ABSTRACT
WHAT IS KNOWN AND OBJECTIVES: Most of the clotting factor (CF) dispensations to haemophiliac patients are centralized in a few haemophilia treatment centres, necessitating frequent visits and long travel distances. The aim was to evaluate the home delivery programme developed by the Outpatient Pharmaceutical Care Unit (OPCU) through the association of patients (ASHECOVA). METHODS: A specific software programme was designed to communicate the individual CF requirements. Dispensations were prepared in advance, and an ASHECOVA member collected and delivered to patients' homes in optimal conditions. Data regarding the programme were analysed from December 2011 to December 2017. An electronic satisfaction survey with 34 questions was conducted, asking about organizational aspects, education and communication, use of apps and satisfaction level. RESULTS AND DISCUSSION: Forty-nine patients were included and 2464 home deliveries were made, without any reported incident related to dispensation errors, drug preservation, communication or confidentiality problems. This system avoids 11.4 annual dispensation visits per patient to OCPU, and a mean travel distance, time and cost of 1189.1 km, 945.3 minutes and 373.5 euros, respectively. Overall satisfaction with home delivery was 9.7, without any change suggested in the current system. Ninety-five per cent of individuals believed that the programme improves adherence and all patients would recommend it to other patients. The most common benefits reported were less frequent visits to hospital, reducing time and cost spent on transportation. WHAT IS NEW AND CONCLUSION: The home delivery programme guarantees a proper follow-up of treatments with full patient satisfaction. This programme allows OPCU to achieve better pharmaceutical care, traceability of the process and optimization of working times and CF stock management.
Subject(s)
Blood Coagulation Factors/administration & dosage , Hemophilia A/drug therapy , Home Care Services/organization & administration , Pharmaceutical Services/organization & administration , Adolescent , Adult , Ambulatory Care/organization & administration , Female , Humans , Male , Middle Aged , Patient Satisfaction , Pilot Projects , Software , Surveys and Questionnaires , Young AdultABSTRACT
El ibuprofeno es un antiinflamatorio no esteroideo (AINE) ampliamente utilizado vía oral por sus propiedades analgésicas, antiinflamatorias y antipiréticas. La utilización del ibuprofeno intravenoso para el control del dolor y la fiebre en pacientes adultos hospitalizados ha sido extensamente estudiada y cuenta con una amplia experiencia de uso en algunos países. El ibuprofeno es un derivado arilpropiónico que se sintetiza como una mezcla racémica en la que el enantiómero activo es el S[+]. El perfil farmacocinético del ibuprofeno intravenoso se considera similar al oral, presentando linealidad cinética a dosis terapéuticas. Se elimina principalmente a través del citocromo P450 hepático. El mecanismo responsable mayoritariamente del efecto farmacológico es la inhibición reversible de las enzimas ciclooxigenasas (COX-1 y COX-2) que catalizan la síntesis de prostanoides a partir del ácido araquidónico. El ibuprofeno es un fármaco con un perfil conocido y tolerable de toxicidad. Entre los efectos secundarios más destacables están los trastornos gastrointestinales y cardiovasculares. Este artículo tiene por objeto describir las principales características farmacocinéticas, farmacodinámicas y farmacogenéticas, además del perfil de reacciones adversas y de interacciones farmacológicas del ibuprofeno administrado por vía intravenosa (AU)
Ibuprofen is a nonsteroidal antiinflammatory drug (NSAID) widely used orally for its analgesic, antiinflammatory and antipyretic properties. The use of intravenous ibuprofen to control pain and fever in hospitalized adult patients has been studied and has a great experience of use in some countries. Ibuprofen is an arylpropionic derivative that is synthesized as a racemic mixture in which the active enantiomer is the S [+]. The pharmacokinetic profiles of intravenous ibuprofen is considered similar to oral, presenting linear kinetics at therapeutic doses. It is mainly eliminated by the hepatic cytochrome P450. The mechanism responsible for its pharmacological effect is largely due to reversible inhibition of cyclooxygenase enzymes (COX-1 and COX-2) that catalyze prostanoid synthesis from arachidonic acid. Ibuprofen is a drug with a known and tolerable toxicity profile. Among the most notable side effects are gastrointestinal and cardiovascular disorders. This chapter aims to describe the main pharmacokinetics, pharmacodynamic and pharmacogenetic characteristics, in addition to adverse reactions profile and drug interactions of intravenous ibuprofen (AU)
