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Cuervas-Mons Vendrell M, Iturgoyen Fuentes DP, Arrojo Suárez J, Jimenez Lozano I, Fernandez-Llamazares CM, Tristancho-Perez A, Yunquera Romero L, Martínez Roca C, Otero Villalustre C, García Robles A, Garrido Corro B, Rodríguez Marrodán B. Medication reconciliation on admission in paediatric chronic patients: A multicentre study. An Pediatr (Barc) 2023; 99:376-384. [PMID: 38036314 DOI: 10.1016/j.anpede.2023.11.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Medication reconciliation (MC) is one of the main strategies to reduce medication errors in care transitions. In Spain, several guidelines have been published with recommendations for the implementation and development of MC aimed at the adult population, although paediatric patients are not included. In 2018, a study was carried out that led to the subsequent publication of a document with criteria for selecting paediatric patients in whom CM should be prioritised. OBJECTIVES To describe the characteristics of paediatric patients most likely to suffer from errors of reconciliation (EC), to confirm whether the results of a previous study can be extrapolated. METHODOLOGY Prospective, multicentre study of paediatric inpatients. We analysed the CE detected during the performance of the CM on admission. The best possible pharmacotherapeutic history of the patient was obtained using different sources of information and confirmed by an interview with the patient/caregiver. RESULTS 1043 discrepancies were detected, 544 were identified as CD, affecting 317 patients (43%). Omission of a drug was the most common error (51%). The majority of CD were associated with drugs in groups A (31%), N (23%) and R (11%) of the ATC classification. Polymedication and onco-haematological based disease were the risk factors associated with the presence of CD with statistical significance. CONCLUSIONS The findings of this study allow prioritisation of CM in a specific group of paediatric patients, favouring the efficiency of the process. Onco-haematological patients and polymedication are confirmed as the main risk factors for the appearance of CD in the paediatric population.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ana García Robles
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Alcalá Minagorre PJ, Domingo Garau A, Salmerón Fernández MJ, Casado Reina C, Díaz Pernas P, Hernández Borges ÁA, Rodríguez Marrodán B. Safe handoff practices and improvement of communication in different paediatric settings. An Pediatr (Barc) 2023; 99:185-194. [PMID: 37640658 DOI: 10.1016/j.anpede.2023.08.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 08/31/2023] Open
Abstract
Inadequate information management, especially during patient handoff, contributes to a large part of health care-related adverse events. The Committee for Quality of Care and Patient Safety of the Asociación Española de Pediatría has developed this document to provide an overview of handover practices in different paediatric care settings (emergency, inpatient, intensive care, neonatal and primary care). It describes resources to achieve safe and effective communication in all these settings, such as standardised handoff tools. It also proposes recommendations for the prevention of medication errors during the handover process, to improve safety in interhospital and intrahospital patient transfer, and to optimise communication and continuity of care in chronically ill and medically complex children.
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Affiliation(s)
- Pedro J Alcalá Minagorre
- Unidad de Pediatría Interna Hospitalaria, Hospital General Universitario Dr Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.
