View source for Classification of Pharmaco-Therapeutic Referrals

The '''Classification of Pharmaco-Therapeutic Referrals''' ('''CPR''') is [[taxonomy]], focused to define and group together situations requiring a [[Referral (medicine)|referral]] from [[pharmacists]] to [[physicians]] (and vice versa) regarding the [[pharmacotherapy]] used by the [[patients]]. It has been published in 2008. It is bilingual: English/Spanish (''[[Clasificación de Derivaciones Fármaco-terapéuticas]]'').

It is a simple and efficient classification of pharmaco-therapeutic referrals between physicians and pharmacists permitting a common inter-professional language. It is adapted to any type of referrals among health professionals, and to increase its specificity it can be combined with [[ATC codes]], [[ICD-10]], and [[ICPC-2 PLUS]].

It is a part of the '''[[MEDAFAR Project]]''', whose objective is to improve, through different scientific activities, the coordination processes between physicians and pharmacists working in [[primary health care]].

[[Image:MEDAFAR logotipo.jpg|thumb|Logo MEDAFAR {{puic|MEDAFAR logotipo.jpg|2010 September 11}}]]

== Supporting institutions ==
[[File:MEDAFAR CPR portada.png|thumb|Book cover "Classification of Pharmaco-Therapeutic Referrals" {{puic|MEDAFAR CPR portada.png|2010 September 11}}]]

• Pharmaceutical Care Foundation of Spain (''Fundación Pharmaceutical Care España'')

• Spanish Society of Primary Care Doctors (''Sociedad Española de Médicos de Atención Primaria'') (SEMERGEN)

== Authors==
• Raimundo Pastor Sánchez ([[Family practice]], "Miguel de Cervantes" [[Primary Health Centre]] SERMAS  [[Alcalá de Henares]] – [[Madrid]] – Spain)

• Carmen Alberola Gómez-Escolar ([[Pharmacist]], Vice-President ''Fundación Pharmaceutical Care España'')

• Flor Álvarez de Toledo Saavedra ([[Community pharmacist]], Past-President ''Fundación Pharmaceutical Care España'')

• Nuria Fernández de Cano Martín ([[Family practice]], "Daroca" [[Primary Health Centre]] SERMAS [[Madrid]] – Spain)

• Nancy Solá Uthurry (Doctor in Pharmacy, ''Fundación Pharmaceutical Care España'')

== Structure ==

[[Image:MEDAFAR CPR mhi.png|thumb|Model of an inter-professional referral form {{puic|MEDAFAR CPR mhi.png|2010 September 11}}]]

It is structured in 4 chapters (E, I, N, S) and 38 rubrics. The terminology used follows the rules of ICPC.

Each rubric consists in an alphanumeric code (the letter corresponds to the chapters and the number to the component) and each  title of the rubric (the assigned name) is expressed and explained by:

– A series of terms '''related with''' the title of the rubric.

– A '''definition''' expressing the meaning of the rubric

– A list of '''inclusion criteria''' and another list with '''exclusion criteria''' to select and qualify the contents corresponding to a rubric.

– Some '''example''' to illustrate every term.

It also includes a glossary of 51 terms defined by consensus, an alphabetical index with 350 words used in the rubrics; and a standardized model of inter-professional referral form, to facilitate referrals from community pharmacists to primary care physicians.

== Classification of Pharmaco-Therapeutic Referrals MEDAFAR==
[[Image:MEDAFAR CPR abstract.png|thumb|Abstract "Classification of Pharmaco-Therapeutic Referrals" MEDAFAR {{puic|MEDAFAR CPR abstract.png|2010 September 11}}]]
* '''E.	Effectiveness / Efficiency''':
**E 0.	[[Effectiveness]] / [[Efficiency]], unspecified
**E 1.	[[Indication]]
**E 2.	[[Prescription]] and [[dispensing]] conditions
**E 3.	[[Active substance]] / [[excipient]]
**E 4.	[[Pharmaceutical form]] / [[how supplied]] 
**E 5.	[[Dose (biochemistry)|Dosage]]
**E 6.	[[Quality]]
**E 7.	[[Storage]]
**E 8.	[[Consumption]]
**E 9.	[[Outcome]].

* '''I.	Information / Health education''':
**I 0.	[[Information]] / [[Health education]], unspecified
**I 1.	[[Situation]] / [[reason for encounter]]
**I 2.	[[Health problem]]
**I 3.	[[Complementary examination]]
**I 4.	[[Risk]]
**I 5.	[[Pharmacological treatment]]
**I 6.	[[No pharmacological treatment]]
**I 7.	[[Treatment goal]]
**I 8.	[[Socio-healthcare system]].

