Reutilización de citostáticos en una unidad centralizada de mezclas / Reusing cytostatics in a centralised pharmacy preparation unit

Objetivo Cuantificar y evaluar económicamente las mezclas devueltas a una unidad centralizada de preparación de citostáticos, analizar causas de devolución, proponer medidas para minimizarlas y valorar su impacto en el hospital de día de oncología médica. Métodos Estudio prospectivo en 2 periodos. En el primero se registraron todas las devoluciones, motivos, reutilizaciones y costes. En el segundo periodo se analizaron las devoluciones del hospital de día de oncología tras adoptar medidas para minimizarlas.Resultados218 mezclas (51.131€) fueron retornadas en el primer periodo. El hospital de día de oncología devolvió el 1% de mezclas e importe solicitado, y en el segundo este valor fue del 0,56% de mezclas y del 0,14% del importe total. Conclusiones Favorecer la información e identificación de tratamientos de elevado coste y escasa estabilidad, e introducir las preparaciones devueltas como indicador de calidad de oncología ha mejorado la gestión de la unidad centralizada de cistostáticos (AU)

Objective To measure and provide an economic assessment of the preparations returned to a centralised cytostatic drug preparation unit, analyse reasons for their return, propose measures for minimising returns and assess their impact on the Medical Oncology division's outpatient services. Methods This prospective study contained two phases. During the first, we registered all returns, motives, cases of reuse and costs. In the second phase, we analysed returns at the Oncology outpatient division after having adopted measures to minimise the returns. Results During the first phase, 218 preparations (worth € 51,131) were returned. The Oncology Day Hospital returned 1% of the preparations worth 1% of the total value; during the second phase, these figures were 0.56% of the preparations and 0.14% of the total value. Conclusions Favouring reporting on and identifying expensive treatments with little stability and using returned preparations as a quality indicator for Oncology has improved management of the central cystostatic preparation unit (AU)

Reusing cytostatics in a centralised pharmacy preparation unit.

OBJECTIVE: To measure and provide an economic assessment of the preparations returned to a centralised cytostatic drug preparation unit, analyse reasons for their return, propose measures for minimising returns and assess their impact on the Medical Oncology division's outpatient services. METHODS: This prospective study contained two phases. During the first, we registered all returns, motives, cases of reuse and costs. In the second phase, we analysed returns at the Oncology outpatient division after having adopted measures to minimise the returns. RESULTS: During the first phase, 218 preparations (worth € 51,131) were returned. The Oncology Day Hospital returned 1% of the preparations worth 1% of the total value; during the second phase, these figures were 0.56% of the preparations and 0.14% of the total value. CONCLUSIONS: Favouring reporting on and identifying expensive treatments with little stability and using returned preparations as a quality indicator for Oncology has improved management of the central cystostatic preparation unit.

Incidencia de resultados negativos de medicación en un servicio de urgencias hospitalario y factores asociados / Incidence rate of adverse drug effects in a hospital emergency unit and its associated factors

Introducción Los resultados negativos de la medicación (RNM) motivan entre un 0,86–38,2% de las urgencias hospitalarias y en un alto porcentaje son evitables. La prescripción racional y el seguimiento farmacoterapéutico reducen la aparición de estos problemas de salud. Método Estudio en el servicio de urgencias de un hospital de tercer nivel con selección de pacientes por muestreo aleatorio bietápico. La información se obtuvo de un cuestionario validado y de la historia clínica. Los datos se estructuraron dentro del siguiente esquema causa-efecto: 1) factores potenciales de riesgo de un RNM; 2) efectos provocados de manera plausible por fármacos; 3) consecuencias del RNM, y 4) potenciales factores de confusión. La información obtenida fue evaluada según la metodología Dáder por cuatro evaluadores independientes. Resultados Se incluyeron 840 pacientes en el estudio, de los cuales el 33% acudió a urgencias por un RNM. Los RNM se observaron con mayor frecuencia en las mujeres, con mayor consumo de fármacos, en los pacientes mayores, en aquellos con alguna enfermedad de base y en los pertenecientes a clases sociales más desfavorecidas. Los factores que determinan el riesgo de aparición de los RNM son la cantidad de medicamentos consumidos, el sexo y el índice de prácticas de la salud. Discusión Un tercio de las urgencias hospitalarias fueron debidas a RNM y se asociaron a los mismos factores que otros estudios (número de fármacos consumidos, sexo femenino, edad y clase social). Además, se observó un predominio de los RNM en los pacientes con valores bajos del índice de prácticas de la salud y en aquellos con enfermedades de base (AU)

Introduction Adverse drug effects (ADEs) are the reason for 0.86% to 38.2% of hospital emergency admissions, and a large percentage of them are avoidable. Rational prescription and pharmacotherapy monitoring decrease the appearance of such health problems. Method Study performed in a tertiary hospital emergency unit with patients selected using a two-phase random sample. The information was obtained from a validated questionnaire and from the clinical history. The data were grouped according to the following cause-effect schema: 1-Potential risk factors for an ADE. 2-Effects likely to be caused by drugs. 3-Consequences of ADEs. 4-Potential confounding factors. The information obtained was evaluated by four independent evaluators using the Dader method.Results840 patients were included in the study, and 33% of them came to the emergency unit due to an ADE. ADEs were more frequently observed in female patients, those with higher drug consumption, older patients, those with an underlying illness and in those from underprivileged backgrounds. The factors determining risk of an ADE are the quantity of drugs consumed, sex and the health practices index. Discussion One third of hospital emergency admissions were due to ADEs, and these were associated with the same factors found in other studies (number of drugs consumed, female sex, age and social background). In addition, we observed that ADEs are predominant in patients with low values on the health practices index, and in those with underlying illnesses (AU)

[Incidence rate of adverse drug effects in a hospital emergency unit and its associated factors]. / Incidencia de resultados negativos de medicación en un servicio de urgencias hospitalario y factores asociados.

INTRODUCTION: Adverse drug effects (ADEs) are the reason for 0.86% to 38.2% of hospital emergency admissions, and a large percentage of them are avoidable. Rational prescription and pharmacotherapy monitoring decrease the appearance of such health problems. METHOD: Study performed in a tertiary hospital emergency unit with patients selected using a two-phase random sample. The information was obtained from a validated questionnaire and from the clinical history. The data were grouped according to the following cause-effect schema: 1-Potential risk factors for an ADE. 2-Effects likely to be caused by drugs. 3-Consequences of ADEs. 4-Potential confounding factors. The information obtained was evaluated by four independent evaluators using the Dader method. RESULTS: 840 patients were included in the study, and 33% of them came to the emergency unit due to an ADE. ADEs were more frequently observed in female patients, those with higher drug consumption, older patients, those with an underlying illness and in those from underprivileged backgrounds. The factors determining risk of an ADE are the quantity of drugs consumed, sex and the health practices index. DISCUSSION: One third of hospital emergency admissions were due to ADEs, and these were associated with the same factors found in other studies (number of drugs consumed, female sex, age and social background). In addition, we observed that ADEs are predominant in patients with low values on the health practices index, and in those with underlying illnesses.