| | - Araceli Domingo Garau
- Servicio de Urgencias de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | | | - Cristina Casado Reina
- Unidad de Farmacia de Atención Primaria, Dirección Asistencial Norte de la Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Pilar Díaz Pernas
- Centro de Salud Rosa Luxemburgo, San Sebastián de los Reyes, Madrid, Spain
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Arias Constanti V, Domingo Garau A, Rodríguez Marrodán B, Villalobos Pinto E, Riaza Gómez M, García Soto L, Hernández Borges Á, Madrid Rodríguez A. Do not do recommendations in different paediatric care settings. An Pediatr (Barc) 2023; 98:291-300. [PMID: 36941186 DOI: 10.1016/j.anpede.2023.02.019] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/03/2023] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION There are many initiatives aimed at eliminating health care interventions of limited utility in clinical practice. The Committee on Care Quality and Patient Safety of the Spanish Association of Pediatrics (AEP) has proposed the development of "DO NOT DO" recommendations (DNDRs) to establish a series of practices to be avoided in the care of paediatric patients in primary, emergency, inpatient and home-based care. MATERIAL AND METHODS The project was carried out in 2 phases: a first phase in which possible DNDRs were proposed, and a second in which the final recommendations were established by consensus using the Delphi method. Recommendations were proposed and evaluated by members of the professional groups and paediatrics societies invited to participate in the project under the coordination of members of the Committee on Care Quality and Patient Safety. RESULTS A total of 164 DNDRs were proposed by the Spanish Society of Neonatology, the Spanish Association of Primary Care Paediatrics, the Spanish Society of Paediatric Emergency Medicine, the Spanish Society of Internal Hospital Paediatrics and the Medicines Committee of the AEP and the Spanish Group of Paediatric Pharmacy of the Spanish Society of Hospital Pharmacy. The initial set was limited to 42 DNDRs, and the selection over successive rounds yielded a final set of 25 DNDRs, with 5 DNDRs for each paediatrics group or society. CONCLUSIONS This project allowed the selection and establishment by consensus of a series of recommendations to avoid unsafe, inefficient or low-value practices in different areas of paediatric care, which may contribute to improving the safety and quality of paediatric clinical practice.
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Affiliation(s)
- Vanessa Arias Constanti
- Comité de Calidad Asistencial y Seguridad del Paciente de la Asociación Española de Pediatría; Sociedad Española de Urgencias Pediátricas (SEUP)
| | - Araceli Domingo Garau
- Comité de Calidad Asistencial y Seguridad del Paciente de la Asociación Española de Pediatría; Sociedad Española de Urgencias Pediátricas (SEUP)
| | - Belén Rodríguez Marrodán
- Comité de Calidad Asistencial y Seguridad del Paciente de la Asociación Española de Pediatría; Comité de Medicamentos de la AEP (CM-AEP) y el Grupo Español de Farmacia Pediátrica de la Sociedad Española de Farmacia Hospitalaria (GEFP-SEFH)
| | - Enrique Villalobos Pinto
- Comité de Calidad Asistencial y Seguridad del Paciente de la Asociación Española de Pediatría; Sociedad Española de Pediatría Interna Hospitalaria (SEPIH)
| | | | | | - Ángel Hernández Borges
- Comité de Calidad Asistencial y Seguridad del Paciente de la Asociación Española de Pediatría; Sociedad Española de Cuidados Intensivos Pediátricos (SECIP)
| | - Aurora Madrid Rodríguez
- Comité de Calidad Asistencial y Seguridad del Paciente de la Asociación Española de Pediatría.
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Arias Constanti V, Domingo Garau A, Rodríguez Marrodán B, Villalobos Pinto E, Riaza Gómez M, García Soto L, Hernández Borges Á, Madrid Rodríguez A. Recomendaciones de no hacer en distintos ámbitos de la atención pediátrica. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2023.02.001] [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: 03/18/2023] Open
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Piñeiro Pérez R, Núñez Cuadros E, Cabrera García L, Díez López I, Escrig Fernández R, Gil Lemus MÁ, Manzano Blanco S, Rodríguez Marrodán B, Calvo C. Results of a national survey on knowledge and use of complementary and alternative medicine by paediatricians. An Pediatr (Barc) 2021; 96:25-34. [PMID: 34906426 DOI: 10.1016/j.anpede.2020.09.012] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/17/2020] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION The use of certain Complementary and Alternative Medicines (CAM) in children has been documented in Spain. The main aim of this study is to estimate the knowledge, recommendations, and use of CAM by Spanish paediatricians. MATERIAL AND METHODS A national study was conducted from June to July 2020 using an online questionnaire. Two e-mails were sent to paediatricians who were members of the Spanish Association of Paediatrics (AEP). RESULTS Out of 1414 responses received, acupuncture was considered as a science by 31.8%. Homeopathy was recommended to parents by 28.1%. CAM was used by 21.3% of physicians, at least once, to improve their own health. Only 3.8% had ever replaced a conventional treatment with CAM. The following variables were associated with a greater disposition to prescribe homeopathy: female, age over 45 years old, paediatricians working in Primary Care, and paediatricians working in private healthcare. CONCLUSIONS This AEP Committee on Medicines questionnaire provides new data that should be considered alarming and should ask for a serious thinking on the use of CAM in Spain. Some paediatricians are recommending parents to give treatments not supported by scientific evidence to their children. This practice could be potentially harmful, especially when conventional treatment is being replaced.
