Experiencia con colistina nebulizada en pacientes con bronquiectasias no fibrosis quística colonizadas por Pseudomonas aeruginosa / Experience with nebulised colistin in patients with non-cystic fibrosis bronchiectasis colonised with Pseudomonas aeruginosa

INTRODUCCIÓN: La colonización/infección crónica por Pseudomonas aeruginosa de las bronquiectasias se relaciona con daño anatómico, deterioro más rápido de la función pulmonar, aumento del número de exacerbaciones y mayor morbi-mortalidad. La colistina nebulizada disminuye la carga bacteriana, esperándose una reducción en número y gravedad de las exacerbaciones y retraso del deterioro pulmonar. El objetivo principal fue valorar si el tratamiento con colistina nebulizada, durante al menos 6 meses, reduce el número de ingresos y visitas a urgencias. MATERIAL Y MÉTODOS: Estudio observacional, retrospectivo y no intervencionista llevado a cabo en una estructura organizativa de gestión integrada. Se seleccionaron pacientes con bronquiectasias no fibrosis quística, mayores de 18 años, colonizados / infectados por P. aeruginosa que recibieron al menos 6 meses colistina nebulizada. De la historia clínica informatizada (IANUS(R) V.04.20.0503) y de la receta electrónica del SERGAS, se recogieron datos clínicos, microbiológicos y de tratamiento de los pacientes, que fueron divididos en dos periodos de tiempo: 1) 6 meses pretratamiento y durante el tratamiento y 2) 12 meses pretratamiento y durante el tratamiento, en aquellos pacientes que completaron 1 año de tratamiento. RESULTADOS: Se incluyeron 44 pacientes y de ellos, 29 (65,9%) tuvieron un seguimiento de 12 meses. El uso de colistina nebulizada disminuyó de forma significativa el número de visitas a urgencias (a los 6 meses), la frecuencia y duración de las hospitalizaciones (a los 6 y 12 meses), el consumo de antibióticos (a los 6 y 12 meses) y los cultivos positivos para P. aeruginosa. El tratamiento fue bien tolerado en casi todos los pacientes. CONCLUSIONES: El tratamiento con colistina nebulizada durante 6 y 12 meses de bronquiectasias no fibrosis quística, colonizadas / infectadas por P. aeruginosa, parece beneficioso para el paciente desde el punto de vista clínico y de calidad de vida y podría reducir el coste económico del proceso

INTRODUCTION: Chronic colonisation/infection by Pseudomonas aeruginosa of the bronchiectasis is related to a faster deterioration of lung function, an increase in the number of exacerbations and a higher morbidity and mortality. Nebulised colistin decreases bacteria load. Therefore, a reduction in the number and in the severity of exacerbations and a delay of pulmonary decline is expected. The main objective is to evaluate if the treatment with nebulised colistin, for at least 6 months reduces the number of admissions and visits to the emergency department. MATERIAL AND METHODS: Observational, retrospective and non-interventionist study carried out in an organizational structure with an integrated management. Patients with non-cystic fibrosis bronchiectasis colonised / infected by P. aeruginosa, older than 18 years, were selected. Patients must have received nebulized colistin during at least 6 months. Clinical, microbiological and therapeutic data from the patients were collected from the SERGAS computerized clinical history (IANUS(R) V.4.20.0503) and the electronic prescription, which were divided into two time periods: 1) 6 months pre-treatment and during the treatment and 2) 12 months pre-treatment and during the treatment, in those who completed 1 year of treatment. RESULTS: Forty-four patients were included and of these, 29 (65.9%) had a follow-up of 12 months. The use of nebulized colistin decreased significantly the number of visits to the emergency (at 6 months), the frequency and duration of hospitalizations admissions (at 6 and 12 months), the antibiotic consumption (at 6 and 12 months) and the positive cultures. The treatment was well tolerated in almost all patients. CONCLUSIONS: The treatment with nebulised colistin during 6 and 12 months of non-cystic fibrosis bronchiectasis, colonised/infected by P. aeruginosa, seems beneficial for the patient, from the clinical and quality of life point of view, and could reduce the economic cost of the process

Evaluación de la satisfacción global de los pacientes connutrición enteral domiciliaria en la consulta de farmaciahospitalaria: estudio Satisfar-Ned / Evaluation of the global satisfaction of patients with home enteral nutritionat the hospital pharmacy consultation: study Satisfy-Ned

