Publication:
La farmacia hospitalaria en el equipo multidisciplinar de las unidades COVID de hospitalización

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Date

2020

Authors

Gil-Navarro, María Victoria
Luque-Márquez, Rafael

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Sociedad Española de Farmacia Hospitalaria. Editor comercial: Grupo Aula Médica, S.L.
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Abstract

La colaboración entre los especialistas en farmacia hospitalaria y enfermedades infecciosas está implantada en la mayoría de los hospitales españoles desde 2012, a raíz de los Programas de Optimización de Antibióticos. Los objetivos principales de esta colaboración son el abordaje integral de los pacientes con enfermedades infecciosas y el uso adecuado de los antimicrobianos en el hospital. Las actividades estructuradas y organizadas que los farmacéuticos tenían dentro de los grupos se vieron truncadas por la pandemia por SARS‑CoV-2, que requirió una alta dedicación. El intercambio de información en tiempo real entre las especialidades ha sido una vía efectiva para generar y mantener protocolos de tratamiento adaptados a cada centro, con continuas modificaciones basadas en las publicaciones que iban apareciendo. Los servicios de farmacia se tuvieron que reorganizar para dar respuesta, por un lado, a los pacientes que ingresaban por esta infección, y por otro, para continuar con las actividades anteriores, con las dificultades añadidas que exigían las normativas para la protección del personal sanitario. Hubo que reinventarse para establecer otros sistemas de comunicación y de colaboración, protocolizando el tratamiento farmacológico de estos pacientes, con modificaciones continuas, gestión de medicamentos a través de medicamentos especiales, diseño de circuitos para tratar a pacientes en su domicilio y en centros sociosanitarios y modificación de circuitos internos para minimizar los desplazamientos de los profesionales en el hospital, así como del personal que atendía a pacientes con SARS-CoV-2. A día de hoy, se desconoce el mejor fármaco antiviral y el mejor tratamiento antiinflamatorio, pero la colaboración del farmacéutico hospitalario es fundamental, pues dispone del conocimiento de los mecanismos de acción de fármacos tan diferentes y de las interacciones que pueden ocasionar. La urgente necesidad de utilizar fármacos experimentales, preferiblemente dentro de ensayos clínicos, coloca al farmacéutico en un papel clave dentro del equipo interdisciplinario imprescindible para conseguir los mejores resultados.
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. New communication and collaboration strategies were adopted. Protocols were established for the management of COVID-19 patients, with continuous changes; special medications had to be prepared and distributed; circuits were designed for the home- or institution-based care of patients; internal circuits were created to minimize the movements of hospital staff and professionals caring for COVID-19 patients. The most effective antiviral drug and anti inflammatory therapy remains elusive. 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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MeSH Terms

Medical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Critical Care
Medical Subject Headings::Psychiatry and Psychology::Psychological Phenomena and Processes::Mental Processes::Thinking::Decision Making
Medical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Disease Management
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Units
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospitals::Hospitals, Teaching::Hospitals, University
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Public Health Practice::Communicable Disease Control::Infection Control
Medical Subject Headings::Persons::Persons::Patients::Inpatients
Medical Subject Headings::Disciplines and Occupations::Health Occupations::Medicine::Internal Medicine::Infectious Disease Medicine
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospital Units::Intensive Care Units
Medical Subject Headings::Information Science::Information Science::Communication::Interdisciplinary Communication
Medical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Patient Care Team
Medical Subject Headings::Persons::Persons::Occupational Groups::Health Personnel::Pharmacists
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Disease Outbreaks::Epidemics::Pandemics
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Pharmaceutical Services::Pharmacy Service, Hospital
Medical Subject Headings::Health Care::Health Services Administration::Organization and Administration::Professional Practice::Professional Staff Committees::Pharmacy and Therapeutics Committee
Medical Subject Headings::Geographical Locations::Geographic Locations::Europe::Spain

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Keywords

Servicio de farmacia hospitalaria, COVID-19, Enfermedades infecciosas, Equipo multidisciplinar, Hospital pharmacy service;, Infectious disease, Multidisciplinary team

Citation

Gil-Navarro MV, Luque-Márquez R. La farmacia hospitalaria en el equipo multidisciplinar de las unidades COVID de hospitalización. Farm Hosp. 2020 Jun 12;44(7):40-42.