Study of a population-wide epidemic outbreak of mumps virus G1 in Jerez de la Frontera (Spain) [Estudio de un brote epidémico de ámbito poblacional por el virus de la parotiditis G1 en JEREZ de la Frontera]
Barrios J.A.,University of Cádiz |
Morales Serna J.C.,Servicio de Farmacia
Atencion Primaria | Year: 2012
Objectives: To characterize the mumps outbreak, assess the effectiveness of vaccines and discuss prevention and control measures. Design: Observational cross-sectional study of cases by person, place, and time. Location: City Jerez de la Frontera and 8 Primary Care centres. Participants: A total of 116 cases of mumps were reported throughout seven months, with the last case in June 2008. Measurements: Main outcomes: age, sex, place of study or work, symptoms start date, clinical description, complications, and genotype of virus isolation, history and vaccination compositions. Calculation of total vaccine effectiveness. Active case finding and contact studies were performed on the families, work places and leisure areas. Results: The mean age of the cases was 16.24 years(SD 10.6). The majority (68.96%) of the cases were children at school and 31.03% arose from family and work areas. Mumps vaccine coverage rates were above 90%. The complete vaccine effectiveness (2 doses); for those under 20 years-old it was: 99.84% (95% CI = 99.77 - 99.89), being lower in schools with the highest attack rate, immunised with current vaccine from Jeryl Lynn strain: 71.01% (95% CI = 55.85 80.97). Two doses of this strain were used in 13.79% of the cases. Susceptible populations were vaccinated at the start of the outbreak: 11,381 doses used in schools and 93 outside schools. Conclusions: An outbreak of mumps virus G 1 population with high rates of mumps vaccine coverage, with areas with low vaccine effectiveness with current vaccine. Mass vaccination of population has contributed to the resolution of the outbreak. © 2011 Elsevier España, S.L. All rights reserved.
Iniesta Navalon C.,Servicio de Farmacia |
Urbieta Sanz Elena E.,Servicio de Farmacia |
Gascon Canovas J.J.,University of Murcia |
Madrigal de Torres Manuel M.,Servicio de Cirugia General y del Aparato Digestivo |
Pinera Salmeron Pascual P.,Hospital General Universitario Reina Sofia Of Murcia
Emergencias | Year: 2011
Objectives: To determine the quality and accuracy of medication histories taken during admission to the emergency department (ED) and to analyze the factors that may be related to the presence of discrepancies. Methods: Descriptive cross-sectional study. Patients over the age of 64 years were enrolled on admission to the hospital from the during the last quarter of 2009. To detect the presence of discrepancies we compared the medication histories taken by a clinical pharmacist to the ones taken by an emergency physician on admission. Regression analysis was used to identify factors associated with the presence of discrepancies. Results: A total of 324 patients (53.4% women) with a mean age of 78.3 years were enrolled. We detected 2928 discrepancies affecting 95.1% (95% confidence interval [CI], 92.7%-97.4%) of the patients. The medication groups with the largest numbers of discrepancies were antiulcer drugs (10.8%), antithrombotic drugs (9.5%), and psycholeptics (7.2%). We detected discrepancies in the recording of 257 high-risk drugs (8.8%) in 33.3% (95% CI, 28.2%-38.5%) of the patients. The only independent variable associated with a higher prevalence of discrepancies was the use of multiple medications (odds ratio, 8.02 (95% CI, 2.79-23.02). Conclusion: Our findings demonstrate that there is ample room for improvement, on medication history taken at ED, and increased cuation should be taken for patients of advanced age and those taking multiple medications.
Gamundi Planas M.C.,Servicio de Farmacia
Farmaceutico Hospitales | Year: 2011
It is not always the hospital pharmacy service that is in charge of healthcare products. Nevertheless it must be familiar with the legislation on and features of these products, as they form part of the therapeutic tool kit and misuse of them can affect the end result of any treatment. This paper assesses the different materials used to manufacture some products used to administer medication and the possible problems which might arise due to the interaction between the drug and the pack used are listed. The pharmacist must play a part in the selection and monitoring of health care products in order to ensure proper administration of medication to patients so as to assure their safety.
