ABSTRACT
Background and importance The most frequently recorded mental health problem is anxiety disorder and in the context of the SARS-CoV-2 pandemic, where an increase in anxiety cases has been evidenced, benzodiazepine derivatives (N05BA) have been one of the most prescribed pharmacological groups in most developed countries for this problem. Although their short-term benefits have been demonstrated, increasing their consumption may have longterm risks. Aim and objectives The main aim of this study was to find out the prescriptions of benzodiazepine derivatives from 2018 to 2021 in the context of the SARS-CoV-2 pandemic and the variation in them. A secondary objective was to learn which benzodiazepine derivatives varied more. Material and methods Retrospective, observational and crosssectional study. The study period included June 2018, June 2019, June 2020 and June 2021. The study population included the 710 581 inhabitants associated with the prescribing doctors of benzodiazepine derivatives from the study province. Results Total study population N=710 581;21.61% (153.574) with a benzodiazepine prescription, 67.33% (103 416) women, between June 2018 and June 2021. The prescribed benzodiazepine derivatives were: alprazolam, diazepam, diazepam/pyridoxine, clotiazepam, lorazepam, ketazolam, clobazam, pinazepam, clorazepato dipotassium, bromazepam, bentazepam, diazepam/sulpiride and diazepam/sulpiride/ pyridoxine. June 2018: 35 800 prescriptions, 67.30% (24 085) women;June 2019: 37 601, 67.20% (25 262) women;June 2020: 39 547, 67.30% (26 622) women;and June 2021: 40 626, 67.60% (27.477) women. From June 2018 to June 2019 prescriptions increased 5.03% (1801), from June 2019 to June 2020 they increased 5.20% (1946);and from June 2020 to June 2021 they increased 2.73% (1079), which represented a 13.48% increase in prescriptions (4826) from June 2018 to June 2021. The largest prescription increases were diazepam +23%, lorazepam +18%, bromazepam +12.5%, and alprazolam +12.3%. The largest prescription decreases were clotiazepam and bentazepam -100%, pinazepam -96.43% and clobazazam - 22.45%. Conclusion and relevance In the context of the SARS-CoV-2 pandemic we have seen a progressive increase in benzodiazepines of 13.48% (4826 prescriptions) from June 2018 to June 2021, with women being the users of 67.33% of prescriptions on average. These data allow us to know the current situation of the prescription of benzodiazepine derivatives to the population and to focus on mental health both in the validation of treatments and in pharmaceutical care.
ABSTRACT
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.
ABSTRACT
Background and importance Erenumab was approved for migraine prophylaxis shortly before the COVID-19 pandemic. After 18 months, there was enough data to conduct several studies. Aim and objectives Evaluate effectiveness and safety of erenumab using real-world data and compare the results with clinical trials. Material and methods A retrospective, observational study was performed in a second-level hospital. Evaluation of patients with migraine being treated with erenumab for at least 6 months. Data extraction from clinical histories and prescription software. Patient-related outcomes filled in their clinical history by the neurologist and pharmacist. Results 55 patients recruited to commence treatment with erenumab between January 2020 and April 2021. 48 patients included (7 patients excluded due to lack of follow-up). 44 women, average age 49.7 years, and 21 days per month with migraine (MMD). 26 patients reached a reduction of MMD of ≥50%, and 10 of ≥75% (54.2% and 20.8%, respectively) after a followup of between 3 and 9 months. Of the 22 patients that did not reach at least 50% reduction in MMD, 7 patients tried a dosage increase, with 5 of them achieving an average 61% reduction in MMD. All patients mentioned having softer migraine pain. Regarding safety, only 11 patients experienced adverse reactions, mostly constipation. Three patients needed to cease treatment. Conclusion and relevance Erenumab has established a new treatment in migraine prophylaxis that works even better than in the clinical trials. According to clinical trials results, erenumab can reduce MMD by 50% in about 40% of patients regardless of the dosage, and by 75% in about 18.9% of patients. In our findings, erenumab achieved a 50% reduction in 54.2% of patients, and a 75% reduction in 20.8% of patients, achieving better results in real life than in the clinical trials. Our study has as a limitation the follow-up being carried out by physicians and not by pharmacists, which could improve patient-related outcomes and experiences as hospital pharmacists dispense medication every 2 months in our hospital. The hospital pharmacist's role can be useful for evaluating treatments results described by patients.