Tele-education in evidence-based medicine applied to pharmaceutical care for community pharmacists

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Bloque 1: Aprendizaje de habilidades técnicas y mentales en la Simulación Clínica Avanzada (SCA): A) La SCA mejora mis habilidades. B)La SCA ayuda a priorizar actuaciones médicas. C)La SCA desarrolla el razonamiento crítico y la toma de decisiones. D)La SCA ayuda a integrar teoría y práctica. Bloque 2: Estructura de la sesión de simulación clínica: E)Escenario realista. F)Caso adaptado a los conocimientos teóricos. G)Duración adecuada del caso. H)Adecuada capacitación del profesorado. Bloque 3: Habilidades de comunicación aprendidas y motivación del estudiante: I)La SCA es útil para el aprendizaje. J)La SCA me ha motivado a aprender. K)La SCA fomenta la comunicación entre los estudiantes del equipo. L)La SCA aumenta la seguridad y confianza ante paciente pediátrico. M)La SCA ha cumplido mis expectativas. N)La SCA aumenta la seguridad y confianza ante paciente adulto." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Susana B. Reyes-Domínguez, Gracia Adánez Martínez, María Miñambres Rodríguez, David Gil Ortega, Eduardo Martínez Salcedo, Luis García Marcos" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Susana B." 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Bermejo-Cabanillas, Guido Sardón-Beltrán, Xavier Munayco-Ortiz, Lady Villanera-Munguia, José Salvador-Carrillo" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Gladys M." "apellidos" => "Delgado-Perez" "email" => array:1 [ 0 => "gdelgadop@unmsm.edu.pe" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "af0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] 1 => array:3 [ "nombre" => "Cristopher E." "apellidos" => "Dávila-Espinoza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "af0010" ] ] ] 2 => array:3 [ "nombre" => "Anthony G." "apellidos" => "Bermejo-Cabanillas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "af0015" ] ] ] 3 => array:3 [ "nombre" => "Guido" "apellidos" => "Sardón-Beltrán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "af0005" ] ] ] 4 => array:3 [ "nombre" => "Xavier" "apellidos" => "Munayco-Ortiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "af0005" ] ] ] 5 => array:3 [ "nombre" => "Lady" "apellidos" => "Villanera-Munguia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "af0005" ] ] ] 6 => array:3 [ "nombre" => "José" "apellidos" => "Salvador-Carrillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "af0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Grupo de investigación Servicios Farmacéuticos Clínicos, FARMACLI, Facultad de Farmacia y Bioquímica, Universidad Nacional Mayor de San Marcos, Lima, Peru" "etiqueta" => "a" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Dirección General de Medicamentos, Insumos y Drogas, San Miguel, Peru" "etiqueta" => "b" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Hospital Nacional de la Policía Nacional del Perú Luis N. Sáenz, Lima, Peru" "etiqueta" => "c" "identificador" => "af0015" ] 3 => array:3 [ "entidad" => "Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru" "etiqueta" => "d" "identificador" => "af0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Jr. Puno N°1002. Jardín Botánico Apartado, 4559 Lima 1, Perú." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Teleeducación en Medicina Basada en la Evidencia aplicada a la atención farmacéutica para farmacéuticos comunitarios" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "f0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1745 "Ancho" => 3163 "Tamanyo" => 248530 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Self-reported application of the EBM in the clinical practice of the participants before and after receiving tele-education: (a) Consulted specialized databases in the search for scientific evidence, (b) number of patients with pharmaceutical care by the pharmacist, and (c) number of ADR reported by the pharmacist. Abbreviations: BC: before the course; AC: after the course; ADR: adverse drug reaction. For figures b and c, the median±interquartile range was presented in parentheses." ] ] ] "textoCompleto" => "IntroductionEvidence-based medicine (EBM) training for pharmacists has been shown to improve information search and analysis skills and strengthen the ability to provide evidence-based answers to real-world clinical questions.