Diseño, implantación y análisis de un modelo para la gestión del seguimiento farmacoterapéutico en una farmacia comunitaria

Abstract

Community pharmacy's contribution to the reduction of drug related morbidity is the practice of pharmaceutical care (PC). PC aims to identify drug related problems (DRP) for the prevention and resolution of negative outcomes associated with medication. It is a service that invests heavily in a single patient and therefore should be carefully managed. This work is an investigation about the management of PC to confront the hypothesis that the implementation and analysis of this service in a community pharmacy would deepen the knowledge of its viability. The overall objective of this study was to design, implement and analyze a model for the management of a pharmaceutical care service in a community pharmacy. METHODOLOGY A PC management´s model in a community pharmacy was designed. Necessary resources for its implementation were provided and it was developed using Dáder´s method in a sample of twenty patients. Statistical analysis of results was performed using Spearman's rho test for nonparametric correlations. RESULTS A model for PC management was designed and implemented. Patients were divided into four risk groups for DRP. Need for pharmacist´s training was identified and a training program was implemented and achieved an external accreditation. Pharmacists time proved to be the most important resource in implementing the model. Clinical outcomes resulted in nterventions to modify the treatment of 75% of patients; efectiveness problems were associated with half of the interventions, and non-compliance with prescribed treatment was the cause of 49% of detected problems. The analysis of the results showed a statistically significant relationship between the number of risk factors for DRP and the number of pharmacy interventions undertaken to solve them as well as between the number of risk factors for DRP and the use of resources and their cost. Revenues from the medication dispensed to these patients were not enough to compensate the service. DISCUSSION AND CONCLUSIONS Implementation of a pharmacotherapy follow-up service in a community pharmacy is possible by training the pharmacists and providing time for service. Patients with risk factors get the most benefit but are the largest consumers of system resources.