Sars-Cov-2 Infection in Patients on Long-Term Treatment with Macrolides in Spain: A National Cross-Sectional Study.

The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64-81) years; 55% were men; 62% smokers/ex-smokers; 56% obese/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p < 0.001). There was no evidence of a beneficial effect of long-term courses of macrolides in preventing SARS-CoV-2 infection or the progression to worse outcomes in old patients with underlying chronic respiratory diseases and a high burden of comorbidity.

Elaboración, implantación y seguimiento de un protocolo de osteoporosis posmenopáusica: colaboración entre Atención Primaria y el Servicio de Reumatología / Elaboration, implementation and follow-up of a postmenopausal osteoporosis protocol: Collaboration between the Primary care and Rheumatology departments

Objetivo Con el objetivo de mejorar la gestión clínica de la osteoporosis posmenopáusica, se ha realizado una intervención basada en la implantación y seguimiento de un protocolo consensuado entre la Atención Primaria y la Especializada de la Mútua de Terrassa. Métodos Estudio descriptivo y de intervención. La intervención consistió en la elaboración de un protocolo consensuado, que fue presentado en todos los centros. Los datos se han evaluado a partir de densitometrías óseas solicitadas por los médicos de familia durante 1 año. Resultados Se han solicitado un total de 1.165 densitometrías, de las cuales 689 son para diagnóstico de nuevas pacientes. Para la evaluación del protocolo se han obtenido datos de 560. 502 densitometrías realizadas (89,6%, IC95%: 87,1–92,2) cumplían con los criterios de indicación marcados por el protocolo. Del total de pacientes que recibieron tratamiento con fármacos antirresortivos (43 osteopénicas y 167 osteoporóticas), el 83,7% (IC95%: 69,3–93,2) y el 89,8% (IC95%: 85,2–94,4), respectivamente, cumplía con las recomendaciones de primera elección. El consumo de fármacos durante el año 2007 se ha reducido en 152.745 euros (−6,3%), aunque el número de pacientes tratadas ha aumentado en 565 (+4,9%) respecto al año anterior. 442 (78,9%, IC95%: 75,6–82,3) densitometrías presentaron un resultado de osteopenia u osteoporosis. Se observan diferencias estadísticamente significativas de los resultados según la edad de las pacientes y el motivo de solicitud. Conclusiones La puesta en marcha del protocolo ha permitido gestionar de forma eficiente el proceso clínico de la osteoporosis en nuestro ámbito (AU)

Objective To improve the clinical management of postmenopausal osteroporosis, an intervention based on the implementation of a guideline agreed to between the Primary Care and Specialized departments of all centers at “Mutua of Terrassa” was carried out. Methods Descriptive and interventional study. The intervention consisted of the elaboration of a consensus guideline that was presented in all centers. Results were assessed from bone densitometry studies requested by family physicians over 1 year. Results 1.165 densitometric studies were requested, of which 689 were for the diagnosis of new patients. For the evaluation of the guidelines, details were obtained from 560. 502 studies (89,6% IC95% 87,1–92,2) complied with indication criteria established in the guideline. Of the total of patients who received bisphosphonates and other drugs affecting bone metabolism (43 osteopenic and 167 osteoporotic), 83,7% (IC95% 69,3–93,2) and 89,8% (IC95% 85,2–94,4) respectively complied with drug recommendations. Drug consumption during the year 2007 was reduced by 152.745 euros (−6,3%) although the number of patients increased in 565 (+4,9%) with respect to the previous year. 442 (78,9% IC95% 75,6–82,3) densitometries presented a result in the osteopenia or osteroporosis category. There were statistically significant differences of the results according to the patients' age and the motive for the bone densitometry request. Conclusions Implementation of the guideline allowed for the effective management of the clinical process of osteroporosis in our field (AU)

[Elaboration, implementation and follow-up of a postmenopausal osteoporosis protocol: Collaboration between the Primary care and Rheumatology departments]. / Elaboración, implantación y seguimiento de un protocolo de osteoporosis posmenopáusica: colaboración entre Atención Primaria y el Servicio de Reumatología.

