1
|
González-Fernández MÁ, Herranz-Pinto P, Alonso-Pacheco ML, Mateo-Salillas C, Hoyo-Muñoz Á, Jiménez-Nácher I, Moreno-Ramos F, Herrero-Ambrosio A. [Incorporation of patient-reported outcomes into pharmacy and dermatology departments, in psoriasis and atopic dermatitis patients, as a tool to improve the healthcare quality and health outcomes]. J Healthc Qual Res 2024; 39:13-22. [PMID: 37919175 DOI: 10.1016/j.jhqr.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/17/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION Patient-reported outcomes (PROs) provide subjective information about their disease, treatment, and quality of life. OBJECTIVE To introduce a new system of work coordinated between pharmacists and dermatologists, based on the collection and analysis of PROs to assess its clinical impact as well as patients satisfaction. METHOD A prospective single-centre observational study was conducted under clinical conditions and included adult patients diagnosed with psoriasis (PS) and atopic dermatitis (AD) between April-2021 and February-2022. Pharmacists and dermatologists agreed on this systematic work. A REDCap® database was designed to facilitate data collection and the subsequent analysis. RESULTS A total of 288 and 41 patients with PS and AD, respectively, were included. Those who started treatment showed significant improvement with a decrease in PROs and clinical parameters (p < 0.001). The pharmacist made 168 and 7 recommendations to dermatologists for PS and AD patients, respectively, of which 66.07% and 57.1% were accepted. The most common recommendations were «consult with rheumatologist» (20.83%), «extend drug regimen» (19.64%) and «consider change in treatment» (11.90%). Adverse events were reported in 55 and 17 patients with PS and AD, respectively. Of 103 patients, 75% were «very satisfied» and 20% «satisfied» with the system. CONCLUSIONS This new working system helps to evaluate the short and long-term effectiveness of treatments and also to identify adverse events, alarm symptoms and co-morbidities in order to optimize therapies. Collaboration between pharmacists and dermatologists reduces decision-making time and patients appreciate better clinical care leading to higher patient satisfaction.
Collapse
Affiliation(s)
| | - P Herranz-Pinto
- Servicio de Dermatología. Hospital Universitario La Paz, Madrid, España
| | | | - C Mateo-Salillas
- Servicio de Farmacia. Hospital Universitario La Paz, Madrid, España
| | - Á Hoyo-Muñoz
- Servicio de Farmacia. Hospital Universitario La Paz, Madrid, España
| | - I Jiménez-Nácher
- Servicio de Farmacia. Hospital Universitario La Paz, Madrid, España
| | - F Moreno-Ramos
- Servicio de Farmacia. Hospital Universitario La Paz, Madrid, España
| | | |
Collapse
|
2
|
Escudero-Vilaplana V, Collado-Borrell R, Gómez Martínez-Sagrera P, Villanueva-Bueno C, Revuelta-Herrero JL, Gonzalez-Haba E, Hoyo-Muñoz Á, Jerez Gilarranz Y, Marzal-Alfaro B, Herranz A, Martin M, Sanjurjo M. Complementary and alternative medicine in cancer patients: characteristics of use and interactions with antineoplastic agents. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04172-1. [PMID: 35790560 DOI: 10.1007/s00432-022-04172-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Our objectives were to analyze the use of complementary and alternative medicine (CAM) in cancer patients and to describe the incidence and characteristics of interactions between CAM and antineoplastic agents. METHODS We performed an observational study in cancer outpatients at a university hospital. Variables were collected through a 22-item questionnaire. Potential interactions between CAM and antineoplastic agents were analyzed using the Lexicomp®, the About Herbs®, and the summary of product characteristics. Mechanism of action, reliability, and the potential clinical effect of interactions were analyzed. RESULTS The study population comprised 937 patients, of whom 65% used CAM (70.6% herbal products, 25.8% dietary supplements, and 3.6% homeopathy). Female sex, younger age, and breast cancer were associated with more frequent use of CAM. The primary source of information about CAM was friends and family (43.5%). A total of 335 (57.1%) patients did not tell their doctor that they took CAM. The five most common CAM were chamomile, green tea, pennyroyal mint, linden, and rooibos. At least one interaction between CAM and antineoplastic agents was reported by 65.0% of CAM users (33.9% of all patients). Depending on the mechanism of action, 80% of CAM diminished the metabolism of the antineoplastic agents. CONCLUSION Our results reveal a high incidence of interactions between CAM and antineoplastic agents. The most frequent CAM were herbal products. Family and friends were the primary sources of information that led patients to start taking CAM, and more than half of the patients did not tell their doctor that they were taking CAM.
Collapse
Affiliation(s)
- Vicente Escudero-Vilaplana
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Roberto Collado-Borrell
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Patricia Gómez Martínez-Sagrera
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Cristina Villanueva-Bueno
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - José Luis Revuelta-Herrero
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Eva Gonzalez-Haba
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ángela Hoyo-Muñoz
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Yolanda Jerez Gilarranz
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- CiberOnc, Madrid, Spain
| | - Belén Marzal-Alfaro
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ana Herranz
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Miguel Martin
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- CiberOnc, Madrid, Spain
| | - María Sanjurjo
- Pharmacy Department, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| |
Collapse
|