1
|
Company Albir MJ, Andrés JLP, Solsona MDE. [Translated article] Good humanisation practices in the healthcare of patients with rare diseases in Pharmacy Services. Farm Hosp 2024; 48:T3-T8. [PMID: 38008659 DOI: 10.1016/j.farma.2023.10.004] [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: 11/24/2022] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 11/28/2023] Open
Abstract
OBJECTIVE To analyse the presence of Good Humanisation Practices in the care of patients with rare diseases in Hospital Pharmacy Services and to identify the strengths and prevalent areas for improvement in the humanisation of healthcare. METHODS An online questionnaire structured in 2 parts was developed using Google Form®. The first one was designed to collect identifying data and the second one included questions related to compliance with the 61 standards of the Manual of Good Humanisation Practices in the healthcare of patients with rare diseases in Hospital Pharmacy Services. Access to the questionnaire was sent by email to the Heads of the Hospital Pharmacy Service of 18 hospitals. The study period was from October 2021 to October 2022. The analysed variables were the number of criteria that were considered met, total compliance (percentage of criteria met), by strategic line and by type or level of standard, globally and grouped by regions of Spain. RESULTS 18 Hospital Pharmacy Services were included. The overall mean of standards met was 31.1 (95% CI: 24.8-37.6) and mean total compliance was 52.1% (95% CI: 44.4%-59.7%). The mean compliance by strategic line was: Line 1, Humanisation culture: 46.5% (95% CI: 35.3%-57.7%), Line 2, Patient empowerment: 47.4% (95% CI: 37.1%-57.8%), Line 3, Professional care: 49.7% (95% CI: 39.8%-59.1%), Line 4, Physical spaces and comfort: 55.6% (95% CI: 46.3%-64.8%), and Line 5, Organisation of healthcare: 63.8% (95% CI: 55.8%-71.9%). CONCLUSION The average compliance with the standards is between 40% and 60%, which indicates that humanisation is present in the Hospital Pharmacy Services, but there is a wide margin for improvement. The main strength in the humanisation of Hospital Pharmacy Services is a patient-centred care organisation, and the area with the greatest room for improvement is the culture of humanisation.
Collapse
|
2
|
Company Albir MJ, Poveda Andrés JL, Edo Solsona MD. Presence of good humanization practices in the healthcare of patients with rare diseases in Pharmacy Services. Farm Hosp 2024; 48:3-8. [PMID: 37495456 DOI: 10.1016/j.farma.2023.06.013] [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: 11/24/2022] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
OBJECTIVE To analyze the presence of Good Humanization Practices in the care of patients with rare diseases in Hospital Pharmacy Services and to identify the strengths and prevalent areas for improvement in the humanization of healthcare. METHODS Online questionnaire structured in two parts was developed using Google Form®. The first one was designed to collect identifying data and the second one included questions related to compliance with the 61 standards of the Manual of Good Humanization Practices in the healthcare of patients with rare diseases in Hospital Pharmacy Services. Access to the questionnaire was sent by email to the Heads of the Hospital Pharmacy Service of 18 hospitals. The study period was from October 2021 to October 2022. The analyzed variables were the number of criteria that were considered met, total compliance (percentage of criteria met), by strategic line and by type or level of standard, globally and grouped by regions of Spain. RESULTS 18 Hospital Pharmacy Services were included. The overall mean of standards met was 31.1 (95% CI: 24.8-37.6) and mean total compliance was 52.1% (95% CI: 44.4-59.7). The mean compliance by strategic line was line 1 Humanization culture: 46.5% (95% CI: 35.3-57.7), line 2 Patient empowerment: 47.4% (95% CI: 37.1- 57.8), line 3 Professional care: 49.7% (95% CI: 39.8-59.1), line 4 Physical spaces and comfort: 55.6% (95% CI: 46.3-64.8) and line 5 Organization of healthcare: 63.8% (95% CI: 55.8-71.9). CONCLUSION The average compliance with the standards is between 40 and 60%, which indicates that humanization is present in the Hospital Pharmacy Services, but there is a wide margin for improvement. The main strength in the humanization of Hospital Pharmacy Services is a patient-centered care organization, and the area with the greatest room for improvement is the culture of humanization.
