HIV and on ART, using a protocol including sociodemographic, clinical, therapeutic and quality of life variables. Compliance was estimated using the SMAQ questionnaire; satisfaction was measured using the ESTAR questionnaire, as was quality of life with the MOS-HIV Health Survey, and treatment preferences were determined using a questionnaire prepared based on the consensus of an expert team in the field of therapeutic monitoring of these patients. A stratified univariate analysis according to compliance and a logistic regression analysis were carried out to study the association of the independent variables with compliance.ResultsA total of 234 patients were evaluated (73.7% male; 43.2 ± 7.8 years of age). The average time since diagnosis and from the initiation of ART was 10.1 ± 5.7 and 7.4 ± 4.4 years respectively. The therapeutic regime of twice-daily doses (bid) was applied to 71% of the patients, and once daily (qd) in 21%. A total of 43% of the patients fulfilled compliance criteria according to the SMAQ. The percentage of the patients with qd complying with the ART was greater than the remaining dosing schedules (55.3 vs. 45.1%), although not significantly (p = 0.251). No differences were observed in the sociodemographic and clinical variables in terms of compliance. An elective preference was observed for the simplest of the therapeutic regimes which contrasts with the evaluation of the ART characteristics, where power is given preference over durability, tolerance and lastly, the convenience of taking the ART. The univariate analysis showed the highest score on the satisfaction scales (50.4 ± 7.8 vs. 46.5 ± 9.7, p = 0.001) and quality of life (81.6 ± 10.7 vs. 75.7 ± 11.8, p < 0.001) in compliant patients with respect to non-compliers. The multivariate models confirm the existence of a significant association between compliance and satisfaction, and between compliance and quality of life.Conclusions Patients consider treatment with a powerful, long-lasting and well-tolerated ART a priority and among their preferences for different treatment regimes, once-daily dosing regimes are highlighted. The ARPAS study showed a direct relationship between compliance and satisfaction with ART, and between compliance and quality of life, in a manner that the strategies improving compliance must necessarily include aspects that allow them to improve patient satisfaction with treatment and quality of life.
    Full-text · Article · Dec 2007 · Farmacia Hospitalaria
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    ABSTRACT: Objective To evaluate the psychometric characteristics, convergent validity and reliability of the antiretroviral treatment satisfaction scale (ESTAR, escala de satisfacción con el tratamiento antirretroviral). Method Patient satisfaction with ART was determined using the ESTAR questionnaire, developed in Spanish based on the English language version of the HIV-Treatment-Satisfaction Questionnaire (HIVTSQ). In order to evaluate this, internal consistency and test-retest reliability were measured. The construct analysis was performed by studying the covariance and correlation of the questions, and the convergent validity was assessed by using the MOS-HIV (Medical Outcomes Study HIV Health Survey) questionnaire as the standard, as was the content validity by the correlation between the ESTAR and the clinical and therapeutic variables. Results The ESTAR is structured in two dimensions (clinical satisfaction and satisfaction with lifestyle) with slight modifications to the original version; question 4, discarded in the original version, has been reworded in the Spanish version, and question 9 was deleted because of low communality. As regards the testretest reliability, all the questions show significant intraclass correlation coefficients (p < 0.001). The internal consistency shows higher values than the original version in the lifestyle dimension (a = 0.81 vs. a =0.74) and in the total score (a = 0.84 vs. a = 0.82). With regard to convergent validity, the ESTAR presents significant correlations with the MOS-HIV as a whole and with different dimensions of it, especially the association with mental health, health distress and cognitive functioning dimensions. Conclusions The ESTAR turns out to be a suitable, reliable instrument for evaluating satisfaction with ART by HIV+ patients.
    No preview · Article · Dec 2007 · Farmacia Hospitalaria
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    ABSTRACT: To evaluate the psychometric characteristics, convergent validity and reliability of the antiretroviral treatment satisfaction scale (ESTAR, escala de satisfacción con el tratamiento antirretroviral). Patient satisfaction with ART was determined using the ESTAR questionnaire, developed in Spanish based on the English language version of the HIV-Treatment-Satisfaction Questionnaire (HIVTSQ). In order to evaluate this, internal consistency and test-retest reliability were measured. The construct analysis was performed by studying the covariance and correlation of the questions, and the convergent validity was assessed by using the MOS-HIV (Medical Outcomes Study HIV Health Survey) questionnaire as the standard, as was the content validity by the correlation between the ESTAR and the clinical and therapeutic variables. The ESTAR is structured in two dimensions (clinical satisfaction and satisfaction with lifestyle) with slight modifications to the original version; question 4, discarded in the original version, has been reworded in the Spanish version, and question 9 was deleted because of low communality. As regards the test-retest reliability, all the questions show significant intraclass correlation coefficients (p<0.001). The internal consistency shows higher values than the original version in the lifestyle dimension (a=0.81 vs. a=0.74) and in the total score (a=0.84 vs. a=0.82). With regard to convergent validity, the ESTAR presents significant correlations with the MOS-HIV as a whole and with different dimensions of it, especially the association with mental health, health distress and cognitive functioning dimensions. The ESTAR turns out to be a suitable, reliable instrument for evaluating satisfaction with ART by HIV+ patients.
    Full-text · Article · Jan 2007 · Farmacia Hospitalaria
  • O. Ibarra Barrueta
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    ABSTRACT: An optimal adherence to antiretroviral treatment is essential to obtain a correct virologic suppression. Achieving and maintaining good adherence levels is an important issue in HIV-1 infection management; but it is often difficult due to the complexity of the treatment, the adverse effects, and because antiretroviral therapy is a long- life treatment. New drugs have been developed that make treatment more convenient and easy without losing potency, that allow therapy simplification to enhance adherence and pacient's quality of life. Patients prefer easier therapies, especially with less pill burden and less doses per day, without food restriction and more favourable toxicity profiles, to adapt the treatment to their necessities and lifestyle.
    No preview · Article · Jan 2005 · Enfermedades Infecciosas y Microbiologia Clinica Monografias