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Prado-Mel E, Ciudad-Gutiérrez P, Rodríguez-Ramallo H, Sánchez-Fidalgo S, Santos-Ramos B, Villalba-Moreno AM. Association between anticholinergic activity and xerostomia and/ or xerophthalmia in the elderly: systematic review. BMC Pharmacol Toxicol 2022; 23:94. [PMID: 36539885 PMCID: PMC9769019 DOI: 10.1186/s40360-022-00637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aim of this work was to investigate the association between anticholinergic burden or anticholinergic drug use and xerostomia and/or xerophtalmia in elderly through a systematic review of the published literature. METHODS A search was carried out in 3 databases (CINAHL, Embase and Pubmed). Studies conducted in people ≥65 years of age, who took anticholinergic medications, and measured the association between the anticholinergic burden or the use of these medications with the prevalence of xerostomia and / or xerophthalmia, published up to August 2022, were selected. Studies published in languages other than Spanish and/or English were excluded. RESULTS One thousand two hundred eleven articles were identified, 10 were selected for this review: six cross-sectional studies, two cohorts, one case-control and one randomized controlled clinical trial. A total of 3535 patients included in the different studies were studied. The most used scales were the Anticholinergic Drug Scale (ADS) and the Anticholinergic Risk Scale (ARS). Four articles studied the relationship between the use of anticholinergic medication and the prevalence of xerostomia and / or xerophthalmia, finding a positive relationship with xerostomia in all of them. Another 6 measured the relationship between anticholinergic burden and xerostomia and / or xerophthalmia. Four found a positive relationship between anticholinergic burden and xerostomia and/or xerophthalmia. CONCLUSIONS Our findings suggest a clear relationship between the use of anticholinergic drugs or anticholinergic burden and the presence of xerostomia. This relationship was less conclusive in the case of xerophthalmia.
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Affiliation(s)
- E. Prado-Mel
- grid.411109.c0000 0000 9542 1158Hospital Universitario Vírgen del Rocío(Pharmacy department), Andalucía, Seville, Spain
| | - P. Ciudad-Gutiérrez
- grid.411109.c0000 0000 9542 1158Hospital Universitario Vírgen del Rocío(Pharmacy department), Andalucía, Seville, Spain
| | - H. Rodríguez-Ramallo
- grid.411109.c0000 0000 9542 1158Hospital Universitario Vírgen del Rocío(Pharmacy department), Andalucía, Seville, Spain
| | - S. Sánchez-Fidalgo
- grid.9224.d0000 0001 2168 1229University of Seville(Department of Preventive Medicine and Public Health), Andalucía, Seville, Spain
| | - B. Santos-Ramos
- grid.411109.c0000 0000 9542 1158Hospital Universitario Vírgen del Rocío(Pharmacy department), Andalucía, Seville, Spain
| | - A. M. Villalba-Moreno
- grid.411109.c0000 0000 9542 1158Hospital Universitario Vírgen del Rocío(Pharmacy department), Andalucía, Seville, Spain
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Calvo-Cidoncha E, González-Bueno J, Toscano-Guzmán MD, Cantudo-Cuenca R, Guzmán-Ramos MI, Santos-Ramos B. CP-111 Medication regimen adherence in polymedicated chronic patients. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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González-Bueno J, Calvo-Cidoncha E, Cantudo-Cuenca MR, Rodríguez-Pérez A, Toscano-Guzmán MD, Santos-Ramos B. DI-041 Design of a methodology for cultural translation and adaptation of the adherence to refills and medications scale (ARMS). Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Calvo-Cidoncha E, González-Bueno J, Santos Rubio MD, Toscano Guzmán MD, Robustillo-Cortés MA, Santos-Ramos B. CP-114 Differences in treatment complexity between multimorbidity patterns in the older population. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cantudo-Cuenca MR, Tristancho-Pérez AM, Saborido-Cansino MDC, Sánchez-Pedrosa A, González-Medina MDC, Santos-Ramos B. PS-103 Prescription of quetiapine from the perspective of patient safety. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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González-Bueno J, Calvo-Cidoncha E, Santos Rubio MD, Vega-Coca MD, Rodríguez Peréz A, Toscano Guzmán MD, Santos-Ramos B. CP-074 Interventions to improve medicines adherence in patients with several chronic conditions: an overview of systematic reviews. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Villalba-Moreno AM, Alfaro-Lara ER, Pérez-Guerrero C, Santos-Ramos B, Nieto-Martin MD, Santos Rubio MD. PS-030 Risk of anticholinergic effects estimated in polypathological patients. the impact project. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Santos-Ramos B, Otero López MJ, Galván-Banqueri M, Alfaro-Lara ER, Vega-Coca MD, Nieto-Martín MD, Ollero-Baturone M. [Health care models for patients with multiple chronic conditions and the role of the hospital pharmacy/the hospital pharmacist]. Farm Hosp 2014; 36:506-17. [PMID: 23461444 DOI: 10.7399/fh.2012.36.6.52] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Managing care for patients with chronic conditions currently represents one of the greatest challenges to health care systems. As a subgroup of these patients, those with multiple chronic conditions are at greater risk for death or disability, and they consume more resources. They are characterized by the coexistence of two or more chronic illnesses lasting a year or longer which require ongoing medical attention and/or interfere with their daily activities. For these polypathological patients pharmaceutical care would be of special benefit, thus, their needs should be a priority objective for hospital pharmacy. OBJECTIVE To increase awareness of this type of patients and the characteristics of the principal approaches and health care models proposed to improve chronic disease management, as well as to emphasize the urgency for hospital pharmacists to join these models, and to present various activities that pharmacists might carry out as an integral part of these approaches. RESULTS Numerous models exist internationally, including the Chronic Care Model and the Kaiser Permanente pyramid of risks. In our country a growing number of initiatives has culminated in the recent Seville Declaration. For the hospital pharmacy, caring for the chronically ill patient following a model that is multi-professional, cooperative, integral, and patient centered, is an enormous task. Pharmacy departments and the Spanish Society of Hospital Pharmacy should reorient their strategies for pharmaceutical care, training, and research. Of special interest are those activities designed to improve adherence, adequacy, and continuity in treatments, all the while emphasizing active patient participation.
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González-Bueno J, Vega-Coca MD, Rodríguez Pérez A, Toscano-Guzmán M, Galván-Banqueri M, Santos-Ramos B. DI-040 Risk of assessment bias of systematic reviews that study interventions to improve medicines adherence in polypathological patients. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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González-Bueno J, Chamorro-de-Vega E, Alfaro-Lara ER, Galván-Banqueri M, Santos-Ramos B. Assessment of new drugs in a tertiary hospital using a standardized tool. Farm Hosp 2013; 37:388-393. [PMID: 24128101 DOI: 10.7399/fh.2013.37.5.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE To describe the profile of new drugs evaluated by the Pharmacy and Therapeutics committee in a tertiary hospital using a standardized tool, the Guideline for the Introduction of New Drugs in the Formulary (GINF form), as main objective. MATERIALS AND METHODS Retrospective observational study of drugs was assessed during 2008-2011. Variables related to the drug, the request, and the result of the evaluation were collected based on information contained in the GINF form and in the assessment reports. RESULTS 63 of 75 assessed drugs (84%) were included in the hospital formulary. Only one drug (1%) was included without any restrictions. The rest of them were included as therapeutic equivalents (23%) or under specific recommendations (61%). Half of the drugs (6) not included had insufficient evidence of effectiveness compared with current treatments. Haematology and Medical Oncology were found to be the most active medical services in the application process. There was a high prevalence of drugs that had more than one advanced clinical trial (phase III and/or phase IV). Furthermore, 28% of assessed drugs were associated with a financial burden of more than ?10,000 per year for our hospital. Highquality information was provided by applicants to the P&T committee for drugs that were finally included. However, the relationship between the information provided to the P&T committee and its decision was not statistical significance. CONCLUSION The requests received were primarily related to drugs intended for parenteral use and most of them were antineoplastic drugs. The medical departments most heavily represented were Haematology and Oncology.
