ABSTRACT
WHAT IS KNOWN AND OBJECTIVE: Medication is the main treatment option for patients with chronic atrial fibrillation. However, medication can have negative effects. We aimed to detect negative outcomes associated with medication that led to patients with chronic atrial fibrillation presenting themselves to hospital emergency departments. We assessed the severity of those outcomes and comment on whether they could have been avoided. METHODS: This descriptive, cross-sectional study included all patients with chronic atrial fibrillation who attended the emergency department of our tertiary hospital. We used the Dader method to identify and evaluate the negative outcomes associated with medication through interviews with patients and scrutiny of the clinical charts. RESULTS AND DISCUSSION: Of the 198 eligible patients who presented at the emergency department, 134 (67·7%) did so because of negative outcomes associated with medication (41% related to necessity, 32·1% to effectiveness and 26·9% to safety); 67·9% of those negative outcomes could have been avoided. In terms of severity, 6·7% were mild, 31·3% moderate, 51·5% severe and 10·4% fatal. The Anatomical Therapeutic Chemical Classification anatomical group most frequently associated with negative outcomes was the cardiovascular system, followed by blood/blood-forming organs. WHAT IS NEW AND CONCLUSION: A high percentage of patients with chronic atrial fibrillation presenting at hospital emergency departments had negative outcomes associated with medication. Some led to deaths. More than half of these were severe, and most could have been avoided.
Subject(s)
Atrial Fibrillation/drug therapy , Drug-Related Side Effects and Adverse Reactions/epidemiology , Emergency Service, Hospital/statistics & numerical data , Aged , Aged, 80 and over , Chronic Disease , Cross-Sectional Studies , Female , Humans , Male , Outcome Assessment, Health Care , Severity of Illness IndexABSTRACT
OBJECTIVE: To assess the effectiveness and safety of the use of erlotinib in the treatment of refractory cervical cancer after retrospective analysis of two clinical cases. METHODS: The clinical records were assessed for the patients who started treatment with erlotinib, on a compassionate-use basis, with an oral dosage of 150 mg/day until June 2008. The pharmacy dispensing records were also assessed to evaluate adherence to treatment. Progression-free survival was assessed and adverse reactions were recorded in the medical records. RESULTS: Three patients with recurrent, advanced cervical cancer were candidates for treatment with erlotinib, two of whom were only starting treatment. In both cases, the women had previously received between 3 and 4 different treatment lines. Progression-free survival was 6 months and 4 months in each case. The adverse reactions to the treatment were slight. CONCLUSIONS: Erlotinib presented some similar results to those obtained from cisplatin doublets in women with refractory cervical cancer, with minor adverse effects. However, these results need to be corroborated in the clinical studies field on a wider section of the population.
Subject(s)
ErbB Receptors/antagonists & inhibitors , Quinazolines/therapeutic use , Uterine Cervical Neoplasms/drug therapy , Aged , Erlotinib Hydrochloride , Female , Humans , Middle Aged , Retrospective StudiesABSTRACT
Objetivo: Evaluar la efectividad y la seguridad del tratamiento con erlotinib en cáncer de cérvix uterino refractario a través del análisis retrospectivo de 2 casos clínicos. Métodos: Se revisaron las historias clínicas de las pacientes que iniciaron tratamiento con erlotinib vía oral a dosis de 150 mg/día como uso compasivo hasta junio del 2008, así como los registros de dispensación de farmacia para valorar la adherencia al tratamiento. Se evaluó la supervivencia libre de progresión y se recogieron las reacciones adversas descritas en la historia clínica. Resultados: Tres pacientes con cáncer de cérvix avanzado recurrente fueron candidatas a tratamiento con erlotinib, 2 de las cuales iniciaron tratamiento. En ambos casos las mujeres habían recibido entre 3 y 4 líneas de tratamiento previas. La supervivencia libre de progresión fue de 6 y 4 meses en cada caso. Las reacciones adversas al tratamiento fueron leves. Conclusiones: El erlotinib presentó unos resultados similares a los logrados con los dobletes de cisplatino en mujeres con cáncer de cérvix refractario, con leves efectos adversos. Sin embargo, habrá que corroborar estos resultados en el ámbito de los ensayos clínicos con poblaciones más amplias (AU)
Objective: To assess the effectiveness and safety of the use of erlotinib in the treatment of refractory cervical cancer after retrospective analysis of two clinical cases. Methods: The clinical records were assessed for the patients who started treatment with erlotinib, on a compassionate-use basis, with an oral dosage of 150 mg/day until June 2008. The pharmacy dispensing records were also assessed to evaluate adherence to treatment. Progression-free survival was assessed and adverse reactions were recorded in the medical records. Results: Three patients with recurrent, advanced cervical cancer were candidates for treatment with erlotinib, two of whom were only starting treatment. In both cases, the women had previously received between 3 and 4 different treatment lines. Progression-free survival was 6 months and 4 months in each case. The adverse reactions to the treatment were slight. Conclusions: Erlotinib presented some similar results to those obtained from cisplatin doublets in women with refractory cervical cancer, with minor adverse effects. However, these results need to be corroborated in the clinical studies field on a wider section of the population (AU)
