Quality of the pharmacotherapeutic recommendations for the integrated care procedures in Andalusia

Muñoz Corte, Rosa María; García Estepa, Raúl; Santos Ramos, Bernardo; Bautista Paloma, Francisco Javier

doi:10.1016/S2173-5085(09)70092-9

Farmacia Hospitalaria

ISSN: 1130-6343

Farmacia Hospitalaria (Farm Hosp) is the official publication of the Spanish Society of Hospital Pharmacists (SEFH), a professional and scientific organization that currently has about 4.351 members.

The Mission of Farm Hosp is to be the support for health professionals for expanding the influence of projects, publications, and training programs, and to promote the exchange of experiences.

Vision Farm Hosp is:
- to increase the state of knowledge about the hospital pharmacy and whose actions should increase the adequate and safe use of medicines and health products.
- to be an instrument of exchange and dissemination of scientific knowledge of pharmacy practice through the best use and safe medication and health outcomes.

It is a peer-reviewed double-blind scientific journal aimed at publishing in the broad field of Hospital Pharmacy advances in Pharmacy Services. This journal included the following topics: Drug evaluation. Quality of life. Patient Reported Outcome Measures (PROMs), and Patient Reported Experience Measures (PREMs) in the use of drugs. Monitoring medication. Pharmaceutical compounding. Medication administration. Management of Pharmacy Services (logistics, quality control). Technologies and information systems in the process of using medication. Medical devices. Patient Education. Pharmacist´s role in the society and /or in the Health System in Spain, and other topics related to clinical, scientific, and institutional role of hospital pharmacists.

Farmacia Hospitalaria publishes bimonthly (6 issues yearly) originals, short originals, reviews, clinical cases, special articles, protocols, consensus documents, clinical guidelines, letters to the editor, editorials.

All the articles are published in Spanish and English language regardless of the language in which they are received.

Farmacia Hospitalaria is an Open Access journal, whose content is available free of charge to users or their institutions. Users are authorised to read, download, copy, distribute, print, search, or link to entire texts of the articles in this journal without prior permission from the editor or author, according to the BOAI definition of Open Access. The papers may be re-used under the terms of the Creative Commons 4.0 license. (CC BY-NC-ND). Such use shall be subject to authorisation from SEFH, the journal owner.

Farmacia Hospitalaria journal charges no fees for submission of papers or publication of articles.

Adherence to international ethics recommendations

Manuscripts must follow the most recent recommendations of the International Committee of Medical Journal Editors (available at http://www.icmje.org).

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Indexed in:

Medline, Emerging Sources Citation Index (ESCI), Directory of Open Access Journals (DOAJ)

The assessment tool was designed based on similar instruments, specifically the AGREE. Other criteria included were taken from various literature sources or were devised by ourselves. The tool was validated prior to being used. After applying it to all the PAIs, we examined the degree of compliance with these pharmacotherapeutical criteria, both as a whole and by PAIs subgroups.

Results

The developed tool is a questionnaire of 20 items, divided into 4 sections. The first section consists of the essential criteria, and the rest make reference to more specific, non essential criteria: definition of the level of evidence, thoroughness of information and definition of indicators. It was found that 4 of the 60 PAIs do not contain any type of therapeutic recommendation. No PAI fulfils all the items listed in the tool, however, 70 % of them fulfil the essential quality criteria established.

Conclusions

There is a great variability in the content of pharmacotherapeutical recommendations for each PAI. Once the validity of the tool has been proved, it could be used to assess the quality of the therapeutic recommendations in clinical practice guidelines.

Keywords:

Care procedures

Health planning guidelines

Pharmacotherapeutica recommendations

Health service evaluation

Resumen

Objetivos

Evaluar, a través del diseño y la validación de una herramienta, la calidad de las recomendaciones farmacoterapéuticas incluidas en los Procesos Asistenciales Integrados (PAI) de la Consejería de Salud de la Junta de Andalucía, publicados hasta marzo de 2008.

Métodos

La herramienta de evaluación se diseñó a partir de instrumentos similares, fundamentalmente el Appraisal of Guidelines for Research and Evaluation. Otros criterios incluidos provenían de diversas fuentes bibliográficas o fueron de elaboración propia. Previamente a su utilización, la herramienta fue validada. Tras la aplicación a todos los PAI, se analizó el grado de cumplimiento de estos criterios farmacoterapéuticos globalmente y por subgrupos de PAI.

Resultados

La herramienta elaborada consiste en un cuestionario de 20 ítems dividido en 4 bloques. El primer bloque corresponde a criterios esenciales, el resto hace referencia a criterios más específicos y considerados no esenciales: definición del nivel de evidencia, exhaustividad de la información y definición de indicadores. De los 60 PAI, 4 no contienen ningún tipo de recomendación terapéutica. Ningún PAI cumple el total de ítems recogidos en la herramienta; no obstante, un 70 % de ellos cumple los criterios esenciales de calidad establecidos.

Conclusiones

Hay una gran variabilidad en cuanto al contenido de recomendaciones farmacoterapéuticas de cada PAI. Una vez demostrada la validez de la herramienta diseñada, podría utilizarse para valorar la calidad de las recomendaciones terapéuticas en guías de práctica clínica.

Palabras clave:

Procesos asistenciales

Directrices para la planificación en salud

Recomendaciones farmacoterapéuticas

Evaluación de servicios sanitarios

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