Intervención farmacéutica al alta hospitalaria para reforzar la comprensión y cumplimiento del tratamiento farmacológico / Pharmaceutical intervention upon hospital discharge to strengthen understanding and adherence to pharmacological treatment

Objetivo Conocer la efectividad de una intervención farmacéutica en pacientes, al alta hospitalaria, para mejorar la comprensión de los tratamientos farmacológicos y en consecuencia el cumplimiento de las pautas prescritas, en su domicilio. Observar si esta intervención repercute en el número de reingresos hospitalarios. Método Estudio experimental, controlado, aleatorizado, con dos grupos paralelos. Fueron incluidos 100 pacientes polimedicados del área de medicina interna. Al grupo control no se le realizó ninguna actividad complementaria a la práctica clínica habitual. Al grupo intervención, ya sea paciente o cuidador en el caso de pacientes dependientes, un farmacéutico le explicó y le hizo entrega de un diagrama horario personalizado de los medicamentos prescritos. Además, se informó al paciente acerca de la utilidad de cada medicamento, cómo debía ser administrado y la importancia de seguir las pautas correctamente. Al cabo de siete días, todos los pacientes o cuidadores fueron entrevistados telefónicamente acerca de su medicación, mediante un cuestionario. Se compararon las respuestas obtenidas con la prescripción médica al alta y se registraron las discrepancias. Mediante el sistema informático del censo hospitalario se consultaron los reingresos a los treinta y sesenta días del alta hospitalaria. Resultados El 70,7% de pacientes del grupo intervención, a la semana del alta, tomaba toda su medicación conforme a las pautas prescritas, en el grupo control este porcentaje fue de 19,5% (p < 0,001). El número de pacientes que reingresaron en el hospital al mes del (..)(AU)

Objective To determine the effectiveness of a pharmaceutical intervention with the patient upon hospital discharge, to improve understanding of pharmaceutical treatment and, as a consequence, improve adherence to prescribed regimens at home. To observe whether this intervention has an impact on the number of hospital admissions. Methods Experimental, controlled, randomised study with two parallel groups. One-hundred polymedicated internal medicine patients were included. Routine clinical practice was performed on the control group. For the intervention group, whether patient or carer (in the case of dependent patients), a pharmacist explained the drugs prescribed giving the patient a personalised medication timetable. Furthermore, the pharmacist explained why each drug had been prescribed, how to take it and why it was important to take the medication correctly. After seven days, all patients or carers were asked to complete a questionnaire about their treatment by telephone. The responses obtained were compared with the prescription upon discharge and discrepancies were recorded. We consulted the hospital's computer records to check for admissions thirty and sixty days following discharge. Results A week following hospital discharge, 70.7% of the intervention group were taking all of their medication in accordance with the prescribed regimen, whereas 19.5% of the control group was (P < .001). Three (7.3%) patients from the intervention group and 10 patients (24.4%) from the control group were readmitted a month following hospital discharge (P < .05). After two months, 3 (7.2%) patients from the intervention group and 13 (31.7%) from the control group had been readmitted (P < .01).Conclusions The pharmacist's intervention upon discharge has helped increase the percentage of patients that understood and took their medication correctly in accordance with their prescription. The number of hospital readmissions in the intervention group has also reduced (AU)

Pharmaceutical intervention upon hospital discharge to strengthen understanding and adherence to pharmacological treatment.

OBJECTIVE: To determine the effectiveness of a pharmaceutical intervention with the patient upon hospital discharge, to improve understanding of pharmaceutical treatment and, as a consequence, improve adherence to prescribed regimens at home. To observe whether this intervention has an impact on the number of hospital admissions. METHODS: Experimental, controlled, randomised study with two parallel groups. One-hundred polymedicated internal medicine patients were included. Routine clinical practice was performed on the control group. For the intervention group, whether patient or carer (in the case of dependent patients), a pharmacist explained the drugs prescribed giving the patient a personalised medication timetable. Furthermore, the pharmacist explained why each drug had been prescribed, how to take it and why it was important to take the medication correctly. After seven days, all patients or carers were asked to complete a questionnaire about their treatment by telephone. The responses obtained were compared with the prescription upon discharge and discrepancies were recorded. We consulted the hospital's computer records to check for admissions thirty and sixty days following discharge. RESULTS: A week following hospital discharge, 70.7% of the intervention group were taking all of their medication in accordance with the prescribed regimen, whereas 19.5% of the control group was (P < .001). Three (7.3%) patients from the intervention group and 10 patients (24.4%) from the control group were readmitted a month following hospital discharge (P < .05). After two months, 3 (7.2%) patients from the intervention group and 13 (31.7%) from the control group had been readmitted (P < .01). CONCLUSIONS: The pharmacist's intervention upon discharge has helped increase the percentage of patients that understood and took their medication correctly in accordance with their prescription. The number of hospital readmissions in the intervention group has also reduced.

