RESUMO
OBJECTIVE: Extravasation is a potential complication resulting from parenteral administration of drugs. The purpose of this study was to characterise the physicochemical properties of non-antineoplastic parenterally administered drugs and determine their potential to cause a toxic effect on tissue. METHODS: A list of drugs administered by intermittent or continuous intravenous (IV) infusion was prepared. A database was also established to collect information from the literature. Each active substance was classified according to its risk to cause tissue damage using the following criteria: (1) High risk: active substances presenting with any of the following characteristics: osmolarity of the IV solution form >500 mOsm/L; vasoconstriction; vesication; cellular toxicity; very common, common or uncommon adverse events such as phlebitis, necrosis or pain at the site of administration according to the Summary of Product Characteristics. (2) Moderate risk: active substances where the pH range was <3 or >11 or where adverse events at the site of administration occurred rarely, very rarely or with unknown frequency. (3) Low risk: active substances where the osmolarity of the IV solution was <500 mOsm/L and the pH ranged between 3 and 11. These active substances did not cause vasoconstriction, neither were they classified as vesicant or cytotoxic or presented with adverse events at the site of administration. RESULTS: The risk classification list included 138 active substances, of which 86 were classified as 'high risk', 18 as 'moderate risk' and 34 as 'low risk'. CONCLUSION: The classification of intravenously administered drugs according to their risk profile is useful to ensure their safe use, as it can be used to implement the necessary safety measures to prevent adverse events.
RESUMO
Objetivo: Conocer las necesidades formativas y de recursos de lostutores de formación especializada de farmacia hospitalaria de España,así como su motivación y satisfacción con la docencia.Método: Se realizó, mediante Google-forms®, una encuesta dirigida atutores de farmacia hospitalaria durante enero-marzo de 2019 con preguntas generales (tutor, hospital, servicio) y específicas (medios disponibles,actividades docentes, satisfacción con la docencia, necesidades formativas). Se realizó un análisis exploratorio univariante para estudiar posiblesfactores relacionados con la satisfacción y la motivación docente.Resultados: Respondieron 83 tutores (tasa de respuesta: 52,8%),de 15/17 comunidades autónomas. El número de residentes/año-tutorresultó 4 (rango intercuartílico = 2-4). El 96,4% realizan entrevistas (trimestrales [65,1%]-ninguna [3,6%]. También se ocupan principalmente dela gestión de rotaciones externas [97,6%], planificación de rotaciones [97,6%] y la evaluación anual [96,4%]). El 17,1% dispone de horas parala docencia insuficientes para el 71,4%. Un 70,7% de los tutores deocho comunidades autónomas con normativa sobre el tiempo de liberación carecen de dicho tiempo. Los tutores se declararon mayoritariamentesatisfechos con la docencia (66,7%) y motivados (63,0%). (AU)
Objective: To provide new insight into the training needs and resourcesrequired by hospital pharmacy resident tutors in Spain, as well as into theirlevel of motivation and satisfaction with their teaching.Method: Google Forms® was used to design a survey addressed to hospital pharmacy resident tutors between January and March 2019. Theysurvey consisted of generic (tutor, hospital, service) and specific questions(available resources, teaching activities, teaching satisfaction, trainingneeds). A univariate exploratory analysis was conducted to study possiblefactors related to teaching satisfaction and motivation.Results: Replies were received from 83 tutors (rate of response:52.8%), from 15/17 Spanish regions. The annual resident/tutor ratio was4 (IQR = 2-4). A total of 96.4% of tutors conducted interviews, of whom65.1% did so quarterly. Other activities included the management of external training rotations (97.6%), planning of rotations (97.6%) and annual appraisals (96.4%). Only 17.1% of respondents were given time off theirregular duties for their tutorship work, with 71.4% stating that the time theywere allowed was insufficient. A total of 70.7% of tutors from eight Spanish regions where the granting of protected time was regulated said werenot given any time off for their teaching endeavors. Most tutors declaredto be satisfied (66.7%) and motivated (63%) with their teaching work. (AU)
Assuntos
Internato e Residência , Serviço de Farmácia Hospitalar , Satisfação no Emprego , MentoresRESUMO
