Pharmacokinetic monitoring of antiepileptic drugs.

Monitoring plasma levels of antiepileptic drugs for the treatment and prophylaxis of epilepsy is one of the strategies enabling clinical results to improve by reducing adverse affects and increasing effectiveness. The objective of this article is to review the basic aspects in the monitoring of antiepileptic drugs using a consensus document prepared and endorsed by the pharmacokinetics and pharmacogenetics working group (PK.gen) of the Sociedad Española de Farmacia Hospitalaria (Spanish Society of Hospital Pharmacists).

[Methods for analyzing uncertainty]. / Métodos de análisis de la incertidumbre.

Current budgetary restrictions in health systems have increased the influence of economic evaluation studies on decision making. Nevertheless, uncertainty about the parameters used in pharmacoeconomic models is inevitable and may affect the conclusions drawn. The present article aims to review the main methods proposed to quantify the uncertainty inherent in pharmacoeconomic evaluations applied to health technologies. The most accurate pharmacoeconomic estimations are obtained by probabilistic methods of uncertainty analysis such as Monte Carlo simulation, repetitive sampling and the Fieller method. Alternatives to these methods are calculation of the cost-effectiveness acceptability curve or net health benefit. Equally, the economic impact of uncertainty in the pharmacoeconomic models used in the decision-making process can be estimated by obtaining what is known as the value of perfect information.

Métodos de análisis de la incertidumbre / Methods for analyzing uncertainty

La actual situación de restricción presupuestaria en los sistemas sanitarios ha provocado que la toma de decisiones esté cada vez más influenciada por los estudios de evaluación económica. No obstante, la incertidumbre en los parámetros empleados en los modelos farmacoeconómicos es inevitable y puede afectar a las conclusiones alcanzadas. El objetivo de este artículo es revisar los principales métodos propuestos para cuantificar la incertidumbre inherente a las evaluaciones farmacoeconómicas aplicadas a las tecnologías sanitarias. Los métodos probabilísticos de análisis de la incertidumbre como la simulación de Monte Carlo, el método de muestreo repetitivo o el método de Fieller proporcionan las estimaciones farmacoeconómicas más precisas. Otras alternativas a estos métodos son el cálculo de la curva de aceptabilidad de coste-efectividad o el beneficio neto sanitario. Igualmente, es posible estimar el impacto económico de la incertidumbre en los modelos farmacoeconómicos empleados en el proceso de toma de decisiones mediante la obtención del denominado valor de la información perfecta (AU)

Current budgetary restrictions in health systems have increased the influence of economic evaluation studies on decision making. Nevertheless, uncertainty about the parameters used in pharmacoeconomic models is inevitable and may affect the conclusions drawn. The present article aims to review the main methods proposed to quantify the uncertainty inherent in pharmacoeconomic evaluations applied to health technologies. The most accurate pharmacoeconomic estimations are obtained by probabilistic methods of uncertainty analysis such as Monte Carlo simulation, repetitive sampling and the Fieller method. Alternatives to these methods are calculation of the cost-effectiveness acceptability curve or net health benefit. Equally, the economic impact of uncertainty in the pharmacoeconomic models used in the decision-making process can be estimated by obtaining what is known as the value of perfect information (AU)

[A time series analysis of the cost of the most common drug treatment groups in an intensive care unit]. / Análisis de series temporales del coste de los grupos terapéuticos más utilizados en un servicio de medicina intensiva.

OBJECTIVE: To determine the evolution of the most common drug treatment groups in an intensive care unit over a period of seven years, characterise the time-cost relationship and establish an ARIMA prediction model using Box-Jenkins methodology. METHOD: A retrospective analysis of the costs of thirteen drug treatment groups was carried out in an intensive care unit with 19 beds between the period of 1998 to 2004. The monthly cost of these treatment groups constituted the time series. The descriptive analysis was carried out by means of descriptive statistics and graphs. The trend was analysed by means of smoothing by weighted local regression, and seasonality was analysed by multiple linear regression. Stochastic models for time series were developed using Box-Jenkins methodology for descriptive and forecasting purposes. RESULTS: 70% of drug costs are generated by thirteen groups. Three of these groups display a downward trend, four have an upward trend and the remaining groups do not display any significant trend. Seasonality is only relevant in series with upward trends. The ARIMA model allows models to be obtained for seven series. CONCLUSIONS: The descriptive cost analysis, the determination of trends and the analysis of seasonality provide information about the dynamics in drug use in an intensive care unit. However, the use of ARIMA models to optimise the planning of treatment resources in these types of hospital units is still extremely limited.

