Incorporation of a mock drug information telephone call exercise in a health-systems pharmacy laboratory.

BACKGROUND AND PURPOSE: Hospital pharmacists routinely receive and answer drug information questions via telephone while performing order verification. This report describes the development, implementation, and evaluation of a mock learning experience for student performance of these tasks in a health-systems pharmacy laboratory course. EDUCATIONAL ACTIVITY AND SETTING: An active learning skills-based exercise involving students receiving and answering a standardized drug information question via telephone during an order verification activity, referred to as a cold-call exercise, was developed and implemented. Data collected included student grades on a baseline assessment, the cold call exercise, order verification exercises, and student perceptions from a voluntary post-exercise survey. Student performance on the cold-call exercise was further evaluated via individual sections of the cold-call rubric. Data were summarized using descriptive statistics. Thematic analysis of student opinion and an estimate of faculty time were also executed. FINDINGS: Student grades on the cold call and order verification exercises were 86.14% and 88.8%, respectively. Students often failed to ask category-specific questions because they did not categorize the ultimate question appropriately. Students found the activity organized and applicable. Time dedicated to creation was extensive, but execution and grading were reasonable. SUMMARY: Students performed well on the drug information exercise as well as the order verification component. Students and faculty enjoyed the experience, and students found the exercise relevant and challenging. This exercise could be implemented into any pharmacy curriculum in order to prepare students using authentic learning experiences.

Associations of gender and age groups on the knowledge and use of drug information resources by American pharmacists / Asociación de grupos de género y edad con el conocimiento y uso de fuentes de información sobre medicamentos por farmacéuticos estadounidenses

Objectives: To explore knowledge and use of drug information resources by pharmacists and identify patterns influenced by gender and age-group classification. Methods: A survey questionnaire was mailed nationwide to 1,000 practitioners working in community (n = 500) and hospital (n = 500) settings who answer drug information questions as part of their expected job responsibilities. Responses pertaining to drug information resource use and knowledge of different types of drug-related queries, resource media preferences, and perceived adequacy of resources maintained in the pharmacy were analyzed by gender and age group. The t statistic was used to test for significant differences of means and percentages between genders and between age groups. Descriptive statistics were used to characterize other findings. Results: Gender and age group classification influenced patterns of knowledge and use of drug information resources by pharmacists. They also affected pharmacists’ perceptions of the most common types of questions prompting them to consult a drug information reference, as well as the resources consulted. Micromedex, exclusively available in electronic format, was the most commonly consulted resource overall by pharmacists. Lexi-Comp Online was the leading choice by women, preferred over Micromedex, but was not one of the top two resources selected by men. Conclusion: This study successfully identified the influence of gender and age-group classification in assessing drug information resource knowledge and use of general and specific types of drug-related queries (AU)

Objetivos: Explorar el conocimiento y el uso de fuentes de información por farmacéuticos e identificar los patrones afectados por género y grupo etario. Métodos: Se envió un cuestionario por correo a 1000 facultativos de todo el país cuyas funciones en farmacias comunitarias (n=500) y de hospital incluían responder preguntas sobre información de medicamentos. Se analizaron por género y grupo etario las respuestas relativas al uso de fuentes de información y al conocimiento de los diferentes tipos de áreas, preferencias de fuentes e idoneidad percibida de las fuentes. Se utilizó el test t para probar las diferencias de medias y porcentajes entre géneros y grupos etarios. Se usó estadística descriptiva para caracterizar otros hallazgos. Resultados: El género y los grupos etarios afectaron los patrones de conocimiento y uso de fuentes de información sobre medicamentos por farmacéuticos. También afectaron las percepciones de los farmacéuticos sobre los tipos de preguntas más frecuentemente formuladas que les llevaban a consultar fuentes de información sobre medicamentos, así como las fuentes consultadas. Micromedex, sólo disponible en formato electrónico, fue la fuente más consultada por el conjunto de los farmacéuticos. Lexi-Comp Online fue la fuente preferida por las mujeres, seguida de Micromedex, pero no estaba entre las dos fuentes más populares entre los hombres. Conclusión: Este estudio identificó con éxito la influencia del género y del grupo etario en la evaluación de las fuentes de información sobre medicamentos y el uso en general y específico de búsquedas relativas a medicamentos (AU)

An electronic system to document reasons for medication discontinuation and to flag unwanted represcriptions in geriatric patients.