OBJECTIVE: To provide new insight into the training needs and resources required by hospital pharmacy resident tutors in Spain, as well as into their level of motivation and satisfaction with their teaching. Method: Google Forms® was used to design a survey addressed to hospital pharmacy resident tutors between January and March 2019. They survey consisted of generic (tutor, hospital, service) and specific questions (available resources, teaching activities, teaching satisfaction, training needs). A univariate exploratory analysis was conducted to study possible factors related to teaching satisfaction and motivation. Results: Replies were received from 83 tutors (rate of response: 52.8%), from 15/17 Spanish regions. The annual resident/tutor ratio was 4 (IQR = 2- 4). A total of 96.4% of tutors conducted interviews, of whom 65.1% did so quarterly. Other activities included the management of external training rotations (97.6%), planning of rotations (97.6%) and annual appraisals (96.4%). Only 17.1% of respondents were given time off their regular duties for their tutorship work, with 71.4% stating that the time they were allowed was insufficient. A total of 70.7% of tutors from eight Spanish regions where the granting of protected time was regulated said were not given any time off for their teaching endeavors. Most tutors declared to be satisfied (66.7%) and motivated (63%) with their teaching work. Motivation appeared to fall with age, and both motivation and satisfaction decreased as a function of the tutors' years of professional experience and when they were given no time off for their tutorship work or when the remuneration was low, without any relationship being identified between these factors. Tutors pointed out that work should be done to increase the number of hours assigned to tutorships (78%), preparing SEFH-validated training plans (76.8%), improving teaching techniques (65.9%), and decreasing the clinical workload (62.2%). Over the past 3 years, 69.1% of tutors had received training. This training was arranged by educational committees (63.3%), the Spanish regional authorities (42.4%) and SEFH (13.6%). All the training in clinical, teaching, and communicative competencies enjoyed wide acceptance (> 90%). The preferred delivery method was hybrid (partly on-line and partly onsite) (64.6%). CONCLUSIONS: SEFH's tutors' group conducted its first national survey addressed to hospital pharmacy resident tutors. The survey showed that, although tutors are highly satisfied with their teaching activities, they ould like more training and to be able to devote more time to their tutorship work. It was also shown that a regulatory framework needs to be implemented in various Spanish regions and that compliance with existing regional regulations must be improved.
Objetivo: Conocer las necesidades formativas y de recursos de los tutores de formación especializada de farmacia hospitalaria de España, así como su motivación y satisfacción con la docencia.Método: Se realizó, mediante Google-forms®, una encuesta dirigida a tutores de farmacia hospitalaria durante enero-marzo de 2019 con preguntas generales (tutor, hospital, servicio) y específicas (medios disponibles, actividades docentes, satisfacción con la docencia, necesidades formativas). Se realizó un análisis exploratorio univariante para estudiar posibles factores relacionados con la satisfacción y la motivación docente. Resultados: Respondieron 83 tutores (tasa de respuesta: 52,8%), de 15/17 comunidades autónomas. El número de residentes/año-tutor resultó 4 (rango intercuartílico = 2-4). El 96,4% realizan entrevistas (trimestrales [65,1%]- ninguna [3,6%]. También se ocupan principalmente de la gestión de rotaciones externas [97,6%], planificación de rotaciones [97,6%] y la evaluación anual [96,4%]). El 17,1% dispone de horas para la docencia insuficientes para el 71,4%. Un 70,7% de los tutores de ocho comunidades autónomas con normativa sobre el tiempo de liberación carecen de dicho tiempo. Los tutores se declararon mayoritariamente satisfechos con la docencia (66,7%) y motivados (63,0%). Parece que la motivación desciende con la edad, y que motivación y satisfacción disminuyen con los años como tutor y como especialista, también son menores en ausencia de liberación o retribución económica, sin haberse podido demostrar asociación. Los tutores seleccionaron como acciones de mejora: aumento de dedicación horaria (78%), planes formativos validados por la Sociedad Española de Farmacia Hospitalaria (76,8%), mejorar técnicas pedagógicas (65,9%) y menor carga asistencial (62,2%). En los últimos 3 años el 69,1% recibió formación. La formación fue organizada por la Comisión de Docencia (63,3%), comunidades autónomas (42,4%) y Sociedad Española de Farmacia Hospitalaria (13,6%). La formación propuesta en competencias clínicas, docentes y de comunicación fue ampliamente aceptada (> 90%). El formato docente preferido fue semipresencial (64,6%).Conclusiones: El Grupo de Tutores de la Sociedad Española de Farmacia Hospitalaria ha realizado la primera encuesta nacional dirigida a tutores de farmacia hospitalaria. La encuesta muestra que, aunque la satisfacción con la actividad docente es elevada, los tutores demandan más tiempo de dedicación y una mayor formación. Además, pone de manifiesto que es preciso desarrollar el marco normativo en varias comunidades autónomas y mejorar el cumplimiento de la normativa autonómica vigente.
