ABSTRACT
Goal: To describe the experience of a dispensing model of outpatient hospital medicines (OHM) via collaboration of hospital and community pharmacies, and to explore patient satisfaction with the strategy as compared with the hospital pharmacy only service. Background: Patient satisfaction is an important component of the quality of health care. Study: A new model of dispensing OHM was conducted in the Outpatients Unit of the Service of Hospital Pharmacy of Hospital del Mar, in Barcelona, Spain. Participants were patients on stable chronic treatment with clinical or social fragility, immunocompromised patients, and those whose residence was located at a distance from the hospital that justified drug delivery through the community pharmacy. A cross sectional study was done using an ad hoc 14-item questionnaire collecting demographic data, duration of treatment, usual mode of collecting medication, and the degree of satisfaction regarding waiting time for the collection of medication, attention received by professionals, information received on treatment, and confidentiality. Results: The study population included a total of 4,057 patients (66.8% men) with a mean age of 53 (15.5) years, of whom 1,286 responded, with a response rate of 31.7%. Variables significantly associated with response to the survey were age over 44 years, particularly the age segment of 55-64 years (odds ratio [OR] 2.51) and receiving OHM via the community pharmacy (OR 12.76). Patients in the community pharmacy group (n = 927) as compared with those in the hospital pharmacy group (n = 359) showed significantly higher percentages of 'satisfied' and 'very satisfied' (p < 0.001) in the waiting time for the collection of OHM (88.1% vs. 66%), attention received by professionals (92.5% vs. 86.1%), and information received on treatment (79.4% vs. 77.4%). In relation to confidentiality, results obtained were similar in both pharmacy settings. Conclusion: Dispensing OHM through the community pharmacy was a strategy associated with greater patient satisfaction as compared with OHM collection at the hospital pharmacy service, with greater accessibility, mainly due to close distance to the patient's home. The participation of community pharmacists could further optimize the care received by patients undergoing OHM treatment.
Subject(s)
Patient Satisfaction , Pharmacy Service, Hospital , Humans , Cross-Sectional Studies , Male , Middle Aged , Female , Patient Satisfaction/statistics & numerical data , Adult , Surveys and Questionnaires , Pharmacy Service, Hospital/statistics & numerical data , Spain , Aged , Community Pharmacy Services/statistics & numerical data , Outpatients/statistics & numerical dataABSTRACT
BACKGROUND: Recent clinical guidelines suggest that treatment of postoperative anaemia in colorectal cancer surgery with intravenous iron reduces transfusion requirements and improves outcomes. The study aimed at comparing two intravenous iron regimens in anaemic patients after colorectal cancer surgery. MATERIALS AND METHODS: This was a single-centre, open-label, randomised, controlled trial in patients undergoing elective colorectal cancer surgery. Patients with moderate to severe anaemia (haemoglobin [Hb] <11 g/dL) after surgery were randomly assigned 1:1 to receive ferric carboxymaltose (FC; 1,000 mg, single dose) or iron sucrose (IS; 200 mg every 48 hours until covering the total iron deficit or discharge). Randomisation was stratified by Hb level: <10 g/dL (Group A) or ≥10-10.9 (Group B). The primary endpoint was the change in Hb concentration at postoperative day 30. Secondary endpoints included iron status parameters, transfusion requirements, complications, and length of hospital stay. RESULTS: From September 2015 to May 2018, 104 patients were randomised (FC 50, IS 54). The median intravenous iron dose was 1,000 mg and 600 mg in the FC and IS groups, respectively. There were no between-group differences in mean change in Hb from postoperative day 1 to postoperative day 30 (FC: 2.5 g/dL, 95% CI: 2.1-2.9; IS: 2.4 g/dL, 95% CI: 2.0-2.8; p=0.52), in transfusion requirements or length of stay. The infection rate was lower in the FC group compared with the IS group (9.8% vs 37.2%, respectively). DISCUSSION: The administration of approximately 500 mg of IS resulted in an increase in Hb at postoperative day 30 similar to that of 1,000 mg of FC, but it was associated with a higher infection rate. Future research will be needed to confirm the results, and to choose the best regime in terms of effectiveness and side effects to treat postoperative anaemia in colorectal cancer patients.
Subject(s)
Anemia, Iron-Deficiency , Anemia , Colorectal Neoplasms , Administration, Intravenous , Anemia/drug therapy , Anemia/etiology , Anemia, Iron-Deficiency/complications , Anemia, Iron-Deficiency/etiology , Colorectal Neoplasms/complications , Colorectal Neoplasms/surgery , Ferric Compounds , Ferric Oxide, Saccharated/therapeutic use , Hemoglobins , Humans , Iron , Maltose/analogs & derivativesABSTRACT
No disponible
Subject(s)
Humans , Medical Records , Organizational Innovation , Drug Therapy , Treatment Outcome , Forms and Records Control/organization & administration , Spain , Databases as Topic/organization & administration , Medical Order Entry Systems/organization & administration , Data Analysis , International Classification of Diseases/standardsSubject(s)
Hot Temperature/adverse effects , Serotonin Syndrome/epidemiology , Aged , Aged, 80 and over , Antihypertensive Agents/adverse effects , Antihypertensive Agents/therapeutic use , Comorbidity , Cyproheptadine/therapeutic use , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Disease Susceptibility , Emergencies , Female , Humans , Hypertension/complications , Hypertension/drug therapy , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use , Male , Polypharmacy , Serotonin Syndrome/drug therapy , Serotonin Syndrome/etiology , Spain/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Serotonin Agents/adverse effects , Drug-Related Side Effects and Adverse Reactions/therapy , Heat Stroke/diagnosis , Heat Stroke/drug therapy , Heat Wave (Meteorology) , Emergency Medical Services/methods , Cyproheptadine/therapeutic use , Heat Exhaustion/diagnosis , Heat Exhaustion/drug therapy , Delirium/complications , Fever/drug therapyABSTRACT
No disponible