* '''N.	Need''':
**N 0.	[[Need]], unspecified
**N 1.	[[therapy|Treatment]] based on [[symptoms]] and/or [[signs]]
**N 2.	[[therapy|Treatment]] based on [[socio]]&ndash;[[economic]]-work issues
**N 3.	[[therapy|Treatment]] based on [[public health]] issues
**N 4.	[[Prevention]]
**N 5.	[[Healthcare provision]]
**N 6.	[[Complementary test]] for treatment control
**N 7.	[[Administrative activity]]
**N 8.	On [[patient]] request ([[fears]], [[doubts]], [[wants]]).

* '''S.	Safety''':
**S 0.	[[Safety]], unspecified
**S 1.	[[Toxicity]] 
**S 2.	[[Interaction]]
**S 3.	[[Allergy]]
**S 4.	[[Substance dependence|Addiction]] (dependence)
**S 5.	Other [[side effects]]
**S 6.	[[Contraindication]]
**S 7.	[[Medicalisation]] 
**S 8.	Non-regulate substance
**S 9.	[[Data]] / [[confidentiality]].

== See also ==
{{portal|Medicine}}
*[[ATC codes]] Anatomical Therapeutic Chemical Classification System
*[[Family medicine]]
*[[Family practice]]
*[[General practice]]
*[[ICD-10]] International Classification of Diseases
*[[ICPC-2 PLUS]]
*[[International Classification of Primary Care]] ICPC-2
*[[Pharmaceutical care]]
*[[Pharmacists]]
*[[Pharmacy]]
*[[Pharmacotherapy]]
*[[Primary care]]
*[[Referral (medicine)]]

== Bibliography ==
• [http://www.medafar.com/eWebs/GetFicheroDoc.do?doc%3D580632%26ver%3D581762%26fichero%3D580632_fi_3.pdf%26entorno%3Dlectura Pastor Sánchez R, Alberola Gómez-Escolar C, Álvarez de Toledo Saavedra F, Fernández de Cano Martín N, Solá Uthurry N. Clasificación de Derivaciones Fármaco-terapéuticas (CDF). MEDAFAR. Madrid: IMC; 2008. ISBN 978-84-691-8426-4 ]

• [http://www.medafar.com/eWebs/GetFicheroDoc.do?doc%3D580632%26ver%3D581762%26fichero%3D580632_fi_4.pdf%26entorno%3Dlectura Pastor Sánchez R, Alberola Gómez-Escolar C, Álvarez de Toledo Saavedra F, Fernández de Cano Martín N, Solá Uthurry N. Classification of Pharmaco-Terapeutic Referrals (CPR). MEDAFAR. Madrid: IMC; 2008. ISBN 978-84-691-8426-4]

• [http://www.medafar.com/eWebs/GetFicheroDoc.do?doc%3D580632%26ver%3D581762%26fichero%3D580632_fi_2.pdf%26entorno%3Dlectura Álvarez de Toledo Saavedra F, Fernández de Cano Martín N,  coordinadores. MEDAFAR Asma. Madrid: IMC; 2007.]

• [http://www.medafar.com/eWebs/GetFicheroDoc.do?doc%3D580632%26ver%3D581758%26fichero%3D580632_fi_1.pdf%26entorno%3Dlectura Álvarez de Toledo Saavedra F, Fernández de Cano Martín N,  coordinadores. MEDAFAR Hipertensión. Madrid: IMC; 2007.]

• [http://www.msc.es/organizacion/sns/planCalidadSNS/docs/estudio_apeas.pdf Aranaz JM, Aibar C, Vitaller J, Mira JJ, Orozco D, Terol E, Agra Y. Estudio sobre la seguridad de los pacientes en atención primaria de salud (Estudio APEAS). Madrid: Ministerio de Sanidad y Consumo; 2008.]

• [http://www.msc.es/organizacion/sns/planCalidadSNS/pdf/excelencia/opsc_sp2.pdf Aranaz JM, Aibar C, Vitaller J, Ruiz P. Estudio Nacional sobre los Efectos Adversos ligados a la Hospitalización. ENEAS 2005. Madrid: Ministerio de Sanidad y Consumo; 2006.]

• Cervera Barba EJ, Sagredo Pérez J, Martín González MC, Heras Salvat G, Peña Rodríguez E, Suárez del Villar Acebal E, et al. Oficinas de farmacia y centros de salud: podemos trabajar juntos. Una experiencia de colaboración. SEMERGEN. 2004;30(10)491-7.

• Comité Internacional de Clasificación de la WONCA. CIAP-2. Barcelona: MASSON; 1999.