BACKGROUND: Earlier studies have shown poor documentation of the reasons for medication discontinuation during hospitalization. Communication of reasons for discontinuation, e.g. adverse drug reactions (ADRs), to general practitioners and pharmacists was also found to be insufficient, leading to a rate of represcription after an ADR of 27% during the first 6 months after discharge. OBJECTIVE: The aim of this study was to develop and implement a user-friendly electronic clinical decision support system to document reasons for medication discontinuation in hospitalized geriatric patients and to flag potentially undesirable represcriptions. METHODS: The electronic clinical decision support module was developed using the Gaston framework. Pop-up windows force physicians to document reasons for medication discontinuation, and the system alerts physicians to the represcription of drugs withdrawn because of an ADR. We interviewed users regarding the acceptability of the system. RESULTS: On a 20-bed geriatric ward, the electronic system documented 2,228 medication discontinuations and the reasons for them over 11.4 months and alerted physicians to represcription of drugs associated with an ADR 20 times. The system was considered to be user-friendly. CONCLUSIONS: This clinical decision support system fulfilled its aims of documenting the reasons for medication discontinuation and alerting physicians to potentially undesirable represcription of previously withdrawn drugs. It was found to be user-friendly.

Educating patients about warfarin therapy using information technology: a survey on healthcare professionals’ perspectives / Educando a pacientes sobre el uso terapéutico de warfarina utilizando tecnologías de información: estudio sobre perspectivas de profesionales de la salud

Objective: To explore healthcare professionals’ views about the benefits and challenges of using information technology (IT) resources for educating patients about their warfarin therapy. Methods: A cross-sectional survey of both community and hospital-based healthcare professionals (e.g., doctors, pharmacists and nurses) involved using a purpose-designed questionnaire. The questionnaires were distributed using a multi-modal approach to maximise response rates. Results: Of the total 300 questionnaires distributed, 109 completed surveys were received (43.3% response rate). Over half (53.2%) of the healthcare participants were aged between 40-59 years, the majority (59.5%) of whom were female. Fifty nine (54.1%) participants reported having had no access to warfarin-specific IT-based patient education resources, and a further 19 (38.0%) of the participants who had IT-access reported that they never used such resources. According to the healthcare participants, the main challenges associated with educating their patients about warfarin therapy included: patient-related factors, such as older age, language barriers, cognitive impairments and/or ethnic backgrounds or healthcare professional factors, such as time constraints. The healthcare professionals reported that there were several aspects about warfarin therapy which they found difficult to educate their patients about which is why they identified computers and interactive touch screen kiosks as preferred IT devices to deliver warfarin education resources in general practices, hospital-based clinics and community pharmacies. At the same time, the healthcare professionals also identified a number of facilitators (e.g., to reinforce warfarin education, to offer reliable and easily comprehensible information) and barriers (e.g., time and costs of using IT resources, difficulty in operating the resources) that could impact on the effective implementation of these devices in educating patients about their warfarin therapy Conclusion: The findings of the study suggest that there is a need for improving healthcare professionals’ use of, and access to IT-based warfarin education resources for patients. The study findings also suggest addressing the concerns raised by the healthcare professionals when implementing such IT resources successfully to help educate patients about their warfarin therapy (AU)

