[Use of psychoactive drugs in a health and welfare centre]. / Utilización de psicofármacos en un centro sociosanitario.

OBJECTIVE: To analyse the use of psychoactive drugs in a health and welfare centre and compare this use with current guidelines. METHOD: A cross-sectional study of the drug treatment regime of hospitalised patients in a health and welfare centre was carried out. Information was obtained from prescriptions and the clinical histories of patients in the centre. The following variables were assessed: demographic data, treatment with psychoactive drugs, date of commencing treatment, dosage, drug combinations, indication and total number of drugs analysed. The results were compared with the literature and current prescription guidelines. RESULTS: 45 of the 70 patients analysed were taking psychoactive drugs: 51.1% were being treated with neuroleptic drugs, 42.2% with antidepressants, and 6.7% with anxiolytic agents. 62% were women. The overall mean age was 80.3 years old. The average number of psychoactive drugs administered to each patient was 1.6 and the average number of total drugs prescribed was 10.5. The most frequently administered psychoactive drugs were risperidone, lorazepam and citalopram. The most frequent association was neuroleptic drugs with benzodiazepine. The indication and dosage prescribed were appropriate according to the data sheet, although some inappropriate prescription practices were observed. CONCLUSIONS: The results of the study would recommend controlling the duration of treatment with benzodiazepine, confirming the diagnosis of states of depression and correctly monitoring the associations between psychoactive drugs.

Utilización de psicofármacos en un centro sociosanitario / No disponible

Objetivo: Analizar la utilización de psicofármacos en un centro sociosanitario y compararlo con las guías de recomendación existentes. Material y métodos: Se realizó un estudio transversal del perfil farmacoterapéutico de los residentes ingresados en un centro sociosanitario. Las fuentes de información fueron las prescripciones médicas y las historias clínicas del centro. Se evaluaron variables demográficas, del tratamiento con psicofármacos, fecha de inicio, dosis y combinaciones, indicación y número total de medicamentos estudiados. Se compararon los resultados con la bibliografía y las guías de prescripción existentes. Resultados: Tomaban psicofármacos 45 de los 70 pacientes estudiados observándose que el 51,1% estaban siendo tratados con fármacos neurolépticos, el 42,2% con antidepresivos, el 6,7% con ansiolíticos. El 62% eran mujeres. La edad media global fue de 80,3 años. El número medio de psicofármacos por paciente fue 1,6 y del total de medicamentos 10,5. Los psicofármacos más utilizados fueron risperidona, lorazepam y citalopram. Las asociación más frecuente fue neuroléptico más benzodiazepina. La indicación y dosis prescritas eran adecuadas según ficha técnica, aunque se observaron pautas de prescripción desaconsejadas. Conclusiones: Los resultados del estudio aconsejarían controlar la duración de los tratamientos con benzodiazepinas, asegurar el diagnóstico de los estados depresivos y realizar un adecuado seguimiento de las asociaciones entre psicofármaco

Objective: To analyse the use of psychoactive drugs in a health and welfare centre and compare this use with current guidelines. Method: A cross-sectional study of the drug treatment regime of hospitalised patients in a health and welfare centre was carried out. Information was obtained from prescriptions and the clinical histories of patients in the centre. The following variables were assessed: demographic data, treatment with psychoactive drugs, date of commencing treatment, dosage, drug combinations, indication and total number of drugs analysed. The results were compared with the literature and current prescription guidelines. Results: 45 of the 70 patients analysed were taking psychoactive drugs: 51.1% were being treated with neuroleptic drugs, 42.2% with antidepressants, and 6.7% with anxiolytic agents. 62% were women. The overall mean age was 80.3 years old. The average number of psychoactive drugs administered to each patient was 1.6 and the average number of total drugs prescribed was 10.5. The most frequently administered psychoactive drugs were risperidone, lorazepam and citalopram. The most frequent association was neuroleptic drugs with benzodiazepine. The indication and dosage prescribed were appropriate according to the data sheet, although some inappropriate prescription practices were observed. Conclusions: The results of the study would recommend controlling the duration of treatment with benzodiazepine, confirming the diagnosis of states of depression and correctly monitoring the associations between psychoactive drugs