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Affiliation(s)
- Roi Piñeiro Pérez
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid, Spain.
| | | | | | - Ignacio Díez López
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid, Spain
| | | | | | | | | | - Cristina Calvo
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid, Spain
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Piñeiro Pérez R, Núñez Cuadros E, Rodríguez Marrodán B, Escrig Fernández R, Gil Lemus MÁ, Manzano Blanco S, Calvo C. Off-label pediatric medicines in Spain. Anales de Pediatría (English Edition) 2021. [DOI: 10.1016/j.anpede.2020.12.008] [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: 10/22/2022] Open
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Piñeiro Pérez R, Núñez Cuadros E, Rodríguez Marrodán B, Escrig Fernández R, Gil Lemus MÁ, Manzano Blanco S, Calvo C. [Off-label pediatric medicines in Spain]. An Pediatr (Barc) 2021; 94:188.e1-188.e9. [PMID: 33509731 DOI: 10.1016/j.anpedi.2020.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/11/2020] [Accepted: 12/11/2020] [Indexed: 01/25/2023] Open
Abstract
Since 2009, the use of off-label and unlicensed drugs has been regulated in Spain. In pediatrics, this exceptional use is more common than in other medical specialties. It varies from 10% to 90% of all prescriptions in children. This variability is due to differences in methodology, classification and sources of information used, and also to the different pediatrics subspecialties. In addition, the knowledge of several pediatricians on this issue is limited and more than half do not comply with the law, in many cases due to ignorance. However, the use of off-label and unlicensed drugs is legal and necessary. The Medicines Committee of the Spanish Association of Pediatrics (CM-AEP) considers that it is necessary to improve the existing information on medicines in the pediatric population. Therefore, the CM-AEP works out a document where suggestions and actions are proposed to achieve it, because children's health deserves it.
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Affiliation(s)
- Roi Piñeiro Pérez
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid España.
| | | | | | | | | | | | - Cristina Calvo
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid España
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Piñeiro Pérez R, Núñez Cuadros E, Cabrera García L, Díez López I, Escrig Fernández R, Gil Lemus MÁ, Manzano Blanco S, Rodríguez Marrodán B, Calvo C. [Results of a national survey on knowledge and use of complementary and alternative medicine by paediatricians]. An Pediatr (Barc) 2020; 96:S1695-4033(20)30426-4. [PMID: 33139207 DOI: 10.1016/j.anpedi.2020.09.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The use of certain Complementary and Alternative Medicines (CAM) in children has been documented in Spain. The main aim of this study is to estimate the knowledge, recommendations, and use of CAM by Spanish paediatricians. MATERIAL AND METHODS A national study was conducted from June to July 2020 using an online questionnaire. Two e-mails were sent to paediatricians who were members of the Spanish Association of Paediatrics (AEP). RESULTS Out of 1,414 responses received, acupuncture was considered as a science by 31.8%. Homeopathy was recommended to parents by 28.1%. CAM was used by 21.3% of physicians, at least once, to improve their own health. Only 3.8% had ever replaced a conventional treatment with CAM. The following variables were associated with a greater disposition to prescribe homeopathy: female, age over 45 years old, paediatricians working in Primary Care, and paediatricians working in private healthcare. CONCLUSIONS This AEP Committee on Medicines questionnaire provides new data that should be considered alarming and should ask for a serious thinking on the use of CAM in Spain. Some paediatricians are recommending parents to give treatments not supported by scientific evidence to their children. This practice could be potentially harmful, especially when conventional treatment is being replaced.