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Galván-Banqueri M, de la Higuera-Vila L, Vega-Coca MD, Nieto Martín MD, Pérez-Guerrero C, Santos-Ramos B. Reliability of a questionnaire for pharmacological treatment appropriateness in patients with multiple chronic conditions. Eur J Intern Med 2013; 24:420-4. [PMID: 23428531 DOI: 10.1016/j.ejim.2013.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 12/25/2012] [Accepted: 01/23/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The original Medication Appropriateness Index was validated for elderly and polymedicated patients, both in hospital and outpatient contexts. However, no studies have applied this questionnaire in patients with multiple chronic conditions. The objective of this study is to assess the reliability of a modified Medication Appropriateness Index questionnaire in a population of patients with multiple chronic conditions. METHODS We selected patients with multiple chronic conditions who were included in an integrated care project conducted at the Hospital Universitario Virgen del Rocío. To determine inter-observer reliability, each professional (internist or hospital pharmacy specialist) applied the questionnaire under the same conditions and with the same resources. To determine intra-observer reliability, each physician applied the tool at baseline and two months later. We measured inter- and intra-observer reliability using the kappa coefficient. The proportion of overall agreement was also determined. RESULTS We obtained a weak overall kappa (k=0.38) for inter-observer reliability and moderate (k=0.52) and very good (k=0.84) values for intra-observer reliability of the internist and specialist in hospital pharmacy, respectively. The proportion of overall agreement is very high in all three situations: 96%, 98%, and 99%, respectively. CONCLUSIONS Despite its limitations, the Medication Appropriateness Index questionnaire modified by our group can be used, as a reliable method, to assess the appropriateness of pharmacotherapy in patients with multiple chronic conditions.
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Affiliation(s)
- M Galván-Banqueri
- Pharmacy Department, Hospital Universitario Virgen del Rocio, Seville, Spain.
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Santos-Ramos B, Galván-Banqueri M, Ollero-Baturone M. [Comment to the article: « Program of pharmacy care in patients with chronic diseases »]. Farm Hosp 2013; 37:83-84. [PMID: 23461510 DOI: 10.7399/fh.2013.37.1.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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Ortega Eslava A, Fraga Fuentes MD, Alegre del Rey EJ, Ventayol Bosch P, Puigventós Latorre F, Santos-Ramos B, Clopés Estela A. [Indirect comparisons, author response]. Farm Hosp 2012; 36:558. [PMID: 23461457 DOI: 10.7399/fh.2012.36.6.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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Pérez-Moreno MA, Villalba-Moreno AM, Santos-Ramos B, Marín-Gil R, Varela-Aguilar JM, Torelló-Iserte J, Núñez-Vázquez R, Jiménez-Jiménez J, Bautista-Paloma FJ. [Off-label approval of drug use in a tertiary hospital]. Rev Calid Asist 2012; 28:12-8. [PMID: 22789731 DOI: 10.1016/j.cali.2012.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 05/02/2012] [Accepted: 05/05/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The Pharmacy and Therapeutics Committee (PTC) evaluates the requests for off-label uses with an abbreviated report format. The aim of this study is to perform a descriptive analysis of this activity and to study the rate of approvals. MATERIAL AND METHODS A descriptive study was performed on the PTC reports in a tertiary hospital between September 2009 and April 2011. The type of drug by treatment group and by type of dispensing, indication and requesting department was analysed. The final decision adopted was studied as the primary outcome, and the percentage of requests approved according to the characteristics of the drug evaluated, indication requested, alternatives used, evidence and cost, as secondary outcomes. RESULTS A total of 51 applications were analysed, of which 60.8% were drugs for hospital use and 54.9% cytostatic. The most requested indications were the onco-haematological (43.2%) and autoimmune (35.3%). Haematology was the department that made most requests (11 requests with 72.7% approved), Oncology and Paediatrics (both with 10 requests, with 50% approved). Almost two-thirds (60.8%) of the requests were approved. Of those that were not approved, 11 had not used up the therapeutic alternatives, and 8 had no evidence. Just under half (47.1%) of the drugs requested had a cost/patient between 10,000-100,000 euros,of which 58.3% were approved (cost per course of treatment if it had a defined period, or cost of treatment per year for chronic treatment). CONCLUSION There is an increase in the activity of the PTC that is growing over the years. Most applications focus on drugs for hospital use and cytostatic drugs by Onco-haematology. There is a high rate of approval by the PTC, and high variability in the percentage of approval depending on the department and the evidence of use. The difference between approved and unapproved requests followed a logic of cost-effectiveness.