Seguimiento de la utilización de metformina en la población de riesgo / Follow-up of the use of metformin among the risk population

Objetivo: Realizar un seguimiento de utilización de metforminapara comprobar la adecuada prescripción del medicamento en lapoblación con mayor riesgo de desarrollar reacciones adversas.Método: Se ha realizado un seguimiento prospectivo de utilizaciónde metformina durante un periodo de cuatro meses. En lospacientes seleccionados se ha registrado: edad, sexo, peso y talla,motivo del ingreso, perfil farmacoterapéutico, origen de la prescripción(anterior al ingreso o durante la estancia hospitalaria),glucemia, función renal, efectos adversos y el motivo de interrupcióndel tratamiento, si procede.Resultados: La media diaria de pacientes ingresados duranteeste periodo fue de 352 (desviación estándar ± 36,8), la edadmedia fue de 73 años (33-102), el total de pacientes estudiadosfue de 135, siendo un 46% hombres.La prescripción de metformina está contraindicada en pacientescon valores de creatinina superiores a 0,132 mMol/L, por ellose controló la función renal. Con los datos de 20 pacientes, serealizaron seis intervenciones farmacéuticas para aconsejar la suspensióndel tratamiento, aceptadas en un 83% de los casos. Tambiénse registraron efectos adversos y glucemia.Conclusiones: Durante el periodo de seguimiento no hemosobservado ningún efecto adverso grave como la acidosis lácticaasociada, aunque en ocasiones la prescripción de metformina seha realizado en pacientes en los que no estaría recomendada. Sinembargo, consideramos interesante el seguimiento de estospacientes puesto que hemos observado efectos adversos (diarrea)que han requerido la disminución de la dosis de metformina

Objective: To perform a follow-up of the use of metformin inorder to ensure the appropriate prescription of the drug amongthe population with the highest risk of adverse reactions.Method: A prospective follow-up was conducted of the use ofmetformin during a four-month period. In the patients recruitedfor the study, the following data were recorded: age, sex, weightand height, cause of hospitalization, pharmacotherapeutic profile,origin of the prescription (prior to hospitalization or during thehospital stay), glycemia, renal function, side effects and cause ofthe discontinuation of the treatment, if appropriate.Results: The mean number of patients hospitalized each dayduring the study period was 352 (standard deviation ± 36,8), themean age was 73 years (33-102) and the total number of patientsstudied was 135, with 46% of males.Since prescription of metformin is contraindicated in patientswith creatinine values > 0.132 mMol/L, renal function was monitored.Based on the data of 20 patients, six pharmaceutical interventionswere performed in order to recommend the discontinuationof the treatment, which was accepted in 83% of the cases.Side effects and glycemia were also recorded.Conclusions: During the follow-up period, we did not observeany severe side effects such as associated lactic acidosis, althoughin some cases metformin was prescribed to patients inwhich it was not recommended. However, the follow-up ofpatients is important, since we have observed side effects (diarrhea)that require reduction of the dose of metformin

[Follow-up of the use of metformin among the high risk population]. / Seguimiento de la utilización de metformina en la población de riesgo.

OBJECTIVE: To perform a follow-up of the use of metformin in order to ensure the appropriate prescription of the drug among the population with the highest risk of adverse reactions. METHOD: A prospective follow-up was conducted of the use of metformin during a four-month period. In the patients recruited for the study, the following data were recorded: age, sex, weight and height, cause of hospitalization, pharmacotherapeutic profile, origin of the prescription (prior to hospitalization or during the hospital stay), glycemia, renal function, side effects and cause of the discontinuation of the treatment, if appropriate. RESULTS: The mean number of patients hospitalized each day during the study period was 352 (standard deviation +/- 36,8), the mean age was 73 years (33-102) and the total number of patients studied was 135, with 46% of males.Since prescription of metformin is contraindicated in patients with creatinine values > 0.132 mMol/L, renal function was monitored. Based on the data of 20 patients, six pharmaceutical interventions were performed in order to recommend the discontinuation of the treatment, which was accepted in 83% of the cases. Side effects and glycemia were also recorded. CONCLUSIONS: During the follow-up period, we did not observe any severe side effects such as associated lactic acidosis, although in some cases metformin was prescribed to patients in which it was not recommended. However, the follow-up of patients is important, since we have observed side effects (diarrhea) that require reduction of the dose of metformin.

