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1.
Clinicoecon Outcomes Res ; 11: 695-701, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31819561

RESUMO

Purpose: The availability of different routes of administration of rituximab, with different dosing and times of infusion in the day care unit, raises the question of which formulation would be the best in terms of direct cost, particularly with the approval of new intravenous (IV) rituximab biosimilars. We aim to retrospectively compare the direct costs of IV and subcutaneous (SC) rituximab in lymphoma, considering drug cost, pharmacy handling and occupation in day care unit in Son Espases University Hospital during 2017, now that the IV biosimilar is available. Patients and methods: The data were collected from Oncosafety®-AVIDA for doses and SAP® for economic data. The costs of occupation are published by the Local Health Service. Results: In 2017, 527 cycles were prescribed for 103 patients with lymphoma: 141 IV and 386 SC. Median doses were 690 mg and 1400 mg with a median cost of the drug of 1458.45€ and 1334.77€ for IV and SC routes, respectively. The nurse handling costs were 4.49€ and 2.24€, respectively. The cost of the day care unit occupation was 493€ and 123€, respectively. Overall, the median total cost per cycle was 1955.94€ for the IV, 1460.01€ for the SC and 1729€ for the biosimilar (p<0.001). The sensitivity analysis showed that it would be necessary for the cost of the IV biosimilar to be 34% lower than the price of SC rituximab to make a difference. Conclusion: This study shows a reduction in the cost with the administration of SC rituximab in real life compared with using the IV original rituximab and the biosimilar. This information is relevant for healthcare managers and administrations and applies only in the case of drugs with SC original presentations still not available in their correspondent biosimilars.

2.
Acta Neurochir (Wien) ; 161(8): 1733-1741, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31187267

RESUMO

BACKGROUND: 5-Aminolevulinic acid (5-ALA) has become an important assistant in glioblastoma (GB) surgery. Unfortunately, its price affects its widespread use. OBJECTIVE: The aim of this study was to compare commercial 5-ALA with the pharmacy-compounded solution. METHODS: Using first an in vitro experimental approach, different concentrations of the pharmacy-compounded solution and commercial 5-ALA were tested in U87MG, LN229, U373, and T98G commercial glioblastoma cell lines. Fluorescence intensity was compared for each concentration by flow cytometry. Mean fluorescence of culture supernatant and lysate samples were analyzed. In a second phase, both preparations were used for surgical glioblastoma resection and tumor samples were analyzed by confocal microscopy. Mean fluorescence intensity was analyzed for each preparation and compared. RESULTS: There was a high variability of fluorescence intensity between cell lines, but each cell line showed similar fluorescence for both preparations (compounded preparation and commercial 5-ALA). In the same way, both preparations had similar fluorescence intensity in glioblastoma samples. CONCLUSION: Both, compounded and commercial 5-ALA preparations produce equivalent fluorescent responses in human glioblastoma cells. Fluorescence intensity is cell line specific, but fluorescent properties of both preparations are undistinguishable.

5.
PLoS One ; 13(11): e0206558, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30388144

RESUMO

BACKGROUND: Thrombotic microangiopathy (TMA) is an important complication associated with several diseases that are rare and life-threatening. TMA is common to thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). TTP is defined by a severe deficiency of ADAMTS13, and early treatment is associated with good prognosis. The diagnosis of HUS can be difficult due to the potential multiple etiologies, and the best treatment option in most cases is not well-established yet. The implementation of a multidisciplinary team (MDT) could decrease the time to diagnosis and treatment for HUS and may improve the outcomes of these patients. OBJECTIVE: To determine the impact of MDT on morbidity and mortality [death or chronic renal replacement therapy (CRRT) requirements], incidence and response time [(RT) defined as the period between hospital admission and the first day of direct therapy administration], length of stay at an intensive care unit (ICU-LOS) and total hospitalization (T-LOS) were also assessed. METHODS: We compared a pre-MDT implementation period (from January/2008 to May/2016) versus post-MDT period (from May/2016 to December/2016). The screening TMA diagnosis was made according the following criteria: hemolytic anemia, thrombocytopenia and acute renal damage and without ADAMTS13 deficiency. An online chat was implemented to provide instant medical information. RESULTS: Twenty-eight patients were included. The incidence changed from 2.3 cases/pre-MDT: (all cases: n = 18) to 10 cases/year post-MDT (all cases: n = 10). Two patients died in pre-MDT and post- MDT (11% versus 20%, P = 0.60). From pre-MDT, the number of patients who required CRRT by post-MDT decreased from 7 (39%) to 0, P = 0.03. Similarly, RT, ICU-LOS and T-LOS [median(p25-p75)] decreased from 10 (2-12) days to 0.5 (0-1.5) days, P = 0.04, from 16 (9-30) days to 10 (4-13) days, P = 0.01 and from 33 (22-53) days to 16 (12-32) days, P < 0.01, respectively. CONCLUSION: MDT implementation was associated with a greater number of patients who meet TMA criteria. A decrease in the RT and T-LOS periods were observed and associated with better outcomes in these patients.


