Guidelines for evidence synthesis reporting: medications.

In the process of determining if a drug is valuable enough to be included in a hospital's pharmacotherapeutic repertoire many factors should be taken into account. In order to develop a guide, the methodology of different appraisal working groups and similar methodological documents published by Health Technology Assessment agencies have been taken into account. We recommend that reports are structured with the following headings: Medication/Description/Authorised indication; Description of the disease; Pathology reference treatment; Evaluation of efficacy and safety (Bibliographic search, Quality assessment, Efficacy and safety results); Assessment of ethical, organisational, social and legal aspects; Strengths and limitations of available evidence; Pharmacoeconomic evaluation; and Key points. This guide to evaluate technologies may be used as a tool in decision-making scenarios related to health innovation. It could be used by hospital pharmacists and by clinicians, health system professionals and public services advisors.

Sustancias y mezclas activas contra el SARS-CoV-2 en el ámbito de salud pública / No disponible

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Systematic review for the development of a pharmaceutical and medical products prioritization framework.

OBJECTIVE: To identify and analyze the criteria, approaches, and conceptual frameworks, used for national/international priority setting. DATA SOURCES: We performed a search of the main biomedical databases (Medline/PubMed, Embase, Centre for Reviews and Dissemination, and Cochrane), and we reviewed assessment agency websites, among other sources. STUDY DESIGN: An systematic review of the literature was carried out. DATA COLLECTION: Eligibility criteria for inclusion were based on set of predefined criteria. Systematic reviews and/or qualitative studies (interviews, surveys, expert consensus, etc) that aimed to identify prioritization criteria or develop general operational frameworks for the selection of health priorities were included. A critical analysis is made of all the aspects that may be useful for any public body that intends to establish priorities in health. PRINCIPAL FINDINGS: We found that there are no standardized criteria for priority setting, although common trends have been identified regarding key elements. Eight key domains were identified: 1) need for intervention; 2) health outcomes; 3) type of benefit of the intervention; 4) economic consequences; 5) existing knowledge on the intervention/quality and uncertainties of the regarding evidence; 6) implementation and complexity of the intervention/feasibility; 7) justice and ethics; and 8) overall context. CONCLUSIONS: Our review provides a thorough analysis of the relevant issues and offers key recommendations regarding considerations for developing a national prioritization framework. Findings are envisioned to be useful for different public organizations that are aiming to establish healthcare priorities.

Incorporación del farmacéutico de hospital al proyecto 'Compromiso por la calidad de las Sociedades Científicas en España' / Incorporation of the hospital pharmacist into the project 'Commitment to quality of the Spanish scientific societies'

No disponible

Effectiveness of biosimilar filgrastim vs. original granulocyte colony-stimulating factors in febrile neutropenia prevention in breast cancer patients.

PURPOSE: The purpose of this study is to describe the effectiveness of biosimilar filgrastim and original granulocyte colony-stimulating factors (G-CSFs), lenograstim and pegfilgrastim, in febrile neutropenia (FN) prevention in breast cancer patients receiving docetaxel/doxorubicin/cyclophosphamide (TAC) as adjuvant/neoadjuvant treatment and to analyze their treatment patterns. METHODS: A pharmacoepidemiology cohort study was developed in a university hospital (with 23 healthcare centers) with retrospective data collection (2012-2014). Effectiveness of G-CSFs was assessed by the FN incidence. Other parameters analyzed were as follows: moderate and severe neutropenia incidence, neutropenia-related hospitalizations, dosage, and duration. Data was analyzed using each cycle as a unit of analysis. RESULTS: We identified 98 patients representing 518 chemotherapy cycles, 215 with original G-CSFs (35 lenograstim and 180 pegfilgrastim) and 303 with biosimilar filgrastim. The FN incidence was similar in both groups (3.7% original vs. 3.3% biosimilar; p = 0.79). No statistically significant differences were found in moderate and severe neutropenia incidence (4.7 vs. 6.3%; p = 0.43) or neutropenia-related hospitalizations (3.3 vs. 3.6%; p = 0.19). When the three drugs were evaluated separately, a higher FN incidence was observed with lenograstim than with pegfilgratim or biosimilar (p = 0.024). The dosage and duration of biosimilar were lower than lenograstim (4.9 vs. 5.7 µg/kg/day; 5 vs. 7 days; p < 0.001). CONCLUSION: An abbreviated 5-day course of biosimilar filgrastim provided optimal primary prophylaxis against FN post-chemotherapy TAC in patients with breast cancer. The clinical relevance of the highest FN incidence in the lenograstim cohort needs further attention.

[Not Available]. / Sumario de recomendaciones nutricionales basadas en la evidencia de la Guía de Prácti ca Clínica para el manejo de pacientes con enfermedad de Parkinson.

