ABSTRACT
Objective: The consolidation of Telepharmacy during the COVID-19 pandemic has raised the need for managing large volumes of real-time activity data through data analysis. The aim of this project was to design a dynamic, user-friendly, customizable scorecard in a hospital pharmacy service for the visualization and analysis of Telepharmacy activity indicators through the use of advanced business intelligence technology. Method: The software tool was developed by a multidisciplinary team between April and May 2021, driven from the hospital pharmacy service. Once the Telepharmacy indicators of interest were established, datasets were extracted from raw databases (administrative databases, Telepharmacy database, outpatient dispensing software, drug catalogues) through data analysis. The different data sources were integrated in a scorecard using PowerBI®. The criteria for processing missing and duplicated data were defined, and data pre-processing, normalization and transformation were performed. Once the pilot scorecard was validated by different profiles of users, the structure was designed for the panels to automatically update as databases were updated. Results: Design and implementation of a scorecard of Telepharmacy activity: general descriptive panel (demographic profile of patients, count and delivery conditions, program and medical service);geolocation of destination;pharmacological profile;relative analysis of patients involved in the Telepharmacy program with respect to the total of outpatients. In the last updating as of January 2022, data from 16, 000 dispensations to more than 4, 000 patients had been collected. This means that 21.93% of outpatients had benefited at some time point from the Telepharmacy service. Filters enable the visualization of timeline progress and patient characterization, and measure Telepharmacy activity by program. Conclusions: The processing of large Telemedicine datasets from various sources through Business Intelligence in a hospital pharmacy service makes it possible to synthesize information, generate customized reports, and visualize information in a dynamic and attractive format. The application of this new technology will help us improve strategic clinical and management decision making. © 2022 Grupo Aula Medica S.L.. All rights reserved.
ABSTRACT
Background: Arterial hypertension has been described as one of the main risk factors for poor prognosis in Covid-19. In this context, the role of angiotensin-converting enzyme 2 (ACE2) in this infection has been studied, with studies showing how this enzyme acts as a functional receptor for SARS-CoV-2, favoring the penetration of the virus into the cell. The main objective of this work is to study the impact of chronic antihypertensive treatment in a cohort of SARS-CoV-2 positive patients with arterial hypertension, as well as clinical outcomes during hospitalization. Method: Single-center observational retrospective cohort study conducted at a tertiary level university hospital from 1st March 2020 to 31st May 2020. All adult patients admitted with a diagnosis of COVID-19 and a history of arterial hypertension on chronic treatment with an antihypertensive drug during the three months prior to contracting the infection were included. For the analysis, patients were divided into three groups according to the chronic antihypertensive treatment they were receiving: angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor antagonists (ARB) or other treatment, excluding those patients who during the three months prior to the start of the study had been on concomitant treatment with ACE inhibitors and ARB, as well as those on treatment with more than four antihypertensive drugs. Results: A total of 475 cases with positive PCR for SARS-CoV-2 cases had hypertension as an associated comorbidity on antihypertensive treatment in the three months prior to admission. The mean age of this cohort of patients was 77.05 (SD 10.95) years, most of them male (56.8%) Regarding the prolonged length of stay variable, 127 patients (26.7%) were admitted for 14 days or more, with no statistically significant differences between the three groups. For patients admitted to the Intensive Care Unit (ICU) (29 patients, 6.1%) no differences were observed between the three study groups either.Regarding the outcome variable, all-cause in-hospital mortality, no statistically significant differences were observed between the groups (p = 0.836). Conclusions: Patients admitted with SARS-CoV2 respiratory infection with a diagnosis of hypertension and pre-admission treatment with an antihypertensive drug showed no statistically significant differences in mortality between those hypertensive patients who received renin-angiotensin-aldosterone system (RAAS) inhibitor antihypertensive drugs and those who received other antihypertensive treatments.
ABSTRACT
Background and importance The SARS-CoV-2 pandemic has highlighted the need to avoid exposure of patients to places with a high probability of transmission, such as hospitals. Home delivery makes this possible, particularly in patients with disabilities and those especially vulnerable to coronavirus infection due to their drug therapy or previous pathology, such as multiple sclerosis (MS) Aim and objectives To describe the telepharmacy system implanted in a teaching hospital for MS outpatients, based on telephone consultations and home delivery medication, from 25 March to 30 September. Material and methods A logistic system was organised and implemented to ship medication to patient's residence, after a telephone pharmaceutical care interview. The following data were recorded: total home deliveries made by the outpatients pharmacy department (OPD), total patients attended by this system, total home deliveries made by OPD for MS patients and total MS patients attended by telepharmacy. All deliveries for MS patients requiring refrigeration conditions were also registered. Results From 25 March to 30 September 2020, we performed 2166 home deliveries of 10 different MS medicines (24.0% of the total telepharmacy shipments made by OPD during this period). Up to 772 MS patients benefited from the telepharmacy system (75.0% of the total MS patients attended by our OPD). Almost 20% of these shipments required refrigeration. At the beginning, when lockdown was imposed in Spain, shipments for MS outpatients accounted for 23.2% of the total. Afterwards, with concrete conditions to maintain this system (reduced mobility, elderly, pluripathology), the percentage of MS patients attended by telepharmacy and also home delivery increased to 32.6% of the total. Conclusion and relevance The development of telepharmacy has become a useful and necessary tool for the delivery of specialised pharmaceutical care, especially during the pandemic where patients with certain medical conditions, such as MS, were at risk. This made it possible to guarantee continuity of care for a large number of MS patients, avoiding hospital visits, and therefore reducing SARS-CoV-2 transmissions. Otherwise, to maintain the sustainability of the implanted telepharmacy system, using the resources efficiently, it is necessary to apply patient stratifications tools, which allows access to this service to those patients who need it the most.