[A bibliometric analysis of the Farmacia Hospitalaria journal (2001-2006)]. / Análisis bibliométrico de la revista Farmacia Hospitalaria (2001-2006).

OBJECTIVE: To carry out a bibliometric analysis of the Farmacia Hospitalaria journal from 2001 to 2006. METHOD: A retrospective analysis of all of the articles published in Farmacia Hospitalaria from 2001-2006 was performed and the main bibliometric indicators for production, circulation, distribution and sales were calculated. RESULTS: 416 articles by 1,515 authors were analysed. Original articles were the most predominant with a growth of 30%. There were 4.6 +/- 2.3 authors per article. The Community of Valencia, Catalonia, Madrid and Andalusia were the autonomous communities with the highest levels of production. Four authors had a productivity index of > 1, with one group of 15 authors having an index of > 0.75. Only 14% of articles were included in presentations to congresses and 17% had funding. The subject matters of drug treatment and safety had the highest production levels. The publication delay remained constant. There was a circulation index of 0.74 in Medline. CONCLUSIONS: Farmacia Hospitalaria maintained or improved their bibliometric indicators between 2001 and 2006. There has been an increase in the publication of original articles and letters to the editor over recent years and this increase was in line with the journal s strategies. There has also been a decrease in literature reviews. There were some generational changes among the authors although the main authors remained the same. The subject matters and geographical origin of the authors corresponded to areas with the largest development of the specialty in Spain.

Análisis de series temporales del coste de los grupos terapéuticos más utilizados en un servicio de medicina intensiva / No disponible

Objetivo: Determinar la evolución de los grupos terapéuticosmás utilizados en un servicio de medicina intensiva durante un periodode siete años, caracterizar la temporalidad del coste y desarrollarun modelo de predicción ARIMA por metodología Box-Jenkins.Método: Análisis retrospectivo de los costes de trece gruposterapéuticos en un servicio de medicina intensiva de 19 camas,entre 1998 y 2004. El coste mensual de estos grupos terapéuticosconstituye las series temporales. El análisis descriptivo se llevóa cabo mediante estadísticos descriptivos y representación gráfica.El estudio de la tendencia se realizó mediante alisamiento porregresión local ponderada, y la estacionalidad se analizó porregresión lineal múltiple. Se desarrollaron modelos estocásticos deseries temporales por la metodología de Box-Jenkins, con finesdescriptivos y predictivos.Resultados: El 70% del gasto en medicamentos está generadopor trece grupos. Tres de estos grupos presentan una tendenciaa la baja, cuatro una tendencia al alza, y el resto de grupos nopresentan una tendencia significativa. La estacionalidad solamentees relevante en aquellas series con tendencia al crecimiento. Lamodelización ARIMA permite la obtención de modelos para sieteseries.Conclusiones: El análisis descriptivo de los costes, la determinaciónde la tendencia y el análisis de la estacionalidad permitenconocer la dinámica del medicamento en un servicio de medicinaintensiva. No obstante, la aplicación de modelos ARIMA para laoptimización en la planificación de recursos terapéuticos en estetipo de unidades hospitalarias se encuentra todavía muy limitada

Objective: To determine the evolution of the most commondrug treatment groups in an intensive care unit over a period ofseven years, characterise the time-cost relationship and establishan ARIMA prediction model using Box-Jenkins methodology.Method: A retrospective analysis of the costs of thirteen drugtreatment groups was carried out in an intensive care unit with 19beds between the period of 1998 to 2004. The monthly cost ofthese treatment groups constituted the time series. The descriptiveanalysis was carried out by means of descriptive statistics andgraphs. The trend was analysed by means of smoothing byweighted local regression, and seasonality was analysed by multiplelinear regression. Stochastic models for time series were developedusing Box-Jenkins methodology for descriptive and forecastingpurposes.Results: 70% of drug costs are generated by thirteen groups.Three of these groups display a downward trend, four have anupward trend and the remaining groups do not display any significanttrend. Seasonality is only relevant in series with upwardtrends. The ARIMA model allows models to be obtained for sevenseries.Conclusions: The descriptive cost analysis, the determinationof trends and the analysis of seasonality provide information aboutthe dynamics in drug use in an intensive care unit. However, theuse of ARIMA models to optimise the planning of treatmentresources in these types of hospital units is still extremely limited

