Drug prescription pattern in exotic pet and wildlife animal practice: a retrospective study in a Spanish veterinary teaching hospital from 2018 to 2022.

Exotic companion animals have had an important role in our society since ancient times. Preserving animal health is necessary to do a responsible use of veterinary medicines. This study aimed to describe the prescription patterns of drugs in exotic pets and wildlife animals attending the Veterinary Teaching Hospital of the University of León (HVULE). A retrospective study was carried out between 2018 and 2022. Birds were the largest group of exotic animals attending the HVULE. Visits were related to emergency reasons and for musculoskeletal disorders. One-third of the animals were eventually euthanised. Regarding pharmacological treatments, the most frequently active ingredients used were pentobarbital, isoflurane, meloxicam, and within antibiotics, marbofloxacin (category B in the classification of European Medicines Agency).

Assessing the Expression of Emotions in Breast Cancer Survivors during the Time of Recovery: Perspective from Focus Groups.

Breast cancer has major public health implications, as it is the most frequent malignant tumor and the leading cause of cancer death in women. Survivors have many needs, including strategies to cope with the associated distress. We explore whether focus groups are useful for nurses to obtain information about the emotional state of breast cancer women, and develop strategies for coping with the stress that this disease entails. A qualitative study was carried out, involving 25 focus groups with 83 women treated for breast cancer, recruited from the local Breast Cancer Association (ALMOM). Four open-ended questions were employed, and 60-min discussions were carried out. They were transcribed, analyzed, coded, and the themes identified. Four major themes emerged, including "complex emotional evolution", "emotional isolation", "lack of information" and "inability to give advice". Women admitted that this disease had been a stressful factor for them, causing emotional (anxiety, irritability, anger or guilt) and cognitive disorders (confusion, lack of concentration, forgetfulness). The use of focus groups in breast cancer survivors allows nurses to evaluate the expression of emotions in these women, and collect and share information about their feelings, thoughts and experiences, so that survivors can cope more easily with the stress related to their illness.

Pharmacokinetics of menbutone after intravenous and intramuscular administration to sheep.

Menbutone is a drug currently approved in several European Union (EU) countries to treat digestive disorders in different animal species. The objective of this study was to establish the pharmacokinetic parameters resulting from intravenous (IV) and intramuscular (IM) administration of this drug in sheep. Menbutone was administered to 12 animals at the dose of 10 mg/kg for both IV and IM routes. Plasma samples were collected up to 24 h (15 points, IV route; 14 points, IM route). Concentrations were determined using high-performance liquid chromatography with photodiode-array (PDA) detection, following a method validated according to the EMEA/CHMP/EWP/192217/2009 guideline. Pharmacokinetic data were analyzed by non-compartmental methods. After IV administration, a total clearance (Cl) of 63.6 ± 13.6 mL/h/kg, a volume of distribution at steady-state (Vss) of 259.6 ± 52.7 mL/kg, and an elimination half-life (t½λ) of 6.08 ± 2.48 h were calculated. After IM administration, menbutone peak plasma concentration (Cmax) was 18.8 ± 1.9 µg/mL, the time to reach Cmax (tmax) 3.75 ± 0.45 h, the mean absorption time (MAT) 3.31 ± 1.36 h, and the fraction of dose absorbed (F) 103.1 ± 23.0 %. The results obtained indicate that menbutone absorption after IM administration is quick and complete.

Potentially Inappropriate Medication and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study.

Inappropriate prescribing in the elderly is a risk factor for higher adverse drugs reactions, hospitalisation, and mortality rates. Therefore, it is necessary to identify irrational prescriptions and implement interventions to improve geriatric clinical practices in nursing homes. This study aimed to examine and compare the prevalence of potentially inappropriate medications in nursing home residents using three different updated criteria: 2019 Beers criteria, PRISCUS list, and v2 STOPP criteria, and to determine the prevalence of potential prescribing omissions according to v2 START criteria. A descriptive, observational, and cross-sectional study design was used. A total of 218 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds. Potentially inappropriate medications were present in 96.3%, 90.8%, and 35.3% of residents, according to the STOPP, Beers, and PRISCUS criteria or list, respectively. Inappropriate medication was found to be significantly associated with polypharmacy and severe or moderate drug-drug interactions with the three tools and with pathologies and unnecessary drugs only for STOPP criteria. The most frequent inappropriate medications were benzodiazepines and proton pump inhibitors. A regular use of software to review medications in nursing home residents would help to reduce the risk of these drug-related problems.

