[Impact of a software application to improve medication reconciliation at hospital discharge]. / Impacto de una aplicación informática en la mejora de la conciliación de la medicación al alta hospitalaria.

BACKGROUND AND OBJECTIVE: To assess the impact of a software application to improve the quality of information concerning current patient medications and changes on the discharge report after hospitalization. To analyze the incidence of errors and to classify them. MATERIAL AND METHOD DESIGN: Quasi-experimental pre / post study with non-equivalent control group study. STUDY POPULATION: Medical patients at hospital discharge. INTERVENTION: implementation of a software application. VARIABLES: Percentage of reconciled patient medication on discharge, and percentage of patients with more than one unjustified discrepancy. RESULTS: A total of 349 patients were assessed; 199 (pre-intervention phase) and 150 (post-intervention phase). Before the implementation of the application in 157 patients (78.8%) medication reconciliation had been completed; finding reconciliation errors in 99 (63.0%). The most frequent type of error, 339 (78.5%), was a missing dose or administration frequency information. After implementation, all the patient prescriptions were reconciled when the software was used. The percentage of patients with unjustified discrepancies decreased from 63.0% to 11.8% with the use of the application (p<.001). The main type of discrepancy found on using the application was confusing prescription, due to the fact that the professionals were not used to using the new tool. CONCLUSIONS: The use of a software application has been shown to improve the quality of the information on patient treatment on the hospital discharge report, but it is still necessary to continue development as a strategy for improving medication reconciliation.

Efectividad y seguridad del régimen FLAG-IDA en leucemias agudas resistentes o recidivantes / Effectiveness and safety of the FLAG-IDA regimen in acute refractory or recurrent leukaemia

Objetivo: Evaluar la efectividad y seguridad del esquema FLAG-IDA en pacientes con leucemias agudas refractarias o recidivantes. Método Estudio observacional descriptivo retrospectivo en el que se revisaron las historias clínicas de pacientes con el esquema FLAG-IDA en el periodo 2005-2010. La efectividad se evaluó mediante la respuesta objetiva, el intervalo libre de progresión y la supervivencia global. La seguridad se midió según el sistema de clasificación NCI, Criterios comunes de Toxicidad para Acontecimientos Adversos. Resultados Fueron 12 pacientes (52,17 ± 8,26 años entre las mujeres y 54,83 ± 7,22 años en los hombres), 11casos fueron leucemias mieloides agudas (5 resistentes, 3 en recaída, una secundaria a leucemia mieloide crónica (LMC) resistente y 2 secundarias a síndrome mielodisplásico (SMD), de las que una fue resistente y la otra no había sido tratada previamente) y un caso de leucemia linfoide aguda (LLA) resistente. Seis pacientes (50%) alcanzaron una respuesta completa (RC). Un paciente consiguió una respuesta parcial (RP) tras la cual se administró otro protocolo indicado consiguiendo posteriormente una RC, 2 fallecieron por progresión de la enfermedad y 3 por complicaciones secundarias al tratamiento. El intervalo libre de progresión para los pacientes que alcanzaron la RC fue de 24,38 semanas (6 meses). La mediana de supervivencia global fue de 8,4 semanas. La media del tiempo necesario para la recuperación de la neutropenia fue de 23 y 37 días en el primer y segundo ciclo respectivamente. La media del tiempo necesario para la recuperación de la trombocitopenia fue de 24 y 35 días en cada ciclo. Conclusiones El esquema de inducción FLAG-IDA para el tratamiento de pacientes con leucemias de alto riesgo es un esquema establecido, bien tolerado y con una toxicidad aceptable que ofrece una oportunidad para optar al trasplante de progenitores hematopoyéticos (AU)

Objective: To evaluate the effectiveness and safety of the FLAG-IDA regimen in patients with acute refractory and/or recurrent leukaemia. Method: Descriptive, retrospective, observational study of the clinical histories of patients with the FLAG-IDA regimen during the period of 2005-2010. Effectiveness was measured using objective response, progression-free interval, and global survival. Safety was measured using the NCI classification system of common toxicity criteria for adverse events. Results: We registered 12 patients (52.17±8.26 years in women, and 54.83±7.22 years in men),11 cases were acute myeloid leukaemia (5 refractory, 3 in recurrence, 1 secondary to chronicre fractory myeloid leukaemia (CML) and 2 secondary to myelodysplastic syndrome (MDS), one of which was refractory and the other had not been previously treated) and one case was acuterefractory lymphoblastic leukaemia (ALL). Six patients (50%) reached a complete response (CR).One patient reached a partial response (PR), which was followed by another protocol that produced a CR, two died due to disease progression, and three due to secondary complications from treatment. The progression-free interval for patients that reached a CR was 24.38 weeks (6 months).Median global survival was 8.4 weeks. Mean time needed for the recovery of neutropenia was 23 and 37 days in the first and second cycle, respectively. The mean time required for recuperation of thrombocytopenia was 24 and35 days in each cycle. Conclusions: The FLAG-IDA induction regimen for the treatment of high-risk leukaemia patients is an established protocol, with good tolerance and acceptable toxicity levels that offers an opportunity for facilitating the transplantation of haematopoietic progenitors (AU)

[Effectiveness and safety of the FLAG-IDA regimen in acute refractory or recurrent leukaemia]. / Efectividad y seguridad del régimen FLAG-IDA en leucemias agudas resistentes o recidivantes.

OBJECTIVE: To evaluate the effectiveness and safety of the FLAG-IDA regimen in patients with acute refractory and/or recurrent leukaemia. METHOD: Descriptive, retrospective, observational study of the clinical histories of patients with the FLAG-IDA regimen during the period of 2005-2010. Effectiveness was measured using objective response, progression-free interval, and global survival. Safety was measured using the NCI classification system of common toxicity criteria for adverse events. RESULTS: We registered 12 patients (52.17±8.26 years in women, and 54.83±7.22 years in men), 11 cases were acute myeloid leukaemia (5 refractory, 3 in recurrence, 1 secondary to chronic refractory myeloid leukaemia (CML) and 2 secondary to myelodysplastic syndrome (MDS), one of which was refractory and the other had not been previously treated) and one case was acute refractory lymphoblastic leukaemia (ALL). Six patients (50%) reached a complete response (CR). One patient reached a partial response (PR), which was followed by another protocol that produced a CR, two died due to disease progression, and three due to secondary complications from treatment. The progression-free interval for patients that reached a CR was 24.38 weeks (6 months). Median global survival was 8.4 weeks. Mean time needed for the recovery of neutropenia was 23 and 37 days in the first and second cycle, respectively. The mean time required for recuperation of thrombocytopenia was 24 and 35 days in each cycle. CONCLUSIONS: The FLAG-IDA induction regimen for the treatment of high-risk leukaemia patients is an established protocol, with good tolerance and acceptable toxicity levels that offers an opportunity for facilitating the transplantation of haematopoietic progenitors.