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Farm. hosp ; 32(6): 315-322, nov.-dic. 2008. ilus, tab
Article in Spanish | IBECS | ID: ibc-105257

ABSTRACT

Objetivo: Evaluar un programa interdisciplinario de mejora de la calidad de la farmacoterapia y la seguridad de los pacientes con enfermedad renal cronica tratados con estimulantes eritropoyeticos. Metodo: Estudio observacional longitudinal. Analisis retrospectivo (periodo A) y prospectivo tras implantar el programa (periodo B) de valores de hemoglobina y dosis de estimulantes eritropoyeticos mensuales. Se compararon, cada 4 meses, la proporcion de pacientes con valores de hemoglobina dentro del ambito objetivo (10,5-12,5 g/dl) y superiores al limite de seguridad (¡Ý 12,5g/dl), y el porcentaje medio de tiempo con valores de hemoglobina dentro del ambito objetivo y superiores al limite de seguridad, respectivamente, durante los periodos A y B. Resultados: Se incluyeron 59 pacientes. La proporcion de estos con hemoglobina dentro del ambito objetivo se incrementa de un 28,8 a un 65,4% (riesgo relativo = 2,27; intervalo de confianza [IC] del 95%, 1,56-3,30) y la de pacientes con hemoglobina superior al limite de seguridad se reduce de un 57,6 a un 19,2% (reduccion absoluta del riesgo = 0,39; IC del 95%, 0,19-0,55). El tiempo con hemoglobina en el ambito objetivo se incrementa un 15,7% (IC del 95%, 7,1-24,2) y el tiempo con valores superiores al limite de seguridad se reduce un 26,9% (IC del 95%, -35,1 a -18,6). El n¨²mero de pacientes que hay que incluir para evitar que 1 alcance un valor de hemoglobina superior al limite de seguridad fue 2,6 (IC del 95%, 2,5-2,7). Conclusion: La implantacion de un programa de mejora de la calidad de la farmacoterapia con estimulantes eritropoyeticos en pacientes en hemodiolisis aumenta significativamente la proporcion de pacientes con valores de hemoglobina dentro del ambito de efectividad y seguridad recomendados (AU)


Objective: To assess an interdisciplinary programme for the improvement of pharmacotherapy quality and patient safety in patients with chronic renal disease who are treated with erythropoiesis-stimulating agents. Method: Observational, longitudinal study. Retrospective analysis (period A) and prospective analysis (period B) following implementation of the programme for haemoglobin values and monthly erythropoiesis-stimulating agent dosage. The proportion of patients with haemoglobin values within the target range (10-5-12.5 g/dl) and those with values above the safety limit (¡Ý 12.5g/dl) were compared every four months and the average percentage of time with haemoglobin values within the target range and above the safety limit were compared during periods A and B. Results: 59 patients were included in the study. The proportion of patients with haemoglobin levels within the target range increased from 28.8% to 65.4% (RR = 2.27; 95% CI, 1.56-3.30) and the value in patients with haemoglobin levels above the safe level reduced from 57.6% to 19.2% (RAR = 0.39; 95% CI, 0.19-0.55). The time with haemoglobin levels in the target range increased 15.7% (95% CI, 7.1-24.2) and the time with values above the safe level reduced 26.9% (95% CI, -35.1 to -18.6). The number of patients included to avoid one reaching a haemoglobin value above the safe range was 2.6 (95% CI, 2.5-2.7). Conclusions: the implementation of an improvement programme for the quality of pharmacotherapy with erythropoiesis-stimulating agents in patients with haemodialysis significantly increases the proportion of patients with haemoglobin values within the recommended ranges of effectiveness and safety (AU)


Subject(s)
Humans , Erythropoiesis , Hemodialysis Solutions/pharmacology , Anemia/drug therapy , Renal Dialysis/methods , Renal Insufficiency, Chronic/therapy , Safety Management , Hemoglobin A/analysis , Retrospective Studies , Quality Improvement/trends
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