ABSTRACT
Introducción: Las Guías de Práctica Clínica re-cogen el mejor manejo de la Enfermedad Trom-boembólica Venosa (ETEV) en función de la estratificación del riesgo en cuanto a ingreso o tratamiento ambulatoria. La utilidad de la Hos-pitalización a Domicilio (HAD) en esta enferme-dad es poco conocida. Métodos: Realizamos un estudio descriptivo y comparativo de todos los pacientes admitidos en HAD por ETEV durante dos años, empareján-dolos con otro grupo de pacientes de hospitali-zación convencional (HC). Analizamos también el destino de los pacientes (HAD o HC) en fun-ción de la estratificación del riesgo. Resultados: Obtuvimos una muestra de n=76 pacientes. La estancia hospitalaria fue menor en el grupo de HAD. No hubo diferencias esta-dísticamente significativas en el resto de varia-bles. El 22,9% de los pacientes con riesgo bajo de mortalidad ingresaron. Conclusión: La estratificación del riesgo o las características clínicas de los pacientes con ETEV no tuvieron relevancia frente a la elec-ción del destino en régimen de HAD, pudien-do haber primado más los criterios generales de ingreso en HAD (preferencias del paciente, soporte domiciliario adecuado, o el manejo de otras comorbilidades).(AU)
Introduction: Clincal Practice Guidelines show the best management of Venous Thromboem-bolic Disease (VTE) based on risk stratification in terms of admission or outpatient treatment. The utility of Home Hospitalization (HH) in this disease is poorly understood. Methods: We conducted a descriptive and com-parative study of all patients admitted at HH for VTE for two years, matching them with another group of conventional hospitalization (CH) pa-tients. We also analyzed the destination of the patients (HH or CH) based on their risk strati-fication. Results: We obtained a sample of n=76 pa-tients. The hospital length of stay was shorter in the HAD group. There were no statistically sig-nificant differences in the rest of the variables. 22.9% of patients with low risk of mortality were admitted at CH or HH. Conclusion: Risk stratification or clinical charac-teristics of patients with VTE were not relevant when it came to the choice of destination under the HH regimen. General criteria for admission to HH (patient preferences, adequate home support, or management other comorbidities) may have prevailed more in order to take that decision.(AU)
Subject(s)
Humans , Male , Female , Thromboembolism , Venous Thromboembolism , Pulmonary Embolism , Medical Records , Home Care Services , Epidemiology, DescriptiveABSTRACT
BACKGROUND: Detecting and managing antimicrobial drug interactions (ADIs) is one of the facets of prudent antimicrobial prescribing. Our aim is to compare the capability of several electronic drug-drug interaction (DDI) checkers to detect and report ADIs. METHODS: Six electronic DDI checking platforms were evaluated: Drugs.com®, Medscape®, Epocrates®, Medimecum®, iDoctus®, and Guía IF®. Lexicomp® Drug Interactions was selected as the gold standard. Ten ADIs addressing different mechanisms were evaluated with every electronic DDI checker. For each ADI, we assessed five dimensions and calculated an overall performance score (maximum possible score: 10 points). The explored dimensions were sensitivity (capability to detect ADI), clinical effect (type and severity), mechanism of interaction, recommended action(s), and documentation (quality of evidence and availability of references). RESULTS: The electronic DDI checkers did not detect a significant proportion of the ADI assessed. The overall performance score ranged between 4.4 (Medimecum) and 8.8 (Drugs.com). Drugs.com was the highest ranked platform in four out of five dimensions (sensitivity, effect, mechanism, and recommended action). CONCLUSIONS: There is significant variability in the performance of the available platforms in detecting and assessing ADI. Although some ADI checkers have proven to be very accurate, others missed almost half of the explored interactions.