<a class="elsevierStyleCrossRef" href="#bb0005">1</a>,<a class="elsevierStyleCrossRef" href="#bb0010">2</a> In primary care, community pharmacists (CPs) should be prepared in EBM to provide appropriate care and promote rational use of medicines through pharmaceutical care (PC) with pharmaceutical interventions.The objective was to measure the self-perceived of knowledge and clinical practices of CPs after tele-education in EBM applied to PC in the province of Cajamarca, located in northeastern Perú and one of its poorest regions.MethodsWe developed a course-workshop (August–November 2022) as a tele-education program in EBM for CPs caring for patients with chronic non-communicable diseases and working at the Dirección Regional de Salud–DIRESA of the Cajamarca region in Perú.The Google-Classroom and Google-Meets platforms were used, consisting of 5 weekly sessions (an 1-hour theoretical class and a 4-hour workshop). Participants were divided into groups of 5, where they conducted group discussions supervised by a senior clinical pharmacist and previously trained clinical pharmacy residents. Sessions included: (i) PC procedure, (ii) advanced search for drug-related information, (iii) PubMed search using PICO (Patient, Intervention, Comparison, Outcome), (iv) search in other databases using PICO, and (v) pharmaceutical intervention plan.A self-administered virtual questionnaire was applied before and after tele-education. The questionnaire was validated by experts and showed adequate reliability (KR coefficient >0.7).The McNemar test for categorical variables, and the Wilcoxon test for quantitative variables were used. Results were statistically significant when p<.05. The study was approved by the Ethics Committee of the DIRESA Cajamarca (Perú), with code MAD 6661390.ResultsTwenty-eight pharmacists enrolled and 23 completed the course. Among them, 65.22% (n=15) were women, with an average professional experience of 7.95±5.0 years (between 1 and 22 years).There was an increase in the adequate formulation of the PICO strategy at the end of the course-workshop compared to the beginning (52.17%, n=12 vs 8.70%, n=2; p=.0019). However, the other components did not show a significant increase between the post- and pre-test: performing scientific information searches (73.91%, n=17 vs 7.83%, n=11; p>.05), interpreting statistical parameters: RR, OR, NNT (34.78%, n=8 vs 21.74%, n=5; p>.05), and applying EMB in clinical cases (56.52%, n=13 vs 39.13%, n=9; p>.05).In the self-reported application of EBM in their clinical practice, significant increases were observed in the three aspects described in <a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>: p<.001 (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>a), p<.0001 (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>b), as well as p=.004 (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>c) per PC at the end of the tele-education.<elsevierMultimedia ident="f0005"></elsevierMultimedia>DiscussionThe tele-education program was successful in improving self-perceived knowledge about formulating a PICO question and clinical practice related to EBM in PC. These results suggest that this method can be effective in training EBM skills. Another important finding is the increase in the self-reported number of patients with PC and adverse drug reaction notifications. Several authors agree that clinical behaviors will be facilitated with the support of in-service training and EBM practice.<a class="elsevierStyleCrossRef" href="#bb0015">3</a>,<a class="elsevierStyleCrossRef" href="#bb0020">4</a>Likewise, it is assumed that this change in their clinical practices was due to the interaction of PC with clinical pharmacy specialists. Pharmacists have been shown to have an information need for evidence-based counseling.<a class="elsevierStyleCrossRef" href="#bb0025">5</a>The main limitations of this study were: (i) the reduced number of participants, (ii) health restrictions during the COVID-19 pandemic in Peru, (iii) limited access to information and communication technology, (iv) work overload in the management of medicines supply. A multicenter study with a larger population and longer duration will be conducted.Our results suggest that tele-education may partially improve self-perceived of knowledge and clinical practice related to EBM in CP. It is acknowledged that response bias limits strength of conclusions.FundingThis study has been self-financed by the authors.Statement of authorship contributionGladys Delgado: Conceptualization, Methodology, Validation, Investigation, Resources, Writing – original draft, Writing – review & editing, Project administration, Visualization, Supervision. Cristopher Dávila: Conceptualization, Methodology, Validation, Investigation, Writing – original draft, Writing – review & editing, Visualization, Supervision. Anthony Bermejo: Investigation, Writing – original draft. Writing – review & editing. Guido Sardón: Investigation, Writing – original draft, Writing – review & editing. Xavier Munayco: Investigation, Resources, Writing – original draft, Writing – review & editing. Lady Villanera: Investigation, Writing – original draft, Writing – review & editing. José Salvador-Carrillo: Conceptualization, Data curation, Formal analysis, Writing – original draft, Writing – review & editing." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres2285042" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "as0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "as0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "as0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "as0020" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1900498" "titulo" => "Keywords:" ] 2 => array:3 [ "identificador" => "xres2285041" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "as0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "as0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "as0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "as0040" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1900499" "titulo" => "Palabras clave:" ] 4 => array:2 [ "identificador" => "s0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "s0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "s0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "s0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "s0025" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "s0030" "titulo" => "Statement of authorship contribution" ] 10 => array:2 [ "identificador" => "xack784832" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-12-21" "fechaAceptado" => "2024-03-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords:" "identificador" => "xpalclavsec1900498" "palabras" => array:5 [ 0 => "Evidence-based medicine" 1 => "continuing pharmacy education" 2 => "Perú" 3 => "Community pharmacy services" 4 => "Evidence-based pharmacy practice" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave:" "identificador" => "xpalclavsec1900499" "palabras" => array:5 [ 0 => "Medicina Basada en Evidencias" 1 => "Formación farmacéutica continua" 2 => "Perú" 3 => "Servicios de farmacia comunitaria" 4 => "Práctica de farmacia basada en evidencias" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionEvidence-based medicine (EBM) training for pharmacists has been shown to improve information search and analysis skills. MethodsWe developed a virtual course-workshop for community pharmacists (CPs) and used an online questionnaire to assess self-perceived of knowledge and clinical practices related to EBM. ResultsTwenty-three participants completed the course-workshop. There was an increase in the adequate formulation of the PICO strategy at the end of the course-workshop (52.17%, n=12 vs 8.70%, n=2; p<.0019). While, in self-reported clinical practice, there was an increase in consultation of specialized databases (86.5%, n=45 vs 57.69%, n=30; p<.001). DiscussionThe tele-education program was successful in improving self-perceived knowledge on the formulation of a PICO question and clinical practice related to EBM in pharmaceutical care." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "as0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "as0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "as0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "as0020" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "Introducciónse ha demostrado que la formación en Medicina Basada en la Evidencia (MBE) en farmacéuticos mejora las habilidades de búsqueda y análisis de información. Métodosdesarrollamos un curso-taller virtual para farmacéuticos comunitarios (FC) y utilizamos un cuestionario online para evaluar la autopercepción del conocimiento y las prácticas clínicas relacionadas con la MBE. Resultadosveintitrés participantes completaron el curso-taller. Hubo un aumento en la formulación adecuada de la estrategia PICO al final del curso-taller (52,17%, n=12 vs. 8,70%, n=2; p<0,0019). Mientras que, en la práctica clínica auto declarada, hubo un aumento en la consulta de bases de datos especializadas (86,5%, n=45 vs. 57,69%, n=30; p<0,001). DiscusiónEl programa de teleeducación logró mejorar los conocimientos auto percibidos sobre la formulación de una pregunta PICO y la práctica clínica relacionada con la MBE en atención farmacéutica." 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Teleeducación en Medicina Basada en la Evidencia aplicada a la atención farmacéutica para farmacéuticos comunitarios

Gladys M. Delgado-Pereza,

Corresponding author

gdelgadop@unmsm.edu.pe

Corresponding author at: Jr. Puno N°1002. Jardín Botánico Apartado, 4559 Lima 1, Perú.