OBJECTIVE: To improve the clinical management of postmenopausal osteroporosis, an intervention based on the implementation of a guideline agreed to between the Primary Care and Specialized departments of all centers at "Mutua of Terrassa" was carried out. METHODS: Descriptive and interventional study. The intervention consisted of the elaboration of a consensus guideline that was presented in all centers. Results were assessed from bone densitometry studies requested by family physicians over 1 year. RESULTS: 1.165 densitometric studies were requested, of which 689 were for the diagnosis of new patients. For the evaluation of the guidelines, details were obtained from 560. 502 studies (89,6% IC95% 87,1-92,2) complied with indication criteria established in the guideline. Of the total of patients who received bisphosphonates and other drugs affecting bone metabolism (43 osteopenic and 167 osteoporotic), 83,7% (IC95% 69,3-93,2) and 89,8% (IC95% 85,2-94,4) respectively complied with drug recommendations. Drug consumption during the year 2007 was reduced by 152.745 euros (-6,3%) although the number of patients increased in 565 (+4,9%) with respect to the previous year. 442 (78,9% IC95% 75,6-82,3) densitometries presented a result in the osteopenia or osteroporosis category. There were statistically significant differences of the results according to the patients' age and the motive for the bone densitometry request. CONCLUSIONS: Implementation of the guideline allowed for the effective management of the clinical process of osteroporosis in our field.

Sistemas de gestión para la renovación de recetas médicas: estrategia para optimizar su utilización / Repeat prescription management systems: strategy for optimising their use

Objetivo: Mejorar el cumplimiento de los pacientes con el sistema de medicación repetida. Evaluar los motivos de impuntualidad en la recogida de las recetas y su relación con el incumplimiento terapéutico declarado por el mismo paciente.DiseñoEstudio de intervención cuasiexperimental antes-después con grupo control.EmplazamientoCentro de atención primaria que atiende a una población de 62.981 habitantes.ParticipantesPacientes con enfermedades crónicas incluidos en el sistema de gestión de medicación repetida (100 en el grupo control y 100 en el grupo intervención) que son impuntuales al recoger las recetas.IntervencionesSesión informativa-educativa consistente en una breve entrevista con la farmacéutica del centro de atención primaria, en la que se educaba al usuario en el cumplimiento del sistema de medicación repetida y del tratamiento, se identificaban los motivos de impuntualidad y se realizaba el test de Morisky-Green.Mediciones principalesPuntualidad de los pacientes en las recogidas de recetas posteriores a la intervención. Motivo de impuntualidad en la recogida de reclutamiento. Cumplimiento terapéutico según el test de Morisky-Green.ResultadosGlobalmente se obtuvo una mejora absoluta de la puntualidad del 17% en el grupo intervención (el 60% de los pacientes del grupo intervención y el 43% del grupo control fueron puntuales tanto en la primera como en la segunda recogida de seguimiento). Las mujeres del grupo intervención fueron más puntuales. No se observaron diferencias por edad, número de medicamentos o motivo de impuntualidad.ConclusionesEs posible mejorar el cumplimiento de los pacientes con el sistema de medicación repetida mediante una sencilla intervención informativa-educativa(AU)

Objective: To improve patient compliance with a repeat prescription system. To evaluate the reasons for not being punctual in collecting prescriptions and the non-compliance declared by the patients themselves.DesignQuasi-experimental study before and after intervention including a control group.SettingPrimary health care centre which serves a population of 62,981 inhabitants.ParticipantsPatients with chronic diseases included in the repeat prescription management system (100 in the control group and 100 in the intervention group) who were unpunctual in collecting their prescriptions.InterventionsAn informative-educational session consisting of a short interview with the pharmacist from Primary Health Care Centre, in which the patient was educated on compliance of the repeat prescription system and treatment. The reasons for the unpunctuality were identified and the Moriskey-Green test was performed.Main measurementsPunctuality of the patients in collecting their prescriptions after the intervention. Reasons for unpunctuality recorded at recruitment. Therapeutic compliance according to the Moriskey-Green test.ResultsThere was an overall absolute improvement of 17% in punctuality in the intervention group (60% of the patients in the intervention group and 43% in the control group were punctual in the first as well as in the second follow up. Women were more punctual in the intervention group. There were no differences seen due to age, number of medications or reason for unpunctuality.ConclusionsIt is possible to improve patient compliance with the prescription renewal system using a simple informative-educational intervention(AU)

[Repeat prescription management systems: strategy for optimising their use]. / Sistemas de gestión para la renovación de recetas médicas: estrategia para optimizar su utilización.

