Pharmacotherapy follow-up: as a quality component in patient care
Keywords:
Pharmacotherapy follow-up, Quality in health, Patient safety, Drug Therapy ProblemsAbstract
The principal aim of management of the Quality of Care is to assure patient satisfaction, through theactive involvement of health care staff and the incorporation of strategies, whose main aim is to achievecontinuous improvement in clinical activities and to incorporate patient safety as one of its principlecomponents.The management of patient safety is a means to minimizing any possible harm to patients in careprocesses, including the use of medicines. The principles of patient safety can be applied to both levelsof patient care and involve all health care professionals. The risk management is an integral part ofpatient care. Patient safety depends on the solution of problems and the prevention of errors.
The pharmacist’s role in patient safety is carried out through Pharmaceutical Care processes and especiallythrough Pharmacotherapy follow-up (PF), which aims to prevent, detect and resolve Drug TherapyProblems (DTP).One of the main difficulties associated with this field is the lack of uniformity of the results obtainedthroughout the different studies carried out, where differences in definitions occur, as in the classificationof drug problems themselves, where process and result are constantly intermingled: Adverse effect,undesirable events, medication errors, DTP, etc.The criteria for classifying such aspects should be uniform, so as to make common information available,which will enable pharmacists to obtain greater knowledge on prevalence, their types, causes, severityand consequences.There is a general desire to improve upon patient safety, to assess the technological processes involvedin evaluating effectiveness and safety, and to certify the establishments and health care professionalsresponsible for such processes.This same approach should also be applied to PF, which is subject to the same basic safety principles.As in the case of all work carried out within the health system, the work of the pharmacist involvesthe professional and ethical responsibility of making his knowledge, experience and methodology availableto his patients. Pharmacists now have the opportunity of making a significant contribution to patientsafety, both in general terms and more specifically in the use of medicines, in a field which is currentlyset for future development.
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References
Consejo de Europa. Comité Europeo de la Sanidad. Comité de expertos en la gestión de la seguridad y la calidad de la atención sanitaria. La prevención de efectos adversos en la atención sanitaria: un enfoque sistémico. Estrasburgo, 4 de noviembre de 2004
Barr DP. Hazards of modern diagnosis and therapy. The price we pay. JAMA 1955; 159: 1452.
Mosser RH. Diseases of medical progress. N Engl J Med 1956; 255: 606.
Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Washington DC: National Academy Press; 1999.
Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients : Results of the Harvard Medical Practice Study I-II. N Engl J Med 1991; 324: 370-384.
Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD. The Quality in Australian Health Care Study. Med J Aust 1995; 163: 458-71.
Schioler T, Lipczak H, Pedersen BL, Mogensen TS, Bech KB, Stockmarr A, et al. Incidence of adeverse events in hospitals. A retrospective study of medical records. Ugeskr Laeger 2001; 163: 5370-8.
Vincent C, Neale G, Woloshynowych M. Adverse events in Brithish hospitals: preliminary retrospective record review. BMJ 2001; 322: 517-9.
Davis P, Lay-Yee R, Schug S, Briant R, Scott A, et al. Adverse events regional feasibility study: indicative findings. NZ Med J 2001; 114: 203-5.
Comité Económico y Social Europeo. Dictamen sobre «la seguridad sanitaria: una obligación colectiva, un derecho nuevo». Bruselas, 27 de octubre de 2004.
Ministerio de Sanidad y Consumo. Consenso sobre Atención Farmacéutica. Madrid: MSC 2001
Consensus committee. Second consensus of Granada on drug therapy problems. Ars Pharm 2002; 43: 175-84.
Aranaz JM, Aibar C, Gea MT, León MT. Efectos adversos en la asistencia hospitalaria. Una revisión crítica. Med Clin (Barc) 2004; 123(1): 21-5.
Plan de Calidad. Nuevas estrategias para la sanidad andaluza. Ed. Consejería de Salud. Junta de Andalucía. 2000
Guía de diseño y mejora continua de procesos asistenciales. Ed. Consejería de Salud. Junta de Andalucía. 2001
Machuca M, Férnandez-Llimós F, Faus MJ. Método Dáder. Guía de Seguimiento Farmacoterapéutico. Ed. La Gráfica. S. C. And. Granada 2003
Lachaux B, Lemoine P. Un medicamento que busca la verdad. McGraw-Hill; Madrid 1988; 5-6
Ley 14/1986, de 25 de abril, General de Sanidad, BOE nº 102, de 29 de abril de 1986.
United States Pharmacopeial Convention. National council focuses on coordinating error reduction efforts. Qual Rev(newsletter) 1997; 57: 1-4
WHO Quality of care: patient safety. Informe EB113/37 de la Secretaría al Consejo Ejecutivo, 4 de diciembre de 2003, 6p.
Fernández-Llimós F, Faus MJ, Gastelurrutia MA, Baena MI, Tuneu L, Martínez Martínez F. Identificación sistemática de resultados clínicos negativos de la farmacoterapia. Seguimiento Farmacoterapeutico 2004; 2(3): 195-205.
Bates DW, Boyle DL, Vander-Vliet MB, Schneider J, Leape L. Relationship between medication erros and adverse drug events. J Gen Intern Med 1995; 10(4): 199-205.
