Sunday, June 20, 2010

Pharmacotherapeutic follow-up DaderWeb

The journal Atención Primaria have published the overall results during the first year of initiation and piloting a new Primary Care database accessible from DaderWeb.

This web application arises from the need to optimize all data related to the program Dáder. The program was designed by the Research Group on Pharmaceutical Care, University of Granada, in 1999, and is currently being used in different countries by hundreds of pharmaceutical professionals in thousands of patients. It is based on obtaining the patient's pharmaceutical record in the community pharmacy and the personal pharmaceutical monitoring (SFT) by detecting, preventing and resolving drug-related problems on a continuous, systematic and documented way. It cooperates with the patient and all professionals of the Health System, in order to achieve concrete results that improve the quality of life of patients.

This first year of initiation and piloting is aimed to improve the organization of the information provided, to avoid loss of it, to optimize the processing of data and, ultimately, to enhance the quality of the information stored in it by:

a) Preparation of records and collection of information about its activity,

b) Location and access to updated information and quality,

c) Communication between professionals.

Among the registration documents available in DaderWeb we distinguish the pharmaceutical intervention sheet (HIF), which refer to a possible pharmaceutical care across countries and fields on the detection and intervention on negative results associated with the use of drugs (RNM).

Among their findings, only in the field of primary care in Spain, 234 HIF sent (a RNM for HIF) by 27 community pharmacies, 147 patients involved, with a mean age of 66 years (SD 11.8) and 59.4% of women. The 88.5% of the RNM was clinically manifested when detected.

The most frequent RNM were related to the ineffectiveness of drug therapy, supporting the need for closer monitoring of clinical outcomes of medications.

As most prevalent causes of failure were identified the neglect (17.9%) and the not appropriate dose, regime or duration of treatment (13.7%). In the 16% of cases they did not identify any cause and in a 36.9%, although there was a problem in the application process, it was not specify in the default list provided by the HIF3.

In the 35.9% of cases the pharmacist intervened independently through direct patient education to resolve the RNM. After measuring the appropriate clinical variables indicating, in each case, the development of RNM, these were resolved in the 81.2% of the times.

To systematize the SFT has made great strides thanks to the Dáder program. The evaluation of the quality of the prescription allows to detect any differences, points of improvement and to develop and design appropriate interventions to optimize outcomes in the health field. The Dáder, certainly, is a huge step that should appeal to all community pharmacists in improving the SFT and to build on its steps.

Sabater-Hernández D, Faus D, Fikri-Benbrahim N, García-Cárdenas V. Resultados globales de la base de datos del Programa Dáder de Seguimiento Farmacoterapéutico: 2008. Aten Primaria. 2010;42:297-8.

Contribution by M ª José Montero Fernández. Primary Care Pharmaceutical, Area 4, Madrid.
English version by Jesús Moreno

No comments:

Post a Comment