OBJECTIVE: To improve patient compliance with a repeat prescription system. To evaluate the reasons for not being punctual in collecting prescriptions and the non-compliance declared by the patients themselves. DESIGN: Quasi-experimental study before and after intervention including a control group. SETTING: Primary health care centre which serves a population of 62,981 inhabitants. PARTICIPANTS: Patients with chronic diseases included in the repeat prescription management system (100 in the control group and 100 in the intervention group) who were unpunctual in collecting their prescriptions. INTERVENTIONS: An informative-educational session consisting of a short interview with the pharmacist from Primary Health Care Centre, in which the patient was educated on compliance of the repeat prescription system and treatment. The reasons for the unpunctuality were identified and the Moriskey-Green test was performed. MAIN MEASUREMENTS: Punctuality of the patients in collecting their prescriptions after the intervention. Reasons for unpunctuality recorded at recruitment. Therapeutic compliance according to the Moriskey-Green test. RESULTS: There was an overall absolute improvement of 17% in punctuality in the intervention group (60% of the patients in the intervention group and 43% in the control group were punctual in the first as well as in the second follow up. Women were more punctual in the intervention group. There were no differences seen due to age, number of medications or reason for unpunctuality. CONCLUSIONS: It is possible to improve patient compliance with the prescription renewal system using a simple informative-educational intervention.

[Management systems for the renewal of medical prescriptions: the vision of users and health professionals]. / Sistemas de gestión para la renovación de recetas médicas: la visión del usuario y del profesional sanitario.

OBJECTIVE: To find the degree of satisfaction of users and doctors who use the repeat medical prescription system. DESIGN: Multi-centre, cross-sectional study. SETTING: Four primary care centres covering 160 000 inhabitants. PARTICIPANTS: Users included in the repeat medical prescription system and doctors who use it. MAIN MEASUREMENTS: Questionnaire on satisfaction. MAIN RESULTS: Users (52.4% women) filled in 429 questionnaires (mean age, 64.2; SD, 13.98). Average medicines taken were 4.4 (SD, 3.04). The period established for picking up prescriptions was usually 60 days (77.4%). 83.9% (95% CI, 80.4-87.4) of those questioned stated they had no problems, with a mean degree of satisfaction at 8.4 (SD, 1.52). There were no significant differences for gender (P=.53). There was a very weak but significant positive correlation between the score and the age of those questioned (r(2)=1%; P=.03). Mean score of satisfaction had statistically significant differences, depending on the PCC. 86.9% (95% CI, 83.8-90.1) of users collected the prescriptions within the term set. The factors associated with greater adherence were age and a greater number of medicines per person. Doctors filled in 47 questionnaires. Mean score was 7.42 (SD, 1.09) and all except one (98%; 95% CI, 89.1-99.9) thought that the system meant an improvement in clinical management. CONCLUSION: Users are very satisfied, although they believe certain organisational points should be improved in order to improve accessibility.

Sistemas de gestión para la renovación de recetas médicas: la visión del usuario y del profesional sanitario / Management systems for the renewal of medical prescriptions: the vision of users and health professionals

Objetivo. Conocer el grado de satisfacción de los usuarios y médicos que utilizan el sistema de repetición de recetas médicas. Diseño. Estudio multicéntrico, transversal. Ámbito. Cuatro centros de atención primaria que atienden a 160.000 habitantes. Participantes. Usuarios incluidos en el sistema de repetición de recetas médicas y médicos que lo utilizan. Mediciones principales. Encuesta de satisfacción. Resultados principales. Se han realizado 429 encuestas a usuarios (edad media 64,2 ± 13,98 años, con un 52,4% de mujeres). El promedio de medicamentos que tomaban era de 4,4 ± 3,04. El período establecido para la recogida de recetas era principalmente de 60 días (77,4%). El 83,9% (intervalo de confianza [IC] del 95%, 80,4-87,4) de los encuestados declaró no haber tenido problemas y la puntuación media de satisfacción fue de 8,4 ± 1,52. No se observaron diferencias estadísticamente significativas según el sexo (p = 0,53). Hay una correlación positiva muy débil aunque significativa entre la puntuación y la edad de los encuestados (r² = 1%; p = 0,03). La puntuación media de satisfacción presentaba diferencias estadísticamente significativas según el centro de atención primaria. El 86,9% (IC del 95%, 83,8-90,1) de los usuarios recogió las recetas en el plazo fijado. Los factores que se asociaron con un mayor cumplimiento fueron la edad y el mayor número de medicamentos por persona. Se realizaron 47 encuestas a los médicos. La puntuación media fue de 7,42 ± 1,09 y todos excepto uno (98%; IC del 95%, 89,1-99,9) opinaron que había sido una mejora para la gestión de la consulta. Conclusión. Los usuarios están muy satisfechos aunque consideran que deben mejorarse aspectos relacionados con la organización para mejorar la accesibilidad