Objetivo: Explorar la visión de los profesionales de la salud sobre los beneficios y retos de usar tecnologías de información (TI) para educar pacientes sobre su tratamiento con warfarina. Métodos: Estudio transversal tanto de profesionales de la salud comunitarios y hospitalarios (e.g. médicos, farmacéuticos y enfermeras) que envolvió el uso de un cuestionario específicamente diseñado. Se distribuyeron los cuestionarios utilizando un diseño multi-modal para maximizar las tasas de respuesta. Resultados: De los 300 cuestionarios distribuidos, se recibieron 109 completos (43,3% de tasa de respuesta). Más de la mitad (53,2%) de los sanitarios participantes tenían entre 40-59 años y la mayoría (59,9%) eran mujeres. 59 participantes (54,1%) comunicaron no tener acceso a recursos de TI para educación de pacientes específicos de warfarina, y 19 de los que tenían acceso (38.0%) comunicaron que nunca los habían utilizado. De acuerdo con los sanitarios participantes, los principales retos asociados con la educación de sus pacientes sobre el tratamiento con warfarina incluían: factores relacionados con los pacientes, tales como elevada edad, barreras lingüísticas, deterioros cognitivos o antecedentes étnicos, o factores de los profesionales de la salud tales como restricción de tiempo. Los profesionales sanitarios comunicaron que había muchos aspectos del tratamiento con warfarina que encontraban difíciles de explicar a sus pacientes, por lo que identificaron los ordenadores y los quioscos interactivos de pantalla táctil como los aparatos de TI preferidos para proporcionar educación sobre warfarina en las consultas generales, en las clínicas hospitalarias y en las farmacias comunitarias. Al mismo tiempo, los profesionales de la salud también identificaron varios facilitadores (e.g. reforzar la educación sobre warfarina, ofrecer información fiable y fácilmente comprensible) y barreras (e.g. tiempo y costes de usar las TI, dificultad en manejar esos recursos) que podrían impactar en la implantación efectiva de estos aparatos para educar pacientes sobre su tratamiento con warfarina. Conclusión: Los hallazgos del estudio sugieren que se necesita mejorar el uso y el acceso de los profesionales de la salud a los recursos educativos para pacientes basados en TI sobre warfarina. El hallazgos del estudio también sugieren afrontar las preocupaciones levantadas por los profesionales al implantar con éxito tales TI para educar pacientes sobre sus tratamientos con warfarina (AU)

Smart medical environment at the point of care: auto-tracking clinical interventions at the bed side using RFID technology.

We developed a wireless auto-tracking system for tracking clinical intervention such as drug administrations and blood tests at the patient bedside. The system can not only authenticate patients and nurses, but also confirm medications and provide relevant information, depending on the clinical situation and personnel location. We conducted a feasibility experiment and examined whether or not the system could work as a patient safety measure in terms of reducing misidentifications of patients and medical errors including wrong medication type, dose, time, and route. Also, the duration of clinical interventions in the system were measured to compare with the BCMA system. Moreover, we conducted a qualitative evaluation with nurses and received feedback clarifying their perceptions of the system. The results showed that the system correctly recognized medical staff, patient ID, and medication data in real time. With regards to workflow time, a significant reduction of time of clinical interventions was observed, when compared to a bar-coding system. In addition, on the nurses' evaluation, we received mostly positive comments although they also clarified some issues to consider with regards to operability and privacy issues. We concluded that the system had great potential for reducing medical errors and nurse workload with high efficiency.

Personal digital assistant with a barcode reader--a medical decision support system for nurses in home care.