Drug-Related Problems and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study.

At present, 19.2% of the Spanish population is aged 65 or older. Polypharmacy is a frequent condition among the elderly, especially in those living in nursing homes, which is associated with adverse outcomes, such as adverse drug events or drug-drug interactions. This study aimed to assess the pattern of polypharmacy in a nursing home in Leon, one of Spain's most ageing regions, and its relationship with different drug-related problems. A descriptive, observational, and cross-sectional study design was used; 222 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds, BOT PLUS and Drug-Reax. Residents were on a median of 7 medicines. Polypharmacy and inappropriate medications were present in 78.8% and 96.8% of residents, respectively. Drug-related problems were present in almost all the populations evaluated. Drug-drug interactions were very common in participants (81.1%), being severe/moderate in 24.7%. A high prevalence of polypharmacy and drug-related problems in the nursing home population assessed has been observed. A significantly higher risk of suffering drug-drug interactions was revealed for increasing polypharmacy and anticholinergic risk. A regular evaluation of drug prescribing in nursing home residents is necessary to minimize drug-related problems risk.

Improvement of Albendazole Bioavailability with Menbutone Administration in Sheep.

The pharmacokinetic interaction between a benzimidazole (albendazole, ABZ) and a choleretic drug (menbutone, MEN) was evaluated in sheep. The plasma disposition of albendazole sulfoxide (ABZSO, active metabolite) and albendazole sulfone (ABZSO2, inactive metabolite) was investigated following an oral administration of albendazole (ABZ) (5 mg/kg) alone or with menbutone (MEN) (intramuscular, 10 mg/kg). Blood samples were collected over 3 days post-treatment, and drug plasma concentrations were measured by high performance liquid chromatography (HPLC). ABZSO was measured from 0.5 to 48 h, and ABZSO2 from 2 to 60 h. No parent drug was detected at any sampling time. Mean maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve (AUC) were 12.8% and 21.5% higher for ABZSO when ABZ and MEN were administered together, which indicates a significant increase in the amount absorbed. The rate of absorption was not modified, with similar values for the time to reach Cmax (tmax) (11.5 h with ABZ + MEN and 10.7 h with ABZ treatment), although no significant differences were observed for these latter pharmacokinetic parameters. Regarding ABZSO2, Cmax, AUC and tmax values were similar after both treatments (ABZ or ABZ + MEN). The results obtained indicate that co-administration of ABZ and MEN may be an interesting and practical option to increase the efficacy of this anthelmintic.

Babesia and Theileria Identification in Adult Ixodid Ticks from Tapada Nature Reserve, Portugal.

This study, conducted in a nature reserve in southern Portugal, investigated the frequency and diversity of tick-borne piroplasms in six species of adult ixodid ticks removed from 71 fallow deer (Dama dama) and 12 red deer (Cervus elaphus), collected over the period 2012-2019. The majority of 520 ticks were Ixodes ricinus (78.5%), followed by Rhipicephalus sanguineus sensu lato, Hyalomma lusitanicum, Haemaphysalis punctata, Dermacentor marginatus, and Ixodes hexagonus. The R. sanguineus ticks collected from the deer were clearly exophilic, in contrast to the endophilic species usually associated with dogs. Four tick-borne piroplasms, including Theileria spp., and the zoonotic species, Babesia divergens and Babesia microti, were detected. B. divergens 18S rDNA, identical to that of the bovine reference strain U16370 and to certain strains from red deer, was detected in I. ricinus ticks removed from fallow deer. The sporadic detection of infections in ticks removed from the same individual hosts suggests that the piroplasms were present in the ticks rather than the hosts. Theileria sp. OT3 was found in I. ricinus and, along with T. capreoli, was also detected in some of the other tick species. The natural vector and pathogenic significance of this piroplasm are unknown.

Use of medicinal plants by veterinary practitioners in Spain: A cross-sectional survey.

