The ''Classification of Pharmaco-Therapeutic Referrals'' (''CPR'') is a taxonomy focused on defining and grouping together situations requiring a referral from pharmacists to

physicians A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

(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 ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, ...

, 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.

Supporting institutions

* 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 Alcalá de Henares () is a Spanish city in the Community of Madrid. Straddling the Henares River, it is located to the northeast of the centre of Madrid. , it has a population of 193,751, making it the region's third-most populated Municipalities ...

– Madrid – Spain) * Carmen Alberola Gómez-Escolar (

Pharmacist A pharmacist, also known as a chemist (Commonwealth English) or a druggist (North American and, archaically, Commonwealth English), is a healthcare professional who prepares, controls and distributes medicines and provides advice and instructi ...

, 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

It is structured in 4 chapters (E, I, N, S) and 38 rubrics. The terminology used follows the rules of ICPC-2.International Classification Committee of WONCA. ICPC-2 International Classification of Primary care (2 ed.). Oxford: Oxford University Press; 1998. 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

E. Effectiveness / efficiency

* E 0. Effectiveness /

Efficiency Efficiency is the often measurable ability to avoid wasting materials, energy, efforts, money, and time in doing something or in producing a desired result. In a more general sense, it is the ability to do things well, successfully, and without ...

, unspecified * E 1.

Indication Indication may refer to: * A synonym for sign * Human interface, highlighting the single object pointed to as a cursor is moved, without any other user action such as clicking, is indication * Indication (medicine). A valid reason to use a certain ...

* E 2. Prescription and dispensing conditions * E 3. Active substance / excipient * E 4. Pharmaceutical form / how supplied * E 5. Dosage * E 6. Quality * E 7.

Storage Storage may refer to: Goods Containers * Dry cask storage, for storing high-level radioactive waste * Food storage * Intermodal container, cargo shipping * Storage tank Facilities * Garage (residential), a storage space normally used to store car ...

* E 8. Consumption * E 9.

Outcome Outcome may refer to: * Outcome (probability), the result of an experiment in probability theory * Outcome (game theory), the result of players' decisions in game theory * ''The Outcome'', a 2005 Spanish film * An outcome measure (or endpoint) ...

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 In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis ...

* I 8. Socio-healthcare system.

N. Need

* N 0. Need, unspecified * N 1. Treatment based on

symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an disease, illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormali ...

and/or

signs Signs may refer to: * ''Signs'' (2002 film), a 2002 film by M. Night Shyamalan * ''Signs'' (TV series) (Polish: ''Znaki'') is a 2018 Polish-language television series * ''Signs'' (journal), a journal of women's studies *Signs (band), an American ...

* N 2. Treatment based on socio– economic- work issues * N 3. 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 Doubt is a mental state in which the mind remains suspended between two or more contradictory propositions, unable to be certain of any of them. Doubt on an emotional level is indecision between belief and disbelief. It may involve uncerta ...

, wants).

S. Safety

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

References

Bibliography

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.

Álvarez de Toledo Saavedra F, Fernández de Cano Martín N, coordinadores. MEDAFAR Asma. Madrid: IMC; 2007.

Álvarez de Toledo Saavedra F, Fernández de Cano Martín N, coordinadores. MEDAFAR Hipertensión. Madrid: IMC; 2007.

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.

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.

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.
Foro de Atención Farmacéutica. Documento de consenso 2008. Madrid: MSC, RANF, CGCOF, SEFAP, SEFAC, SEFH, FPCE, GIAFUG. 2008.
{dead link, date=August 2017 , bot=classifieads , fix-attempted=yes * García Olmos L. Análisis de la demanda derivada en las consultas de medicina general en España. Tesis doctoral. Madrid: Universidad Autónoma de Madrid; 1993.
Garjón Parra J, Gorricho Mendívil J. Seguridad del paciente: cuidado con los errores de medicación. Boletín de Información Farmacoterapéutica de Navarra. 2010;18(3)
* Gérvas J. Introducción a las classificaciones 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 médica. Madrid: OMC; 1999. * Palacio Lapuente F. Actuaciones para la mejora de la seguridad del paciente en atención primaria ditorial 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. * 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. * WONCA Classification Committee. An international glossary for general/family practice. Fam Pract. 1995; 12(3): 341-69.
World Alliance for Patient Safety. International Classification for Patient Safety (ICPS). 2007.

External links

Classification of Pharmaco-Terapeutic Referrals (CPR)

Clasificación de Derivaciones Fármaco-terapéuticas (CDF)

MEDAFAR

SEMERGEN

Fundación Pharmaceutical Care España

ICPC-2e
(by the Norwegian Centre for Informatics in Health and Social Care)]
International Classification of Diseases (ICD)

ICD-10

Código ATC (''Anatomical Therapeutic Chemical drug classification)''
Medical manuals Pharmacological classification systems Primary care Clinical procedure classification