Collapse
|
3
|
Gómez-Cebrián N, Gras-Colomer E, Poveda Andrés JL, Pineda-Lucena A, Puchades-Carrasco L. Omics-Based Approaches for the Characterization of Pompe Disease Metabolic Phenotypes. Biology (Basel) 2023; 12:1159. [PMID: 37759559 PMCID: PMC10525434 DOI: 10.3390/biology12091159] [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] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Lysosomal storage disorders (LSDs) constitute a large group of rare, multisystemic, inherited disorders of metabolism, characterized by defects in lysosomal enzymes, accessory proteins, membrane transporters or trafficking proteins. Pompe disease (PD) is produced by mutations in the acid alpha-glucosidase (GAA) lysosomal enzyme. This enzymatic deficiency leads to the aberrant accumulation of glycogen in the lysosome. The onset of symptoms, including a variety of neurological and multiple-organ pathologies, can range from birth to adulthood, and disease severity can vary between individuals. Although very significant advances related to the development of new treatments, and also to the improvement of newborn screening programs and tools for a more accurate diagnosis and follow-up of patients, have occurred over recent years, there exists an unmet need for further understanding the molecular mechanisms underlying the progression of the disease. Also, the reason why currently available treatments lose effectiveness over time in some patients is not completely understood. In this scenario, characterization of the metabolic phenotype is a valuable approach to gain insights into the global impact of lysosomal dysfunction, and its potential correlation with clinical progression and response to therapies. These approaches represent a discovery tool for investigating disease-induced modifications in the complete metabolic profile, including large numbers of metabolites that are simultaneously analyzed, enabling the identification of novel potential biomarkers associated with these conditions. This review aims to highlight the most relevant findings of recently published omics-based studies with a particular focus on describing the clinical potential of the specific metabolic phenotypes associated to different subgroups of PD patients.
Collapse
Affiliation(s)
- Nuria Gómez-Cebrián
- Drug Discovery Unit, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain
| | - Elena Gras-Colomer
- Pharmacy Department, Hospital Manises of Valencia, 46940 Valencia, Spain
| | | | - Antonio Pineda-Lucena
- Molecular Therapeutics Program, Centro de Investigación Médica Aplicada, 31008 Pamplona, Spain
| | | |
Collapse
|
4
|
García-Robles A, Solaz-García Á, Verdú-Andrés J, Andrés JLP, Cañada-Martínez AJ, Pericás CC, Ponce-Rodriguez HD, Vento M, González PS. The association of salivary caffeine levels with serum concentrations in premature infants with apnea of prematurity. Eur J Pediatr 2022; 181:4175-4182. [PMID: 36169712 DOI: 10.1007/s00431-022-04628-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/05/2022] [Accepted: 09/16/2022] [Indexed: 11/03/2022]
Abstract
UNLABELLED The purpose of this paper is to verify whether the concentrations of caffeine in saliva are comparable to serum concentrations in preterm infants who are treated with caffeine for apnea of prematurity. This is a prospective observational study. Eligible participants were newborn infants < 37 weeks of gestational age treated with oral or intravenous caffeine for apnea of prematurity. Two paired samples of saliva and blood were collected per patient. Tube solid-phase microextraction coupled online to capillary liquid chromatography with diode array detection was used for analysis. A total of 47 infants with a median gestational age of 28 [26-30] weeks and a mean of 1.11 ± 0.4 kg of birth weight. Median postmenstrual age, when samples were collected, was 31 [29-33] weeks. Serum caffeine median levels of 19.30 μg/mL [1.9-53.90] and salivary caffeine median levels of 16.36 μg/mL [2.20-56.90] were obtained. There was a strong positive Pearson's correlation between the two variables r = 0.83 (p < 0.001). CONCLUSION The measurement of salivary caffeine concentrations after intravenous or oral administration offers an alternative to serum caffeine monitoring in apnea of prematurity. Measurement of salivary concentration minimizes blood draws, improves blood conservation, and subsequently minimizes painful procedures in premature infants. WHAT IS KNOWN • Salivary sampling may be useful when is applied to extremely low birth weight infant, in whom blood sampling must be severely restricted. WHAT IS NEW • The measurement of caffeine salivary concentrations after intravenous or oral administration offers an alternative to serum caffeine monitoring in apnoea of prematurity. • Salivary sampling may be a valid non-invasive alternative that could be used to individualize and optimize caffeine dose.
