Farmacia hospitalaria : órgano oficial de expresión científica de la Sociedad Española de Farmacia Hospitalaria
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Type 2 coronavirus pandemics that is plaguing almost all the world has caused qualitative and quantitative strains in health systems that have had to be responded to. The lack of known vaccines and effective treatments has generated the need to use drugs with very little evidence for their incorporation into pharmacotherapeutic protocols agreed by the clinical team. The hospital pharmacist, within the multidisciplinary team, has been responsible for critically evaluating the alternatives and positioning them in these protocols. Finally, some ethical and legal questions that should be considered in this scenario are analyzed in this article.
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Since the implementation of the Antimicrobial Therapy Optimization Programme, hospital pharmacy specialists have collaborated with infectious disease specialists on a regular basis in most hospitals in Spain. Cooperation between these professionals ensures the integrated management of patients with infectious diseases and the appropriate use of antimicrobials in hospitals. The COVID-19 pandemic forced hospital pharmacists to abruptly suspend all their structured activities and concentrate on the health crisis. Realtime information sharing between different medicine specialties is an effective strategy to generate and maintain treatment protocols adapted to each center, with continuous evidence-based modifications as new publications appear. Hospital pharmacies had to reorganize their activities to respond to the pandemic. On the one side were patients with COVID-19, and on the other were routine hospital pharmacy tasks, with the added difficulty of adapting to individual protection measures. ⋯ In this scenario, hospital pharmacists emerge as a key player, as they have a deep understanding of the mechanisms of action of drugs and potential interactions. In a setting where experimental drugs preferably tested in clinical trials are being used, the role of hospital pharmacists in interdisciplinary teams has become essential for the optimization of clinical outcomes.
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The WHO declared the SARS- CoV-2 outbreak a pandemic in March 11, 2020. Spain has been the third country with the highest number of reported cases of COVID-19. In the face of the pandemic, the authorities of the Autonomous Community of Madrid led an unprecedented transformation of hospital services by increasing the number of beds available, setting up temporary field hospitals in fairgrounds, and transforming hotels into support centers for patients with mild symptoms of COVID-19. In the light that this crisis will continue to be a real threat for the years to come, our hospital pharmacies need to be better prepared for similar outbreaks in the future. During the COVID-19 pandemic, the Department of Hospital Pharmacy of Hospital General Universitario Gregorio Marañón has faced four challenges: an exponential increase in the demand for resources, constant changes to therapeutic protocols and approaches, regulatory changes, and a dramatic impact on hospital staff (strain on human resources and psychological impact). This article is aimed at describing the main organizational changes implemented to the Department of Hospital Pharmacy of Hospital GU Gregorio Marañón and its relationship with other hospital pharmacies of the Community of Madrid. ⋯ People, patients and professionals are at the core of these strategies. This paper is a reflection on key factors of "humanization in COVID times".
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Medical devices have become essential to the prevention and control of the COVID-19 pandemic, being crucial for health professionals and patients in particular, and the population in general. It is important to be aware of the laws that regulate the management, distribution, and control of medical devices. Article 82 of the Spanish Law 29/2006 on Guarantees and Rational Use of Medicines and Medical Devices establishes that it is the responsibility of Hospital Pharmacy Services "to participate in and coordinate the purchase of medicines and medical devices in the hospital to ensure an efficient acquisition and rational use of medical devices". For this reason, working groups of the Spanish Society of Hospital Pharmacy and other scientific societies have issued technical guidelines and consensus statements to provide technical support and updated information on the use of masks, individual protection equipments and other medical devices. In addition, the shortage of medical devices caused by the high demand has resulted in the uncontrolled production and distribution of medical devices. This phenomenon, added to the fraudulent selling of medical devices, highlights the need for a closer surveillance of the market to guarantee the efficacy and safety of available medical devices. A rational use of medical devices is necessary to ensure the availability and safety of these products, which requires the involvement of different stakeholders, including hospital pharmacists. ⋯ This will help guarantee an effective and safe use of medical products. The acquisition and use of medical devices requires a keen understanding of the technical and legal aspects concerning these products, which makes hospital pharmacists essential for the integral management of medical devices.
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The COVID-19 pandemic is having a devastating effect on the nursing homes for dependent older people. The difficulty of management of this crisis is aggravated by the frailty of the people served and by the specific characteristics of the care area, mainly the fact of not being integrated into the health system. The objective of this work is to describe the pharmaceutical care developed by a hospital pharmacy service established in a nursing home and, from a more global perspective, analyze the strengths and weaknesses found from the various experiences of hospital pharmacy in all spanish autonomous communities to deal with this pandemic. Specialized pharmaceutical care has provided rigor in the validation and treatments review processes from a comprehensive perspective, maximizing safety and collaborating in the establishment of the therapeutic intensity degree most appropriate to the individual situation, has ensured the availability of all necessary medications, has collaborated in the acquisition and management of personal protective equipment, has been able to adapt the dispensation processes to the internal nursing homes sectorization and has facilitated the coordination between the nursing home and the health system. It is clear that the crisis casued by COVID- 19 has put relevance of the need to integrate the social-health level into the health system. And also, the contribution of specialized pharmaceutical care in improving healthcare coverage and coordination with health services has highlighted the urgency of developing the current legislation, prioritizing the establishment of pharmacy services able to provid specialized and specific care for this area, so that it meets healthcare needs and is integrated into the health system.