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Background and ImportanceDuring the context of the COVID-19 pandemic, in order to avoid the possible transmission of SARS-COV2, some hospitals developed an outpatient hospital medication dispensing programme through delivery to community pharmacies. To access the programme , outpatients had to meet all the criteria established by Health Authorities: adherence to treatment, live more than 30 km from the hospital and present some vulnerability condition (age >65 years, reduced mobility or respiratory pathology). This programme has been maintained over time due to the excellent acceptance by patients.Aim and ObjectivesTo evaluate the compliance of our hospital with the inclusion criteria and analyse possible deviations, assessing whether it is necessary to modify them based on the current health context.Material and MethodsCross-sectional observational study in which all active outpatients in the programme between July and September 2022 were included.The following variables were collected: demographic, distance between home and hospital, vulnerability conditions and adherence to treatment.Results95 patients were evaluated, 94 (98.9%) of them were adherent to chronic treatment, 81 (85.3%) lived more than 30 km from the hospital. Regarding the vulnerability conditions: 68 (71.6%) were older than 65 years and 14 (14.7%) had a vulnerability condition other than age over 65 years.Of all the evaluated patients, 75 (78.9%) met all the inclusion criteria. 20 (21.1%) patients were in the programme , but did not meet some criteria: 6 (30.0%) patients lived less than 30 km away, 8 (40.0%) did not have a vulnerable condition and 6 (30 .0%) did not meet more than one inclusion criteria.Conclusion and RelevanceThe medication dispensing programme through community pharmacies offers an option for vulnerable patients and/or those with difficulty going to the hospital to collect their chronic medication, thus facilitating therapeutic compliance of treatment.Although a high percentage of patients met the established criteria, deviations were detected. That make us consider the need to modify these criteria in order to access in the programme according to current needs of outpatients.References and/or AcknowledgementsConflict of InterestNo conflict of interest
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The objective of this current work was to explore whether modification of the diagnostic criteria upon the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the impact of the COVID-19 pandemic had influenced the diagnostic and sociodemographic profiles of mental health admissions. For that purpose, we designed an observational, longitudinal, and retrospective study of the data recorded in the discharge reports of the Brief Hospitalization Unit at Castellon (Spain), between January 2006 and December 2021. The sample consisted of 7,037 participants, with a mean age of 42.1 years. The mean age of admissions, number of women, and presentation of affective disorders, addictions, and dementias all increased significantly during the DSM-5 period. Beyond diagnoses, the reduction in readmissions before the pandemic could be attributed to the use of long-acting injectable antipsychotics. In contrast, the pandemic did not change the percentage of readmissions or the volume of admissions. Also, during the pandemic period, the significant results obtained indicate that the average stay was reduced, affective disorders decreased, and addictions increased. Therefore, clinicians should consider these diagnostic and sociodemographic fluctuations when adapting clinical care, taking into account gender perspective, ageing of patients and increasing of dual and affective disorders.
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COVID-19 , SARS-CoV-2 , Adult , Female , Humans , COVID-19/epidemiology , Hospitalization , Pandemics , Retrospective Studies , MaleABSTRACT
Introduction. Everyone has faced restrictions affecting their social lives during the COVID- 19 pandemic. However, older adults have experienced more extreme conditions due to their being part of the highest-risk group. The aim of this study was to analyse the incidence of emotional and social loneliness among older women during the lockdown in Spain. Potential differences were assessed based on household structure and type of living arrangement, examining the experience of lockdown and its repercussions for the wellbeing of older women. Methodology. A mixed methods study was performed with a transversal design and a descriptive scope, involving the participation of thirty older women from Bilbao. Semi-structured interviews were conducted to assess psychosocial wellbeing and feelings of loneliness in particular. Results. The findings indicated differences in feelings of loneliness according to household structure, with women living alone tending to feel more lonely. Older women experienced more emotional loneliness than social loneliness during the lockdown. The lockdown period also affected women in terms of mental and physical health. Discussion. Household structure is a central element in the analysis of wellbeing in old age. In this study, single-person households were more likely to trigger loneliness. This study also confirmed a trend toward social relationships with lower levels of intimacy during the pandemic, reinforcing feelings of incomprehension, sadness and insecurity. The data showed greater emotional loneliness as a result. Feelings of loneliness are complex, insofar as they include emotional and social factors and hence require a more comprehensive approach. Conclusions. The pandemic has accentuated a change in social relationships, mainly affecting older adults and triggering higher levels of emotional loneliness. From a Gerontological Social Work perspective, progress must be made in terms of incorporating a feminist gerontological perspective and the current ageing model. Both of these theories would facilitate a comprehensive and appropriate approach to understanding and intervening in cases of loneliness. © 2022 by the authors.