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Affiliation(s)
- M A Pérez-Moreno
- Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
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Ortega Eslava A, Fraga Fuentes MD, Puigventós Latorre F, Santos-Ramos B, Clopés Estela A, Vilanova Boltó M. [Indirect comparisons in drug assessment reports on the GENESIS group (SEFH) webpage]. Farm Hosp 2012; 36:176-9. [PMID: 22440517 DOI: 10.1016/j.farma.2011.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 11/02/2011] [Accepted: 11/07/2011] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Quantify use of indirect comparisons (IC) in drug evaluation reports published on the GENESIS Group web page for new drug assessment, standardisation, and drug selection research. METHOD Retrospective study of drug reports written between 2008 and 2009. DATA COLLECTED presence of an active comparator and details from any direct and indirect comparative studies included. RESULTS An active comparator was present in 95% of the 337 analysed reports; 50% included a direct comparative study vs comparator. In 114 reports (34%), an IC was used; 69% of the ICs were made by the report author. Most ICs were narrative and none were adjusted. An IC could have been made in an additional 16% of the cases and possibly in 24% more. CONCLUSIONS Most evaluated drugs have an active comparator but studies comparing them directly are not as common. ICs could be included in more reports along with quality control criteria.
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Affiliation(s)
- A Ortega Eslava
- Servicio de Farmacia, Clínica Universidad de Navarra, Pamplona, España.
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Puigventós Latorre F, Santos-Ramos B, Ortega Eslava A, Durán-García ME. Variability in activity and results from drug assessments by pharmacy and therapeutics committees in Spanish hospitals. Farm Hosp 2011; 35:305-14. [PMID: 21497125 DOI: 10.1016/j.farma.2010.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 07/28/2010] [Accepted: 07/30/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To quantify the Spanish Pharmacy and Therapeutics Committees (P&TC) activity with regard to assessing and selecting drugs and describing variability in decisions made to include them. METHOD Descriptive, cross-sectional study based on a questionnaire aimed to 513 hospitals with more than 75 beds. We included questions referring to the P&TC resolutions, the therapeutic positioning and assessment reports. Recruitment was carried out between November 2007 and January 2008. Variability among P&TC conclusions were presented in five categories or levels of coincidence. RESULTS One hundred and seventy-five hospitals participated, with a response rate of 34% (54% of beds). The mean (SD) number of drug-indications assessed per hospital was 10.35 (7.45). The proportion of assessments that conclude with drug inclusion or rejection was 75.3 and 21.4%, respectively. 16.2% concluded with therapeutic equivalence. Conditions for use were established for 64% of them, and 33% were included in a clinical guide. With regard to variability, 81.0% of assessments coincided with the conclusion to include or reject the drug. A contradictory decision was made for 19.0%. CONCLUSIONS Drug assessment and selection activity in hospitals involve an amount of work. The proportion of drugs approved is similar in different types of hospitals. There is extensive variability as regards deciding upon inclusion and is similar to studies conducted in other countries. They indicate that a standardising methodology would be recommendable.
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Affiliation(s)
- F Puigventós Latorre
- Servicio de Farmacia, Hospital Universitario Son Dureta, Palma de Mallorca, España.
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Ortega Eslava A, Puigventós Latorre F, Santos-Ramos B, Calderon Hernanz B, Vilanova Boltó M. [Classification and variability of drug assessment reports on the GENESIS group (SEFH) webpage]. Farm Hosp 2011; 35:140-7. [PMID: 21450502 DOI: 10.1016/j.farma.2010.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 07/05/2010] [Accepted: 07/15/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To analyse the assessment reports published on the GENESIS webpage (Group for Innovation, Assessment, Standardisation and Research in the Selection of Drugs) and assess the variability of the group's proposals to include drugs in the Formulary. METHOD We analysed reports published by hospitals on the GENESIS webpage between 2004 and 2007. Data were collected on drugs and indications, ATC group, open or restricted access publications, hospital, and publication date. We drafted a questionnaire that would measure to what extent to what extent the 9-section model recommended by GENESIS was included in each report. For drugs with two or more reports, we analysed whether the recommendation coincided and the possible cause in the event of conflict. RESULTS We analysed 416 reports corresponding to 185 different drug indications. 93% included 6 or more of the recommended sections, a number which increased over time. The most frequently included sections were: approved indications (92%), mechanism of action (95%), and references (86%) (percentages from 2007). Sections which had an increasing but lower percentage were: differential characteristics (60%), literature search method (40%) and conclusions with a summary of efficacy, safety and cost data (52%). 73% of which had definite recommendations, which coincided for 42 out of the 67 drugs with more than one recommendation report. CONCLUSIONS The work carried out by the GENESIS group has enabled Spanish hospitals to share their drug assessment reports and making them more complete, although there are still some aspects that can be improved.