Análisis bibliométrico de la revista Farmacia Hospitalaria (2001-2006) / No disponible

Objetivo: Análisis bibliométrico de la revista Farmacia Hospitalaria en el periodo 2001-2006. Método: Análisis retrospectivo de todos los artículos publicados en Farmacia Hospitalaria durante el periodo 2001-2006 y cálculo de los principales indicadores bibliométricos de producción, circulación, dispersión y consumo. Resultados: Se analizan 416 artículos firmados por 1.515 autores. Predominan los originales con un crecimiento del 30%. El número de autores por artículo fue de 4,6 ± 2,3. Las comunidades autónomas con mayor producción fueron la Comunidad Valenciana, Cataluña, Madrid y Andalucía. Cuatro autores tienen un índice de productividad > 1, destacando un grupo de 15 autores que lo tienen > 0,75. Sólo el 14% de los artículos procedían de presentaciones a congresos y el 17% tenía financiación. Las áreas temáticas con mayor producción son farmacoterapia y seguridad. La demora en la publicación se mantiene constante. El índice de circulación en Medline fue de 0,74. Conclusiones: Farmacia Hospitalaria ha mantenido o mejorado sus indicadores bibliométricos entre los años 2001 y 2006. Se detecta un aumento en la publicación de originales y cartas al director en los últimos años de acuerdo con las estrategias de la revista, así como una disminución de las revisiones literarias. Se detecta una cierta renovación generacional en los autores aunque se mantienen los mismos grandes productores. Las áreas temáticas y la procedencia geográfica de los autores se corresponden con las de mayor desarrollo de la especialidad en España

Objective: To carry out a bibliometric analysis of the Farmacia Hospitalaria journal from 2001 to 2006. Method: A retrospective analysis of all of the articles published in Farmacia Hospitalaria from 2001-2006 was performed and the main bibliometric indicators for production, circulation, distribution and sales were calculated. Results: 416 articles by 1,515 authors were analysed. Original articles were the most predominant with a growth of 30%. There were 4.6 ± 2.3 authors per article. The Community of Valencia, Catalonia, Madrid and Andalusia were the autonomous communities with the highest levels of production. Four authors had a productivity index of > 1, with one group of 15 authors having an index of > 0.75. Only 14% of articles were included in presentations to congresses and 17% had funding. The subject matters of drug treatment and safety had the highest production levels. The publication delay remained constant. There was a circulation index of 0.74 in Medline. Conclusions: Farmacia Hospitalaria maintained or improved their bibliometric indicators between 2001 and 2006. There has been an increase in the publication of original articles and letters to the editor over recent years and this increase was in line with the journal’s strategies. There has also been a decrease in literature reviews. There were some generational changes among the authors although the main authors remained the same. The subject matters and geographical origin of the authors corresponded to areas with the largest development of the specialty in Spain

Home total parenteral nutrition in a "no-bowel" patient in Spain.

OBJECTIVE: To report a case of a patient with no functional bowel who was receiving home total parenteral nutrition in a country that has had a few professional experiences in this area of therapy. CASE SUMMARY: A woman with a history of scattered colonic polyposis developed a mesenteric tumor that caused intestinal obstruction. Tumor withdrawal required the excision of 1.5 m of jejunum-ileum. Postoperative complications required further surgical intervention and subtotal intestinal resection. Duodenocolic anastomosis was not possible and a high output and permanent fistula remained. DISCUSSION: The complications of home parenteral nutrition addressed in the literature are reviewed. The problems encountered in our patient have been resolved. CONCLUSIONS: After three years of postoperative survival, we believe the quality of life of our patient has increased and the parenteral nutrition team members are much better prepared to manage patients with similar problems.