Assuntos
Equipe de Assistência ao Paciente , Microangiopatias Trombóticas/terapia , Adulto , Algoritmos , Cuidados Críticos , Feminino , Humanos , Incidência , Tempo de Internação , Masculino , Melhoria de Qualidade , Terapia de Substituição Renal , Microangiopatias Trombóticas/diagnóstico , Microangiopatias Trombóticas/mortalidade , Tempo para o Tratamento , Resultado do Tratamento
6.
Farm. hosp ; 41(2): 257-269, mar.-abr. 2017. tab
Artigo em Inglês | IBECS | ID: ibc-160952

RESUMO

Objective: To describe the actions taken by the Pharmacy Unit in a tertiary hospital in order to adapt to the recommendations established by NIOSH 2014 for handling Hazardous Drugs. Method: A retrospective observational study. A list was prepared including all hazardous drugs according to NIOSH 2014 that were available at the hospital as marketed or foreign drugs, or used in clinical trials, and there was a review of the processes of acquisition, repackaging, preparation, circuits, organizational, dispensing and identification. Results: After the analysis, a report including all needs was prepared and sent to the Hospital Management. Any relevant information about the handling and administration of hazardous drugs was included in the prescription computer program. There were changes in the acquisition process of two drugs, in order to avoid splitting and multi-dose formulations. An alternative or improvement was found for 35 253 of the 75 779 units of hazardous drugs repackaged in one year. The Pharmacy Unit took over the preparation of four non-sterile medications, as well as the preparation of all sterile parenteral medications included in Lists 1 and 2 that were not previously prepared there, as well as one from List 3. Information was also included about the preparation processes of Magistral Formulations that involved hazardous drugs from Lists 2 or 3. Conclusion: The adaptation to the recommendations by NIOSH 2014 has represented a change, but also a significant reduction in the handling process of hazardous drugs by the healthcare staff, therefore reducing the risk of occupational exposure (AU)


Objetivo: Describir las actuaciones realizadas en el Servicio de Farmacia de un hospital de tercer nivel para adaptarse a las recomendaciones establecidas en NIOSH 2014 para el manejo de medicamentos peligrosos. Método: Estudio observacional retrospectivo. Se elaboró una lista de los medicamentos peligrosos según NIOSH 2014 disponibles en el hospital como comercializados, extranjeros o utilizados en ensayos clínicos y se revisaron los procesos de adquisición, re-envasado, preparación, circuitos organizativos, dispensación e identificación. Resultados: Tras el análisis se redactó y envió un informe de las necesidades a la gerencia del hospital. Se incluyó en el sistema informático de prescripción la información pertinente sobre la manipulación y la administración de medicamentos peligrosos. Hubo cambios en la adquisición de dos medicamentos para evitar el fraccionamiento y la presentación multidosis. De las 75.779 unidades de medicamentos peligrosos re-envasadas en un año, se encontró alternativa o mejora para 35.253. El Servicio de Farmacia asumió la preparación de cuatro medicamentos no estériles, así como de todos los medicamentos parenterales estériles de las listas 1 y 2 que no se preparaban allí con anterioridad y uno de la lista 3. También se incluyó información en los procedimientos de elaboración de fórmulas magistrales que implicaban medicamentos peligrosos de las listas 2 y 3. Conclusión: La adaptación a las recomendaciones NIOSH 2014 ha supuesto un cambio, pero también una minimización significativa de la manipulación de medicamentos peligrosos por parte del personal sanitario, reduciéndose de esta manera el riesgo de exposición ocupacional (AU)