, Cristopher E. Dávila-Espinozab, Anthony G. Bermejo-Cabanillasc, Guido Sardón-Beltrána, Xavier Munayco-Ortiza, Lady Villanera-Munguiaa, José Salvador-Carrillod

a Grupo de investigación Servicios Farmacéuticos Clínicos, FARMACLI, Facultad de Farmacia y Bioquímica, Universidad Nacional Mayor de San Marcos, Lima, Peru

b Dirección General de Medicamentos, Insumos y Drogas, San Miguel, Peru

c Hospital Nacional de la Policía Nacional del Perú Luis N. Sáenz, Lima, Peru

d Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0065">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">Evidence-based medicine &#40;EBM&#41; training for pharmacists has been shown to improve information search and analysis skills and strengthen the ability to provide evidence-based answers to real-world clinical questions&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a> In primary care&#44; community pharmacists &#40;CPs&#41; should be prepared in EBM to provide appropriate care and promote rational use of medicines through pharmaceutical care &#40;PC&#41; with pharmaceutical interventions&#46;</p><p id="p0010" class="elsevierStylePara elsevierViewall">The objective was to measure the self-perceived of knowledge and clinical practices of CPs after tele-education in EBM applied to PC in the province of Cajamarca&#44; located in northeastern Per&#250; and one of its poorest regions&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0070">Methods</span><p id="p0015" class="elsevierStylePara elsevierViewall">We developed a course-workshop &#40;August&#8211;November 2022&#41; as a tele-education program in EBM for CPs caring for patients with chronic non-communicable diseases and working at the Direcci&#243;n Regional de Salud&#8211;DIRESA of the Cajamarca region in Per&#250;&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">The Google-Classroom and Google-Meets platforms were used&#44; consisting of 5 weekly sessions &#40;an 1-hour theoretical class and a 4-hour workshop&#41;&#46; Participants were divided into groups of 5&#44; where they conducted group discussions supervised by a senior clinical pharmacist and previously trained clinical pharmacy residents&#46; Sessions included&#58; &#40;i&#41; PC procedure&#44; &#40;ii&#41; advanced search for drug-related information&#44; &#40;iii&#41; PubMed search using PICO &#40;Patient&#44; Intervention&#44; Comparison&#44; Outcome&#41;&#44; &#40;iv&#41; search in other databases using PICO&#44; and &#40;v&#41; pharmaceutical intervention plan&#46;</p><p id="p0025" class="elsevierStylePara elsevierViewall">A self-administered virtual questionnaire was applied before and after tele-education&#46; The questionnaire was validated by experts and showed adequate reliability &#40;KR coefficient &#62;<span class="elsevierStyleHsp" style=""></span>0&#46;7&#41;&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">The McNemar test for categorical variables&#44; and the Wilcoxon test for quantitative variables were used&#46; Results were statistically significant when <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46; The study was approved by the Ethics Committee of the DIRESA Cajamarca &#40;Per&#250;&#41;&#44; with code MAD 6661390&#46;</p></span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0075">Results</span><p id="p0035" class="elsevierStylePara elsevierViewall">Twenty-eight pharmacists enrolled and 23 completed the course&#46; Among them&#44; 65&#46;22&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41; were women&#44; with an average professional experience of 7&#46;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;0 years &#40;between 1 and 22 years&#41;&#46;</p><p id="p0040" class="elsevierStylePara elsevierViewall">There was an increase in the adequate formulation of the PICO strategy at the end of the course-workshop compared to the beginning &#40;52&#46;17&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12 vs 8&#46;70&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;0019&#41;&#46; However&#44; the other components did not show a significant increase between the post- and pre-test&#58; performing scientific information searches &#40;73&#46;91&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17 vs 7&#46;83&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#44; interpreting statistical parameters&#58; RR&#44; OR&#44; NNT &#40;34&#46;78&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8 vs 21&#46;74&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#44; and applying EMB in clinical cases &#40;56&#46;52&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13 vs 39&#46;13&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p><p id="p0045" class="elsevierStylePara elsevierViewall">In the self-reported application of EBM in their clinical practice&#44; significant increases were observed in the three aspects described in <a class="elsevierStyleCrossRef" href="#f0005">Fig&#46; 1</a>&#58; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 &#40;<a class="elsevierStyleCrossRef" href="#f0005">Fig&#46; 1</a>a&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001 &#40;<a