Medicinal plants have been used in veterinary medicine since ancient times, and they are gaining importance in Eastern Europe. The aim of this study was to conduct a survey on the use of medicinal plants in Spain. A cross-sectional study with an online questionnaire was carried out among Spanish small animal veterinarians, to evaluate the use patterns of medicinal plants and attitudes of professionals toward it. 313 veterinarians took part in the study. Most of them were female (80.2%) and age ranged 35-49 (49.5%). 80.3% of respondents use phytotherapy. Musculoskeletal and gastrointestinal disorders were those most frequently treated, with cannabis, aloe and thyme the most often medicinal plants used. The most common pattern of user was women working in clinics.

Tasa de retorno y características asistenciales de pacientes mayores de 65 años en un servicio de Urgencias en Atención Primaria / Return rate to the Primary Care Emergency Service for elderly patients over 65 years old and their assistance requirements

Objetivo: Determinar la tasa de retorno inesperado a las 72 h y las características clínico- asistenciales de los mayores de 65 años que retornan. Diseño: Estudio epidemiológico observacional retrospectivo. Emplazamiento: Servicio Urgencias Atención Primaria (SUAP) Cotolino en Cantabria, España. Participantes: Se incluyó a 1.940 pacientes mayores de 65 años que acudieron al SUAP durante el año 2016. Mediciones principales: La variable dependiente fue el retorno y las independientes las variables sociodemográficas, clínicas y asistenciales. Los datos fueron suministrados por la Gerencia de Atención Primaria. Se analizaron las variables mediante el test de la chi al cuadrado de Pearson y el test exacto de Fisher utilizando como nivel de significación p ≤ 0,05. Resultados:Tasa de retorno inesperado 2,3%. Edad media 77,4 años (DE 8,4), siendo el 37,6% varones. El grupo etario más frecuente de retorno fue el de 75 a 84 años. Se detectó polifarmacia en el 54,4% y un riesgo cardiovascular medio. Al 42,2% lo asistió el personal de enfermería (p <0,001). Los pacientes con disnea (p=0,015), cura programada o inyección programada regresan con mayor frecuencia (p <0,001). Se detectó una mayor probabilidad de retorno en el mes de diciembre y enero (p <0,001). Conclusiones: El retorno inesperado del total de asistencias es bajo. El retornado precisa cuidados urgentes fundamentalmente por problemas generales inespecíficos o enfermedades del aparato respiratorio. Proponemos desarrollar protocolos en todos los servicios de Urgencias de Atención Primaria que integren a los profesionales de Geriatría y Gerontología, con el fin de mejorar la atención urgente a este grupo poblacional.(AU)

Objective: To determine the unexpected return rate to the Primary Care Emergency Service of elderly patients over 65 years old within the following 72h of a previous visit, as well as to determine the clinical and assistance requirements of these patients. Procedure: Retrospective and observational epidemiologic study. Location: Cotolino's Primary Care Emergency Service in Cantabria, Spain. Participants: 1940 elderly patients over 65 years old were included. These patients returned to the Primary Care Emergency Service in 2016.Main data for the study: The dependent variable was the return rate to the Primary Care Emergency Service. The independent variables were socio-demographic characteristics, health details and medical assistance information. All data was collected from the Primary Care Emergency Service Management Office database. All variables were analysed applying Pearson's chi-squared test and Fisher's exact test, with statistical significance P≤.05. Results: The rate of unexpected return was 2.3%. The average age was 77.4 years old (standard deviation (SD): 8.4), of which the 37.6% were male. The most frequent range of age was from 75 to 84 years old, with males being the predominant group. A history of polymedication was detected in 54.4% of the cases, as well as a medium cardiovascular risk within this group. Nursing professionals attended the 42.2% of these return cases (P<.001). Patients with dysnea (P=.015), scheduled care or scheduled injection returned with a higher frequency (P<.001). It was as well noticed a higher frequency of return for subsequent attention during the months of December and January (P<.001). Conclusions: The rate of unexpected return is low. The main causes why elderly patients returned to the service requiring urgent assistance were issues categorised as unspecific general health indicators and/or respiratory system illnesses.(AU)

Distribution of Flumequine in Intestinal Contents and Colon Tissue in Pigs after Its Therapeutic Use in the Drinking Water.