Assuntos
Humanos , Substâncias Perigosas/análise , Gestão da Segurança/métodos , Composição de Medicamentos/normas , Serviço de Farmácia Hospitalar/organização & administração , Boas Práticas de Manipulação , Exposição Ocupacional/prevenção & controle , Precauções Universais , Atenção Terciária à Saúde/organização & administração , Estudos Retrospectivos
7.
Farm Hosp ; 41(2): 257-269, 2017 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-28236800

RESUMO

OBJECTIVE: To describe the actions taken by the Pharmacy Unit in a tertiary hospital in order to adapt to the recommendations established by NIOSH 2014 for handling Hazardous Drugs. Method: A retrospective observational study. A list was prepared including all hazardous drugs according to NIOSH 2014 that were available at the hospital as marketed or foreign drugs, or used in clinical trials, and there was a review of the processes of acquisition, repackaging, preparation, circuits, organizational, dispensing and identification. Results: After the analysis, a report including all needs was prepared and sent to the Hospital Management. Any relevant information about the handling and administration of hazardous drugs was included in the prescription computer program. There were changes in the acquisition process of two drugs, in order to avoid splitting and multi-dose formulations. An alternative or improvement was found for 35 253 of the 75 779 units of hazardous drugs repackaged in one year. The Pharmacy Unit took over the preparation of four non-sterile medications, as well as the preparation of all sterile parenteral medications included in Lists 1 and 2 that were not previously prepared there, as well as one from List 3. Information was also included about the preparation processes of Magistral Formulations that involved hazardous drugs from Lists 2 or 3. CONCLUSION: The adaptation to the recommendations by NIOSH 2014 has represented a change, but also a significant reduction in the handling process of hazardous drugs by the healthcare staff, therefore reducing the risk of occupational exposure.


Assuntos
Composição de Medicamentos , Substâncias Perigosas , Exposição Ocupacional/prevenção & controle , Preparações Farmacêuticas , Fidelidade a Diretrizes , Humanos , Exposição Ocupacional/efeitos adversos , Recursos Humanos em Hospital , Serviço de Farmácia Hospitalar/organização & administração , Estudos Retrospectivos
12.
Farm Hosp ; 37(1): 27-34, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23461497

RESUMO

OBJECTIVE: To find out the incidence of drug-induced thrombocytopenia and which medications are implicated, and to establish pharmaceutical activity for its prevention and resolution. METHODS: A prospective study was conducted between June and December 2009 in hospitalized patients over 18 years of age with thrombocytopenia. The medications considered to be associated with thrombocytopenia were included in a database drawn up from the bibliography. In a suspected case, the doctor was recommended to discontinue, decrease the dosage or keep the drug under observation; and a follow-up of the patient's platelet count was made in order to classify the relationship between the drug and thrombocytopenia. RESULTS: 273 patients were included (61.5% men) with a mean age of 60 ± 15 years. Mean stay was 18 ± 17 days. TCP incidence was 2.26%. The services most involved were Haematology (56), Intensive Care Medicine (48) and Oncology (40). TCP was moderate in 69% of cases, mild in 26 % and severe in 5%. There were 8 cases of drug-induced thrombocytopenia (0.063% incidence), which were resolved in an average of 7.6 days. The medications related were enoxaparin (2), linezolid (2), tacrolimus (2), thymoglobulin (1) and heparin (1). The doctor was recommended to discontinue the drug (2), decrease the dosage (3) or keep it under observation (3), with 100% acceptance. CONCLUSIONS: Pharmaceutical validation must incorporate an assessment of the platelet count, as it may contribute both to early identification of thrombocytopenia, and to following up platelet counts in patients receiving therapy with thrombocytopenia related drugs.


