RECERCAT - Articles publicats en revistes (Farmàcia i Tecnologia Farmacèutica)

Community pharmacist intervention in depressed primary care patients (PRODEFAR study): randomized controlled trial protocol.

Community pharmacist intervention in depressed primary care patients (PRODEFAR study): randomized controlled trial protocol. Rubio Valera, Maria; Serrano Blanco, Antoni; Travé i Mercadé, Pere; Peñarrubia María, María Teresa; Ruiz, Mar; March Pujol, Marian Background: Treatment of depression, the most prevalent and costly mental disorder, needs to be improved. Non-concordance with clinical guidelines and non-adherence can limit the efficacy of pharmacological treatment of depression. Through pharmaceutical care, pharmacists can improve patients' compliance and wellbeing. The aim of this study is to evaluate the effectiveness and costeffectiveness of a community pharmacist intervention developed to improve adherence and outcomes of primary care patients with depression. Methods/design: A randomized controlled trial, with 6-month follow-up, comparing patients receiving a pharmaceutical care support programme in primary care with patients receiving usual care. The total sample comprises 194 patients (aged between 18 and 75) diagnosed with depressive disorder in a primary care health centre in the province of Barcelona (Spain). Subjects will be asked for written informed consent in order to participate in the study. Diagnosis will be confirmed using the SCID-I. The intervention consists of an educational programme focused on improving knowledge about medication, making patients aware of the importance of compliance, reducing stigma, reassuring patients about side-effects and stressing the importance of carrying out general practitioners' advice. Measurements will take place at baseline, and after 3 and 6 months. Main outcome measure is compliance with antidepressants. Secondary outcomes include; clinical severity of depression (PHQ-9), anxiety (STAI-S), health-related quality of life (EuroQol-5D), satisfaction with the treatment received, side-effects, chronic physical conditions and sociodemographics. The use of healthcare and social care services will be assessed with an adapted version of the Client Service Receipt Inventory (CSRI). Discussion: This trial will provide valuable information for health professionals and policy makers on the effectiveness and cost-effectiveness of a pharmaceutical intervention programme in the context of primary care. Trial registration: NCT00794196

Positive Outcomes Influence the Rate and Time to Publication, but Not the Impact Factor of Publications of Clinical Trial Results

Positive Outcomes Influence the Rate and Time to Publication, but Not the Impact Factor of Publications of Clinical Trial Results Suñé Martin, Maria Pilar; Suñé i Negre, Josep M. (Josep Maria); Montoro Ronsano, José Bruno Objectives: Publication bias may affect the validity of evidence based medical decisions. The aim of this study is to assess whether research outcomes affect the dissemination of clinical trial findings, in terms of rate, time to publication, and impact factor of journal publications. Methods and Findings: All drug-evaluating clinical trials submitted to and approved by a general hospital ethics committee between 1997 and 2004 were prospectively followed to analyze their fate and publication. Published articles were identified by searching Pubmed and other electronic databases. Clinical study final reports submitted to the ethics committee, final reports synopses available online and meeting abstracts were also considered as sources of study results. Study outcomes were classified as positive (when statistical significance favoring experimental drug was achieved), negative (when no statistical significance was achieved or it favored control drug) and descriptive (for non-controlled studies). Time to publication was defined as time from study closure to publication. A survival analysis was performed using a Cox regression model to analyze time to publication. Journal impact factors of identified publications were recorded. Publication rate was 48·4% (380/785). Study results were identified for 68·9% of all completed clinical trials (541/785). Publication rate was 84·9% (180/212) for studies with results classified as positive and 68·9% (128/186) for studies with results classified as negative (p<0·001). Median time to publication was 2·09 years (IC95 1·61
2·56) for studies with results classified as positive and 3·21 years (IC95 2·69
3·70) for studies with results classified as negative (hazard ratio 1·99 (IC95 1·55
2·55). No differences were found in publication impact factor between positive (median 6·308, interquartile range: 3·141
28·409) and negative result studies (median 8·266, interquartile range: 4·135
17·157). Conclusions: Clinical trials with positive outcomes have significantly higher rates and shorter times to publication than those with negative results. However, no differences have been found in terms of impact factor.

Clinical pharmacokinetics of mycophenolic acid and its metabolites in solid organ transplant recipient

Clinical pharmacokinetics of mycophenolic acid and its metabolites in solid organ transplant recipient Colom Codina, Helena; Lloberas Blanch, Núria; Caldés, Ana; Andreu, Franc; Torras Ambròs, Joan; Oppenheimer Salinas, Federico; Sanchez-Plumed, Jaime; Gentil, Miguel A.; Kuypers, Dirk R.; Brunet i Serra, Mercè; Ekberg, Henrik; Grinyo Boira, Josep M. Mycophenolate mofetil (MMF), an ester prodrug of the immunosuppressant mycophenolic acid (MPA), is widely used for maintenance immunosuppressive therapy and prevention of renal allograft rejection in renal transplant recipients.MPA inhibits inosine monophosphate dehydrogenase (IMPDH), an enzyme involved in the “de novo” synthesis of purine nucleotides, thus suppressing both T-cell and B-cell proliferation. MPA shows a complex pharmacokinetics with considerable interand intra- patient by between- and within patient variabilities associated to MPA exposure. Several factors may contribute to it. The pharmacokinetic modeling according to the population pharmacokinetic approach with the non-linear mixed effects models has shown to be a powerful tool to describe the relationships between MMF doses and the MPA exposures and also to identify potential predictive patients’ demographic and clinical characteristics for dose tailoring during the post-transplant immunosuppresive treatment.; Podeu consultar el llibre complet a: http://hdl.handle.net/2445/32393

Ensenyament presencial a l'aula. Anàlisi metodològica i avaluació dels coneixements adquirits

Ensenyament presencial a l'aula. Anàlisi metodològica i avaluació dels coneixements adquirits Barbé Rocabert, Coloma; Aróztegui Trenchs, Montserrat; Halbaut, Lyda; García Montoya, Encarna; Torres Farrés, Esther; Suñer Carbó, Joaquim; Aparicio Pelegrin, R.M.; Ticó Grau, Josep R.; Penzo, Wilma; Vendrell i Gómez, Pere; Sánchez González, S. El treball que es presenta gira a l'entorn de la classe teòrica presencial, dissenyada segons les possibilitats d'aquesta classe quan es planteja per a un nombre elevat d'alumnes i es pretén la màxima implicació de l'estudiant. Analitza l'assistència a classe, el tipus de classe teòrica que s'imparteix i els resultats de les iniciatives preses per incentivar la participació activa. Els resultats demostren que els plantejaments didàctics són globalment adients en aquest context, fet que es reflecteix en la bona acceptació per part de l'alumne de les iniciatives proposades i en la millora notable del rendiment acadèmic, objectiu primordial del projecte REDICE-06 titulat Deconstrucció/construcció de l'ensenyament presencial, del qual forma part.