Flumequine concentrations in plasma, colon tissue and intestinal contents were evaluated in 12 healthy pigs after oral administration (12 mg/kg every 24 h for 5 consecutive days in drinking water). Plasma, colon tissue and intestinal content samples were collected from animals sacrificed on days 3, 6 and 7. Concentrations were measured by high performance liquid chromatography after having validated the method, following the European Medicines Agency (EMA) requirements. The drug was not detected in any plasma sample. In colon tissue, concentrations were higher on day 3 (0.230 ± 0.033 µg/g, descending colon; 0.156 ± 0.093 µg/g, ascending colon) than on day 6 (0.187 ± 0.123 µg/g, descending colon; 0.107 ± 0.007 µg/g, ascending colon). Concentrations were considerably higher in intestinal contents, again on day 3 (1.349 ± 1.401 µg/g, descending colon; 0.591 ± 0.209 µg/g, ascending colon) than on days 6 (0.979 ± 0.346 µg/g, descending colon; 0.595 ± 0.075 µg/g, ascending colon) and 7 (0.247 ± 0.172 µg/g, descending colon; 0.172 ± 0.086 µg/g, ascending colon). Measured concentrations were lower than those effective against the most common intestinal pathogenic microorganisms in swine and, more specifically, Brachyspira hyodysenteriae.

[Return rate to the Primary Care Emergency Service for elderly patients over 65 years old and their assistance requirements]. / Tasa de retorno y características asistenciales de pacientes mayores de 65 años en un servicio de Urgencias en Atención Primaria.

OBJECTIVE: To determine the unexpected return rate to the Primary Care Emergency Service of elderly patients over 65 years old within the following 72h of a previous visit, as well as to determine the clinical and assistance requirements of these patients. PROCEDURE: Retrospective and observational epidemiologic study. LOCATION: Cotolino's Primary Care Emergency Service in Cantabria, Spain. PARTICIPANTS: 1940 elderly patients over 65 years old were included. These patients returned to the Primary Care Emergency Service in 2016. MAIN DATA FOR THE STUDY: The dependent variable was the return rate to the Primary Care Emergency Service. The independent variables were socio-demographic characteristics, health details and medical assistance information. All data was collected from the Primary Care Emergency Service Management Office database. All variables were analysed applying Pearson's chi-squared test and Fisher's exact test, with statistical significance P≤.05. RESULTS: The rate of unexpected return was 2.3%. The average age was 77.4 years old (standard deviation (SD): 8.4), of which the 37.6% were male. The most frequent range of age was from 75 to 84 years old, with males being the predominant group. A history of polymedication was detected in 54.4% of the cases, as well as a medium cardiovascular risk within this group. Nursing professionals attended the 42.2% of these return cases (P<.001). Patients with dysnea (P=.015), scheduled care or scheduled injection returned with a higher frequency (P<.001). It was as well noticed a higher frequency of return for subsequent attention during the months of December and January (P<.001). CONCLUSIONS: The rate of unexpected return is low. The main causes why elderly patients returned to the service requiring urgent assistance were issues categorised as unspecific general health indicators and/or respiratory system illnesses. Our proposal is to develop specific protocols combining the work from both Geriatrics and Gerontology professionals, in order to improve the support to this group of population at every Primary Care Emergency Service.

Basic life support training programme in schools by school nurses: How long and how often to train?

BACKGROUND: Cardiopulmonary resuscitation (CPR) training in schools, despite being legislated in Spain, is not established as such within the subjects that children are taught in schools. OBJECTIVE: to evaluate the acquisition of CPR skills by 11-year-old children after a brief theoretical-practical teaching programme taught by nurses at school. METHODS: 62 students were assessed in a quasi-experimental study on 2 cohorts (51.4% of the sample in control group [CG]). In total, 2 sessions were given, a theoretical one, and a practical training for skill development in children, in which the CG performed the CPR in 2-minute cycles and the intervention group in 1-minute cycles. The anthropometric variables recorded were weight and height, and the variables compression quality and ventilation quality were recorded using the Laerdal ResusciAnne manikin with Personal Computer/Wireless SkillReport. RESULTS: The assessment showed better results, in terms of BLS sequence performance and use of automated external defibrillator, in the CG and after training, except for the evaluation of the 10-second breathing assessment technique. The quality of chest compressions was better in the CG after training, as was the quality of the ventilations. There were no major differences in CPR quality after training and 4 months after the 1-minute and 2-minute training cycles. CONCLUSIONS: 11-year-old children do not perform quality chest compressions or ventilations but, considering their age, they are able to perform a BLS sequence correctly.

