access personalized dosing system

Less than 10 percent of patients who are candidates for personalized dosing system (SPD) of medicines accesses it, despite the fact that it is an increasingly widespread service in Spain and has a largely positive evaluation by users and pharmacists, according to a study by the General Council of Pharmaceutical Colleges of Spaincollected by Europa Press.

The president of the Council, Jesus Aguilar, highlighted this Tuesday at a press conference that SPDs, which allow pharmacists to organize patients’ medication, are a “consolidated reality” in Spain and help to face “one of the most important challenges” of the health system, such as the lack of therapeutic adherence, but there is a lack of greater institutional support to guarantee their access to all people who can benefit.

The study Personalized Dosing Systems and Adherence Services in Spanish community pharmacyprepared by the consulting firm Hiris and in which the Spanish Society for Care of People with Chronic Diseases (SEAPEC) has collaborated, is based on a bibliographic review and two surveys, carried out 384 patients and caregivers and 475 pharmacists.

According to it, all autonomous communities and cities, with the exception of Asturias and Melillahave developed initiatives to improve adherence to treatments and the safe use of medications. The SPDs are the most widespread service, present in all territories except Asturias and Melilla, while the adherence programs are only implemented in seven Autonomous Communities.

Regarding SPDs, it stands out that 81 percent of the pharmacies surveyed provide the service, in addition to the fact that satisfaction on the part of users and pharmacists is high, around 91 percent. However, Aguilar has asserted that the institutional support offered by the CCAA “it’s unequal.”

For this reason, he stressed that the “challenge” is to go beyond the successful experiences consolidated in some territories and achieve a “full, accessible, equitable and sustainable implementation” of service throughout the country.

Benefits of SPDs

SPDs help patients use your treatments correctly and comply with them. In this sense, the vast majority of users surveyed are polypharmacy patients and, specifically, 47.6 percent take between five and 10 medications, while 5.5 percent take more than 10 and 46.9 percent take less than five.

The main reason they were offered or decided to participate in the SPD program is the comfort (53.1%), followed by the prevention of errors in taking medication (34.6%) and the fact of being chronic patients (34.1%) or polymedicated patients (20.8%).

The level of satisfaction of patients and caregivers with the SPD program is very high. More than 90 percent of those interviewed are quite (47%) or completely satisfied with the service provided by their pharmacist (44.5%). The most notable benefits of the service are greater knowledge of their medication (46.4%), less confusion (45.1%) and better remembering that they have to take medications (43.2%).

Patients who express lower satisfaction They ask for greater coordination between the pharmacist and the Primary Care professional (19.8), longer periods of the program to avoid having to go to the pharmacy so frequently (19%) and to be able to have communication with their doctors at each SPD collection (17.2%).

In line with all these results, the study highlights that a vast majority of patients and caregivers would recommend the use of SPD to other people. Almost 80 percent assign eight points or more to the probability of recommendation.

On the other hand, three out of four interviewees would welcome the pharmacist being able to access their medical record in order to improve the pharmaceutical care offered. Only 12.5 percent are opposed.

Barriers to the extension of SPDs

According to the study, the average number of patients using SPD per pharmacy that offers this service is 22.6, although the figure is conditioned by the autonomous communities in which there are agreements between pharmacies and public administrations for the provision of the service, which increases this average.

Only 26.2 percent of the pharmacies surveyed develop the service through an agreement or concertationwhich allows remuneration for the service and its free use for vulnerable patients. Most of them are carried out through an agreement with their regional service or health department (40%) or with a local entity, such as the town hall or the provincial council (44%).

The pharmacists surveyed consider that the lack of knowledge of other professionals about SPD (57%) is the main barrier for the extension of SPD to new patients, since in almost half of the cases it is the pharmacist who recommends the use of this service, although it is true that doctors increasingly suggest it more (32.8%).

Among the barriers too highlights the cost for pharmacies (50%), the lack of sufficient professional resources in pharmacies (49%), the lack of access to electronic medical records (47%), the cost of the service for patients (43%) and the lack of information for patients (39%).

In view of the obstacles identified, the report details a series of good practices to promote the extension of SPDs, such as greater knowledge on the part of doctors and nursesallow Primary Care doctors to prescribe them in electronic prescription and develop institutional campaigns.

In parallel, the General Council of Pharmaceutical Colleges has demanded the expansion of agreements, an increase in pharmacy remuneration, greater empowerment of pharmacists and greater coordination with social services to include patients.

Regarding the possibility of including the SPD in the portfolio of services of the National Health System (SNS), Jesús Aguilar has stated that it has been discussed “on many occasions”, but that It’s “very complicated”also taking into account the difference between autonomous communities in the implementation of agreements in this regard.

For his part, the vice president of SEAPEC, Juan Torres, has valued the role of pharmacists in addressing the chronicity and aging of the population, a task that he has considered “underused.”

In this sense, he has advocated establishing frameworks by the Ministry of Health and the Autonomous Communities to be able to extend benefits such as the SPD. From the Patient Organizations Platform (POP), its president, Carina Escobar, has also asked to increase the dissemination of this service, since many patients do not know about it.