[Health related problems as cause of visits to hospital emergency departments]. / Problemas de salud relacionados con los medicamentos en un servicio de urgencias hospitalario.

BACKGROUND AND OBJECTIVE: Medication-related problems (MRPs) are health problems resulting from patient pharmacotherapy failure that interfere with the expected outcome in the patient's health status. The aim of this study was to discover the health problems associated with the appearance of MRPs. PATIENTS AND METHOD: Patient interviews, together with the assessment of medical records were the sources of information used in the assessment and identification of MRPs. A validated questionnaire was used for the interviews; in order to classify the health problems found, the ICD-9 was used. RESULTS: 2,556 patients were interviewed over a period of one year at a hospital emergency department. 2,261 of these cases were valid. Osteoarticular diseases, poorly defined signs and symptoms of illness, injuries and intoxications were the disorders most commonly associated with the appearance of MRPs. MRPs of necessity and effectiveness had a similar profile. MRPs of safety were more commonly associated with poorly defined signs and symptoms of illness, injuries and intoxications, as well as nervous, digestive and blood problems. CONCLUSIONS: Most frequent medication related health problems causing visits to hospital emergency departments were osteoarticular disorders, followed by poorly defined signs and symptoms of illness. Differences were observed in the diagnoses between the different dimensions and types of MRP.

Problemas de salud relacionados con los medicamentos en un servicio de urgencias hospitalario / Health related problems as cause of visits to hospital emergency departments

FUNDAMENTO Y OBJETIVO: Los problemas relacionados con los medicamentos (PRM) son problemas de salud que se producen como consecuencia de fallos de la farmacoterapia del paciente y que interfieren con los resultados esperados de salud. El objetivo de este trabajo es conocer los problemas de salud más frecuentes que constituyen PRM. PACIENTES Y MÉTODO: La entrevista con el paciente junto con la evaluación de la historia clínica son las principales fuentes de información para evaluar e identificar PRM. Se utilizó un cuestionario validado como instrumento para la entrevista y la CIE-9 para la clasificación de los problemas de salud encontrados. RESULTADOS: Se entrevistó a un total de 2.556 pacientes durante 1 año en el servicio de urgencias hospitalario, de los que se estudiaron 2.261 tras las exclusiones. Las enfermedades osteoarticulares, los signos y síntomas mal definidos y las lesiones y envenenamientos son los problemas más relacionados con la aparición de PRM. Los PRM de necesidad y efectividad mantienen un perfil similar. Los PRM de seguridad se asociaron más a signos y síntomas mal definidos y lesiones y envenenamientos así como a alteraciones nerviosas, digestivas y sanguíneas. CONCLUSIONES: Los PRM más frecuentes que son causa de consulta en un servicio de urgencias hospitalario son los osteoarticulares, seguidos de los signos y síntomas mal definidos. Se observan diferencias en los diagnósticos entre las distintas dimensiones de PRM y sus tipos

BACKGROUND AND OBJECTIVE: Medication-related problems (MRPs) are health problems resulting-from patient pharmacotherapy failure that interfere with the expected outcome in the patient’s health status. The aim of this study was to discover the health problems associated with the appearance of MRPs. PATIENTS AND METHOD: Patient interviews, together with the assessment of medical records were the sources of information used in the assessment and identification of MRPs. A validated questionnaire was used for the interviews; in order to classify the health problems found, the ICD-9 was used. RESULTS: 2,556 patients were interviewed over a period of one year at a hospital emergency department.2,261 of these cases were valid. Osteoarticular diseases, poorly defined signs and symptoms of illness, injuries and intoxications were the disorders most commonly associated with the appearance of MRPs. MRPs of necessity and effectiveness had a similar profile. MRP sof safety were more commonly associated with poorly defined signs and symptoms of illness, injuries and intoxications, as well as nervous, digestive and blood problems. CONCLUSIONS: Most frequent medication related health problems causing visits to hospital emergency departments were osteoarticular disorders, followed by poorly defined signs and symptoms of illness. Differences were observed in the diagnoses between the different dimensions and types of MRP

Análisis de la información sobre las condiciones de conservación fuera del envase original de los medicamentos más prescritos / Analisys on information about preservation conditions of the most prescribed medicines when removed from their original package

La práctica de reenvasado de medicamentos, tanto por los pacientes en diferentes dispositivos, como por los farmacéuticos en los sistemas de ayuda al cumplimiento, requiere un estudio previo de requisitos de condiciones de conservación de las especialidades a reenvasar. Objetivo: Conocer la información disponible para pacientes (prospectos) y farmacéuticos (fichas técnicas e información de la industria) sobre las condiciones de conservación y la posible alteración de los medicamentos fuera de su envase original. Métodos: Se seleccionaron los medicamentos cuya venta en la provincia de Granada en Septiembre de 2000 superaba la mediana (sólo las formas farmacéuticas orales sólidas). En diciembre de 2000 se solicitó a los laboratorios fabricantes la información sobre las condiciones de conservación una vez desprovisto de su envase original, la ficha técnica, y el prospecto para cada especialidad incluida en el estudio. Resultados: De las 162 especialidades, se recibió respuesta de 148. Sólo 124 enviaron prospectos y 85 fichas técnicas. En 107 (72,3%) de las contestaciones recibidas fueron calificadas como con «ausencia de información»; igual que ocurría en 70 (56,4%) de los prospectos y 35 (41,0%) de las fichas técnicas. Para 79 especialidades, la respuesta era que no existían estudios sobre la estabilidad fuera del envase original. Conclusiones: La información disponible en prospectos y fichas técnicas no permite conocer ni a los ciudadanos ni a los profesionales farmacéuticos las condiciones de conservación propias de cada especialidad farmacéutica a la hora de poder re-envasarlas (AU)

The practice of re-packaging of medicines, by patients in different appliances and by the pharmacists in the adherence help systems, requires a preliminary study on the requisites of conservation conditions in the specialties to be re-packaged. Objective: The objective was to know the available information for patients (insert) and pharmacists (summary of product characteristics -SPC- and industry information) about conditions of preservation and eventual alteration of medicines once the original package was removed. Methods: The medicines whose sale in Granada province in September 2000 was superior to the average (only the oral solid forms of pharmaceuticals) were chosen. In December 2000 information from the manufacturing laboratories as to condition of preservation once the original package was removed, the Summary of Product Characteristics and the insert for each specialty included in the study was requested. Results: Of the [62 specialties, [48 replies were received. Only 124 sent inserts and 85 SPC. In 107 (72.3%) ofthe replies received were qualified as «lack of information»; the some as occurred in 70 (56.4%) of the inserts and 35 (41.O%) of the SPC. The reply for 79 specialties was that studies on stability outside the original package did not exist. Conclusions: The available information on insert and SPC does not allow either citizens or pharmaceutical professionals knowledge on individual conditions of preservation for each pharmaceutical specialty when they can be re-packaged (AU)