INTRODUCTION: Inappropriate medication among elderly people increases the risk of adverse drug-drug interactions, drug-related falls and hospital admissions. In order to prevent these effects it is necessary to obtain a profile of the patients' medication. A personal digital assistant (PDA) can be used as a medical decision support system (MDSS) to obtain a profile of the patients' medication and to check for inappropriate drugs and drug combinations, and to reduce medication errors. AIM: The aim of the present study was to evaluate nurses' experiences of using a MDSS in a PDA with a barcode reader, in order to obtain profiles of the patients' medication, regarding drug-drug interactions, therapeutic duplications, and warnings for drugs unsuitable for elderly in home care. METHODS: The LIFe-reader is a MDSS in a PDA with a barcode reader. By scanning the drug packages in the patients' home, the LIFe-reader obtained profiles of the patients' medication and checked for drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. The LIFe-reader also contained, e.g. drug information and medical reference works. Nurses (n=15) used the LIFe-reader for five weeks during their nursing home care practice assignment. The nurses answered questionnaires about the content and functions of the LIFe-reader before, during and after the nursing home care practice assignment, and were interviewed in focus groups. Descriptive statistics were used and content analysis was applied for qualitative data. RESULTS: By using the LIFe-reader, the majority of the nurses found it easy to obtain profiles of the patients' medication and check for drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly people. Most nurses regarded the LIFe-reader to reduce drug-related risks of falling, and some thought it could reduce the drug-related admissions to hospitals. The scanning function was described as easy and time saving, although not always possible to use. The LIFe-reader was regarded as a useful and user-friendly MDSS, but more content and functions were requested. CONCLUSIONS: We found that the LIFe-reader has the potential to be a useful and user-friendly MDSS for nurses in home care when obtaining profiles of the patients' medication regarding drug-drug interactions, therapeutic duplications and warnings for drugs unsuitable for elderly. A regular scanning of the patients' drugs in their home might support nurses and general practitioners (GPs) in reducing the inappropriate use of drugs. If the LIFe-reader should be used in a larger scale among nurses, more content and functions are necessary.

La interpretación de los pictogramas utilizados en la dispensación del medicamento de acuerdo con la perspectiva de personas con diferentes niveles de educación / The interpretation of pictograms used in the dispensation of medications according to the perspective of people with different education levels

Introducción: La función principal de los pictogramas es orientar, informar, educar y difundir los mensajes. El farmacéutico puede utilizar los pictogramas para hacer que el paciente disponga de la información más importante, clara y rápidamente, sobre el tratamiento medicamentoso. Objetivo: Determinar el nivel de comprensión de los pictogramas relacionados con el uso de medicamentos por personas con diferentes niveles de escolaridad, que viven en el área urbana de la ciudad de Poços de Caldas, en la Provincia de Minas Gerais (Brasil). Métodos: Se ha entrevistado a un total de 55 personas, entre 18 y 84 años de edad, de ambos sexos y con diferentes niveles de escolaridad. Resultados: Los resultados muestran que la comprensión de los pictogramas no depende del nivel de escolaridad. Conclusiones: La escolaridad no influyó sobre la muestra, y un mismo pictograma fue interpretado de diversas formas cuando fue observado por diferentes personas. Muchos factores influyen en la comprensión y están relacionados con las características socioculturales de cada paciente (AU)

Introduction: The main function of pictograms is to guide, inform, educate and transmit the messages. The pharmacist can use pictograms to make sure that the patient obtains the most important and clear information on the medical treatment in a concise way. Objective: To determine the level of understanding of pictograms related to the use of medicines by people with different education levels from the urban area of the city of Poços de Caldas, at Minas Gerais, Brazil. Methods: A total of 55 (fifty-five) individuals aged between 18-84 years, of both sexes, with different education levels, participated in the study. Results: The results demonstrate that the understanding of pictograms does not depend on the education level. Conclusions: The education level of the individual did not influence in the sample and when observed, different individuals interpreted one same pictogram in several ways. The factors, which influence such understanding, are many and they are related to the social and cultural characteristics of each patient (AU)

Comparison of RFID systems for tracking clinical interventions at the bedside.

