RESUMEN
We assessed the efficacy and safety of colchicine and low-dose naltrexone (LDN), alone and in combination, in preventing progression to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this prospective, randomized, open-label trial, colchicine and LDN were compared to standard of care (SOC) in patients hospitalized with SARS-CoV-2 not requiring high levels of ventilatory support. Patients were randomly assigned to colchicine alone, LDN alone, colchicine/LDN in combination, or SOC. The primary outcome was time to disease recovery. Secondary outcomes included total time hospitalized, study enrollment, level of care, oxygen support, and adverse events. One-hundred and thirty-seven patients were randomized (Nc = 34, Nc+ldn = 33, Nldn = 35, Nsoc = 35). Eighty-four patients (61%) achieved disease recovery by day 5. There was no significant difference in the proportion of patients who experienced the primary efficacy outcome among those who received colchicine, LDN, or between the four study arms.Patients receiving colchicine had a shorter length of enrollment but not a significant reduction in the length of stay. Diarrhea was the most common adverse reaction. In adults hospitalized with SARS-CoV-2 not requiring high-level ventilatory support, colchicine and LDN, alone and in combination, were not associated with significant reductions in progression to severe disease.
RESUMEN
BACKGROUND: With 30-day Medicare readmission rates reaching 20%, a heightened focus has been placed on improving the transition process from hospital to home. For many institutions, this charge has identified medication-use safety as an area where pharmacists are well-positioned to improve outcomes by reducing medication therapy problems (MTPs). METHODS: This system-wide (425 bed community hospital plus 18 primary care clinics) prospective study recruited inpatient and ambulatory pharmacists to provide comprehensive medication management before and after hospital discharge. The results analyzed were the success rate and timing of the inpatient to ambulatory pharmacist handoff, as well as the number, type, and severity of MTPs resolved in both settings. RESULTS: Of the 105 eligible patients who received a pharmacist evaluation before discharge, 61 (58%) received follow-up with an ambulatory pharmacist an average of 2.88 days after discharge (range 1-8 days). An average of 5 and 1.4 MTPs per patient were identified and resolved in the inpatient vs. ambulatory setting, respectively. Although average MTP severity ratings were higher in the inpatient setting, the highest severity rating was seen most frequently in the ambulatory setting. CONCLUSIONS: In the transition from hospital to home, pharmacist evaluation in both the inpatient and ambulatory settings are necessary to resolve medication therapy problems.