Background. Community pharmacy practice needs to demonstrate services beyond traditional dispensing roles to continue to function in a changing marketplace. Pharmacists have established themselves as being capable of improving patient outcomes and saving healthcare dollars by providing disease management services to patients. This paper describes a sustained community pharmacy-run disease management program that continued after a grassroots grant-funding effort in 2007. Methods. The city of Colorado Springs recognized the successes shown by the pharmacy during the Ten City Challenge funded project, and decided to financially support pharmacy diabetes care services. Partnering with the local School of Pharmacy, the pharmacist obtained advanced training and continued to deliver individualized counseling and management to approximately 100 patients per year for the past 14 years. Objective lab measurements (systolic and diastolic blood pressures, A1C values, total lipid profiles) were obtained or performed, and clinical goals were set based on national guidelines. Patients received a series of appointments to learn how to control their diabetes, and later their cardiovascular disease. Financial estimates were calculated using 2008 baseline numbers and adding estimated inflation based on published Segal rates. Results. The pharmacy services successfully maintained participation of approximately 100 patients annually each year since its inception. Average lab value markers for disease control were at or close to clinical guideline recommendations for the population. Services were associated with estimated cost savings for the health system. Positive results led to expansion in services to include cardiovascular disease in 2017. Conclusions. A community pharmacy has successfully sustained a disease management program for patients for over 14 years, demonstrating high patient enrollment, health outcomes at or near clinical guidelines for control, and positive financial outcomes associated with the program.

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with all the patients, regardless of the levels of CD4 lymphocytes and the symptomatology. Purpose Persistence: time a patient remains with a treatment frome the beginning until the interruption, regardless of the reason. Aim of this research: comparison between the patients' persistence who different ART. Material and methods Descriptive, transversal and retrospective research that includes all the patients who have started an ART for HIV, 2013-10 October 2018, and who have suffered a change in the therapy.Variables: starting date, initial treatment, changing date and reason for the change. Analysis: SPSS Statistics. Results Six-hundred and sixteen patients have started ART and 186 (30.2%) of them have changed it.Fifty-one (27.4%) patients started ART with single tablet regimens (STRs), 40 (78.4%) started with Tenofovir/Emtricitabine (TDF o TAF/FTC) and 11 (21,6%) Abacavir/Lamivudine (ABC/3TC). Thirty-two 62.7%) were with an integrase inhibitor (INI) as a third drug, and 19 (37.3%) with no analogous (ITINN).One-hundred and thirty-five (72.6%) patients started with multiple tablet regimens (MTRs), 115 (85.2%) TDF/FTC and 16 (11.8%) ABC/3TC. Seventy-two (53.7%) were with protease inhibitor (IP) as a third drug, 34 (25.4%) ITINN and 28 (20.9%) INI.The median survival for STRs was 229 days (95% CI 146.0 to 311.9) and 164 for MTRs (95% CI 87.8 to 240.2), no statistically significant differences. Regarding the third drug, the median survival with INI was 103 days (95% CI 65.0 to 140.9), 241 days with IP (95% CI 162.1 to 319.9) and 265 days with ITINN (95% CI 162.1 to 367.9). Between INI-IP and INI-ITNN, there were statistically significant differences.One-hundred and five (56.5%) patients changed their treatment because of toxicity, 48 (25.8%) patients simplification, 19 (10.2%) patients virologic failure, seven (3.8%) patients due to interaction with their home treatment and seven (3.7%) other causes. One-hundred and five patients changed ART by toxicity ( 39of them (37.1%) had as a third drug IP, 37 (35.2%) ITINN and 29 (27.6%) INI) In 2013-2015, 20 (16.8%) patients started STRs and in 2016-2018, 31 (46.3%) patients started STRs. Conclusion ART combinations with STRs have a longer survival in the treatment and in patients with IP as a third drug, a greater survival is observed. The main cause of ART in naïve patients is toxicity. There was a gradual rise in the use of STRs throughout the years studied.

BackgroundThe role of the hospital pharmacist has evolved in the last years and is becoming a more frequent presence in the medical teams, and is acquiring a fundamental role in pharmacotherapeutic decision-taking.PurposeTo analyse the pharmaceutical interventions (IF) performed during 3 years in a general and digestive surgery unit (CGD) by a clinical pharmacist after integration into the team.Material and methodsThe pharmaceutical interventions performed in the general and digestive surgery unit were selected from the database (April 2014 to March 2017). The main activity was carried out with the coloprocto rectal surgery team participating in the daily checking visiting room with them, and the subsequent follow-up. For the evaluation of pharmaceutical interventions, an Excel tool has been developed, classifying them according to the Isofar®program.Results2,263 IF were performed, classified in nine items. In frequency order these were: initiation of treatment (782), nutritional adjustments (496), drug suspension (348), dose modification (193), drug change (129), modification of pharmaceutical form/administration route (116), confirmation of prescriptions (95), frequency modifications (77) and pharmacokinetic monitoring (27). Of the three most frequent items, regarding the start of treatment, 49% of the 782 IF were due to the need for additional treatment and 51% to non-prescribed home treatment. From the 496 IF of nutritional adjustments: 55.6% are due next to nutrition, 29.6% to adjustment of nutritional requirements, 7.4 to volume modifications, 3.7% to suspend nutrition and 3.7% to modify type of nutrition. Referring to the suspension of medication, from the 348 IF performed, the 40% correspond to therapeutic duplicity, 40% to excessive duration, 15% to non-indicated medicament and 5% to the prevention of adverse reactions.ConclusionThe key points of the role of the clinical pharmacist in surgery are based on the IFs performed and the reconciliation of home medication and nutrition.The integration of the clinical pharmacist into the surgical care team is fundamental in the optimisation of pharmacotherapeutic treatment.References and/or AcknowledgementsAcknowledgements to all the general surgery teamNo conflict of interest