In recent years, there have been high expectations for RFID technologies applied in the medical field, particularly for automatic identification and location of patients and medical supplies. However, few studies have measured the applicability of currently available RFID technologies in a medical environment. To determine the technical factors that affect the performance of RFID systems, we examined the performance of different types of tags for medications, medical equipment, nurses, and patients under different experimental conditions. Three kinds of passive RFID tags and one active RFID tag were used in our study. Passive tags were affected by materials such as liquid and metal. Tags based on 13.56MHz were most suited for identifying medications. Tag placement was one of the main factors involved in correct identification of nurses, patients, and medical equipment. The results of this study may help decision makers decide whether (which) RFID technologies are useful for tracking clinical workflow.

Smart infusion technology: a minimum safety standard for intensive care?

There is overwhelming evidence that medication errors present a risk to patients. This risk is highest in the intensive care unit (ICU) setting and even greater when medications are administered via an infusion pump. Standard pumps will not alert for, or prevent, drug calculation, drug unit, button push, or multiple of ten errors when medication delivery data is inputted. However, the literature suggests that smart pumps programmed with hard (unchangeable) limits can significantly reduce drug errors at the point of administration. Staff at St George's Hospital paediatric ICU wanted to implement an infusion pump system that would be immediately effective in reducing medication errors at the point of administration. This article presents an overview of the relevant literature together with clinical examples from the authors' ICU, which demonstrates their experiences with smart pumps. It is the authors' firm belief that smart infusion technology sets a new minimum safety standard for intensive care.

Gestión del fondo rotatorio de medicamentos y su relación con los conocimientos y actitudes del personal de salud / Administration of the rotational bottom of medications and their relationship with those knowledge and the personnel's of health attitudes

Pregunta de investigaión. ¿Existe relación entre la gestión del fondo rotatorio de medicamentos con la actitud y conocimientos del personal de salud de la Red Sur?. Objetivos. Favorecer la producción de conocimientos y estrategias que permitan mejorar la cobertura, disponibilidad y continuidad de servicios relacionados con el medicamento. Diseño. Investigación correlacional que determina el grado de relación entre dos variables en un momento determinado. Lugar. Red de salud Sur de la ciudad de La Paz. Población Personal de los centros de salud y muestra de recibos recetarios extendidos en los centros de salud a pacientes mayores de cinco años. Métodos. Para determinar el grado de cumplimiento de los procesos administrativos en la gestión de los medicamentos, se revisaron y analizaon recibos recetarios extendidos en el segundo semestre del 2002 y para medir conocimiento y actitud se aplicó una encuesta al personal médico y de enfermería. Resultados. El 67 por ciento de las enfermeras son responsables del fondo rotatorio y el 100 por ciento del personal no fue capacitado en los últimos cuatro años, por tanto la organización interna es improvisada. Los conocimientos son insuficientes y la actitud positiva. No se cumplen adecuadamente algunos pasos del proceso administrativo como la adquisición mensual de mediamentos o por agotamiento, no se aplica el sistema de control, mas de 40 por ciento de las recetas no se dispensan en los servicios, no se especifican costos, el prescriptor no se identifica y en mas del 70 por ciento de las recetas se prescriben antibióticos. Por otro lado, se cumplen con otro parámetros de uso racional como el incremento del fondo, prescripción con nombre genérico en 81 por ciento y llenado minucioso de indicaciones médicas en 95 por ciento. Conclusiones. La falta de capacitación en el manejo del fondo rotatorio influyó en el rendimiento del personal y la gestión de medicamentos responde mas a la organización interna e iniciativa en los centros de salud. Pese a contar con recursos, existe insuficiente abastecimiento de medicamentos y bajo porcentaje de dispensación en servicio, lo que obliga a los pacientes a la adquisición de medicamentos en farmacias privadas a costos mayores o a quedar sin tratamiento. Sin emabargo el fondo rotatorio garantiza el acceso de la población que no cuenta con el beneficio de los seguros públicos o de otros programas de salud a medicamentos que responden a sus necesidades en cantidad, costo y calidad.