Assuntos
Serviço de Farmácia Hospitalar , Humanos , Motivação , Espanha , Inquéritos e QuestionáriosRESUMO
OBJETIVO: Analizar el grado de satisfacción de los residentes de la especialidad de farmacia hospitalaria e identificar áreas de mejora en su formación. MÉTODO: Cuestionario on line con 51 preguntas dirigido a residentes de cuarto año en Farmacia Hospitalaria que finalizaban su formación en 2018. Se realizó un análisis bivariante y multivariante para identificar la asociación de cada una de las variables independientes con respecto a la satisfacción global y delimitar en qué medida las asociaciones pudieran explicarse por el efecto del resto de variables recogidas en el estudio. RESULTADOS: Un total de 91 (67,4%) residentes cumplimentaron el cuestionario. La media de satisfacción global fue aceptable-buena (3,52 ± 0,92). El 86,8% disponía de un Plan Individualizado de Formación y el 50% valoraron su adaptación al programa de la especialidad como buena o muy buena. El 63,7% valoró positivamente la labor del tutor principal y un 72,5% la del resto de adjuntos. El 15,4% contestó que su servicio disponía de un protocolo de supervisión y responsabilidad progresiva. El 81% consideró adecuado el nivel de responsabilidad en as guardias y el 69,2% su supervisión. El 96,7% disponía de menos de 10 horas semanales para actividades docentes o de investigación. Un 35,2% tenía cinco o menos publicaciones o comunicaciones a congresos como primer autor y un 45,1% participaba en algún proyecto de investigación. Un 89% valoró positivamente la formación recibida en su centro y un 75,8% de los residentes volvería a elegir el mismo hospital. El análisis estadístico mostró una asociación respecto a la satisfacción global con significación estadística de varias variables, siendo la labor del tutor principal la que se relacionó de forma independiente con la satisfacción global. CONCLUSIONES: La satisfacción global con la formación recibida es aceptable, siendo la tutorización del tutor principal y la del resto de farmacéuticos de los servicios de farmacia los factores que afectan a la satisfacción global, si bien sólo la del tutor de un modo estadísticamente significativo. Como áreas de mejora se han detectado la supervisión de la formación, la labor del colaborador docente farmacéutico en las rotaciones clínicas y la investigación
OBJECTIVE: To analyze the degree of satisfaction of hospital pharmacy residents and identify areas of improvement in their training. METHOD: A survey (5-point Likert scale) was administered among fourth-year hospital pharmacy residents due to complete their residency in 2018. Bivariate and multivariate logistic regression analyses was performed to identify the association of each independent variable with overall satisfaction. RESULTS: 67.4% (91/135) of residents filled out the questionnaire. The mean overall satisfaction rate was acceptable-good (3.52 ± 0.92); 86.8% of residents had received an individualized training program, with 50% of them considering their individualized training program to be very well attuned to their day-to-day professional practice. The work of the tutor and other staff members involved in resident education was rated as positive by 63.7% and 72.5% of residents, respectively. A total of 15.4% of residents said that their units had a supervision and progressive empowerment pr-tocol in place. With respect to the level of on-call responsibility