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Manizales, Colombia

Machado-Alba J.E.,Technological University of Pereira | Machado-Alba J.E.,Audifarma SA | Torres-Rodriguez S.,Audifarma SA | Vallejos-Narvaez A.,Audifarma SA
Colombia Medica | Year: 2011

Objective: To determine the effectiveness of pharmaceutical care to improve control of type-2 diabetes mellitus. Methods: We carried out pharmacotherapeutical intervention during 19 months on patients with type-2 diabetes mellitus who were affiliate members of the contributive regime of the General System for Healthcare and Social Security in Bogotá and Cartagena. Through an interview and evaluation of medical records, we obtained information about antidiabetic medications used, doses, other medications, along with Hemoglobin A1c level, arterial pressure, serum low-density lipoprotein cholesterol level, nephropathy screening, retinal screening, foot exams in the last year and problems associated with medication use by means of the DADER method Negative Outcomes Associated with Medication (NOM). Results: The study had a sample of 143 patients (64 intervened and 79 controls) with female predominance (67.1% and 53.1%, respectively), mean age of 63.9±11.2 years. The patients in both groups were taking an average of 6.0±2.7 medications. Initial HbA1c mean was 7.7% and 7.8%, without improvement by the end of the study (7.4% for those intervened and 7.8% for the control group). Hypertension (81.1%) and dyslipidemia (62.9%) were the most important comorbidities. About 50.4% of NOM were of effectiveness, follows 31.3% of necessity. The mean cost per patient in controls was 1.4 greater than for the intervened group. Conclusions: Increased effectiveness of the antidiabetic therapy was not demonstrated in patients intervened with pharmacotherapeutical monitoring, but we did obtain a reduction in healthcare costs. © 2011 Universidad del Valle, Facultad de Salud.

Machado-Alba J.E.,Technological University of Pereira | Machado-Alba J.E.,Audifarma SA | Morales-Plaza C.D.,Technological University of Pereira
Revista Colombiana de Psiquiatria | Year: 2013

Objectives To determine the possible drugs interactions with antidepressive agents in data bases of patients in the Health Insurance System of Colombia. Methods From data bases of about 4 million users in Colombia, a systematic review of drugs dispensation statistics was made to identify drug interactions between antidepressive agents, cholinergic antagonists and tramadol in 2010. Results We identified 114,465 monthly users of antidepressive agents. Of these, 5776 (5.0%) received two, and 178 (0.2%) received three antidepressive agents simultaneously. The most frequent combination was fluoxetine+trazodone (n=3235; 56.9% of cases). About 1127 (1.0%) patients were prescribed a cholinergic antagonist simultaneously; 2523 (2.1%) users were dispensed tramadol at the same time, while raising the risk of serotonin syndrome. Conclusions Drug interactions represent a potential risk that is often underestimated by physicians. Pharmacovigilance is a useful tool to optimize resources and prevent negative outcomes associated with medication. It is recommended that systematic search is made to enhance surveillance programs for the rational use of medicines in this country. © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España S.L. Todos los derechos reservados.

Machado-Alba J.,Technological University of Pereira | Machado-Alba J.,Audifarma SA | Alzate-Carvajal V.,Technological University of Pereira | Mondragon-Cardona A.,Technological University of Pereira | Jimenez-Canizales C.E.,Technological University of Pereira
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2013

Objective. To identify the frequency of drug use for the prevention of corticosteroid induced osteoporosis (CIO) among patients using corticosteroids for more than three months affiliated to the General Social Health Security System of Colombia. Materials and methods. Cross-sectional study. Information about people affiliated to the General Social Health Security System of Colombia (3.7 million) was used. This study included men and women of all ages having been prescribed any glucocorticoide from August 1 to November 30, 2011. Sociodemographic variables and the characteristics of of the glucocorticoide prescription and CIO prophylaxis drugs in a defined daily dose (DDD) were identified. Results. A database of 255,568 prescriptions of glucocorticoids was obtained, with a total of 1,837 patients receiving some glucocorticoide chronically. The majority of participants were females (60.2%), with an average age of 55.2±16.9 years distributed in 65 cities of the country. Prednisolone was the most commonly used glucocorticoide (1,546 patients, 84.1%), whereas the most prescribed prophylaxis drug used was calcitriol (67.1%). Despite the need to receive prophylaxis, 994 cases (54.2%) were not receiving it. Conclusions. There is a poor utilization of CIO prophylaxis. The implementation of drug surveillance actions that allow the identification of problems related to these drugs in order to prevent adverse events and optimize resources is recommended, thus anticipating the emergence of complications in the patients.

Machado-Alba J.E.,Technological University of Pereira | Ruiz A.F.,Audifarma SA | Machado-Duque M.E.,Technological University of Pereira
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2014

This study describes the adverse drug reactions (ADRs) and their incidence in patients with rheumatoid arthritis who were treated in the Colombian health system. A retrospective cohort study was conducted using information from all patients who were diagnosed with rheumatoid arthritis and attended specialized health care centers in the cities of Bogotá, Cali, Manizales, Medellin, and Pereira between 1 December 2009 and 30 August 2013. The ADRs were obtained from medical records and the pharmacovigilance system registry and sorted by frequency and affected tissue according to World Health Organization Adverse Reaction Terminology (WHO-ART). A total of 949 reports of ADRs were obtained from 419 patients (32.8 ADRs per 100 patient-years); these patients were from a cohort of 1 364 patients being treated for rheumatoid arthritis and followed up for an average of 23.8 months (± 12.9). The cohort was mostly female (366, 87.4%) and had a mean age of 52.7 years (± 13.1). The highest numbers of ADRs were reported following the use of tocilizumab, rituximab, and infliximab (28.8, 23.1, and 13.3 reports per 100 patient-years respectively). The most frequently reported ADRs were elevated transaminase levels and dyspepsia. Overall, 87.7% of ADRs were classified as type A, 36.6% as mild, 40.7% as moderate, and 22.7% as severe. As a result, 73.2% of patients who experienced an ADR stopped taking their drugs. The occurrence of ADRs in patients treated for rheumatoid arthritis is common, especially in those associated with the use of biotechnologically produced anti-rheumatic drugs. This outcome should be studied in future research and monitoring is needed to reduce the risks in these patients.

Machado-Alba J.E.,Technological University of Pereira | Machado-Alba J.E.,Audifarma SA | Ossa-Ochoa L.M.,Technological University of Pereira | Lotero-Jaramillo N.,Technological University of Pereira | Valencia-Rojas A.,Technological University of Pereira
Revista Facultad de Medicina | Year: 2013

Background. Medication errors are preventable events that may affect the health of hospitalized patients. Objective. Determine the frequency of occurrence of Medication errors and the variables that are associated with the presentation in a first level hospital. Materials and Methods. Descriptive observational study in patients older than 18 who were hospitalized between February 1 and March 9 2012 with all diagnoses. We assessed sociodemographic, clinical and pharmacological variables from medical records. We evaluated the appropriateness of the medication for the diagnosis, contraindications, sufficiency and frequency of dosing, route of administration, duration of treatment and legibility of medical records of formulation. Results. We evaluated 96 patients, average age 59.7±18.8, male predominance (53.1%), average 2.8±1.2 days of hospitalization. The most frequent medication errors were missing record of length formulation (97.3%), no description administration (29.9%), inadequate dose (9.8%), insufficient dose (8.2%), medication contraindicated (3.9%). Conclusions. The hospital prescription system should be improved with the addition of safer practices, continuing medical education programs, warning of interactions and reorganization of procedures for patient care.

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