Valoración del interrogatorio de la alergia a antibióticos en la historia clínica / Assessment of the antibiotic allergy questionnaire in the medical history

Introducción: el interrogatorio clínico es un instrumentoeficaz para evaluar la alergia a los antibióticos. El objetivo denuestro trabajo es valorar su prevalencia y su fiabilidad para ladetección de alergias en las historias clínicas.Métodos: análisis observacional de la presencia del datode alergia a los antibióticos en las historias de un hospital general.Comprobación mediante interrogatorio dirigido de lafiabilidad del dato.Resultados: se evalúan 610 historias. En 98% de los casosconstaba interrogada la alergia a antibióticos. Setenta y un pacientes(12%) tenían registrada alergia a algún antibiótico. Enla valoración por el investigador, sólo un 5% (33 de 610 casos)resultó tener alergia. De detectó un 44% de falsas alergia. Lascausas más frecuentes de confusión fueron lipotimia e intoleranciagástrica.Conclusiones: la presencia del dato de alergia o no a losantibióticos es prácticamente constante en todas las historiasclínicas. La prevalencia de alergia a algún antibiótico medianteinterrogatorio dirigido es del 5%. Es necesario explicar periódicamenteal colectivo sanitario el significado de la alergia a losantibióticos y la importancia del interrogatorio dado que ésteconstituye un instrumento rápido, sencillo y muy eficaz(AU)

Objectives: Antibiotic allergy questionnaire is a usefultool for prescribing antibiotics. The objective of thisstudy is to assess the prevalence and clinical reliabilityof antibiotic allergy in medical records.Patients and method: Observational analysis of clinicalrecords. Assessment of antibiotic allergy by directinterview conducted by the investigator.Results: 610 medical records were evaluated. Antibioticallergy was checked in 98%, mainly in medicalwards. In 12 % of patients, antibiotic allergy was suspected,but after investigator interview only 5% of patientsfulfilled clinical criteria for allergy. 44% of falsesallergies were recorded. The most frequent cause of confusionwas faint and gastric intolerance.Conclussion: The questionnaire about antibioticallergy is present in almost all medical records. Howeverits reliability is low, less than 50%. Prevalence of veritableantibiotic allergy is 5% in this study. Antibioticallergy questionnaire in medical records is a practical tool.However periodical training about antibiotic allergydefinition is necessary for nurses and medical staff(AU)

[Assessment of the antibiotic allergy questionnaire in the medical history]. / Valoración del interrogatorio de la alergia a antibióticos en la historia clínica.

OBJECTIVES: Antibiotic allergy questionnaire is a useful tool for prescribing antibiotics. The objective of this study is to assess the prevalence and clinical reliability of antibiotic allergy in medical records. PATIENTS AND METHOD: Observational analysis of clinical records. Assessment of antibiotic allergy by direct interview conducted by the investigator. RESULTS: 610 medical records were evaluated. Antibiotic allergy was checked in 98%, mainly in medical wards. In 12 % of patients, antibiotic allergy was suspected, but after investigator interview only 5% of patients fulfilled clinical criteria for allergy. 44% of falses allergies were recorded. The most frequent cause of confusion was faint and gastric intolerance. CONCLUSIONS: The questionnaire about antibiotic allergy is present in almost all medical records. However its reliability is low, less than 50%. Prevalence of veritable antibiotic allergy is 5% in this study. Antibiotic allergy questionnaire in medical records is a practical tool. However periodical training about antibiotic allergy definition is necessary for nurses and medical staff.