Collapse
Affiliation(s)
- Ana García-Robles
- Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Álvaro Solaz-García
- Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Jorge Verdú-Andrés
- MINTOTA Research Group, Departament de Química Analítica. Facultat de Química, Universitat de València, Valencia, Spain
| | | | | | - Consuelo Cháfer Pericás
- Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Máximo Vento
- Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain.,Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Pilar Sáenz González
- Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain. .,Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.
| |
Collapse
|
5
|
Gómez-Cebrián N, Vázquez Ferreiro P, Carrera Hueso FJ, Poveda Andrés JL, Puchades-Carrasco L, Pineda-Lucena A. Pharmacometabolomics by NMR in Oncology: A Systematic Review. Pharmaceuticals (Basel) 2021; 14:ph14101015. [PMID: 34681239 PMCID: PMC8539252 DOI: 10.3390/ph14101015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/14/2022] Open
Abstract
Pharmacometabolomics (PMx) studies aim to predict individual differences in treatment response and in the development of adverse effects associated with specific drug treatments. Overall, these studies inform us about how individuals will respond to a drug treatment based on their metabolic profiles obtained before, during, or after the therapeutic intervention. In the era of precision medicine, metabolic profiles hold great potential to guide patient selection and stratification in clinical trials, with a focus on improving drug efficacy and safety. Metabolomics is closely related to the phenotype as alterations in metabolism reflect changes in the preceding cascade of genomics, transcriptomics, and proteomics changes, thus providing a significant advance over other omics approaches. Nuclear Magnetic Resonance (NMR) is one of the most widely used analytical platforms in metabolomics studies. In fact, since the introduction of PMx studies in 2006, the number of NMR-based PMx studies has been continuously growing and has provided novel insights into the specific metabolic changes associated with different mechanisms of action and/or toxic effects. This review presents an up-to-date summary of NMR-based PMx studies performed over the last 10 years. Our main objective is to discuss the experimental approaches used for the characterization of the metabolic changes associated with specific therapeutic interventions, the most relevant results obtained so far, and some of the remaining challenges in this area.
Collapse
Affiliation(s)
- Nuria Gómez-Cebrián
- Drug Discovery Unit, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain;
| | | | | | | | - Leonor Puchades-Carrasco
- Drug Discovery Unit, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain;
- Correspondence: (L.P.-C.); (A.P.-L.); Tel.: +34-963246713 (L.P.-C.)
| | - Antonio Pineda-Lucena
- Molecular Therapeutics Program, Centro de Investigación Médica Aplicada, 31008 Navarra, Spain
- Correspondence: (L.P.-C.); (A.P.-L.); Tel.: +34-963246713 (L.P.-C.)
| |
Collapse
|
6
|
Valero García S, Centelles-Oria M, Palanques-Pastor T, Vila Clérigues N, López-Briz E, Poveda Andrés JL. Analysis of chemical contamination by hazardous drugs with BD HD Check ® system in a tertiary hospital. J Oncol Pharm Pract 2021; 28:1583-1593. [PMID: 34565241 DOI: 10.1177/10781552211038518] [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] [Indexed: 11/16/2022]
Abstract
The presence of contamination in the healthcare work environment by one of the types of hazardous drugs, cytostatics, has been found in multiple international studies. Recent studies and guidelines recommend surface monitoring for risk assessment of healthcare professionals' exposure. The availability of detection techniques is critical to successfully carry out this type of monitoring. The use of new semi-quantitative techniques allows quicker results. The main objective of this study was to determine the existence of hazardous drugs on the working surfaces in different locations of a tertiary hospital using the BD HD Check® semi-quantitative device. The presence of methotrexate, doxorubicin and cyclophosphamide was analysed at 80, 89 and 82 locations in 10, 13 and 11 clinical units, respectively. A total of 251 samples were analysed. The monitoring results were positive for 13.1% of the analysed samples, with 36.3% of the methotrexate samples, 0% of the doxorubicin samples and 4.9% of the cyclophosphamide samples. Mapping the presence of HD in our hospital has allowed us to evaluate the effectiveness of controls established in the hospital to minimise the exposure of healthcare professionals to hazardous drugs. The speed in obtaining results has enabled immediate corrective actions in cases where contaminated surfaces were detected.
