Consumo de analgésicos de formulación oral y adecuación de las formas galénicas en pacientes mayores: estudio de base poblacional

Identification of effective parameters for anti-inflammatory concentration in València City's wastewater using fuzzy-set qualitative comparative analysis

The current literature about pharmaceutical and personal care compounds (PPCPs) focuses on identifying their concentration and toxicological risk both in surface water and in wastewater. However, the influence of urban areas (population ageing, income level, hospitals and others) has not yet been analysed. Knowing how a population (and its facilities) affects PPCPs' presence in wastewater is important to identify the conditions that are responsible for their presence. In this work, the influence of water consumption, population ageing, income level, hospitals and nursing homes on the anti-inflammatory concentration have been analysed. To fill the gap between the quantitative data on PPCPs' concentration and the qualitative reasoning of the influence of urban areas on the anti-inflammatory concentration, the use of fuzzy-set qualitative comparative analysis (fsQCA) is proposed. The fsQCA results are presented as recipes that show the different causal combinations of conditions that explain the presence of anti-inflammatories in wastewater. Using fsQCA for urban wastewater management with the aim of explaining the presence of anti-inflammatories in wastewater treatment plants (WWTPs) is a novelty in the literature. The results obtained here show the influence of water consumption (WATCON), hospitals (HOSP) and population ageing (POPAG) as the main conditions for the anti-inflammatory concentration in Valèncian wastewater. Specifically, these conditions are present in all the recipes obtained with consistency of 99%. Through the results obtained, it would be possible to identify that HOSP are the main facilities that discharge anti-inflammatories into urban wastewater. Hence, the necessity of preventive measures to avoid the anti-inflammatory discharge into water bodies has been showed. Furthermore, under a methodological point of view, this work highlights the eligibility of fsQCA as a wastewater cycle management tool.

Prescription and consumption of solid oral drugs dispensed as unitary doses in a third level hospital

BACKGROUND

The knowledge about the pattern of prescription and consumption of solid oral drugs dispensed as unitary doses (UD) in Mexico is sparing.

PURPOSE

The aim of this study was to describe the pattern of prescription and consumption of solid oral drugs dispensed as unitary doses (UD) in a third level private hospital of Mexico. A retrospective study of a 60-month period (from 2007 to 2011) was carried out to know the pattern of drugs dispensed as UD in a third level hospital.

RESULTS

Among the principal drugs consumed were analgesic, antihypertensive, antibiotic, anti-inflammatory, antiepileptic, and diuretics. The dispensation of drugs per year was as follows: 181 drugs with 85,167 UD in 2007; 199 with 90,519 UD in 2008; 193 with 101,479 UD in 2009; 195 with 100,798 UD in 2010; and 198 with 103,913 UD in 2011.

CONCLUSION

The findings confirmed that prescription and consumption of unitary doses in the hospitalization service increased, and revealed the extensive use of analgesics as the principal prescribed drug in this kind of hospital.

Medication regimen complexity in institutionalized elderly people in an aging society

BACKGROUND

Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research.

OBJECTIVE

To use the MRCI to assess medication regimen complexity in institutionalized elderly people.

SETTING

Five nursing homes in mainland Portugal.

METHODS

A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day.

MAIN OUTCOME MEASURE

Medication regimen complexity index.

RESULTS

The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742).

CONCLUSION

Medication regimen complexity proved to be high. There is certainly potential for the pharmacist's intervention to reduce it as part as the medication review routine in all the patients.