Prevalence and Associated Factors of Polypharmacy in Nursing Home Residents: A Cross-Sectional Study.

In Spain, there has been a progressive increase in aging. Specifically, Leon has been one of the Spanish provinces with the highest aging index. Polypharmacy is highly prevalent among the elderly, with significant consequences for safety. The aim of this study was to assess the consumption of drugs in a nursing home in the province of Leon and establish the relationship between polypharmacy and the most common comorbid diseases. A descriptive, observational, and cross-sectional study design was used. Residents' information and treatments were collected by reviewing on medical charts, completed with clinical information obtained from the physician of the nursing home. The mean age of residents was 86.8 years, and 63.8% were female. Mean medical consumption amounted to 7.02 prescriptions. Polypharmacy was observed in 54.9% of residents, and excessive polypharmacy in 22.1%. The most commonly used medications (ATC classification) were those acting on the cardiovascular system (84.4%) and the nervous system (82.8%). A high-level of drug consumption was observed in the nursing home. Interventions should focus on those residents hospitalized the last year and with recent contact with a general practitioner. There is a need to develop a comprehensive monitoring system to assess the quality of prescriptions for nursing home residents.

Long-term treatment for emotional distress in women with breast cancer.

PURPOSE: Breast cancer patients have many needs, including strategies to cope with the associated distress, during and after cancer treatment. Establishing and implementing adequate social and emotional support for these women, to reduce the detrimental effects of stress resulting from their treatment and disease, is the need of the hour. This study aims to assess how women, diagnosed and treated for breast cancer, combat emotional stress using mechanisms of coping and control and emotional defense, as well as to identify potential groups among them, with different long-term patterns and needs. METHODS: 98 patients belonging to a local breast cancer support association (ALMOM), were enrolled in this study. A questionnaire specifically designed for them was administered, and its internal consistency and reliability assessed. A hierarchical clustering was employed to classify the women. The questionnaire focused on four sections, including personal feelings, coping strategies, environmental influences and maladaptive coping. RESULTS: An adequate internal reliability was obtained with Cronbach's α near or greater than 0.60. Personal feelings were significant and clearly correlated with coping strategies and maladaptive coping. Three groups of women with different patterns of emotional characteristics and needs were identified: positivist, unsafe, and hopeless women, with different long-term emotional needs to be satisfied. CONCLUSIONS: Psychological therapeutic interventions should be maintained in many breast cancer patients over time, even after treatment completion, in order to consolidate adaptive and sustainable responses.

Assessment of the Antioxidant/Hypolipidemic Relationship of Sideritis hyssopifolia in an Experimental Animal Model.

Many publications have described the potential cardioprotective action of different medicinal plants, relating this effect with blood lipid levels. However, these publications do not justify the right amount of plant administered, which can vary greatly. Sideritis hyssopifolia is a little woody plant endemic to western and southwestern Europe. We have quantified its antioxidant activity, which can be used as an indicator of its cardioprotective action. This study evaluates the antioxidant capacity of Sideritis hyssopifolia to design a feed whose hypolipidemic effects are proven in cholesterol-fed New Zealand rabbits. Antioxidant action was assessed in infusions, which were prepared with 1 or 3 g of plant in 200 mL of water by using an ABTS assay and expressed as Ascorbic acid Equivalent Antioxidant Capacity (AEAC). Aqueous infusions with infusion times of 10 min and prepared with 3 g plant exhibited the strongest antioxidant activity. Sideritis hyssopifolia showed an intermediate antioxidant capacity for the concentrations and times of the infusion tested. According to our results, we suggest incorporating 2.36 g of S. hyssopifolia every 150 g of rabbit feeding stuff (15.73 g/kg). This chow decreased cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides levels in cholesterol-fed rabbits, as well as the atherogenic index. This reduction was similar to that obtained with simvastatin.

Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits.