Collapse
|
7
|
Palanques-Pastor T, Megías-Vericat JE, Bosó Ribelles V, Gómez Seguí I, Poveda Andrés JL. Effectiveness of Caplacizumab Nanobody in Acquired Thrombotic Thrombocytopenic Purpura Refractory to Conventional Treatment. Acta Haematol 2021; 145:72-77. [PMID: 34352748 DOI: 10.1159/000517813] [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: 02/28/2021] [Accepted: 06/08/2021] [Indexed: 11/19/2022]
Abstract
Acquired thrombocytopenic thrombotic purpura (aTTP) is an autoantibody-mediated disease against the enzyme A Disintegrin and Metalloprotease domain with ThromboSpondin-1 type motif 13, which until now has been treated with plasma exchange (PEX) and corticosteroids. A 29-year-old female patient, who presented with aTTP in the context of pregnancy, has developed multiple relapses after treatment with PEX, corticosteroids, and rituximab. Recently, caplacizumab, a nanobody against von Willebrand factor, has been approved for the treatment of aTTP. In our patient, caplacizumab achieved better disease control, with a lower platelet count restoration time, days of PEX and hospitalization duration, as compared to standard therapy, reproducing the results of clinical trials. Caplacizumab represents a significant advance in the treatment of aTTP, especially in cases of recurrent relapses.
Collapse
Affiliation(s)
| | | | | | - Inés Gómez Seguí
- Hematology and Hemotherapy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | |
Collapse
|
8
|
Iglesias Gómez R, Méndez R, Palanques-Pastor T, Ballesta-López O, Borrás Almenar C, Megías Vericat JE, López-Briz E, Font-Noguera I, Menéndez Villanueva R, Román Iborra JA, Poveda Andrés JL. Baricitinib against severe COVID-19: effectiveness and safety in hospitalised pretreated patients. Eur J Hosp Pharm 2021; 29:e41-e45. [PMID: 34321249 PMCID: PMC8326024 DOI: 10.1136/ejhpharm-2021-002741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/05/2021] [Indexed: 12/15/2022] Open
Abstract
Objectives To analyse the effectiveness and safety of baricitinib for severe COVID-19 in cytokine storm syndrome based on its potential role as an anti-inflammatory immunomodulator and inhibitor of viral endocytosis. Methods This was an observational retrospective study of hospitalised patients treated with baricitinib for severe COVID-19. Outcomes were clinical improvement on an ordinal scale of 1–8 on day 1 of baricitinib compared with day 14 (where 8=death and 1=not hospitalised with no limitations of activities), overall survival, time to recovery since baricitinib treatment started (days until hospital discharge) and laboratory parameters related to COVID-19 poor prognosis. Adverse events related to baricitinib during the admission period were also reported. Results Forty-three patients (70% men, mean age 70 years (IQR 54–79)) treated with baricitinib daily for 6 days (IQR 5–7) were included. Thirty-six patients were treated with corticosteroids (84%). Clinical improvement was 3 points (IQR 1–4) in patients on an ordinal scale of 4–6, overall survival was 100% at day 30 and day 60 with a mean time to recovery of 12 days (IQR 9–25) from start of baricitinib treatment. No adverse events of interest were found and all poor prognosis risk factors improved at day 14: interleukin-6, C-reactive protein, ferritin, lymphocytes, platelets and D-dimers. Conclusions Patients treated with baricitinib for severe COVID-19 showed improvements in clinical and analytical values without relevant adverse events and 100% overall survival. Clinical randomised trials are needed to confirm the clinical benefit of baricitinib.
