Economic impact of improving patient safety using Sugammadex for routine reversal of neuromuscular blockade in Spain.

BACKGROUND: Neuromuscular blocking (NMB) agents are often administered to facilitate tracheal intubation and prevent patient movement during surgical procedures requiring the use of general anesthetics. Incomplete reversal of NMB, can lead to residual NMB, which can increase the risk of post-operative pulmonary complications. Sugammadex is indicated to reverse neuromuscular blockade induced by rocuronium or vecuronium in adults. The aim of this study is to estimate the clinical and economic impact of introducing sugammadex to routine reversal of neuromuscular blockade (NMB) with rocuronium in Spain. METHODS: A decision analytic model was constructed reflecting a set of procedures using rocuronium that resulted in moderate or deep NMB at the end of the procedure. Two scenarios were considered for 537,931 procedures using NMB agents in Spain in 2015: a scenario without sugammadex versus a scenario with sugammadex. Comparators included neostigmine (plus glycopyrrolate) and no reversal agent. The total costs for the healthcare system were estimated from the net of costs of reversal agents and overall cost offsets via reduction in postoperative pneumonias and atelectasis for which incidence rates were based on a Spanish real-world evidence (RWE) study. The model time horizon was assumed to be one year. Costs were expressed in 2019 euros (€) and estimated from the perspective of a healthcare system. One-way sensitivity analysis was carried out by varying each parameter included in the model within a range of +/- 50%. RESULTS: The estimated budget impact of the introduction of sugammadex to the routine reversal of neuromuscular blockade in Spanish hospitals was a net saving of €57.1 million annually. An increase in drug acquisition costs was offset by savings in post-operative pulmonary events, including 4806 post-operative pneumonias and 13,996 cases of atelectasis. The total cost of complications avoided was €70.4 million. All parameters included in the model were tested in sensitivity analysis and were favorable to the scenario with sugammadex. CONCLUSIONS: This economic analysis shows that sugammadex can potentially lead to cost savings for the reversal of rocuronium-induced moderate or profound NMB compared to no reversal and reversal with neostigmine in the Spanish health care setting. The economic model was based on data obtained from Spain and from assumptions from clinical practice and may not be valid for other countries.

Elaboración de un video sobre calidad, seguridad y medio ambiente en la unidad de laboratorios docentes (ULD) de la Facultad de Farmacia de la Universidad de Barcelona / Development of a video on quality, safety and environment in the teaching laboratories unit (ULD) of the Faculty of Pharmacy of the University of Barcelona

La Unidad de Laboratorios Docentes (ULD) de la Facultad de Farmacia (UB) ha implantado unsistema de gestión de la calidad (SGC) que permite transmitir al estudiante una formación adicionalcon el objetivo de mejorar sus competencias transversales (siguiendo las directrices del EspacioEuropeo de Educación Superior, EEES). Además, en el curso académico 06-07, se instauraron lasBuenas Prácticas Ambientales (BPAL) para disponer de un sistema de gestión que incorporase loscriterios de calidad, medioambiente y seguridad (sistema de gestión integrada, SGI). Durante elpresente curso académico se ha procedido a la grabación y edición de un video sobre calidad,seguridad y medioambiente en la ULD con el objetivo de mejorar la formación transversal de losestudiantes facilitando la integración de los conocimientos y habilidades profesionales. De esta forma,al salir del entorno universitario, los licenciados y graduados de la Facultad de Farmacia dispondrán deun valor añadido en su formación, mejorando así sus competencias para el desarrollo de su futuraprofesión. En el video se muestra la manera de trabajar correctamente según las normas de calidad,seguridad y medioambiente recogidas además en un tríptico que se entrega a los estudiantes al accederpor primera vez a un laboratorio de prácticas. El video se difundirá a través de la página web de laULD, de la videoteca de la UB, del canal You Tube Canal UB, así como de las asignaturas que losoliciten (sirviendo de soporte para el personal docente)(AU)