INTRODUCCIÓN: Conocer la opinión de los pacientes nos permite mejorar la calidad de los servicios prestados y los resultados en salud. OBJETIVOS: Evaluar la satisfacción de los pacientes que acuden a recoger nutrición enteral domiciliaria a la consulta del Servicio de Farmacia. Analizar los factores predictivos de una mayor satisfacción. MÉTODOS: Se realizó un estudio transversal en un hospital universitario (425 camas). Se diseñó un cuestionario autocumplimentable para medir la satisfacción de los pacientes ambulatorios con nutrición enteral domiciliaria en un servicio de farmacia del hospital. La satisfacción se midió mediante una escala de 1 a 10. Los índices de calidad percibida fueron analizados por un modelo de análisis de componentes utilizando la rotación de varimax. Para evaluar la relación entre la satisfacción global y los principales componente se realizó un análisis de regresión. RESULTADOS: Entre los meses de mayo-junio 2015, se realizaron 187 cuestionarios. La puntuación global de satisfacción fue de 7,3 (IC 95%: 5,1 a 9,4). El análisis de componentes puso de manifiesto que dos componentes explicaron el 64,4% de la varianza. El primero (CP1) contenía preguntas relacionadas con la adecuación de los recursos o servicios y el segundo (CP2), preguntas sobre la relación profesional-paciente. Se vio que una unidad adicional en CP2 está asociada con un aumento de 2,6 del riesgo de tener mayores puntuaciones de satisfacción. CONCLUSIONES: Nuestro estudio muestra que el grado de satisfacción de los pacientes es elevado. El factor que predice una mayor satisfacción de los pacientes con nutrición enteral domiciliaria es la atención ofrecida por los profesionales sanitarios

INTRODUCTION: The knowledge of the patients' opinions allows us to improve the quality of services provided, as well as health outcomes. OBJECTIVES: The objective of this study was to evaluate the factors leading to greater satisfaction among patients who come to pick up home enteral nutrition at the Pharmacy Service. METHODS: A cross-sectional study was conducted in a 425-bed university hospital. A self-fulfilling questionnaire was designed to measure patient satisfaction during may and june 2015. Global satisfaction was measured on a 1 to 10 scale. Indices of perceived quality were modelled through a principal component analysis using varimax rotation. The relationship between principal components and overall satisfaction was evaluated using regression analysis. RESULTS: A total of 187 questionnaires were collected. The overall satisfaction score was 7.3 (95% CI: 5.1 to 9.4). The analysis of components revealed two components that explained 64.4% of the variance. The first (CP1) contained questions related to the adequacy of resources and services and the second (CP2), questions about the professional-patient relationship. It was found that an additional unit in CP2 is associated with an increase of 2.6 in the risk of having higher satisfaction scores. CONCLUSIONS: Our study shows that the degree of patient satisfaction is high. The factor which predicts the satisfaction of patients on Enteral Nutricion is the care offered by health professionals

Factors associated with patient satisfaction in an outpatient hospital pharmacy.

OBJECTIVE: To analyse the factors leading to greater satisfaction among patients attending the outpatient hospital pharmacy (OPh). METHODS: A cross-sectional study was conducted of patients attending the OPh of a 1250-bed university hospital. A self-administered questionnaire for measuring outpatients' satisfaction was developed. Global satisfaction was measured on a scale of 1 to 10. Indices of perceived quality for accessibility, interpersonal professional-patient relationship and the convenience of the process were modelled through a principal component analysis using varimax rotation. The relationship between the principal components and overall satisfaction was evaluated using regression analysis. RESULTS: A questionnaire-based survey was conducted between May and June 2015. A total of 509 valid responses (86.9% response rate) were collected from the OPh. The overall satisfaction score was 7.81 (95% CI 7.59 to 8.04). The principal component analysis produced two components that explained 62.1% of the variance. The first component (CP1) contained questions related to the adequacy of the resources and services. The second component (CP2) contained questions about interpersonal professional-patient relationship. An additional unit in the CP2 was associated with a 3.23 increased risk of having higher satisfaction scores, while an increase of an additional unit in CP1 was associated with a 1.93 increased risk of having higher satisfaction scores. CONCLUSIONS: Our study shows that the factor which predicts the satisfaction of patients who come to the OPh is the quality of care provided by pharmacists-in particular, information provided, resolution of doubts, personal attention and time devoted to the patient.