BACKGROUND: Metformin is an oral hypoglycemic agent frequently used in patients with type 2 diabetes. In this study, we have investigated the influence of the dietary fiber Plantago ovata husk on the pharmacokinetics of this drug when included in the diet, as well as when administered at the same time as metformin. METHODS: Six groups of 6 rabbits were used. Groups 1 to 3 were fed with standard chow and groups 4 to 6 with chow supplemented with fiber (3.5 mg/kg/day). Groups 1 and 4 received metformin intravenously (30 mg/kg). Groups 2 and 5 received metfomin orally (30 mg/kg), and number 3 and 6 were treated orally with metformin (30 mg/kg) and fiber (300 mg/kg). RESULTS: The changes caused by the inclusion of fiber in the feeding were more important in groups that received oral metformin. In this way, metformin oral bioavailability showed an increase of 34.42% when rabbits were fed with supplemented chow. CONCLUSIONS: Plantago ovata husk increased the amount of absorbed metformin when included in the diet (significant increase in AUC), and delayed its absorption when administered at the same time (significant increase in tmax).

Study of the protective effect on intestinal mucosa of the hydrosoluble fiber Plantago ovata husk.

BACKGROUND: Several studies have indicated that dietary fiber may have a protective effect on gastrointestinal mucosa. The aim of this study was to evaluate the protective action of the soluble fiber Plantago ovata husk against intestinal damage. METHODS: To evaluate the anti-ulcerogenic effect on duodenal mucosa of the soluble fiber Plantago ovata husk, low-dose acetylsalicylic acid (10 mg/kg) was given orally to animals once daily for 14 or 28 days with and without Plantago ovata husk (100 mg/kg). 24 h after final dosing duodenal samples were removed for anatomopathological evaluation. Villi were examined by both light and scanning electron microscopy. RESULTS: Acetylsalicylic acid induced severe lesions in duodenal mucosa of rabbits, including erosions, epithelium disorganization, and cell vacuolization, increasing as well the amount of mononuclear and caliciform cells. Damage was much more severe in animals treated for 28 days. In groups receiving Plantago ovata husk, a significant attenuation of acetylsalicylic acid-induced lesions was already observed in group treated for 14 days, becoming more evident in those treated for 28 days, all of them with duodenal cytoarchitecture normal and similar to control animals. CONCLUSIONS: These findings suggest that Plantago ovata husk may protect intestinal mucosa probably by limiting acetylsalicylic acid penetration into epithelial cells, although further studies are needed to confirm the same effect in other experimental models of induced mucosal damage and to elucidate the mechanisms of fiber protection.

Systemic and mammary gland disposition of enrofloxacin in healthy sheep following intramammary administration.

BACKGROUND: Mastitis is one of the most important diseases affecting dairy sheep. Antimicrobial drugs are often administered directly through teat to treat or prevent this disease, but data on drug distribution within glandular tissue are scarce and it cannot be estimated from concentrations in milk. Thus, the aim of this study was to investigate systemic and mammary gland distribution of enrofloxacin after intramammary administration. The drug was administered to 6 healthy lactating Assaf sheep with an injector containing an enrofloxacin preparation (1 g drug/5 g ointment). Blood samples were collected at 0, 30, 60, 90, 120, 150 and 180 min. Animals were then sedated and sacrificed, and glandular tissue samples were obtained from treated udders at 2, 4, 6 and 8 cm height. Enrofloxacin concentrations were measured in plasma and tissue samples by UV high-performed liquid chromatography. RESULTS: Mean enrofloxacin plasma concentrations were below 0.5 µg/mL. Mean tissue concentrations decreased in mammary gland with vertical distance from the teat, ranging from 356.6 µg/g at 2 cm to 95.60 µg/g at the base of the udder. Glandular tissue concentrations best fitted to a decreasing monoexponential model, and showed a good correlation with an ex vivo model previously developed. CONCLUSIONS: Enrofloxacin concentrations were effective in the entire glandular tissue against the main pathogens causing mastitis in sheep. These results suggest that this drug may be suitable to treat mastitis in sheep by intramammary administration.

[Risk prevention evaluation in the incorporation of new drugs for healthcare practices: a methodological proposal]. / Evaluación preventiva de riesgos en la incorporación de nuevos medicamentos a la práctica asistencial: una propuesta metodológica.