Assuntos
Pacientes Internados , Trombocitopenia/induzido quimicamente , Acetamidas/efeitos adversos , Adulto , Idoso , Algoritmos , Soro Antilinfocitário/efeitos adversos , Relação Dose-Resposta a Droga , Substituição de Medicamentos , Enoxaparina/efeitos adversos , Feminino , Heparina/efeitos adversos , Humanos , Incidência , Tempo de Internação/estatística & dados numéricos , Linezolida , Masculino , Pessoa de Meia-Idade , Oxazolidinonas/efeitos adversos , Contagem de Plaquetas , Estudos Prospectivos , Tacrolimo/efeitos adversos , Trombocitopenia/sangue , Trombocitopenia/diagnóstico , Trombocitopenia/epidemiologia , Adulto Jovem
13.
Farm. hosp ; 37(1): 27-34, ene.-feb. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-115644

RESUMO

Objetivo: Los objetivos del estudio fueron conocer la incidencia de trombocitopenia inducida por fármacos, los medicamentos implicados y establecer la actividad del farmacéutico para su prevención y resolución. Método: Se realizó un estudio prospectivo entre Junio y Diciembre de 2009 en mayores de 18 años ingresados con trombocitopenia. Se consideraron medicamentos asociados a trombocitopenia los incluidos en una base de datos elaborada a partir de bibliografía. En caso de sospecha, se recomendaba al médico suspender, disminuir dosis o monitorizar el fármaco y se realizaba el seguimiento del recuento plaquetario para clasificar la relación entre fármaco y trombocitopenia. Resultados: Se incluyeron 273 pacientes (61,5% hombres), edad media 60 ± 15 años. La estancia media fue de 18 ± 17 días. La incidencia de trombocitopenia fue de un 2,26%. Los servicios más implicados fueron Hematología (56), Medicina Intensiva (48) y Oncología (40). La trombocitopenia fue moderada en un 69% de los casos, en un 26 % leve y en un 5% grave. Hubo 8 casos de trombocitopenia inducida por fármacos (incidencia 0,063%), resueltos en una media de 7, 6 días. Los medicamentos relacionados fueron enoxaparina (2), linezolid (2), tacrolimus (2), timoglobulina (1) y heparina (1). Se recomendó al médico suspender el fármaco (2), disminuir la dosis (3) o monitorización (3), con una aceptación del 100%. Conclusiones: La validación farmacéutica debe incorporar la valoración del recuento plaquetario, porque puede contribuir tanto a la identificación precoz de una trombocitopenia, como al seguimiento del recuento plaquetario en pacientes en tratamiento con fármacos relacionados con trombocitopenia (AU)


Objective: To find out the incidence of drug-induced thrombocytopenia and which medications are implicated, and to establish pharmaceutical activity for its prevention and resolution. Methods: A prospective study was conducted between June and December 2009 in hospitalized patients over 18 years of age with thrombocytopenia. The medications considered to be associated with thrombocytopenia were included in a database drawn up from the bibliography. In a suspected case, the doctor was recommended to discontinue, decrease the dosage or keep the drug under observation; and a follow-up of the patient's platelet count was made in order to classify the relationship between the drug and thrombocytopenia. Results: 273 patients were included (61.5% men) with a mean age of60±15 years. Mean stay was 18± 17 days. TCP incidence was 2.26%. The services most involved were Haematology (56), Intensive Care Medicine (48) and Oncology (40). TCP was moderate in 69% of cases, mild in 26 % and severe in 5%. There were 8 cases of drug-induced thrombocytopenia (0.063% incidence), which were resolved in an average of 7.6 days. The medications related were enoxaparin (2), linezolid (2), tacrolimus (2), thymoglobulin (1) and heparin (1). The doctor was recommended to discontinue the drug (2), decrease the dosage (3) or keep it under observation (3), with 100% acceptance. Conclusions: Pharmaceutical vaiicianon musi incorporate an assessment of ihe platelet couni, as II may contribute bolh lo early Identification of thrombocytopenia, and to following up platelet counts in patients receiving therapy with thrombocytopenia related drugs (AU)