bestowed on them, 81% of residents considered it to be adequate; 69.2% considered the supervision they received to be adequate. As many as 96.7% of residents dedicated less than 10 hours per week to teaching or research activities; 35.2% of residents had produced five or less articles or congress presentations as first authors. Residents that had defended or were in the process of writing their PhD dissertation were 30.8%; 45.1% were involved in an Research project. Finally, 89% of residents rated the training received as positive, with 75.8% of them stating that they would select the same hospital again. In the statistical analysis, an association was found between overall satisfaction and several variables, with the work done by the main tutor being independently related to overall satisfaction. CONCLUSIONS: Overall satisfaction with the training received by fourth-year residents was acceptable. The work of the tutor and other staff members involved in resident education were the variables with the greatest influence on overall satisfaction, albeit only the tutor ́s work achieved statistical significance. The supervision of residents' progress, the coaching provided by other staff members during clinical rotations, and research were identified as areas for improvement
Assuntos
Humanos , Masculino , Feminino , Adulto , Avaliação Educacional , Educação em Farmácia , Internato e Residência , Inquéritos e Questionários , Satisfação PessoalRESUMO
To conduct a systematic review and meta-analysis investigating the effect of tofacitinib and baricitinib on venous thromboembolism (VTE) risk. Search of PubMed, EMBASE, Web of Science, Scopus, ClinicalTrials.gov, LILACS, and Google Scholar databases to identify controlled observational and clinical trials reporting on adverse effects in patients treated with oral tofacitinib or baricitinib up to July 2020. The outcome measure was occurrence of VTE events. We analyzed 59 studies involving 14,335 patients treated with tofacitinib or baricitinib and 11,612 patients who received another active drug or placebo. The meta-analysis showed an odds ratio (OR) for VTE events of 0.29 (95% confidence interval [CI] = 0.10-0.84) overall for tofacitinib based on data from 10 clinical trials with 15 treatment arms; similar ORs were observed for the 10 mg/d dose (OR = 0.18; 95% CI = 0.02-1.60) and the 20 mg/d dose (OR = 0.19; 95% CI = 0.04-0.91). The ORs for VTE events for baricitinib were 3.39 (95% CI = 0.82-14.04) overall, 3.05 (95% CI = 0.12-75.43) for 2 mg, 3.64 (95% CI = 0.59-22.46) for 4 mg, and 3.0 (95% CI = 0.12-76.49) for 7 mg. The indirect meta-analysis comparing tofacitinib with baricitinib (10 clinical trials with 15 treatment arms) showed an OR for VTE events of 0.086 (95% CI = 0.02-0.51) for tofacitinib and a superior safety profile for VTE events. In the meta-regression analysis (19 clinical trials with 21 treatment arms), the effect was 0.02 (95% CI = -0.04 to 0.08) for tofacitinib and -0.01 (95% CI = -1.29 to 1.26 for baricitinib. Plotting of the data for tofacitinib showed that VTE risk increased with high doses. The effect, however, was less than 1 for the 10-mg and 20-mg doses, indicating a protective effect. This effect was not observed for baricitinib. Tofacitinib is not associated with an increased risk of VTE and has a superior safety profile to baricitinib in this respect. Tofacitinib may exert a protective effect against VTE.