Objetivos: dar a conocer las recomendaciones relacionadas con la Nutrición Humana y Dietética (NHyD) de la Guía de Práctica Clínica para el manejo de la enfermedad de Parkinson del Sistema Nacional de Salud (GPC-EP/SNS) y favorecer su difusión e implementación en la práctica. El objetivo secundario es presentar la implicación de los profesionales de la NHyD en la elaboración de la guía.Material y métodos: siguiendo el Manual Metodológico de Elaboración de Guías de Práctica Clínica en el Sistema Nacional de Salud, se formularon las preguntas clínicas, se realizó una búsqueda sistemática para cada pregunta en bases de datos (PubMed/Medline, Embase, Cochrane Library, CRD, LILACS, IBECS y ClinicalTrials), se definieron los criterios de elegibilidad, al menos dos investigadores seleccionaron los estudios, se realizó lectura crítica de la literatura se resumió en tablas de síntesis de evidencia y se establecieron las recomendaciones.Resultados: se propusieron 14 preguntas relacionadas directamente con NHyD-Parkinson, de las cuales solamente 3 pudieron incluirse. Se formuló una pregunta relacionada con la terapia de logopedia aplicada en personas con EP que presentan problemas de deglución, tratamiento donde se imbrican los profesionales de la NHyD. De 642 artículos localizados, únicamente 2 pudieron ser incluidos para contestar las correspondientes preguntas. De las evidencias halladas, se derivaron 11 recomendaciones directa o indirectamente relacionados con la NHyD.Conclusiones: la implicación de profesionales sanitarios en equipos multidisciplinares mejora el resultado final de las guías y la atención sanitaria de los pacientes. Es necesario que los profesionales sanitarios de la NHyD (los/las dietistas-nutricionistas) se impliquen en iniciativas basadas en la mejor evidencia científica disponible y que formen parte de los equipos de trabajo multidisciplinares.

Sumario de recomendaciones nutricionales basadas en la evidencia de la Guía de Práctica Clínica para el manejo de pacientes con enfermedad de Parkinson / Summary of evidence-based nutritional recommendations of the Clinical Practice Guideline for the management of patients with Parkinson’s disease

Objetivos: dar a conocer las recomendaciones relacionadas con la Nutrición Humana y Dietética (NHyD) de la Guía de Práctica Clínica para el manejo de la enfermedad de Parkinson del Sistema Nacional de Salud (GPC-EP/SNS) y favorecer su difusión e implementación en la práctica. El objetivo secundario es presentar la implicación de los profesionales de la NHyD en la elaboración de la guía. Material y métodos: siguiendo el Manual Metodológico de Elaboración de Guías de Práctica Clínica en el Sistema Nacional de Salud, se formularon las preguntas clínicas, se realizó una búsqueda sistemática para cada pregunta en bases de datos (PubMed/Medline, Embase, Cochrane Library, CRD, LILACS, IBECS y ClinicalTrials), se definieron los criterios de elegibilidad, al menos dos investigadores seleccionaron los estudios, se realizó lectura crítica de la literatura se resumió en tablas de síntesis de evidencia y se establecieron las recomendaciones. Resultados: se propusieron 14 preguntas relacionadas directamente con NHyD-Parkinson, de las cuales solamente 3 pudieron incluirse. Se formuló una pregunta relacionada con la terapia de logopedia aplicada en personas con EP que presentan problemas de deglución, tratamiento donde se imbrican los profesionales de la NHyD. De 642 artículos localizados, únicamente 2 pudieron ser incluidos para contestar las correspondientes preguntas. De las evidencias halladas, se derivaron 11 recomendaciones directa o indirectamente relacionados con la NHyD. Conclusiones: la implicación de profesionales sanitarios en equipos multidisciplinares mejora el resultado final de las guías y la atención sanitaria de los pacientes. Es necesario que los profesionales sanitarios de la NHyD (los/las dietistas-nutricionistas) se impliquen en iniciativas basadas en la mejor evidencia científica disponible y que formen parte de los equipos de trabajo multidisciplinares (AU)

Objectives: To announce the Human Nutrition and Dietetics (NHyD) recommendations of the Clinical Practice Guideline in the management of Parkinson’s disease in the Spanish National health system, and promoting its dissemination and implementation in practice. To point out the implication of NHyD professionals in the quoted guideline was the secondary objective. Material and methods: The following items were carried out according to the Methodological Manual for Clinical Practice Guidelines Preparation in the Spanish National health system: formulating the clinical questions, systematic search for each question in databases (PubMed/ Medline, Embase, Cochrane Library, CRD, LILACS, IBECS and ClinicalTrials), definition of eligibility criteria, studies were selected by at least two researchers, critical reading of the literature was made using evidence summary tables, and corresponding recommendations were established. Results: 14 questions directly related with Parkinson’s disease and NHyD were proposed; only 3 of which could be finally included. It was formulated a question related to speech therapy for Parkinson’s disease patients with swallowing disorders. Human Nutrition and Dietetics professionals got involved in this treatment. Only 2 of the 642 articles were included to answer the corresponding questions. According to evidence found, 11 recommendations were proposed with the active involvement of Human Nutrition and Dietetics. Conclusions: Multidisciplinary healthcare professionals’ implication improves the final result of the guideline and the health care results in patients. It is necessary that Human Nutrition and Dietetics healthcare professionals get involved in this kind of initiatives, based on the best evidence available, and they should be a member of multidisciplinary work teams (AU)

Evidence-based medicine clinical practice guidelines in the Spanish National Health System.

