Continuity of care between hospital pharmacies and community pharmacies, and costs avoided: a pilot experience in times of COVID-19 in Spain.

Introduction: In March 2020, due to the pandemic caused by COVID-19, a pilot experience of pharmaceutical continuity of care received by hospital outpatients was launched in Cantabria, a Spanish autonomous community. Thanks to this experience, the medication was dispensed by the hospital pharmacy through the community pharmacy of the patient's choice. Our objective was to estimate the costs avoided by this practice during the months of April and May 2020. Methods: The analysis of the economic impact was carried out in terms of saved costs, from the hospital and from the social perspective. Savings associated with the avoided home delivery of medication and avoided labor productivity losses were calculated, as well as the time associated with avoided trips in monetary terms. Results: A total of 2,249 hospital-dispensed drugs were delivered through the community pharmacy in the analyzed period, with an average of 57.7 daily deliveries. The experience, which involved one hospital and 262 pharmacies of Cantabria, saved patients 93,305 km in trips to the hospital, associated with an average time saving of 1,374 hours. In terms of costs, the hospital saved on shipments by courier, estimated at €30,205, since it was the community pharmacy and the distribution warehouses that delivered the drugs. From a social perspective, this initiative saved €23,309 due to the trips (€8,907) and productivity losses (€14,402) that were avoided. Conclusions: This exceptional situation may be a good opportunity to improve the coordination between hospital pharmacies and community pharmacies in Spain, not only during the pandemic but also in the post-COVID-19 era.

[Right atrial myxoma in a patient with antiphospholipid antibodies]. / Mixoma auricular derecho en paciente con anticuerpos antifosfolipídicos positivos.

A 28 year-old asymptomatic male with previously detected elevation of antiphospholipid antibodies (aPL) had a right atrial mass diagnosed by transthoracic echocardiography. Although the morphological characteristics were highly suggestive of myxoma, due to the presence of aPL elevation it had to be differentiated from atrial thrombus. The patient underwent surgery and a 3 x 4 cm mass with its large base attached to the interatrial septum was removed. Histopathological examination confirmed that it was a myxoma. On follow-up, the patient was asymptomatic and antiphospholipid antibodies became undetectable.

Mixoma auricular derecho en paciente con anticuerpos antifosfolipídicos positivos / Right atrial myxoma in a patient with antiphospholipid antibodies

Se presenta el caso de un paciente joven asintomático con anticuerpos antifosfolipídicos (AAF) positivos en el que se detectó la presencia de una masa auricular derecha tras la realización de una ecocardiografía transtorácica. Aunque las características morfológicas de la masa resultaron altamente sugestivas de mixoma, la presencia de AAF hizo plantear el diagnóstico diferencial con un trombo intraauricular. El paciente fue intervenido extirpándose una tumoración ligeramente lobulada de 3 × 4 cm ampliamente adherida al tabique intraauricular. El estudio histopatológico confirmó que se trataba de un mixoma. Durante el seguimiento el paciente no presentó síntomas y los AAF se negativizaron (AU)