Collapse
Affiliation(s)
| | - Raúl Méndez
- Pneumology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | | | | | - Eduardo López-Briz
- Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Isabel Font-Noguera
- Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | | |
Collapse
|
9
|
García-Robles A, Solaz García Á, Poveda Andrés JL, Gimeno Navarro A, Aguar Carrascosa M. Preparation and administration of insulin infusions in neonatology: A national survey. An Pediatr (Barc) 2021; 95:48-49. [PMID: 34225956 DOI: 10.1016/j.anpede.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/15/2020] [Indexed: 10/21/2022] Open
Affiliation(s)
- Ana García-Robles
- Servicio de Neonatología, Unidad de Cuidados Intensivos Neonatales, Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Grupo Investigación Perinatología, Valencia, Spain
| | - Álvaro Solaz García
- Grupo Investigación Perinatología, Instituto de Investigación Sanitaria La Fe, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Ana Gimeno Navarro
- Servicio de Neonatología, Unidad de Cuidados Intensivos Neonatales, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Marta Aguar Carrascosa
- Servicio de Neonatología, Unidad de Cuidados Intensivos Neonatales, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| |
Collapse
|
10
|
Torres Martínez E, García Robles AA, Gormaz Moreno M, Gimeno Navarro A, Izquierdo Macián I, Poveda Andrés JL, Vento M. Efecto de la adición de fortificantes y de módulo de proteínas en la osmolalidad de la leche materna donada. An Pediatr (Barc) 2020; 93:297-304. [DOI: 10.1016/j.anpedi.2020.03.009] [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] [Received: 12/07/2019] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022] Open
|
11
|
Palanques-Pastor T, López-Briz E, Poveda Andrés JL. Involvement of interleukin 6 in SARS-CoV-2 infection: siltuximab as a therapeutic option against COVID-19. Eur J Hosp Pharm 2020; 27:297-298. [PMID: 32499314 PMCID: PMC7447248 DOI: 10.1136/ejhpharm-2020-002322] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of the study was to explore the involvement of interleukin 6 in SARS-CoV-2 infection, and to position the drug siltuximab in the management of severe forms of COVID-19. A bibliographic search was performed in Pubmed on the immune response to the disease, and in ClinicalTrials.gov on clinical trials with interleukin 6 blockers. Interleukin 6 is involved in the cytokine cascade, which originates as a consequence of an excessive immune response secondary to viral infection, aggravating lung affectation. Blockers of this cytokine (tocilizumab, sarilumab and siltuximab) are being studied as a strategy for treating the disease. Siltuximab is a monoclonal antibody indicated in Castleman's disease that could be administered in a single dose of 11 mg/kg in severe forms of COVID-19 that have increased interleukin 6.
Collapse
Affiliation(s)
| | - Eduardo López-Briz
- Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | |
Collapse
|
12
|
Nogueras A, Chinchilla Fernández MI, Martínez F, Maria Jose F, Martínez Sesmero JM, Poveda Andrés JL, Calleja MÁ. Clinical pharmacy services: from cost-effectiveness analysis to a productivity indicators model. Eur J Hosp Pharm 2019; 26:242-243. [DOI: 10.1136/ejhpharm-2019-001905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
13
|
Fernández-Megía MJ, Font Noguera I, Merino Sanjuán M, Poveda Andrés JL. Monitoring the quality of the hospital pharmacoterapeutic process by sentinel patient program. Farm Hosp 2018; 42:45-52. [PMID: 29501055 DOI: 10.7399/fh.10793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To analyze the results of sentinel patient program to monitoring the quality pharmacoterapeutic process in the hospitalized patient through medication errors. METHOD Design: Observational, prospective and transversal study. Ambit: General hospital of 1,000 beds. PERIOD From May 2011 to June 2016. Sample: Patients with treatment prescribe within 24 hours of being admitted with 4 or more medications. VARIABLES Medication error, drugs prescribed, medications and doses dispensing, drugs administered. Safety indicators were defined based on medication errors at each stage of the pharmacotherapeutic process. RESULTS Of the 746 patients studied, 334 had at least 1 medication error (44.8%; IC95%: 41.7-47.8). In the 746 treatments, 564 medication errors were detected (0.75 errors by patient; IC95%: 0.7-0.8). The safety indicators (medication error by stage) were: 5.1% (38/746 patients) for omission of allergy record; 2.3% (156/6 724 drugs) for prescription; 0.6% (38/6 724 drugs) for validation, 2.6% for dispensing (142/5 465 drugs) y 3.7% (190/5 111 administered drugs observed) for administration. The temporal evolution of the indicators, with graphs of statistical control showed stable processes, except for the administration. The proposed improvement actions were of a training, standardization and organizational type. CONCLUSIONS The sentinel patient program provides an overview of the quality of the pharmacotherapeutic process and promotes the safety culture at the center. Statistical control charts have been a useful tool for monitoring medication errors. The analysis of medication errors has served to propose improvement actions in each stage of the pharmacotherapeutic process.