class="elsevierStyleCrossRef" href="#f0005">Fig&#46; 1</a>b&#41;&#44; as well as <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004 &#40;<a class="elsevierStyleCrossRef" href="#f0005">Fig&#46; 1</a>c&#41; per PC at the end of the tele-education&#46;</p><elsevierMultimedia ident="f0005"></elsevierMultimedia></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0080">Discussion</span><p id="p0050" class="elsevierStylePara elsevierViewall">The tele-education program was successful in improving self-perceived knowledge about formulating a PICO question and clinical practice related to EBM in PC&#46; These results suggest that this method can be effective in training EBM skills&#46; Another important finding is the increase in the self-reported number of patients with PC and adverse drug reaction notifications&#46; Several authors agree that clinical behaviors will be facilitated with the support of in-service training and EBM practice&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a></p><p id="p0055" class="elsevierStylePara elsevierViewall">Likewise&#44; it is assumed that this change in their clinical practices was due to the interaction of PC with clinical pharmacy specialists&#46; Pharmacists have been shown to have an information need for evidence-based counseling&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a></p><p id="p0060" class="elsevierStylePara elsevierViewall">The main limitations of this study were&#58; &#40;i&#41; the reduced number of participants&#44; &#40;ii&#41; health restrictions during the COVID-19 pandemic in Peru&#44; &#40;iii&#41; limited access to information and communication technology&#44; &#40;iv&#41; work overload in the management of medicines supply&#46; A multicenter study with a larger population and longer duration will be conducted&#46;</p><p id="p0065" class="elsevierStylePara elsevierViewall">Our results suggest that tele-education may partially improve self-perceived of knowledge and clinical practice related to EBM in CP&#46; It is acknowledged that response bias limits strength of conclusions&#46;</p></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0085">Funding</span><p id="p0070" class="elsevierStylePara elsevierViewall">This study has been self-financed by the authors&#46;</p></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0090">Statement of authorship contribution</span><p id="p0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Gladys Delgado&#58;</span> Conceptualization&#44; Methodology&#44; Validation&#44; Investigation&#44; Resources&#44; Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#44; Project administration&#44; Visualization&#44; Supervision&#46; <span class="elsevierStyleBold">Cristopher D&#225;vila&#58;</span> Conceptualization&#44; Methodology&#44; Validation&#44; Investigation&#44; Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#44; Visualization&#44; Supervision&#46; <span class="elsevierStyleBold">Anthony Bermejo&#58;</span> Investigation&#44; Writing &#8211; original draft&#46; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">Guido Sard&#243;n&#58;</span> Investigation&#44; Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">Xavier Munayco&#58;</span> Investigation&#44; Resources&#44; Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">Lady Villanera&#58;</span> Investigation&#44; Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#46; <span class="elsevierStyleBold">Jos&#233; Salvador-Carrillo&#58;</span> Conceptualization&#44; Data curation&#44; Formal analysis&#44; Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#46;</p></span></span>"
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            0 => "Medicina Basada en Evidencias"
            1 => "Formaci&#243;n farmac&#233;utica continua"
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        "titulo" => "Abstract"
        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Introduction</span><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Evidence-based medicine &#40;EBM&#41; training for pharmacists has been shown to improve information search and analysis skills&#46;</p></span> <span id="as0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Methods</span><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">We developed a virtual course-workshop for community pharmacists &#40;CPs&#41; and used an online questionnaire to assess self-perceived of knowledge and clinical practices related to EBM&#46;</p></span> <span id="as0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Results</span><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Twenty-three participants completed the course-workshop&#46; There was an increase in the adequate formulation of the PICO strategy at the end of the course-workshop &#40;52&#46;17&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12 vs 8&#46;70&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0019&#41;&#46; While&#44; in self-reported clinical practice&#44; there was an increase in consultation of specialized databases &#40;86&#46;5&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45 vs 57&#46;69&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="as0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Discussion</span><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">The tele-education program was successful in improving self-perceived knowledge on the formulation of a PICO question and clinical practice related to EBM in pharmaceutical care&#46;</p></span>"