The Teaching Laboratories Unit (ULD) of the Faculty of Pharmacy (UB) has implemented amanagement system (QMS) that allows the student to get an additional training in order to improvetheir generic skills (following the guidelines of the Area European Higher Education Area, EHEA).Furthermore, in the 2006-2007 academic year, were introduced the Good Laboratory Practice (GLP)to have a management system that incorporates the criteria of quality, environment and security(integrated management system, IMS). During the present academic year it has been carried out therecording and editing of a video on quality, safety and environment in the ULD with the aim ofimproving cross-training of students by facilitating the integration of knowledge and professionalskills. Thus, on leaving the university, graduates in Pharmacy will have an added value in theirtraining, and thereby improving their skills for the development of their future profession. The videoshows how to work correctly according to the standards of quality, safety and environment that arealso contained in a leaflet that is given to students when they first access to a laboratory. The video will be disseminated through the website of the ULD, the library of the UB, the You Tube UB Canaland upon request(AU)

Una experiencia más allá de la evaluación continuada: paseo virtual por el jardín medieval de plantas medicinales del monasterio de Pedralbes / An experience beyond continuous assessment activities: virtual tour to the medieval medicinal plant garden of the Pedralbes monastery

El grupo de innovación docente integrado por profesores del área de Botánica (GIBAF) de laUniversidad de Barcelona (UB) se plantea cada curso el diseño de nuevas actividades acreditativas enel marco de la evaluación continuada. Se presenta la experiencia llevada a cabo durante el curso 2008-09 en la asignatura Botánica Farmacéutica. El objetivo ha sido implicar durante un semestre a losestudiantes en la autoría de un proyecto tutorizado de inmediata utilidad y clara perdurabilidad, másallá de su utilidad acreditativa. Como recurso se ha utilizado el Jardín de Plantas Medicinales delMonasterio de Pedralbes y se ha firmado un convenio de colaboración docente entre la UB y elInstituto de Cultura de Barcelona. Los estudiantes han realizado el trabajo utilizando la plataformaMoodle del Campus virtual de la UB en cinco etapas que han incluido la confección de unas fichasque se han ido modificando en función de las diversas retroacciones de los profesores. Al inicio de laactividad, se facilitó a los estudiantes el cronograma completo de la actividad, la pauta para surealización, así como un total de 18 recursos bibliográficos de uso obligado. Finalmente, a través deGoogleSites, se ha realizado una web que permite realizar un paseo virtual por el jardín,documentando de forma referenciada para las 50 plantas medicinales su nomenclatura, descripciónbotánica, distribución, usos (históricos, actuales y futuros) y toxicidad. El resultado de la actividad fuepresentado en un acto público en el Monasterio de Pedralbes y puede consultarse en:http://sites.google.com/site/jardimedievalpedralbes/(AU)

The group of teaching innovation in the area of Botany (GIBAF), University of Barcelona (UB), israised each year to design new accreditation activities under continuous evaluation framework. Wepresent the experience carried out during the academic year 2008-09 in the course of PharmaceuticalBotany. The aim has been to involve students for a semester in the authorship of a tutored projectimmediately useful and of easy permanence, beyond its assessment proving usefulness. The MedicinalPlants Garden of the Monastery of Pedralbes has been used as a resource and a collaborationagreement has been signed between the UB faculty and the Institute of Culture of Barcelona. Thestudents have developed the work using the Moodle platform CampusvirtualUB into five stages whichincluded preparation of files by students that have been modified in some steps following the variousfeedbacks from teachers. At the beginning of the activity, students were provided with a completeschedule of activities, the schedule for its implementation, and a total of 18 forced-use libraryresources. Finally, through Google sites, a website has been implemented, allowing for a virtual tourof the garden, documenting by referenced literature 50 medicinal plants for their nomenclature,botanical description, distribution, uses (historical, current and future) and toxicity. The result of theactivity was presented at a public ceremony in the Monastery of Pedralbes and is available at:http://sites.google.com/site/jardimedievalpedralbes/(AU)