Assuntos
Humanos , Trombocitopenia/induzido quimicamente , Assistência Farmacêutica , Hospitalização/estatística & dados numéricos , Contagem de Plaquetas , Estudos Prospectivos
14.
Rev Esp Enferm Dig ; 104(4): 165-84, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22537365

RESUMO

Chronic liver diseases (CLD) alter the kinetics of drugs. Despite dosage adjustment is based on Child-Pugh scores, there are no available recommendations and/or algorithms of reference to facilitate dosage regimens. A literature review about dose adjustment of the drugs from the hospital guide -which are included in the list of the WHO recommended drugs to be avoided or used with caution in patients with liver disease- was carried out. The therapeutic novelties from the last few years were also included. In order to do so, the summary of product characteristics (SPC), the database DrugDex-Micromedex, the WHO recommendations and the review articles from the last 10 years in Medline were reviewed. Moreover, the kinetic parameters of each drug were calculated with the aim of establishing a theoretical recommendation based on the proposal of Delcò and Huet. Recommendations for 186 drugs are presented according to the SPC (49.5%), DrugDex-Micromedex (26.3%) and WHO (18.8%) indications; six recommendations were based on specific publications; the theoretical recommendation based on pharmacokinetic parameters was proposed in four drugs. The final recommendations for clinical management were: dosage modification (26.9%), hepatic/analytical monitoring of the patient (8.6%), contraindication (18.8%), use with caution (19.3%) and no adjustment required (26.3%). In this review, specific recommendations for the practical management of patients with chronic liver disease are presented. It has been elaborated through a synthesis of the published bibliography and completed by following a theoretical methodology.


Assuntos
Anti-Infecciosos/administração & dosagem , Antineoplásicos/administração & dosagem , Fármacos Cardiovasculares/administração & dosagem , Insuficiência Hepática , Anti-Infecciosos/farmacocinética , Antineoplásicos/farmacocinética , Fármacos Cardiovasculares/farmacocinética , Doença Crônica , Contraindicações , Relação Dose-Resposta a Droga , Cálculos da Dosagem de Medicamento , Insuficiência Hepática/metabolismo , Humanos , Fígado/metabolismo
15.
Rev. esp. enferm. dig ; 104(4): 165-184, abr. 2012.
Artigo em Espanhol | IBECS | ID: ibc-100190

RESUMO

La insuficiencia hepática crónica produce alteraciones que afectan a la cinética de los medicamentos y a pesar de que su ajuste se basa en el índice Child-Pugh, no se disponen de recomendaciones y/o algoritmos de referencia que faciliten su dosificación. Se realizó una revisión bibliográfica de la dosificación en insuficiencia hepática crónica de los medicamentos de la guía del hospital incluidos en el listado de fármacos que la OMS recomienda no utilizar o utilizar con precaución en pacientes con enfermedad hepática, añadiendo las novedades terapéuticas de los últimos años. Para ello se revisaron las fichas técnicas, base DrugDex- Micromedex, recomendaciones de la OMS y artículos de revisión de los últimos 10 años en Medline; además, se calcularon los parámetros cinéticos de cada fármaco con el objeto de establecer una recomendación teórica basada en la propuesta de Delcò y Huet. Se presentan recomendaciones para 186 medicamentos, según lo indicado en la ficha técnica (49,5%), DrugDex-Micromedex (26,3%) y OMS (18,8%); 6 recomendaciones se realizaron en base a publicaciones específicas y en 4 fármacos se propuso la recomendación teórica basada en los parámetros farmacocinéticos. Las recomendaciones finales para el manejo clínico fueron de: modificación de dosis (26,9%), monitorización hepática/analítica del paciente (8,6%), contraindicación (18,8%), emplear con precaución (19,3%) y no requerir ajuste (26,3%). En esta revisión se presentan recomendaciones específicas para el manejo práctico del paciente con insuficiencia hepática crónica, obtenida mediante una síntesis de la bibliografía publicada y completada con aplicación de una metodología teórica(AU)