Objective. To find the degree of satisfaction of users and doctors who use the repeat medical prescription system. Design. Multi-centre, cross-sectional study. Setting. Four primary care centres covering 160 000 inhabitants. Participants. Users included in the repeat medical prescription system and doctors who use it. Main measurements. Questionnaire on satisfaction. Main results. Users (52.4% women) filled in 429 questionnaires (mean age, 64.2; SD, 13.98). Average medicines taken were 4.4 (SD, 3.04). The period established for picking up prescriptions was usually 60 days (77.4%). 83.9% (95% CI, 80.4-87.4) of those questioned stated they had no problems, with a mean degree of satisfaction at 8.4 (SD, 1.52). There were no significant differences for gender (P=.53). There was a very weak but significant positive correlation between the score and the age of those questioned (r²=1%; P=.03). Mean score of satisfaction had statistically significant differences, depending on the PCC. 86.9% (95% CI, 83.8-90.1) of users collected the prescriptions within the term set. The factors associated with greater adherence were age and a greater number of medicines per person. Doctors filled in 47 questionnaires. Mean score was 7.42 (SD, 1.09) and all except one (98%; 95% CI, 89.1-99.9) thought that the system meant an improvement in clinical management. Conclusion. Users are very satisfied, although they believe certain organisational points should be improved in order to improve accessibility

Atención farmacéutica integrada: proyecto de colaboración entre un centro de atención primaria y las farmacias comunitarias / No disponible

Objetivo: establecer una colaboración entre farmacéuticos comunitarios y farmacéuticos de Atención Primaria a través de un estudio donde se recogen los motivos de consulta que la población realiza en las farmacias comunitarias. Diseño: Estudio descriptivo y prospectivo. Ámbito de estudio: farmacias comunitarias del término municipal de Sant Cugat del Vallès y el Centro de Atención Primaria de referencia (población = 69.000 habitantes). Período de estudio: 1 año natural (febrero 2004 hasta enero 2005). Variables estudiadas: sexo, edad, motivos y tipos de consulta. Resultados: al inicio del estudio, participaron 11 de las 15 farmacias comunitarias (73%), y al final del mismo quedaron 9 (60%). Se registraron n = 1.101 consultas. El 71,8% eran mujeres. El motivo de consulta más frecuente fue el de «solicitar consejo farmacéutico» en un 42,8% (IC 95%: 39,9% a 45,7%) de los casos. Las consultas más frecuentes, agrupadas por patologías, fueron las relacionadas con la patología respiratoria (18,3%; IC 95%: 16,0% a 20,5%), seguidas de las dermatológicas (13,2%; IC 95%: 11,2% a 15,2%) Se elaboraron dos protocolos de abordaje terapéutico para la tos y el resfriado común. Se consensuó el correcto procedimiento de la toma de la tensión arterial entre los farmacéuticos comunitarios y el equipo de atención primaria (AU)

No disponible

Problemas relacionados con los medicamentos en pacientes que visitan un servicio de urgencias / Drug related problems in patients who visit an emergency room

El objetivo de este trabajo fue la determinación de la incidencia de problemas relacionados con los medicamentos (PRM) en pacientes que acudían en un servicio de urgencias en un hospital de tercer nivel durante el período de un año. También se propusieron como objetivos secundarios evaluar el tipo de PRM de acuerdo con la clasificación realizada por Strand en 1998, así como qué factores de riesgo estaban involucrados. En nuestro estudio se observó que un 19 por ciento de las urgencias hospitalarias eran causadas por un PRM y que el tipo de PRM más frecuente fue la indicación no tratada y las reacciones adversas. La edad, la polimedicación y el mal cumplimiento han aparecido como factores de riesgo determinantes (AU)

The aim of this study was to know the incidence of drug related problems (DRP)'s admissions in the emergency department in a tertiary hospital. Also, we studied as well which main types of DRP were more frequent and which risk factors were involved. The results were that 19% of emergency admissions were due to DRP. The main types of those were the «non treated indication» and «adverse drug reaction». Age, polymedication and noncompliance appeared as the main risk factors (AU)