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        "resumen" => "<span id="as0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0035">Introducci&#243;n</span><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">se ha demostrado que la formaci&#243;n en Medicina Basada en la Evidencia &#40;MBE&#41; en farmac&#233;uticos mejora las habilidades de b&#250;squeda y an&#225;lisis de informaci&#243;n&#46;</p></span> <span id="as0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0040">M&#233;todos</span><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">desarrollamos un curso-taller virtual para farmac&#233;uticos comunitarios &#40;FC&#41; y utilizamos un cuestionario <span class="elsevierStyleItalic">online</span> para evaluar la autopercepci&#243;n del conocimiento y las pr&#225;cticas cl&#237;nicas relacionadas con la MBE&#46;</p></span> <span id="as0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0045">Resultados</span><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">veintitr&#233;s participantes completaron el curso-taller&#46; Hubo un aumento en la formulaci&#243;n adecuada de la estrategia PICO al final del curso-taller &#40;52&#44;17&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12 vs&#46; 8&#44;70&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0019&#41;&#46; Mientras que&#44; en la pr&#225;ctica cl&#237;nica auto declarada&#44; hubo un aumento en la consulta de bases de datos especializadas &#40;86&#44;5&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45 vs&#46; 57&#44;69&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="as0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0050">Discusi&#243;n</span><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">El programa de teleeducaci&#243;n logr&#243; mejorar los conocimientos auto percibidos sobre la formulaci&#243;n de una pregunta PICO y la pr&#225;ctica cl&#237;nica relacionada con la MBE en atenci&#243;n farmac&#233;utica&#46;</p></span>"
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          "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Self-reported application of the EBM in the clinical practice of the participants before and after receiving tele-education&#58; &#40;a&#41; Consulted specialized databases in the search for scientific evidence&#44; &#40;b&#41; number of patients with pharmaceutical care by the pharmacist&#44; and &#40;c&#41; number of ADR reported by the pharmacist&#46;</p> <p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; BC&#58; before the course&#59; AC&#58; after the course&#59; ADR&#58; adverse drug reaction&#46; For figures b and c&#44; the median<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>interquartile range was presented in parentheses&#46;</p>"
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                      "titulo" => "Evaluation of an evidence-based medicine curriculum in a PGY1 pharmacy residency program using the Fresno test"
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                        0 => array:2 [
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                          "autores" => array:3 [
                            0 => "J&#46;B&#46; Cooper"
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                            2 => "M&#46; Patel"
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                      "doi" => "10.5688/ajpe6294"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Pharm Educ&#46;"
                        "fecha" => "2018"
                        "volumen" => "82"
                        "numero" => "5"
                        "paginaInicial" => "6294"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30013242"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Longitudinal assessment of pharmacy students&#8217; confidence and skill in providing evidence-based answers to clinical questions"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Margolis"
                            1 => "S&#46; Shah"
                            2 => "C&#46; Kraus"
                            3 => "D&#46;W&#46; Pigarelli"
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                      ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5688/ajpe7884"
                      "Revista" => array:4 [
                        "tituloSerie" => "Am J Pharm Educ&#46;"
                        "fecha" => "2020"
                        "volumen" => "84"
                        "numero" => "10"
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                      "titulo" => "The impact of an evidence-based medicine &#40;EBM&#41; learning program on community pharmacists"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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