Collapse
Affiliation(s)
| | | | - Matilde Merino Sanjuán
- Instituto Interuniversitario de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia.
| | | |
Collapse
|
14
|
Edo Solsona MD, Monte Boquet E, Casanova Estruch B, Poveda Andrés JL. Impact of adherence on subcutaneous interferon beta-1a effectiveness administered by Rebismart ® in patients with multiple sclerosis. Patient Prefer Adherence 2017; 11:415-421. [PMID: 28280313 PMCID: PMC5338953 DOI: 10.2147/ppa.s127508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adherence to disease-modifying drugs (DMDs) is one of the key factors for achieving optimal clinical outcomes. Rebismart® is an injection device for subcutaneous administration of interferon beta-1a (INF β-1a) that is also able to monitor adherence objectively. The aim of this study was to describe adherence to INF β-1a using the said electronic autoinjection device and to explore the relationship between adherence and relapses in a Spanish cohort. METHODS This is a retrospective observational study in which 110 Spanish patients self-administered INF β-1a subcutaneously using an electronic autoinjection device between June 2010 and June 2015. The primary end point was the percentage of adherence measured by Rebismart® to subcutaneous INF β-1a injections calculated as number of injections received in time period versus number of injections scheduled in time period. Other variables recorded were demographic and clinical data. Statistical analysis was performed using SPSS 19.0 software. RESULTS Median adherence for the total study period was 96.5% (interquartile range [IQR]: 91.1-99.1). Similar values were observed during the first 6 months: 98.7% (IQR: 91.3-100), and the last 6 months: 97.6% (IQR: 91.1-99.8). Median duration of treatment was 979 days (IQR: 613.8-1,266.8). During the entire treatment period, 77.3% of patients were relapse free and mean annualized relapse rate was 0.14 (standard deviation: 0.33). Increased adherence was associated with better clinical outcomes, leading to lower relapse risk (odds ratio: 0.953; 95% confidence interval: 0.912-0.995). Specifically, every percentage unit increase in adherence resulted in a 4.7% decrease in relapse. CONCLUSION Patients with multiple sclerosis who self-injected INF β-1a with Rebismart® had excellent adherence, correlating with a high proportion of relapse-free patients and very low annualized relapse rate.
Collapse
|
15
|
Cuéllar Monreal MJ, Reig Aguado J, Font Noguera I, Poveda Andrés JL. Reduction in alert fatigue in an assisted electronic prescribing system, through the Lean Six Sigma methodology. Farm Hosp 2017; 41:14-30. [PMID: 28045650 DOI: 10.7399/fh.2017.41.1.10434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. METHOD An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed. In order to measure the qualitative indicators, the most frequent alert types were analyzed, as well as the molecules responsible for over 50% of each type of alert. The action by the prescriber was analyzed in a sample of 496 prescriptions that generated such alerts. For each type of alert and molecule, there was a prioritization of the improvements to be implemented according to the alert generated and its quality. A second survey evaluated the pharmacist action for the alerts most highly valued by physicians. RESULTS The problem, the objective, the work team and the project schedule were defined. A survey was designed in order to understand the opinion of the client about the alert system in the program. Based on the surveys collected (n = 136), the critical characteristics and the quanti/qualitative indicators were defined. Sixty (60) fields in the alert system were modified, corresponding to 32 molecules, and this led to a 28% reduction in the total number of alerts. Regarding quality indicators, false po sitive results were reduced by 25% (p < 0.05), 100% of those alerts ignored with justification were sustained, and there were no significant differences in user adherence to the system. The project improvements and outcomes were reviewed by the work team. CONCLUSIONS LSS methodology has demonstrated being a valid tool for the quantitative and qualitative improvement of the alert system in an Assisted Electronic Prescription Program, thus reducing alert fatigue.
Collapse
Affiliation(s)
| | - Jorge Reig Aguado
- Pharmacy Department. Hospital Universitari i Politècnic La Fe, Valencia. Spain..
| | - Isabel Font Noguera
- Pharmacy Department. Hospital Universitari i Politècnic La Fe, Valencia. Spain..
| | | |
Collapse
|
16
|
Saz-Parkinson Z, Granados Alonso MDS, Bouza C, Poveda Andrés JL, Amate JM. Self-administration of Recombinant Human Growth Hormone with an Electronic Device: Clinical, Economic and Management Benefits of Objective Adherence Monitoring. J Health Econ Outcomes Res 2015; 1:296-307. [PMID: 37662880 PMCID: PMC10471364] [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] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Purpose: The aim was to identify factors affecting treatment adherence and to assess the clinical, economic and management impact of growth hormone deficiency treatment using an electronic auto-injector for recombinant human growth hormone (r-hGH) administration in children. Patients and Methods: A literature review was conducted in PubMed up to 31JUL2013, including the following search terms: "growth hormone deficiency", "human-recombinant growth hormone" and "treatment adherence". An economic model was developed to estimate the economic benefits of using an electronic injection device. In order to quantify this benefit, potential savings due to growth hormone cartridge optimization were analyzed. Results: From the literature review, the following key factors were found to affect treatment adherence: type of device used, discomfort, complexity of treatment regimens, long-term treatment, age and patient or family understanding of treatment benefits were assessed. A better adjustment to prescribed daily dose (accuracy up to 0.01 mg) with the electronic device results in a better optimization of vials and could save an average of 5% of total treatment costs in terms of doses not wasted, amounting to €245 of potential savings per patient and year of treatment. Conclusion: The use of an electronic device for r-hGH administration and monitoring may provide a better identification of responder and adherent patients. It may also generate savings in annual r-hGH consumption by hospitals and regional healthcare services.