Chronic liver diseases (CLD) alter the kinetics of drugs. Despite dosage adjustment is based on Child-Pugh scores, there are no available recommendations and/or algorithms of reference to facilitate dosage regimens. A literature review about dose adjustment of the drugs from the hospital guide –which are included in the list of the WHO recommended drugs to be avoided or used with caution in patients with liver disease– was carried out. The therapeutic novelties from the last few years were also included. In order to do so, the summary of product characteristics (SPC), the database DrugDex- Micromedex, the WHO recommendations and the review articles from the last 10 years in Medline were reviewed. Moreover, the kinetic parameters of each drug were calculated with the aim of establishing a theoretical recommendation based on the proposal of Delcò and Huet. Recommendations for 186 drugs are presented according to the SPC (49.5%), DrugDex-Micromedex (26.3%) and WHO (18.8%) indications; six recommendations were based on specific publications; the theoretical recommendation based on pharmacokinetic parameters was proposed in four drugs. The final recommendations for clinical management were: dosage modification (26.9%), hepatic/analytical monitoring of the patient (8.6%), contraindication (18.8%), use with caution (19.3%) and no adjustment required (26.3%). In this review, specific recommendations for the practical management of patients with chronic liver disease are presented. It has been elaborated through a synthesis of the published bibliography and completed by following a theoretical methodology(AU)


Assuntos
Humanos , Masculino , Feminino , Insuficiência Hepática/complicações , Insuficiência Hepática/tratamento farmacológico , Hepatopatias/tratamento farmacológico , Prescrições de Medicamentos/normas , Relação Dose-Resposta a Droga , Antibióticos Antituberculose/farmacocinética , Antituberculosos/farmacocinética , Busserrelina/farmacocinética , Farmacocinética , Legislação de Medicamentos/normas , Legislação de Medicamentos , Anti-Infecciosos/farmacocinética , Peptídeos Catiônicos Antimicrobianos/farmacocinética , Antirretrovirais/farmacocinética , Leuprolida/farmacocinética
16.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 28(supl.4): 36-39, nov. 2010.
Artigo em Espanhol | IBECS | ID: ibc-179589

RESUMO

El uso prudente de antibióticos requiere un abordaje interdisciplinar en el que la farmacia, tanto hospitalaria como comunitaria, desempeña un papel importante. Las actividades que se realizan en la farmacia hospitalaria se pueden dividir en 3 fases: a) antes de la prescripción: mediante la selección de antimicrobianos, la elaboración de guías de profilaxis y tratamiento empírico, y la incorporación de las decisiones en programas informáticos que permitan una prescripción electrónica informada; b) durante la prescripción: evaluación de la prescripción, adecuación de la dosis y pauta a los datos del paciente y de la infección, preparación de las dosis listas para su uso, ajustes farmacocinéticos y monitorización de la duración de los tratamientos, y c) después del tratamiento: realizando auditorías clínicas y medidas de la utilización de antibióticos. Desde la farmacia comunitaria las actividades a realizar son fomentar la adherencia al tratamiento, el seguimiento farmacoterapéutico del paciente para prevenir y detectar problemas relacionados con la medicación, y evitar la dispensación sin prescripción médica. Como propuestas de mejora se considera principalmente la formación en el control del uso de antimicrobianos, la integración en equipos interdisciplinares y la no venta de medicamentos sin prescripción médica


Appropriate use of antibiotics requires an interdisciplinary approach in which hospital and community pharmacies play a key role. The activities carried out in hospital pharmacy can be divided into 3 stages: a) before prescription: through the selection of antimicrobial agents, the creation of guides on prophylaxis and empirical treatments, and incorporation of the decisions into computer programmes that provide detailed electronic prescriptions; b) during prescription: prescription assessment, dose adjustment, patient information and infection data, preparation of doses to be used, pharmacokinetic adjustments and monitoring of treatment duration, and c) after treatment: clinical audits and measurements of the use of antibiotics. In community pharmacy, activities include promoting patient compliance, pharmacotherapeutic follow-up of patients to prevent and detect drug-related problems and avoidance of over-the-counter drug dispensation. Suggestions for improvement include mainly training in monitoring the use of antimicrobials, integration in interdisciplinary teams and avoiding the sale of over-the-counter antibiotics