• [http://www.atencionfarmaceutica.org/contenido.php?mod=novedades&id=31 Criterios de derivación del farmacéutico al médico general/familia, ante mediciones esporádicas de presión arterial. Consenso entre la Sociedad Valenciana de Hipertensión y Riesgo Vascular (SVHTAyFV) y la Sociedad de Farmacia Comunitaria de la Comunidad Valenciana (SFaC-CV). 2007.]

• Fleming DM (ed). The European study of referrals from primary to secondary care. Exeter: Royal College of General Practitioners; 1992.

• [http://www.pharmaceutical-care.org/doccontenidos/documentos/FORO_At_farma.pdf Foro de Atención Farmacéutica. Documento de consenso 2008. Madrid: MSC, RANF, CGCOF, SEFAP, SEFAC, SEFH, FPCE, GIAFUG. 2008.]

• García Cebrián F. La seguridad del paciente y la colaboración entre médicos y farmacéuticos [editorial]. SEMERGEN. 2006; 32(2):55–7.

• García Olmos L. Análisis de la demanda derivada en las consultas de medicina general en España. Tesis doctoral. Madrid: Universidad Autónoma de Madrid; 1993.

• Gérvas J. Introducción a las clasificaciones en Atención Primaria, con una valoración técnica de los "Consensos de Granada". Pharm Care Esp. 2003; 5(2):98–104.

• Hospital Ramón y Cajal, Área 4 Atención Primaria de Madrid. Guía Farmacoterapéutica. Madrid; 2005. CD-ROM.

• Ley 29/2006, de 26 de julio, de garantías y uso racional de los medicamentos y productos sanitarios. BOE. 2006 julio 27; (178): 28122–65.

• Ley 41/2002, de 14 de noviembre, básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica. BOE. 2002 noviembre 15; (274): 40126–32.

• Ley Orgánica 15/1999, de 13 de diciembre, de Protección de Datos de Carácter Personal. BOE. 1999 diciembre 14; (298): 43088–99.

• Organización Médica Colegial. Código de ética y deontología medica. Madrid: OMC, 1999.

• Palacio Lapuente F. Actuaciones para la mejora de la seguridad del paciente en atención primaria [editorial]. FMC. 2008; 15(7): 405–7.

• Panel de consenso ad hoc. Consenso de Granada sobre Problemas Relacionados con medicamentos. Pharm Care Esp. 1999; 1(2):107–12.

• Pastor Sánchez R, Barbero González A, del Barrio Sánchez H, García Olmos LM, editores. Comunicación interprofesional en atención primaria de salud. Madrid: REAP; 1996.

• Prado Prieto L, García Olmos L, Rodríguez Salvanés F, Otero Puime A. Evaluación de la demanda derivada en atención primaria. Aten Primaria. 2005; 35:146–51.

• Starfield B. Research in general practice: co-morbidity, referrals, and the roles of general practitioners and specialists. SEMERGEN. 2003; 29(Supl 1):7–16.

• Uribe G, Martínez de la Hidalga G. Médicos y farmacéuticos: éxitos y fracasos de colaboración profesional. SEMERGEN. 2002;28(2):86–8.

• WONCA Classification Committee. An international glossary for general/family practice. Fam Pract. 1995; 12(3): 341–69.

• [http://www.who.int/patientsafety/taxonomy/en/ World Alliance for Patient Safety. International Classification for Patient Safety (ICPS). 2007.]

== External links ==
* [http://www.medafar.com/eWebs/GetFicheroDoc.do?doc%3D580632%26ver%3D581762%26fichero%3D580632_fi_4.pdf%26entorno%3Dlectura Classification of Pharmaco-Terapeutic Referrals (CPR)] 
* [http://www.medafar.com/eWebs/GetFicheroDoc.do?doc%3D580632%26ver%3D581762%26fichero%3D580632_fi_3.pdf%26entorno%3Dlectura Clasificación de Derivaciones Fármaco-terapéuticas (CDF)]
* [http://www.medafar.com/ MEDAFAR]
* [http://www.semergen.es/ SEMERGEN]
* [http://www.pharmaceutical-care.org/ Fundación Pharmaceutical Care España]
* [http://www.kith.no/templates/kith_WebPage____1062.aspx ICPC-2e] (by the Norwegian Centre for Informatics in Health and Social Care)]
* [http://www.who.int/classifications/icd/en/ International Classification of Diseases (ICD)]
* [http://apps.who.int/classifications/apps/icd/icd10online/ ICD-10]
* [http://www.whocc.no/ Código ATC (''Anatomical Therapeutic Chemical drug classification)'']

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