Collapse
Affiliation(s)
- Zuleika Saz-Parkinson
- Instituto de Salud Carlos III, Agencia de Evaluación de Tecnologías Sanitarias, Madrid, Spain
| | | | - Carmen Bouza
- Instituto de Salud Carlos III, Agencia de Evaluación de Tecnologías Sanitarias, Madrid, Spain
| | | | - José María Amate
- Instituto de Salud Carlos III, Agencia de Evaluación de Tecnologías Sanitarias, Madrid, Spain
| |
Collapse
|
17
|
Poveda Andrés JL. [Farewell open letter to SEFH members]. Farm Hosp 2015; 39:317-319. [PMID: 26618375 DOI: 10.7399/fh.2015.39.6.10128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
|
18
|
Climente Martí M, Poveda Andrés JL, Culebras J. [IN MEMORIAM Víctor Jiménez Torres]. NUTR HOSP 2015; 32:1841-1842. [PMID: 26545560 DOI: 10.3305/nh.2015.32.4.9704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Affiliation(s)
| | | | - Jesus Culebras
- De la Real Academia de Medicina y Cirugía de Valladolid. Presidente de Honor de SENPE. Director de Nutricion Hospitalaria.
| |
Collapse
|
19
|
Pérez Huertas P, Cueto Sola M, Escobar Cava P, Borrell García C, Albert Marí A, López Briz E, Poveda Andrés JL. [Applying dose banding to the production of antineoplastic drugs: a narrative review of the literature]. Farm Hosp 2015; 39:210-6. [PMID: 26276739 DOI: 10.7399/fh.2015.39.4.8839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The dosage of antineoplastic drugs has historically been based on individualized prescription and preparation according to body surface area or patient´s weight. Lack of resources and increased assistance workload in the areas where chemotherapy is made, are leading to the development of new systems to optimize the processing without reducing safety. One of the strategies that has been proposed is the elaboration by dose banding. This new approach standardizes the antineoplastic agents doses by making ranges or bands accepting a percentage of maximum variation. It aims to reduce processing time with the consequent reduction in waiting time for patients; to reduce errors in the manufacturing process and to promote the rational drug use. In conclusion, dose banding is a suitable method for optimizing the development of anticancer drugs, obtaining reductions in oncologic patients waiting time but without actually causing a favorable impact on direct or indirect costs.
Collapse
Affiliation(s)
- Pablo Pérez Huertas
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia (Spain)..
| | - Margarita Cueto Sola
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia (Spain)..
| | - Paloma Escobar Cava
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia (Spain)..
| | | | - Asunción Albert Marí
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia (Spain)..
| | - Eduardo López Briz
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia (Spain)..
| | | |
Collapse
|
20
|
Ruiz Ramos J, Cueto-Sola M, García Robles A, Pérez Huertas P, Tordera Baviera M, Poveda Andrés JL. [Quality and legibility of written informed consent form in pharmacogenetic research]. Cuad Bioet 2015; 26:129-138. [PMID: 26030019] [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] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 10/29/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Pharmacogenetic studies have become in recent years a common practice in the development of new drugs, with the need to evaluate the information and readability of Informed Consent Forms(ICFs) to ensure compliance with the recommendations set by current legislation and expert groups. MATERIALS AND METHODS Retrospective observational study that analyzes the content of ICFs received by participants of pharmacogenetic studies approved in a tertiary hospital. To evaluate the quality of the ICFs, a questionnaire of 42 questions was prepared (Table 1) with the elements that must contain the information given to subjects, while readability was assessed using different readability indices. RESULTS The 31.5% of the 92 ICFs analyzed showed more than 75% of sections considered in the questionnaire. Sections with lower compliance were relative to risks and benefits (41.7%) and compensation for study participation (56.1%). None of the ICFs fulfilled with less than 50% of overall sections. Regarding legibility, about 90%, have a suitable degree for the most of population based on indexes used. CONCLUSIONS Deficiencies were found in some parts of the information contained in ICFs, while the degree of legibility was high, being necessary for future studies to establish the degree of real understanding of patients.
