Pharmaceutical care started in the nineties in the United States and has rapidly extended in many other countries. Although there are different trends, such as clinical pharmacy services, cognitive services, medication management, medication review, they all share the same philosophy and objectives, namely “the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patients quality of life”. To attain these objectives, a pharmaceutical care process has to be followed point-by-point in order to detect possible medication-related problems. Furthermore, pharmacists have to work together with patients, and ultimately with physicians to establish a care plan. This methodology requires basic skills of documentation and communication and therefore, it is important to establish implementation programs aimed at community-, hospital-, and consultant pharmacists, and to consider PC as a basic element of University teaching programs and postgraduate studies. Moreover, there are still barriers that hinder the provision of this service and have to be overcome. In this article, we have revised the implementation process and the existing projects in many countries and we conclude that despite the enormous amount of work, there is still much to be done from sides of Administration and pharmacists themselves.

Piper carpunya Ruiz & Pav. (Piper lenticellosum C. DC.), a member of the Piperaceae family, is a remedy with anti-inflammatory and antiulcer properties that is used in folk medicine in Ecuador. The present work determined the gastroprotective effects of this plant in a model of diclofenac-induced ulcers in rats and studied the mechanism involved. The aqueous suspension of the ethanol extract of the leaves of P. carpunya was administered twice orally to three groups of Wistar rats at doses of 62.5, 125, and 250 mg/kg, with a 24-h interval between doses. Diclofenac (100 mg/kg) was given 1 h after the last administration of the extract. Pretreatment with P. carpunya decreased the ulcerated area, prevented neutrophil infiltration induced by NSAID administration in vivo, and inhibited the release of the proteolytic enzyme myeloperoxidase by neutrophils stimulated with the calcium ionophore A23187. Superoxide dismutase activity demonstrated a marked increase at the two lowest doses of the extract versus diclofenac group and glutathione peroxidase activity was reverted near to sham levels. On the other hand, P. carpunya treatment did not prevent the increased levels of lipoperoxides in gastric mucosa caused by diclofenac. Furthermore, P. carpunya did not affect PGE₂ levels, which were depleted by diclofenac treatment. These results suggest that the gastroprotective effect of P. carpunya in this experimental model appears through anti-inflammatory and antiradical mechanisms.

The aim was to determine the influence of a complex intervention based on pharmacotherapeutic follow-up (PTF) and the application of therapeutic education (TE) protocols on the clinical and educational parameters of patients at cardiovascular risk (CVR) attending community pharmacies (CPs). A prospective, longitudinal, randomized, controlled clinical trial was conducted over 6 months in patients from four Spanish CPs, divided into control (CG) and intervention (IG) groups. CG patients received usual pharmacy care and IG patients received a PTF- and TE-based intervention. The sample consisted of 85 elderly patients. After pharmaceutical follow-up of the IG patients, the following results were observed: significant reductions in cardiovascular risk (CVR) (p < 0.005), blood pressure (BP) (p < 0.05), and sedentary lifestyle (p < 0.001), as well as an improved knowledge of CVR and cardiovascular risk factors (CVRFs) (p < 0.001). Target values for BP were achieved in 27.2% of patients and for triglycerides in 12.4% of patients. The PTF of the patients showed that 29.2% did not have the expected response to some treatments, while 25% had untreated pathologies and 10% had adverse reactions. The TE protocols related to the patients’ educational needs, applied individually and in conjunction with the PTF, were able to improve their lifestyle habits, their knowledge of CVR, CVRFs, and pharmacotherapy, and their clinical parameters, and, thus, the level of development of their disease

The aim was to determine the influence of a complex intervention based on pharmacotherapeutic follow-up (PTF) and the application of therapeutic education (TE) protocols on the clinical and educational parameters of patients at cardiovascular risk (CVR) attending community pharmacies (CP).