[Pharmaceutical care for older adults. Application of STOPP-START criteria]. / Atención farmacéutica de adultos mayores. Aplicación de los criterios STOPP-START.

INTRODUCTION: Drug-related problems can be caused by potentially inappropriate prescribing (PIP), one of the most used tools for its identification are the STOPP (Older Persons' potentially inappropriate Prescriptions) - START (Screening Tool to Alert doctors to Right Treatment) criteria. The objective of this study is to determine PIP in older adults who receive pharmaceutical care in the Pharmacotherapy Optimization Unit (POU)-Rosario. MATERIALS AND METHODS: Pharmacoepidemiological observational study, which evaluates the quality of medication use. Workplace: POU-Rosario. Population under study: adults over 60 years of age, who received pharmacotherapy follow-up during the period March 2017 to February 2018. PIPs were identified using the STOPP-START criteria, 2014 version; selecting the most appropriate criteria to assess outpatient pharmacotherapy. Prevalence of PIP and amount of PIP per active principle were estimated. RESULTS: 50 patients older than 60 years received pharmacotherapy follow-up in the POU; 47 patients (94.0%) had at least one PIP corresponding to a STOPP criterion; 17 STOPP criteria were found among the 41 initially selected, leading to 145 PIPs identified. And 7 START criteria among the 11 initially selected, leading to 50 PIPs identified. Medications with a higher amount of PIPs: benzodiazepines and proton pump inhibitors. CONCLUSIONS: This study allowed the identification of a high prevalence of PIP. The data obtained show the usefulness of these criteria. The STOPP-START criteria have been included to support decision making during pharmacotherapy follow-up to propose pharmaceutical interventions, in order to enhance pharmacotherapy. These activities contribute to patient safety, a dimension of health quality.

[Patient safety: use of quality management to prevent medication errors in the hospital medication use cycle]. / Seguridad del paciente: aplicación de gestión de calidad para prevenir errores de medicación en el circuito de uso de medicamentos.

OBJECTIVES: To describe the medication errors in the medication use cycle in a general public hospital, and to identify intervention strategies in relation to the detection and prevention of these errors. METHODS: Descriptive study with cross-sectional design. General public hospital of 190 beds, in Rosario (Argentina). Daily and systematic data collection of the circuit of use of medicines during May 2009. Once the errors were identified and classified, an interdisciplinary group sequentially applied different quality management tools to recognize and weigh causes, and propose solutions. (Flowchart, Cause Effect Diagram, Brainstorming, Nominal Group and Matrix Decision). RESULTS: Information on 60 patients was retrieved during the study period, with 506 medication errors detected. The impact indicators showed the following values: 8.4 errors/patient and 88.6 errors/100 patients-day. From the causes identified, two were defined as relevant: "Double prescription" and "Lack of clear policy". Of the various solutions proposed, an intervention strategy was defined to include a differently designed form for "prescription/indication/administration" in the clinical history which could be updated daily, with a duplicate to Pharmacy for the distribution, as well as a Standard Operating Procedure to standardize this new way of working. CONCLUSION: This work achieved, through quality management, the commitment of a team of health professionals to seek and make changes for patient safety, and to improve the quality of services provided by the hospital.

[Economic management of institutional pharmacies of the city of Rosario. Quality indicators proposal]. / Gestión económica en establecimientos asistenciales de la ciudad de Rosario. Propuesta de indicadores de calidad.

OBJECTIVE: To compare structures, procedures and results of the pharmaceutical management of institutional pharmacies in the city of Rosario (Argentina), to define the current situation and thus recommend changes. METHOD: Descriptive study, using a questionnaire and quality indicators of an Accreditation Program of Hospital Pharmacies. Evaluated dimensions: selection, acquisition, reception, storage and stock control of drugs and medical devices. Data was collected for a one-year-period in order to obtain indicators. After tabulation, data was discussed in meetings with all the pharmacists that participate in this study, in order to evaluate the situation and propose changes for the Pharmacies, as well as to evaluate the Program based on usefulness of these indicators. RESULTS: The general results illustrate how each institution has different health policies. 43.2% of indicators were answered, 67.6% reached standard values. CONCLUSIONS: This work allowed for an exhaustive analysis of the current situation. The pharmacists made proposals and unified criteria in order to obtain an improved use of the economic resources of each institution.

[Chromosome changes in ascitic effusions of neoplastic origin]. / Alterazioni cromosomiche nei versamenti ascitici di origine neoplastica.

A chromosome study carried out on neoplastic cells from peritoneal effusion in 19 patients is presented. Clonal and sporadic chromosomal anomalies such as aneuploidy, pseudodiploidy, markers and minutes, were observed in all the cases examined. Chromosome analysis, compared with histological study, proved more useful in the diagnosis in two cases.