Collapse
Affiliation(s)
- Jesús Ruiz Ramos
- Servicio de Farmacia. Hospital Univeritari i Politècnic La Fe. Valencia. Avenida Bulevar sud s/n. 46026. Valencia
| | - Margarita Cueto-Sola
- Servicio de Farmacia. Hospital Univeritari i Politècnic La Fe. Valencia. Hospital Univeritari i Politècnic La Fe. Valencia. Avenida Bulevar sud s/n. 46026. Valencia
| | - Ana García Robles
- Servicio de Farmacia. Hospital Univeritari i Politècnic La Fe. Valencia. Hospital Univeritari i Politècnic La Fe. Valencia. Avenida Bulevar sud s/n. 46026. Valencia
| | - Pablo Pérez Huertas
- Servicio de Farmacia. Hospital Univeritari i Politècnic La Fe. Valencia. Hospital Univeritari i Politècnic La Fe. Valencia. Avenida Bulevar sud s/n. 46026. Valencia
| | - María Tordera Baviera
- Servicio de Farmacia. Hospital Univeritari i Politècnic La Fe. Valencia. Hospital Univeritari i Politècnic La Fe. Valencia. Avenida Bulevar sud s/n. 46026. Valencia
| | - José Luis Poveda Andrés
- Servicio de Farmacia. Hospital Univeritari i Politècnic La Fe. Valencia. Hospital Univeritari i Politècnic La Fe. Valencia. Avenida Bulevar sud s/n. 46026. Valencia
| |
Collapse
|
21
|
Barbieri M, Drummond MF, Puig Junoy J, Casado Gómez MA, Ballina García FJ, Blasco Segura P, Poveda Andrés JL. Critical appraisal of pharmacoeconomic studies comparing TNF-α antagonists for rheumatoid arthritis treatment. Expert Rev Pharmacoecon Outcomes Res 2014; 7:613-26. [DOI: 10.1586/14737167.7.6.613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
22
|
Baeza ML, Caballero Molina T, Crespo Diz C, Guilarte Clavero M, Hernández Fernández de Rojas D, Lobera Labairu T, Marcos Bravo C, Navarro Ruiz A, Poveda Andrés JL, Cebollero MA. [Algorithm for diagnosis and treatment of hereditary angioedema as a tool for management]. Farm Hosp 2013; 37:521-529. [PMID: 24256016 DOI: 10.7399/fh.2013.37.6.980] [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
INTRODUCTION Hereditary angioedema is a disease with low prevalence and high heterogeneity with regards to the severity of the clinical picture, which makes the diagnosis difficult and requires the need for early start of specific treatment in order to prevent complications. OBJECTIVE To propose a decision algorithm for hereditary angioedema (HAE), based on the evidence available on the diagnosis, clinical assessment, and treatment. The aim is to present the available therapeutic options as well as a decision algorithm to select the most efficient therapy at each time. MATERIAL AND METHODS Literature search by means of PubMed and other relevant sources. RESULTS four decision algorithms have been developed for HAE; diagnosis of bradikinin-mediated angioedema, treatment of acute attacks and short and long-term prophylaxis for HAE due to C1 inhibitor deficiency. CONCLUSIONS The application of a decision algorithm based on the clinical variables helps to select the most efficient therapeutic option at each time and may be a useful tool for the therapeutic approach.
Collapse
|
23
|
Lamas Díaz MJ, Delgado Sánchez O, Poveda Andrés JL. [Co-payment and the hospital pharmacy]. Farm Hosp 2013; 37:345-347. [PMID: 24128094 DOI: 10.7399/fh.2013.37.5.1009] [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: 06/02/2023] Open
|
24
|
Sánchez Romero A, Durán Quintana JA, García Delgado R, Margarito Rangel C, Poveda Andrés JL. Posible interacción gabapentina-fenitoína. Rev Neurol 2002. [DOI: 10.33588/rn.3410.2001491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|