Assuntos
Humanos , Antibacterianos/uso terapêutico , Serviços Comunitários de Farmácia/normas , Serviço de Farmácia Hospitalar/normas , Farmacorresistência Bacteriana , Uso de Medicamentos/normas
17.
Med. clín (Ed. impr.) ; 133(19): 741-744, nov. 2009. tab
Artigo em Espanhol | IBECS | ID: ibc-83837

RESUMO

Fundamento y objetivo: El objetivo del estudio es conocer la incidencia de los errores de conciliación en el ingreso y en el alta hospitalaria en pacientes ancianos polimedicados así como los factores de riesgo asociados. Pacientes y método: Estudio prospectivo aleatorizado y multicéntrico en el ingreso o en el alta hospitalaria. Cualquier discrepancia no justificada entre el tratamiento crónico y el prescrito en el hospital se consideró un error de conciliación. Resultados: Se incluyeron 603 pacientes, de los cuales 318 (52,7%) presentaron al menos un error de conciliación. De las 3.991 prescripciones, 2.340 prescripciones (59%) no mostraron discrepancias, mientras que 970 prescripciones (24%) fueron discrepancias justificadas y 644 prescripciones (16%) fueron discrepancias no justificadas; en 37 prescripciones (1%) no fue posible determinarlo. De las 644 discrepancias no justificadas, en 555 discrepancias, el médico las aceptó como error de conciliación (tasa de errores de conciliación del 13,9%). Discusión: El 52,7% de los pacientes ancianos polimedicados presentaron errores de conciliación durante su estancia hospitalaria, lo que implica el 13,9% de los medicamentos. La conciliación de la medicación debe ser un objetivo estratégico para mejorar la seguridad de los pacientes (AU)


Background and objective: The objective of this study was to know of the incidence rate of reconciliation errors in elderly poly-medicated patients. Patients and method: A prospective randomized multicenter study in a cohort of patients at admission or at discharge. Any unjustified discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a Reconciliation Error. Results: From January 2006 to April 2008 603 patients were analyzed: 318 (52.7%) showed at least one Reconciliation Error. The patients had a total of 3.991 medications registered, 2.340 (59%) showed no discrepancies, 970 (24%) HAD justified discrepancies and 644 (16%) not justified; in 37 (1%) it was not possible to determine whether this was an error or not. Of the 644 unjustified discrepancies, 555 were accepted by the doctor as Reconciliation Errors. Reconciliation Error rate of 13.9%. Conclusion: According to this study, 52.7% of elderly poly-medicated patients have reconciliation errors during hospitalization. Medication reconciliation should be a strategic objective to increase the safety of patients (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Alta do Paciente/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Erros de Medicação/estatística & dados numéricos , Polimedicação
18.
Med Clin (Barc) ; 133(19): 741-4, 2009 Nov 21.
Artigo em Espanhol | MEDLINE | ID: mdl-19520393

RESUMO

BACKGROUND AND OBJECTIVE: The objective of this study was to know of the incidence rate of reconciliation errors in elderly poly-medicated patients. PATIENTS AND METHOD: A prospective randomized multicenter study in a cohort of patients at admission or at discharge. Any unjustified discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a Reconciliation Error. RESULTS: From January 2006 to April 2008 603 patients were analyzed: 318 (52.7%) showed at least one Reconciliation Error. The patients had a total of 3.991 medications registered, 2.340 (59%) showed no discrepancies, 970 (24%) HAD justified discrepancies and 644 (16%) not justified; in 37 (1%) it was not possible to determine whether this was an error or not. Of the 644 unjustified discrepancies, 555 were accepted by the doctor as Reconciliation Errors. Reconciliation Error rate of 13.9%. CONCLUSION: According to this study, 52.7% of elderly poly-medicated patients have reconciliation errors during hospitalization. Medication reconciliation should be a strategic objective to increase the safety of patients.


Assuntos
Erros de Medicação/estatística & dados numéricos , Admissão do Paciente , Alta do Paciente , Polimedicação , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estudos Prospectivos
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