Lallana-Alvarez M.J.,Servicio de Farmacia de Atencion Primaria |
Feja-Solana C.,Instituto Aragones Of Ciencias Of La Salud |
Armesto-Gomez J.,Servicio de Farmacia |
Bjerrum L.,Copenhagen University |
Rabanaque-Hernandez M.J.,University of Zaragoza
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2012
Background: The objective of the study is to describe the use of antibiotics among outpatients, the pattern of sub-group prescribing, as well as to analyse age- and gender-specific patterns of use, and to identify high users. Methods: A retrospective, observational study was designed, in which the rate of patients treated with antibiotics in Aragon (Spain) in 2008 was calculated. Data were extracted from the Aragon Pharmaceutical Consumption Database, a complete register of all dispensed prescriptions in Aragon in 2008. Defined Daily Dose (DDD) per 1000 inhabitants per day (DID) was calculated, and the number of patients who had received an antibacterial drug was analysed. Results: The antibiotic prescription rate in 2008 in Aragón was 339.81 per 1000 inhabitants (303.54 and 375.34 per 1000 for men and women, respectively). The DID was 23.72. Population prevalence of antimicrobial use changed markedly between different age groups and between genders. Children (0-4 years) had the highest rate. Females, in general, used antibiotics more than males. Penicillins was the most used antibacterial group in all age groups, except for people of advanced age (>80 years), where quinolones were the most frequently used. Most of the individuals defined as high users (using more than 60 DDDs/year) were in the 60-80 years age group. Conclusion: We observed a high antibiotic prescription rate in Aragon, particularly in children. There are differences between men and women in the use of antibiotics.
Malo-Fumanal S.,University of Zaragoza |
Rabanaque-Hernandez M.J.,University of Zaragoza |
Feja-Solana C.,Instituto Aragones Of Ciencias Of La Salud |
Lallana-Alvarez M.J.,Servicio de Farmacia de Atencion Primaria |
And 2 more authors.
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2014
Introduction Antibiotic use and misuse are linked to pathogen resistance and, as such, both constitute a public health issue with local, national, and global dimensions. Early studies have shown striking variations in the use of these drugs between Nordic and Mediterranean countries. The aim of the present study was to describe and compare antibiotic prescribing in Primary Care in Denmark and Aragón (a North-eastern Spanish region). Methods Outpatient antibiotic prescription data (2010) were obtained from the National Institute for Health Data and Disease Control (Denmark), and the Information System on Medication Consumption in Aragón. The consumption of antibiotics (ATC J01) was analyzed from the prescription rates and the number of defined daily dose (DDD) per 1000 inhabitants/day (DID). Results The rate of antibiotic prescription in 2010 in Aragón was greater than in Denmark (407 compared to 315 exposed individuals/1000 inhabitants). There were significant differences as regards overall consumption of antibiotics (23.2 DID in Aragón and 17.0 DID in Denmark), as well as the therapeutic group selection. There was an elevated use of broad spectrum penicillins, quinolones and cephalosporins in the Spanish region while, in Denmark, the most-consumed antibiotic was narrow spectrum penicillin. Conclusion The use of antibiotics in the Spanish region is very high, and there are marked differences in the choice of drug between this region and Denmark. Interventions are needed that promote the rational use of these drugs to reduce potential bacterial resistance, and to avoid unnecessary risks to patients. © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica.