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Affiliation(s)
- Roi Piñeiro Pérez
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid, España.
| | | | | | - Ignacio Díez López
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid, España
| | | | | | | | | | - Cristina Calvo
- Comité de Medicamentos de la Asociación Española de Pediatría (CM-AEP), Madrid, España
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López Gómez L, Marín Gabriel MA, Encinas B, de la Cruz Troca JJ, Rodríguez Marrodán B. Oxytocin Receptor Antagonist (Atosiban) in the Threat of Preterm Birth: Does It Have Any Effect on Breastfeeding in the Term Newborn? Breastfeed Med 2018; 13:123-128. [PMID: 29356563 DOI: 10.1089/bfm.2017.0206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM Oxytocin is a hormone involved in the mechanism of breastfeeding, uterine contractions, and social relationships. Atosiban (competitive oxytocin antagonist) is one of the most commonly used tocolytics for the threat of preterm labor in Europe. The aim of this study is to determinate if the administration of atosiban has any influence in the type of feeding in the term newborn at discharge. The secondary objective is to verify its effectiveness for the prevention of preterm delivery and in the possibility of applying treatment to complete lung maturation. MATERIALS AND METHODS Retrospective cohort study carried out in a tertiary University Hospital distinguished by WHO-UNICEF as a Baby-Friendly Hospital Initiative. The analysis included 264 women exposed to atosiban during a period of 4 years. One hundred met inclusion criteria. Unexposed infants born right after and before the exposed ones were selected as the not exposed subgroup (n = 200). RESULTS Among women treated with atosiban, 82% maintained exclusively breastfed (EBF), 8% had mixed breastfeeding, and 10% had formula feeding at discharge. In the nonexposed group, 82% maintained EBF, 9.5% had mixed breastfeeding, and 8.5% had formula feeding at discharge (p = 0.84). 97.5% of pregnant women treated with atosiban received corticosteroid for lung maturation, and 49.5% completed gestation with term newborns. CONCLUSION There were no significant differences in the type of feeding at discharge between the atosiban group and the nonexposed group. In most cases, the administration of tocolytic therapy allowed to complete lung maturation.
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Affiliation(s)
| | - Miguel A Marín Gabriel
- 2 Department of Neonatology, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain .,3 Department of Pediatrics, Autónoma University , Madrid, Spain
| | - Begoña Encinas
- 4 Department of Obstetrics, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
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Piñeiro Pérez R, Santiago García B, Rodríguez Marrodán B, Baquero-Artigao F, Fernández-Llamazares CM, Goretti López-Ramos M, Vinent Genestar J, Gómez-Pastrana Durán D, Mellado Peña MJ. Recommendations for the preparation and administration of antituberculosis drugs in children. Second phase of the Magistral Project of the Spanish Network for the Study of Paediatric Tuberculosis (pTBred). Anales de Pediatría (English Edition) 2016. [DOI: 10.1016/j.anpede.2016.10.007] [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: 11/26/2022] Open
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Piñeiro Pérez R, Santiago García B, Rodríguez Marrodán B, Baquero-Artigao F, Fernández-Llamazares CM, Goretti López-Ramos M, Vinent Genestar J, Gómez-Pastrana Durán D, Mellado Peña MJ. Recomendaciones para la elaboración y administración de fármacos antituberculosos en niños. Segunda fase del Proyecto Magistral de la Red Española de Estudio de la Tuberculosis Pediátrica (pTBred). An Pediatr (Barc) 2016; 85:323.e1-323.e11. [DOI: 10.1016/j.anpedi.2016.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 06/22/2016] [Indexed: 10/21/2022] Open
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