Prince BS, Goetz CM, Rihn TL, Olsky M. Drug-related emergency department visits and hospital admissions. Am J Hosp Pharm 1992; 49: 1996-1700.
Raschetti R, Morgutti M, Menniti-Ippolito F, Belisari A, Rossignoli A, Longhini P, La Guidara C. Suspected adverse drug events requiring emergency department visits or hospital admissions. Eur J Clin Pharmacol 1999; 54: 959-63.
Tafreshi MJ, Melby MJ, Kaback KR, Nord TC. Medication-related visits to the emergency department: a prospective study. Ann Pharmacother 1999; 33: 1252-57.
Tuneu L, García-Peláez M, López Sánchez S, Serra G, Alba G, de Irala C, et al. Drug related problems in patients who visit an emergency room. Pharm Care Esp 2000; 2: 177-92.
Otero MJ, Bajo A, Maderuelo JA Dominguez-Gil A. Evitabilidad de los acontecimientos adversos inducidos por medicamentos detectados en un servicio de urgencias. Rev Clín Esp 1999; 199: 796-805.
Guemes M, Sanz E, Garcia M. Adverse reactions and other drug-relared problems in a emergency service departmen. Rev Esp Salud Pública 1999; 73 (4): 512-18.
Dennehy CE, Kishi DT, Louie C. Drug-related illness in emergency department patients. Am J Health-Syst Pharm 1996; 53: 1422-6.
Patel P, Zed PJ. Drug-related visits to the emergency department: how big is the problem?. Pharmacotherapy 2002; 22: 915-23.
Smith KM, McAdams JW, Frenia HL, Todd MW. Drug-related problems in emergency department patients. Am J Health-
Syst Pharm 1997; 54: 295-8
Baena MI, Faus MJ, Marin R, Zarzuelo A, Jiménez-Martín J, Martínez-Olmos J. Problemas de salud relacionados con los medicamentosen un servicio de urgencies hospitalario. Med Clin (Barc) 2005; 124(7): 250-255
Martín MT, Codina C, Tuset M, et al. Problemas relacionados con la medicación como causa del ingreso hospitalario. Med Clin 2002; 118(6):205-210
Climente Martí M, Quintana Vargas I, Martínez Romero G, Atienza García A, Jiménez Torres NV. Prevalencia y características de la morbilidad relacionada con los medicamentos como causa de ingreso hospitalario. Aten Farm 2001; 3(1):9-22.
Einarson TR. Drug related hospital admissions. Am Pharmacother 1993; 27(7-8):832-40
Nelson KM, Talbert RL. Drug-related hospital admissions. Pharmacotherapy 1996; 16: 701-7.
Malthotra S, Karan RS, Pandhi P, Jain S. Drug related emergencies in the elderly: role of adverse drug reactions and non-compliance. Postgrad Med J 2001; 77(913): 703-707
Cunnigham G, Dodd TRP, Grant DJ, McMurdo T, Richards ME. Drug-related problems in elderly patients admitted to Tayside hospital, methods for prevencion and subsequent reassessment. Age Ageing 1997; 28:375-82
Darchy B, Le Miere E, Figueredo B, Bavoux E, Domart Y. Iatrogenic diseases as a reason for admisión to the intensive
care unit. Arch Intern Med 1999; 159:71-78
Major S, Badr S, Bahlawan L, Hassan G, Khogaoghlanian T, Khalil R, et al. Drug-related hospitalization at a tertiary teaching center in Lebanon: incidence, associations and relation to self-medicating behavior. Clin Pharmacol Ther 1998; 64: 450-61.
Howard RL, Avery AJ, Howard PD, Partridge M. Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study. Qual Saf Health Care 2003; 12:280-285
Alonso P, Otero MJ, Maderuelo JA. Ingresos hospitalarios causados por medicamentos: incidencia, características y coste.
Farmacia Hosp 2002; 26(2):77-89
Ibañez L, Laporte JR, Carné X. Adverse drug reactions leading to hospital admission. Drug safety 1991; 6(6): 450-59
Aparauso R. Drug related injury visits to hospital emergency departments. Am J Health-Syst Pharm 1998; 55
Hidalgo A, García del Pozo J, Carvajal A. Mortalidad y Morbilidad producidas por fármacos. Aproximación a su magnitud en nuestro medio. Pharm Care Esp 1999; 1: 179:183
Muñoz MJ, Ayani I, Rodríguez-Sasiain MJ, Gutierrez G, Aguirre C. Monitorización en un servicio de urgencias de reacciones adversas causadas por medicamentos en niños y adultos. Med Clin 1998; 111: 92-98
Hafner JW, Belknap SM, Squillante MD, Bucheit KA. Adverse drug events in emergency department patients. Ann Emerg Med 2002, 39: 258-267
De Abajo FJ, Frias J, Lopo CR, Garijo B, Castro MAS, Carcas A, Suarez S, Gil A. Las reacciones adversas a medicamentos como un motivo de consulta al servico de urgencias de un hospital general. Med Clin 1989; 92: 530-535
Ministerio de Sanidad y Consumo. Plan Estratégico de Política Farmacéutica para el Sistema Nacional de Salud. Madrid; 2004.
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