Assuntos
Antirreumáticos/uso terapêutico , Azetidinas/uso terapêutico , Piperidinas/uso terapêutico , Purinas/uso terapêutico , Pirazóis/uso terapêutico , Pirimidinas/uso terapêutico , Sulfonamidas/uso terapêutico , Tromboembolia Venosa/induzido quimicamente , Antirreumáticos/efeitos adversos , Azetidinas/efeitos adversos , Humanos , Piperidinas/efeitos adversos , Purinas/efeitos adversos , Pirazóis/efeitos adversos , Pirimidinas/efeitos adversos , Fatores de Risco , Sulfonamidas/efeitos adversosRESUMO
OBJECTIVE: To analyze the degree of satisfaction of hospital pharmacy residents and identify areas of improvement in their training. METHOD: A survey (5-point Likert scale) was administered among fourthyear hospital pharmacy residents due to complete their residency in 2018. Bivariate and multivariate logistic regression analyses was performed to identify the association of each independent variable with overall satisfaction. RESULTS: 67.4% (91/135) of residents filled out the questionnaire. The mean overall satisfaction rate was acceptable-good (3.52 ± 0.92); 86.8% of residents had received an individualized training program, with 50% of them considering their individualized training program to be very well attuned to their day-to-day professional practice. The work of the tutor and other staff members involved in resident education was rated as positive by 63.7% and 72.5% of residents, respectively. A total of 15.4% of residents said that their units had a supervision and progressive empowerment protocol in place. With respect to the level of on-call responsibility bestowed on them, 81% of residents considered it to be adequate; 69.2% considered the supervision they received to be adequate. As many as 96.7% of residents dedicated less than 10 hours per week to teaching or research activities; 35.2% of residents had produced five or less articles or congress presentations as first authors. Residents that had defended or were in the process of writing their PhD dissertation were 30.8%; 45.1% were involved in an Research project. Finally, 89% of residents rated the training received as positive, with 75.8% of them stating that they would select the same hospital again. In the statistical analysis, an association was found between overall satisfaction and several variables, with the work done by the main tutor being independently related to overall satisfaction. CONCLUSIONS: Overall satisfaction with the training received by fourthyear residents was acceptable. The work of the tutor and other staff members involved in resident education were the variables with the greatest influence on overall satisfaction, albeit only the tutor´s work achieved statistical significance. The supervision of residents' progress, the coaching provided by other staff members during clinical rotations, and research were identified as areas for improvement.
Objetivo: Analizar el grado de satisfacción de los residentes de la especialidad de farmacia hospitalaria e identificar áreas de mejora en su formación.Método: Cuestionario on line con 51 preguntas dirigido a residentes de cuarto año en Farmacia Hospitalaria que finalizaban su formación en 2018. Se realizó un análisis bivariante y multivariante para identificar la asociación de cada una de las variables independientes con respecto a la satisfacción global y delimitar en qué medida las asociaciones pudieran explicarse por el efecto del resto de variables recogidas en el estudio.Resultados: Un total de 91 (67,4%) residentes cumplimentaron el cuestionario. La media de satisfacción global fue aceptable-buena (3,52 ± 0,92). El 86,8% disponía de un Plan Individualizado de Formación y el 50% valoraron su adaptación al programa de la especialidad como buena o muy buena. El 63,7% valoró positivamente la labor del tutor principal y un 72,5% la del resto de adjuntos. El 15,4% contestó que su servicio disponía de un protocolo de supervisión y responsabilidad progresiva. El 81% consideró adecuado el nivel de responsabilidad en las guardias y el 69,2% su supervisión. El 96,7% disponía de menos de 10 horas semanales para actividades docentes o de investigación. Un 35,2% tenía cinco o menos publicaciones o comunicaciones a congresos como primer autor y un 45,1% participaba en algún proyecto de investigación. Un 89% valoró positivamente la formación recibida en su centro y un 75,8% de los residentes volvería a elegir el mismo hospital. El análisis estadístico mostró una asociación respecto a la satisfacción global con significación estadística de varias variables, siendo la labor del tutor principal la que se relacionó de forma independiente con la satisfacción global.Conclusiones: La satisfacción global con la formación recibida es aceptable, siendo la tutorización del tutor principal y la del resto de farmacéuticos de los servicios de farmacia los factores que afectan a la satisfacción global, si bien sólo la del tutor de un modo estadísticamente significativo. Como áreas de mejora se han detectado la supervisión de la formación, la labor del colaborador docente farmacéutico en las rotaciones clínicas y la investigación.