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Affiliation(s)
- A Ortega Eslava
- Servicio de Farmacia, Clínica Universidad de Navarra, Pamplona, España.
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Alfaro-Lara E, Galván-Banqueri M, Prado-Mel E, Santos-Ramos B, Varela-Aguilar J, Torelló-Iserte J, Castellano Zurera M, Bautista Paloma F. Análisis del proceso de selección de nuevos medicamentos en un hospital terciario. Años 2004–07. Farmacia Hospitalaria 2010; 34:76-84. [DOI: 10.1016/j.farma.2009.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 05/14/2009] [Accepted: 09/15/2009] [Indexed: 11/29/2022] Open
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Rodríguez-Terol A, Caraballo M, Palma D, Santos-Ramos B, Molina T, Desongles T, Aguilar A. Calidad estructural de las bases de datos de interacciones. Farmacia Hospitalaria 2009. [DOI: 10.1016/s1130-6343(09)71155-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Rodríguez-Terol A, Caraballo MO, Palma D, Santos-Ramos B, Molina T, Desongles T, Aguilar A. [Quality of interaction database management systems]. Farm Hosp 2009; 33:134-146. [PMID: 19712597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To identify drug interaction databases (DID) and assess the quality of their structures. METHOD A search was made of the literature for DID and a series of exclusion and structural quality criteria were defined (at least four quality criteria: Classification according to severity, classification according to level of evidence, bibliographical reference data, description of clinical management and 11 criteria used for weighting). The level of compliance of every DID with the criteria defined was analysed, together with the level of compliance of each criteria in each DID. RESULTS A total of 54 DID were identified, 30 of which complied with exclusion criteria and 15 of which did not meet the minimum criteria. The rest of the criteria were evaluated in nine DID: Bot-plus and Medinteract (100 %), SEFH Guide, Lexi-interact and Medscape (89 %), Hansten (83 %), Micromedex and Stockley (78 %), Drug Interactions Facts (68 %). Ninety-two per cent of the DID describe the mechanism of action, 87 % classify the information according to the active ingredient, 75 % do not state they have any conflict of interest, classify according to level of severity, have electronic format and are easy to search. A total of 67 % are specific DID, 62 % are classified according to level of evidence, contain bibliographical references and describe clinical management. CONCLUSIONS A third of the DID comply with the minimum criteria. Differences were observed in the level and compliance criteria among Spanish and foreign DID. Some of the main DID used as references in the bibliography have significant structural defects: no web presentation, no multi-check function and others.
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Affiliation(s)
- A Rodríguez-Terol
- Servicio de Suministros Farmacéuticos, Servicio Andaluz de Salud, Sevilla, España
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Abstract
Objective To identify drug interaction databases (DID) and assess the quality of their structures. Method A search was made of the literature for DID and a series of exclusion and structural quality criteria were defined (at least 4 quality criteria: classification according to severity, classification according to level of evidence, bibliographical reference data, description of clinical management, and 11 criteria used for weighting). The level of compliance of every DID with the criteria defined was analysed, together with the level of compliance of each criteria in each DID. Results A total of 54 DID were identified, 30 of which complied with exclusion criteria and 15 of which did not meet the minimum criteria. The rest of the criteria were evaluated in 9 DID: Botplus and Medinteract (100%), SEFH Guide, Lexi-interact and Medscape (89%), Hansten (83%), Micromedex and Stockley (78%), Drug Interactions Facts (68%). Ninety-two percent of the DID describe the mechanism of action, 87% classify the information according to the active ingredient, 75% do not state they have any conflict of interest, classify according to level of severity, have electronic format, and are easy to search. A total of 67% are specific DID, 62% are classified according to level of evidence, contain bibliographical references, and describe clinical management. Conclusions A third of the DID comply with the minimum criteria. Differences were observed in the level and compliance criteria among Spanish and foreign DID. Some of the main DID used as references in the bibliography have significant structural defects: no web presentation, no multi-check function and others.
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