Gutierrez Suela F.,Servicio de Farmacia
Atencion Farmaceutica | Year: 2012
Objective: To evaluate the results of pharmaceutical actions (PA) in the prevention or resolution of drug-related problems (DRPs) in a hospital's public health geriatric patients with the purpose of improving the quality of pharmacotherapy. Method: We conducted a cross-sectional descriptive and observational study over a three-month period. For the detection of DRPs in the prescription validation process, we created pre-defined criteria about potentially inappropriate drugs, as well as those that should be indicated, in the geriatric patient, based on the de Beers and STOPP-START criteria. PAs were recorded using the laser methodology. Results: We detected 72 DRPs in 46 patients: 26 DRPs related to safety (36.11%), 25 with effectiveness (34.72%) and 21 with indication (29.17%). 65 pharmacotherapeutic recommendations were given, being accepted 62 times (95.39%) by the healthcare professionals. The impact or value added of these PAs was of 41%. Regarding the suitability and result in the patient, of the accepted PAs 60 (96.77%) were significant in improving the patient's healthcare, and in 57 (91.94%) there was a positive outcome without the possibility of any documentation. Conclusions: The performed PAs have improved the quality of pharmacotherapy in the public health geriatric patient. The use of pre-defined criteria for detecting DRPs in the prescription validation, together with the recording of PAs through a standardized system, is shown as an effective method for identifying DRPs in the hospital.
Navarro Ruiz A.,Hospital General Universitario |
Crespo Diz C.,Servicio de Farmacia |
Poveda Andres J.L.,Hospital Universitario La Paz |
Cebollero De Torre A.,ViroPharma
Farmacia Hospitalaria | Year: 2013
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.
Fernandez-Llamazares C.M.,Servicio de Farmacia |
Manrique-Rodriguez S.,Servicio de Farmacia |
Sanjurjo-Saez M.,Hospital General Universitario GregorioMaranon
Archivos Argentinos de Pediatria | Year: 2011
Many studies have reported increased pediatric susceptibility to the development of errors; children are more vulnerable, so it is very important to guarantee the best therapeutic results at the lowest risk. There are many studies related to prescription of drugs in pediatrics under conditions other than those authorized. Studies show that approximately 50% of the drugs used in children are off label or unlicensed, and in about 70% of pediatric patients at least one drug is prescribed under those conditions.
The computerised prescription in primary care and its impact on drug spending using time series analysis [Impacto de la informatización de la prescripción en atención primaria sobre los costes de medicamentos mediante análisis de series temporales]
Catalan-Arlandis J.L.,Servicio de Farmacia |
Catalan-Arlandis J.L.,Hospital Universitario Doctor Peset
Revista de Calidad Asistencial | Year: 2011
Objectives: To describe the monthly costs of drugs per standardized patient in the Doctor Peset health department in Valencia, Spain and to correlate them with the computerization of prescription in primary care clinics using time series analysis. Other objectives were to identify internal causes that could explain the variations observed, and to evaluate the drug costs associated with these variations. Material and methods: Observational and retrospective study to analyse the variables: a) monthly costs of drugs by standardized patient and b) number of defined daily doses (DDD) per 1000 inhabitants and per day of drugs used to prevent cardiovascular risk prescribed by the Primary Care doctors of the Doctor Peset health department in Valencia, between January 2001 and August 2009. Time series were adjusted using ARIMA models. The impact of computerization was assessed using an intervention analysis on time series. Results: ARIMA models for the monthly costs of drugs by standardized patient shows that this indicator was increased by 4.9% in August 2007. The modelling of daily DDD per 1000 inhabitants showed an increase of 8.5% on the same date. Both increases occurred together with the introduction of the computerized prescription in Primary Care clinics. The pharmacoeconomic study estimated that drug costs associated with the trend changes increased by 11,365,409 euros within the period September 2007 to August 2009. Conclusions: The computerization of prescription in Primary Care clinics can be correlated with an increase in the monthly costs of drugs per standardized patient and with the number of daily DDD per 1000 inhabitants of drugs to reduce the cardiovascular risk by 4.5% and 8.5%, respectively. © 2009 SECA. Published by Elsevier España, S.L. All rights reserved.
Nogue S.,Seccion de Toxicologia Clinica |
Corominas N.,Servicio de Farmacia |
Soy D.,Servicio de Farmacia
Emergencias | Year: 2011
This review examines the pharmacologic and pharmacokinetic aspects of the intravenous infusion of lipid emulsion and surveys the literature on the indications for using this treatment in cases of intoxication. Although the level of evidence is low, intravenous lipid emulsion seems now to occupy an undisputed position as an antidote, not only in cardiotoxicity induced by local anesthetics but also in resuscitation after other toxic insults affecting the cardiovascular system.