OBJECTIVE: Submit a preventive assessment methodology for the risk of medication errors when incorporating new drugs in clinical practice as well as a description of the types of actions arising from such action. MATERIALS AND METHODS: A Standard Operating Procedure was established which defines and plans the process of assessing the risks of new drugs purchased by the Pharmacy Services before being incorporated into the distribution and dispensation channels. The pharmacist responsible for each area fills the Risk Assessment Form, a questionnaire that facilitates the analysis of the product characteristics and provides guidance on safety measures to be taken depending on the results of that assessment. If it is confirmed that the drug requires some additional security measures to be taken, all professionals and technical staff of the Pharmacy Services shall be informed of measures to be taken. RESULTS: Between 2011 and 2013, 64 drugs were assessed. 35 of them (54.6%) required some additional security measure to be applied before being incorporated into clinical practice. CONCLUSIONS: The implementation of the method of preventive risk assessment for new drugs purchased by the Pharmacy Services can be a very useful tool when taking the measures deemed necessary to minimize the likelihood of a medication error occurring before they are incorporated into the distribution/dispensing channels put in place by the Pharmacy Services.

Evaluación preventiva de riesgos en la incorporación de nuevos medicamentos a la práctica asistencial: una propuesta metodológica / Risk prevention evaluation in the incorporation of new drugs for healthcare practices: a methodological proposal

Objetivo: Presentar una metodología de evaluación preventiva de riesgos de errores de medicación en la incorporación de nuevos medicamentos a la práctica asistencial, así como una descripción de las acciones derivadas de dicha actuación. Material y métodos: Se estableció un Procedimiento Normalizado de trabajo que define el proceso de evaluación de riesgos de los nuevos medicamentos adquiridos por el Servicio de Farmacia antes de ser incorpora la Ficha de Evaluación de Riesgos, cuestionario que facilita el análisis delas características del medicamento y orienta sobre las medidas de seguridad que se deben adoptar en función de los resultados. Resultados: Se evaluaron 64 medicamentos. En 35 (54,6%) se aplicó alguna medida preventiva de seguridad: incorporación a la Guía de Administración de medicamentos por sonda nasogástrica (3 fármacos), aplicación de la instrucción Técnica de cambio de concentración/presentación segura (7), incorporación al listado de medicamentos que contienen Látex (3), remisión de notas informativas a los profesionales sanitarios (12), adopción de medidas para almacenamiento seguro (6), incorporación de material educativo en los folletos informativos para pacientes externos (12), incorporación de interacciones farmacológicas a la base de datos (2), inicio de procedimiento de resolución de expediente (1) y comunicación a la AEMPS de errores potenciales por similitud de envases (2). Conclusiones: La implantación de esta evaluación preventiva de riesgos puede resultar una herramienta muy útil a la hora de tomar las medidas para minimizar la probabilidad de que se produzca un error de medicación, antes de que se incorpore a los circuitos de distribución/dispensación

Objective: Submit a preventive assessment methodology for the risk of medication errors when incorporating new drugs in clinical practice as well as a description of the types of actions arising from such action. Materials and methods: A Standard Operating Procedure was established which defines and plans the process of assessing the risks of new drugs purchased by the Pharmacy Services before being incorporated into the distribution and dispensation channels. The pharmacist responsible for each area fills the Risk Assessment Form, a questionnaire that facilitates the analysis of the product characteristics and provides guidance on safety measures to be taken depending on the results of that assessment. If it is confirmed that the drug requires some additional security measures to be taken, all professionals and technical staff of the Pharmacy Services shall be informed of measures to be taken. Results: Between 2011 and 2013, 64 drugs were assessed. 35of them (54.6%) required some additional security measure t be applied before being incorporated into clinical practice. Conclusions: The implementation of the method of preventive risk assessment for new drugs purchased by the Pharmacy Services before being incorporated into the distribution and dispensationchannels. The pharmacist responsible for each area fills the RiskAssessment Form, a questionnaire that facilitates the analysisof the product characteristics and provides guidance on safetymeasures to be taken depending on the results of that assessment. If it is confirmed that the drug requires some additionalsecurity measures to be taken, all professionals and technicalstaff of the Pharmacy Services shall be informed of measuresto be taken. Results: Between 2011 and 2013, 64 drugs were assessed. 35of them (54.6%) required some additional security measure tobe applied before being incorporated into clinical practice. Conclusions:The implementation of the method of preventiverisk assessment for new drugs purchased by the Pharmacy Services can be a very useful tool when taking the measures dee-med necessary to minimize the likelihood of a medication erroroccurring before they are incorporated into the distribution/dis-pensing channels put in place by the Pharmacy Services