Análisis de la información sobre las condiciones de conservación fuera del envase original de los medicamentos más prescritos / Analisys on information about preservation conditions of the most prescribed medicines when removed from their original package

La práctica de reenvasado de medicamentos, tanto por los pacientes en diferentes dispositivos, como por los farmacéuticos en los sistemas de ayuda al cumplimiento, requiere un estudio previo de requisitos de condiciones de conservación de las especialidades a reenvasar. Objetivo: Conocer la información disponible para pacientes (prospectos) y farmacéuticos (fichas técnicas e información de la industria) sobre las condiciones de conservación y la posible alteración de los medicamentos fuera de su envase original. Métodos: Se seleccionaron los medicamentos cuya venta en la provincia de Granada en Septiembre de 2000 superaba la mediana (sólo las formas farmacéuticas orales sólidas). En diciembre de 2000 se solicitó a los laboratorios fabricantes la información sobre las condiciones de conservación una vez desprovisto de su envase original, la ficha técnica, y el prospecto para cada especialidad incluida en el estudio. Resultados: De las 162 especialidades, se recibió respuesta de 148. Sólo 124 enviaron prospectos y 85 fichas técnicas. En 107 (72,3%) de las contestaciones recibidas fueron calificadas como con «ausencia de información»; igual que ocurría en 70 (56,4%) de los prospectos y 35 (41,0%) de las fichas técnicas. Para 79 especialidades, la respuesta era que no existían estudios sobre la estabilidad fuera del envase original. Conclusiones: La información disponible en prospectos y fichas técnicas no permite conocer ni a los ciudadanos ni a los profesionales farmacéuticos las condiciones de conservación propias de cada especialidad farmacéutica a la hora de poder re-envasarlas (AU)

The practice of re-packaging of medicines, by patients in different appliances and by the pharmacists in the adherence help systems, requires a preliminary study on the requisites of conservation conditions in the specialties to be re-packaged. Objective: The objective was to know the available information for patients (insert) and pharmacists (summary of product characteristics -SPC- and industry information) about conditions of preservation and eventual alteration of medicines once the original package was removed. Methods: The medicines whose sale in Granada province in September 2000 was superior to the average (only the oral solid forms of pharmaceuticals) were chosen. In December 2000 information from the manufacturing laboratories as to condition of preservation once the original package was removed, the Summary of Product Characteristics and the insert for each specialty included in the study was requested. Results: Of the [62 specialties, [48 replies were received. Only 124 sent inserts and 85 SPC. In 107 (72.3%) ofthe replies received were qualified as «lack of information»; the some as occurred in 70 (56.4%) of the inserts and 35 (41.O%) of the SPC. The reply for 79 specialties was that studies on stability outside the original package did not exist. Conclusions: The available information on insert and SPC does not allow either citizens or pharmaceutical professionals knowledge on individual conditions of preservation for each pharmaceutical specialty when they can be re-packaged (AU)

The Patient Informatics Consult Service (PICS): an approach for a patient-centered service.

The Patient Informatics Consult Service (PICS) at the Eskind Biomedical Library at Vanderbilt University Medical Center (VUMC) provides patients with consumer-friendly information by using an information prescription mechanism. Clinicians refer patients to the PICS by completing the prescription and noting the patient's condition and any relevant factors. In response, PICS librarians critically appraise and summarize consumer-friendly materials into a targeted information report. Copies of the report are given to both patient and clinician, thus facilitating doctor-patient communication and closing the clinician-librarian feedback loop. Moreover, the prescription form also circumvents many of the usual barriers for patients in locating information, namely, patients' unfamiliarity with medical terminology and lack of knowledge of authoritative sources. PICS librarians capture the time and expertise put into these reports by creating Web-based pathfinders on prescription topics. Pathfinders contain librarian-created disease overviews and links to authoritative resources and seek to minimize the consumer's exposure to unreliable information. Pathfinders also adhere to strict guidelines that act as a model for locating, appraising, and summarizing information for consumers. These mechanisms--the information prescription, research reports, and pathfinders--serve as steps toward the long-term goal of full integration of consumer health information into patient care at VUMC.