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Background and importance Evidence regarding the rate of medication errors (ME) and adverse drugs events (ADE) during the COVID-19 pandemic is limited. In that period the risk of ME and unsafe medication practices was potentially higher than average. Thus, voluntary hospital reporting systems are valuable sources of information on ME and ADE. Aim and objectives To describe the ME and ADE registered in the voluntary electronic notification system of our centre (TPSC Cloud) during the first year of the COVID-19 pandemic and compare them with the same period in the previous year. Material and methods A retrospective observational study of ME and AE notifications in the TPSC Cloud from March 2020 to February 2021 compared to notifications recorded from March 2019 to February 2020. Five types of incidents were differentiated: situations with the capacity to cause ME, ME that do not reach the patient, ME that reach the patient without ADE, ME with ADE, and ADE without ME. The drugs involved in those incidents and the professional notifier also were identified. Results 249 incidents were reported from March 2020 to February 2021, which was 31.02% less than in the previous period (n=361) from March 2019 to February 2020. The most common ME was prescription error in both periods (70.4% vs 67.3%). The incident profile by typology was similar in both periods. The most frequent was ME that did not reach the patient (40.24% vs 43.47%), followed by ME that reached the patient without ADE (23.42% vs 28.53%). Systemic anti-infectives drugs were the most involved in both periods (n=57;22.89% vs n=73;20.22%). 84 ADE without ME were reported from March 2020 to February 2021, representing an increase of 500% compared with March 2019 to February 2020 (n=14). Emphasising the notification of 35 ADE of lopinavir/ritonavir and 4 of hydroxychloroquine used in the initial treatment of COVID-19. The main notifier in both periods was the pharmacist (80.48% vs 65.60%). Conclusion and relevance During the first COVID-19 pandemic year, notifications of ME decreased, due to care load pressure, but incident profile was similar. Otherwise, ADE notifications increased notably, due to active pharmacovigilance carried out by pharmacists on off-label drugs used to treat COVID-19.
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Background and importance Digital health is the concept that incorporates information and communication technologies into healthcare services. Nowadays, and favoured by the SARSCoV- 2 pandemic, hospital pharmacy has been forced to adopt digital technologies and tools to improve patient care. Aim and objectives If any area of hospital pharmacy has gained prominence in recent years, it is the area of digital health. Therefore, it was decided to analyse current clinical trials in relation to technological devices or wearables. Material and methods Descriptive study of current clinical trials on technological devices from the pharmacological aspect. The following filters were applied: active trials, devices in digital pharmacy, all phases, all ages and both sexes. The type of device was analysed as intervention, pathology, location, and study topic. Both observational and interventional studies were included. The tool used for evaluation was the ClinicalTrials. gov clinical trials registry. Results Nineteen current active phase clinical trials were analysed. The phases of the projects were: phase I-7, phase II-3, phase III-2 and phase IV-7. The main pathologies of the clinical trials were: musculoskeletal disorders (6), chronic obstructive pulmonary disease (3), Parkinson's neurodegenerative diseases (3), oncology (2), autism (1), renal system (1), cardiac system (1) and self-injection devices (1). The main countries conducting clinical trials were: United States (13), Europe (4), Asia (1) and Oceania (1). Seven projects were detected in the patient recruitment phase. Conclusion and relevance Although the use of wearables in the field of hospital pharmacy is a little known topic, it is increasingly gaining prominence in the literature and in scientific research. Digital health is the driver of change towards new models of care between patients and healthcare professionals. Therefore, it is necessary to continue with research and clinical trials to promote digitisation in hospital pharmacy.
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Background and importance The Pharmacy Service is committed to resident training. The residency programme in the Hospital Pharmacy Service covers all areas of the training programme. The high hospital demand and the weekly updates of the pharmaceutical protocols made it necessary to dedicate almost the entire working day to the hospital pharmacy residents. Aim and objectives To evaluate the impact of the SARS-CoV pandemic on the training period of resident pharmacist interns. Material and methods A survey was conducted among all hospital pharmacy residents in Spain. It was carried out by the Teaching and Hospital Pharmacy units. The survey was anonymous, voluntary and disinterested. Data collected: place of residence, year of training, hospital level, resident supervision, internal and external rotations missed, emotional impact and sick leave. Results The survey was completed by 122 hospital pharmacy residents. The completion period was from 15 March to 15 April 2021. The geographic distribution of the residents was: Andalusia (48.3%), Madrid (11.7%), Catalonia (10%), Valencia (8.3%), Murcia (8.3%), Castilla y León (3%), Galicia (3%), Asturias (1.7%), Cantabria (1.7%) and the Basque Country (1.7%). The year of residence of the respondents was: 4th year (56.7%), 2nd year (18.3%), 1st year (13.3%) and 3rd year (11.7%). With respect to supervision and concern for the work: 65.6% felt adequately supervised, while 27.9% said they were deficient in the process. Regarding rotations in other services and/or hospitals: 50.8% stated that they had missed some type of rotation, of which 13.1% were irrecoverable. 63.9% recognized that the pandemic has had some emotional impact on their lives, while 34.4% stated that it has had a great impact. Of the residents, 50.81% said they had been on sick leave due to SARS-CoV. Conclusion and relevance Pharmacy services met the demand of the hospital and associated residences with increased activity. Despite the situation, residency in a crucial stage of professional training, therefore changes must be faced in order to find the best way to meet the goals.
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The situation generated by COVID-19 has shown that, in early childhood education, the care model has lagged behind the educational one. This investigation has analyzed, in the exceptional situation of confinement, the way of dealing with this situation of closing the classrooms from the educational centers and the responses provided by the families, considering the ownership of the centers, the cycle (first cycle, second cycle or both), the year of birth of the minors, or the number of children in the households. Two questionnaires have been developed ad hoc for it and have been answered during the months ofApril and May by 1235 teachers of this stage, from all the Autonomous Cities and Communities of Spain, and by 1266 parents whose children at infant or preschool level. The collected data has been analyzed by an exploratory examination of the answers and the calculation of the main percentages associated with the variables considered, to subsequently carry out an inferential analysis of the available information, using the Kruskal-Wallis H test to analyze the data from the Likert scales and the Chi-square test for the study of categorical variables. The results show that there are statistically significant differences in the sending of tasks depending on the cycle and the ownership of the center, with the private centers being the ones that have sent the fewest activities. Likewise, almost half of the families surveyed indicate that they need to receive more indications, being those whose children go to public schools the ones that demand it the most. For this reason, it can be concluded that the maxims established in the current legislation have not been met in all cases. © 2021, Universidad Compultense Madrid. All rights reserved.