Spanish Hospital Pharmacies should become deeply implicated in clinical practice guidelines (CPGs) and other evidence-based products (OEBPs), either nationally or globally. The HealthGuide-CPG in the Spanish National Health System (NHS) is an organisation in which the 17 Spanish Autonomous Regions participate. It is endorsed by the Interterritorial Board in the NHS, as an instrument to improve the quality of care. The HealthGuide's mission is to encourage the supply of CPG and OEBP to support professionals and patients' decision making in the NHS and to promote the building of collaborative networks and the cooperation among entities dealing with CPGs and evidence-based medicine (EBM). The HealthGuide Technical Secretariat is located in the Aragon Health Sciences Institute. The aim of this paper is to present the HealthGuide to hospital pharmacists, not only to Spanish-speaking people, as it is applicable to any healthcare system. The resources proposed are methodological manuals for preparation, updating, implementation and patient involvement in the development of CPGs. The methods presented cover preparation, appraisal, updating, adapting and implementation of the CPG. RESULTS: Catalogue of CPGs for the Spanish NHS; programme development of CPGs in the NHS; OEBPs; and education and training for EBM and CPGs. DISCUSSION: The Spanish hospital pharmacist should participate in the development of good CPGs, health technology assessment and OEBPs. CONCLUSIONS: The products and services developed in the HealthGuide framework may be a good way to acquire, improve and transfer methodological knowledge issues of EBM. The HealthGuide should take into account the knowledge of hospital pharmacists.

[Prevalence of antiparkinsonian treatment complications: a systematic review and estimation of projections]. / Prevalencia de las complicaciones del tratamiento antiparkinsoniano: revision sistematica y estimacion de proyecciones.

INTRODUCTION: The development of Parkinson's disease (PD) presents different complications deriving from the disease itself, but also from its treatment. The appearance of side effects with the use of antiparkinsonian drugs is common and their management is complicated, which makes it necessary to determine the epidemiological impact of these problems related with antiparkinsonian medication. AIM: To estimate the prevalence of the side effects of the treatment for the motor symptoms of PD and the possible long-term impact. PATIENTS AND METHODS: A systematic review was performed in the biomedical databases since the year 2004; the most relevant studies were selected and the frequencies of the most common side effects were identified. The data thus obtained were projected in order to estimate their impact in the long term. RESULTS: Altogether 218 studies were identified, of which 24 were selected for the review. Data were obtained for 20 types of complications deriving from the antiparkinsonian treatment, including heart problems, oedemas and neuropsychiatric symptoms. CONCLUSIONS: The estimations performed indicate that the number of patients with PD and therefore the prevalence of the side effects of antiparkinsonian treatments may well double by the year 2050.

TITLE: Prevalencia de las complicaciones del tratamiento antiparkinsoniano: revision sistematica y estimacion de proyecciones.Introduccion. El desarrollo de la enfermedad de Parkinson (EP) presenta diferentes complicaciones derivadas de la propia enfermedad, pero tambien de su tratamiento. La aparicion de efectos adversos con el uso de antiparkinsonianos es comun y su manejo es complicado, por lo que se hace necesario determinar el impacto epidemiologico de estos problemas relacionados con los medicamentos antiparkinsonianos. Objetivo. Estimar la prevalencia de los efectos adversos del tratamiento de los sintomas motores de la EP y su posible impacto a largo plazo. Pacientes y metodos. Se realizo una revision sistematica en bases de datos biomedicas desde el año 2004; se seleccionaron los estudios mas relevantes y se identificaron las frecuencias de los efectos adversos mas comunes. Se proyectaron los datos obtenidos para estimar su impacto a largo plazo. Resultados. Se identificaron 218 estudios, de los cuales 24 fueron seleccionados para la revision. Se obtuvieron datos para 20 tipos de complicaciones del tratamiento antiparkinsoniano, entre las que se encuentran problemas cardiacos, edemas y sintomas neuropsiquiatricos. Conclusion. Las estimaciones realizadas indican que el numero de pacientes de EP y, consecuentemente, la prevalencia de los efectos adversos de los tratamientos antiparkinsonianos pueden duplicarse en el año 2050.