[What do primary care physicians think about deprescription?] / ¿Qué opinan los médicos de atención primaria sobre la deprescripción?

INTRODUCTION: To learn about the perceptions and attitudes of family doctors regarding deprescription. MATERIAL AND METHODS: This is a cross-sectional study conducted at the Organización Sanitaria Integrada Bidasoa, Osakidetza. In November 2018, sessions were held at health centres on deprescribing for family doctors, following which the PACPD-12 questionnaire was handed out, translated into Spanish and adapted. The responses to the questionnaire were collected, together with the socio-demographic variables. RESULTS: Forty-two of the 58 doctors who received the survey responded (72%). One hundred percent considered deprescription beneficial in the current scenario. The drug groups that they most frequently considered deprescribing were the benzodiazepines, bisphosphonates and proton pump inhibitors. The main reasons they gave for deprescribing were to reduce harm from adverse effects and that the medication was of minimal benefit in the patient's circumstances, and they indicated that specific training in deprescribing and pharmacist alerts in the clinical history would facilitate deprescription. Barriers highlighted were lack of time, prescribing by other professionals, or resistance on the part of the patient or their family. CONCLUSIONS: Knowing what doctors think about deprescribing and its barriers and facilitators are necessary to plan a strategy to facilitate the practice. Although all the respondents indicated that they consider deprescription beneficial, they found barriers in their daily practice to their being able to implement it.

On the performance of natural orbital functional approximations in the Hubbard model.

Strongly correlated materials are now under intense development, and natural orbital functional (NOF) methods seem to be able to capture the physics of these systems. We present a benchmark based on the Hubbard model for a class of commonly used NOF approximations (also known as reduced density matrix functional approximations). Our findings highlight the importance of imposing ensemble N-representability conditions in order to obtain consistent results in systems with either weak or strong electronic correlation, such as the Hubbard system with a varying two-particle interaction parameter. Based on the accuracy of the results obtained using PNOF7, which retrieves a large amount of the total strong nondynamic correlation, the Hubbard model points out that N-representability gives solid foundations for NOF development.

Conciliación de la medicación: desde el ingreso hasta la atención primaria / Medication reconciliation: from admission to primary care

Objetivos. Implementar un circuito de conciliación de la medicación interniveles, integral y multidisciplinar en una organización sanitaria integrada. Medir las discrepancias detectadas en cada uno de los pasos estudiados. Método. Estudio de intervención, prospectivo y de un año de duración. La medicación se concilió en 3 momentos distintos del paso del paciente por el sistema sanitario: al ingreso en el hospital, al alta y cuando el paciente acudió a su médico de Atención Primaria. Se recogieron y resolvieron las discrepancias detectadas cada vez que se concilió la medicación, y se cuantificó el número total de medicamentos antes y después de cada proceso de conciliación. Resultados. Entre el 1 de noviembre de 2013 y el 30 de octubre de 2014 se concilió la medicación a 77 pacientes, 63% hombres, con una media de edad de 69,5 años. La media de discrepancias por paciente fue de 7,85 al ingreso, 3,67 al alta y 2,19 en Atención Primaria. Conclusiones. Este programa de conciliación de la medicación, además de detectar y resolver las discrepancias, ha sido un punto de partida para establecer nuevas vías de comunicación entre los diferentes profesionales sanitarios que han intervenido en el programa y difundir la cultura de seguridad dentro de la organización (AU)

Objectives. To implement a medication reconciliation circuit of inter-level, comprehensive and multidisciplinary approach in an integrated health organization. To measure the discrepancies detected in each of the steps studied. Method. A prospective intervention study of one-year duration. The medication is reconciled at admission to the hospital, at discharge and when the patient goes to his Primary Care physician. The number and type of discrepancies detected each time the medication is reconciled are collected and resolved, as well as the total number of drugs before and after each reconciliation process quantified. Results. Between November 1, 2013 and October 31, 2014 the medication had been reconciled to 77 patients, 63% male, mean age 69,5 years. Mean admission discrepancy per patient was 7,85, 3,67 at discharge and 2,19 at Primary Care. Conclusions. This program of medication reconciliation, in addition to detect and resolve discrepancies, has been a starting point for establishing new channels of communication between the different health professionals who have participated in the program and disseminate the safety culture within the organization (AU)

[Medication reconciliation: From admission to primary care]. / Conciliación de la medicación: desde el ingreso hasta la atención primaria.

OBJECTIVES: To implement a medication reconciliation circuit of inter-level, comprehensive and multidisciplinary approach in an integrated health organization. To measure the discrepancies detected in each of the steps studied. METHOD: A prospective intervention study of one-year duration. The medication is reconciled at admission to the hospital, at discharge and when the patient goes to his Primary Care physician. The number and type of discrepancies detected each time the medication is reconciled are collected and resolved, as well as the total number of drugs before and after each reconciliation process quantified. RESULTS: Between November 1, 2013 and October 31, 2014 the medication had been reconciled to 77 patients, 63% male, mean age 69,5 years. Mean admission discrepancy per patient was 7,85, 3,67 at discharge and 2,19 at Primary Care. CONCLUSIONS: This program of medication reconciliation, in addition to detect and resolve discrepancies, has been a starting point for establishing new channels of communication between the different health professionals who have participated in the program and disseminate the safety culture within the organization.