Electronic prescribing: criteria for evaluating handheld prescribing systems and an evaluation of a new, handheld, wireless wide area network (WWAN) prescribing system.

OBJECTIVE: The objectives of this study were: 1) to establish criteria for evaluating handheld computerized prescribing systems; and 2) to evaluate out-of-box performance and features of a new, Palm Operating System (OS)-based, handheld, wireless wide area network (WWAN) prescribing system. The system consisted of a Palm Vx handheld organizer, a Novatel Minstrel V wireless modem, OmniSky wireless internet access and ePhysician ePad 1.1, the Palm OS electronic prescribing software program. DESIGN: A dermatologist familiar with healthcare information technology conducted an evaluation of the performance and features of a new, handheld, WWAN electronic prescribing system in an office practice during a three-month period in 2000. System performance, defined as transmission success rate, was determined from data collected during the three-month trial. Evaluation criteria consisted of an analysis of features found in electronic prescribing systems. METHODS: All prescriptions written for all patients seen during a three-month period (August - November, 2000) were eligible for inclusion. Prescriptions written for patients who intended to fill them at pharmacies without known facsimile receiving capabilities were excluded from the study. The performance of the system was evaluated using data collected during the study. Criteria for evaluating features of electronic prescribing systems were developed and used to analyze the system employed in this study. RESULTS: During this three-month trial, 200 electronic prescriptions were generated for 132 patients included in the study. Of these prescriptions, 92.5 percent were successfully transmitted to pharmacies. Transmission failures resulted from incorrect facsimile numbers and non-functioning facsimile machines. Criteria established for evaluation of electronic prescribing systems included System (Hardware & Software), Costs, System Features, Printing & Transmission, Formulary & Insurance, Customization, Drug Safety and Security. CONCLUSION: This study is the first effort to establish comprehensive criteria for evaluating handheld prescribing systems and to evaluate the performance and features of a handheld, electronic prescribing system. The results demonstrated that the evaluated system: 1) was simple to install; 2) successfully interfaced with a commonly used practice management system; 3) was user-friendly and easy to operate; 4) offered a robust variety of standard features; and, 5) resulted in a high rate of success for transmitting electronic prescriptions. The criteria established for the evaluation of features of an electronic prescribing system can be used to critically evaluate the performance and features of other handheld and personal computer-based electronic prescribing systems.

Análisis de la información sobre el contenido en gluten de las especialidades farmacéuticas / Analysis of the information on gluten content in pharmaceutical specialities

Los enfermos celíacos pueden sufrir alteraciones incluso con las pequeñas cantidades de gluten presentes en algunas especialidades farmacéuticas. Para conocer si una especialidad farmacéutica contiene gluten se utilizan fundamentalmente dos publicaciones: Vademécum Internacional y Catálogo de Especialidades Farmacéuticas. El objetivo de este trabajo es determinar si es fiable la información contenida en estas fuentes. Se revisaron estas dos publicaciones y un listado solicitado al Ministerio de Sanidad y Consumo para elaborar una relación de especialidades farmacéuticas con gluten y almidón de trigo. Se examinaron los cartonajes y prospectos para comprobar que esa información era correcta y en caso de discrepancia se consultó con los fabricantes. (AU)

Celiac patients can suffer alterations even with small quantities of gluten present in some pharmaceutical specialties. To know if a pharmaceutical specialty contains gluten basically two publications are used: «Vademécum Internacional» and the «Catálogo de Especialidades Farmacéuticas» (Pharmaceutical Specialties Catalogue). The objective of this study is to determine if the information contained in these sources is reliable. The two publications were revised and a list was requested from the Ministry of Health and Consumption so as to elaborate a relationship of pharmaceutical specialties with gluten and wheat starch. The packaging and insert were examined in order to verify that this information was correct and in case of discrepancies manufacturers were consulted (AU)