[Monitoring antidepressant use in acute hospital]. / Seguimiento de la utilización de antidepresivos en un hospital de agudos.

OBJECTIVE: To carry out a prospective study on the current use of antidepressants (ADs) in an acute hospital, in order to determine the prescription sources, therapeutic indications, safety and monitoring of these drugs and their use at patient discharge. METHOD AND RESULTS: To this end the therapeutic drug profiles of non-psychiatric inpatients treated with tri-cyclic antidepressants, selective serotonin re-uptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MAOIs) were prospectively reviewed. The following was collected from the patientsâ medical record: reason for admittance, AD indication, prescription source (primary care or in-hospital), modifications of antidepressant treatment during stay, drug-related adverse events (DRAEs), interactions with other drugs, and whether patients were still on antidepressants upon discharge. The mean numer of daily inpatients was 382.6, of which 4.4% received ADs (11-25). Females were 67.5% and males were 32.5%, with a mean age of 67 years (37-92). The total number of patients studied was 126. Prescribed SSRIs represented 73% of cases (92), whereas tricyclic antidepressants represented 27% (34). Prescription originated in primary care for 79.4% of cases (29% tricyclics, 71% SSRIs) and within hospital for 20.6% of cases (tricyclics 11, SSRIs 15), p = 0.02. AD indications were endogenous depression in 72.2%, reactive depression in 7.1%, neuropathic pain in 7.1%, cancer-related pain in 2.4%, and indications not specified in medical records in 11.1%. Treatment was ongoing at patient discharge in 97.5% of cases. CONCLUSIONS: AD prescription source was most commonly primary care. Prescription of ADs for unauthorised indications was seen: management of dementia in the elderly and shyness, support treatment for fibromyalgia, and migraine prophylaxis. In virtually all inpatients on ADs prescriptions were maintained without modification during stay. In the follow-up of patients on ADs, no clinically significant interactions leading to treatment changes were seen.

Seguimiento de la prescripción de antagonistas del calcio en pacientes externos / Follow-up of the prescription of calcium antagonists to outpatients

Objetivo: Conocer los cambios realizados en los tratamientos por los médicos de asistencia primaria de pacientes que fueron diagnosticados de ángor y/o hipertensión durante su ingreso en el hospital y a los cuales se les había prescrito antagonistas del calcio (AC) al alta hospitalaria. Método y resultados: Para este estudio se revisaron todas las historias clínicas de enfermos cardiovasculares ingresados durante el año 1997 con diagnóstico de ángor y/o hipertensión. El criterio de selección fue la prescripción al alta de antagonistas del calcio. La información referente a las modificaciones se obtuvo mediante una conversación telefónica con el paciente. De los 83 pacientes entrevistados, 52 (62,7 por ciento) eran hombres y 31 (37,3 por ciento) eran mujeres. La casi totalidad de los pacientes (98,8 por ciento) fueron dados de alta con un único AC. El AC que se prescribió con mayor frecuencia fue el diltiazem (66,3 por ciento). Tras la entrevista se observó que 61 pacientes (82,4 por ciento) seguían siendo tratados con el mismo AC. La marca comercia se mantuvo en 54 enfermos (88,5 por ciento). Conclusión: De la observación de los resultados se concluye que las prescripciones de AC no presentan modificaciones importantes al ser controlados por los médicos de asistencia primaria (AU)