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      Resultados negativos asociados a la medicación y reacciones adversas a medicamentos en servicio de urgencias. Estudio exploratorio de vida real Translated title: Negative outcomes associated with medication and adverse drug reactions in the emergency department. Real-life exploratory study

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          Abstract

          Resumen Introducción. El objetivo del estudio es determinar la prevalencia de los resultados negativos asociados a la medicación (RNM) y reacciones adversas a medicamentos (RAM) que tienen los pacientes que acuden al servicio de urgencias (SU) de un centro de salud. Método. Estudio observacional exploratorio, de corte transversal, en pacientes con RNM que consultan en un servicio de urgencias. La información, acorde con las variables de interés, se recolectó con un instrumento diseñado y evaluado para ello. Se aplicó un modelo de regresión logística multivariante sobre los RNM encontrados, para determinar las variables más importantes que predisponen a la aparición de RNM. Además, se determinó la evitabilidad de RNM (criterio de Baena et al.), la gravedad de RNM (clasificación de Schneider) y la causalidad de RAM (algoritmo de Naranjo). Resultados. Un total de 158 pacientes fueron incluidos en el estudio. La prevalencia de visitas al SU motivados por RNM fue 35,0 % (55 pacientes) y de RAM fue de 5,1 % (8 pacientes). El 88,0 % de los RNM se consideraron evitables y el 74,0 % fueron de gravedad leve. Por otra parte, el 37,5 % (n=3) de RAM fueron clasificadas como evitables y el 50,0 % como probables. El modelo logístico multivariado indica una posible asociación entre los RNM con bajos niveles de escolaridad, la utilización de plantas medicinales y el número de enfermedades concomitantes. Conclusiones. La visita de 1 de cada 3 pacientes al servicio de urgencias está asociado a un RNM; mientras que 1 de cada 20 lo está a una RAM. Otros estudios son necesarios.

          Translated abstract

          Abstract Introduction. The aim of the study is to determine the prevalence of negative outcomes associated with medication (NOMs) and adverse drug reactions (ADRs) occurring in the emergency department (ED) of a health centre. Method. An exploratory observational, cross-sectional study of patients with NOMs consulting in an ED. According to the variables of interest, the information was collected with an instrument designed and evaluated for this purpose. A multivariate logistic regression model was applied to the NOMs and found the most important variables predisposing to the appearance of NOM. In addition, the avoid ability of NOM (Baena et al. criteria), the severity of NOM (Schneider classification) and the causality of ADR (Naranjo algorithm) were shown. Results. A total of 158 patients were included in the study. The prevalence of visits to the ED due to NOM was 35.0 % (55 patients) and ADR was 5.1 % (8 patients). Overall, 88.0 % of the ADRs were considered avoidable and 74.0 % were of mild severity. On the other hand, 37.5 % (n=3) of suspected ADR were classified as avoidable and 50.0 % as probable. The multivariate logistic model indicates a possible association between NOMs with lower levels of schooling, the use of medicinal plants and the number of diseases. Conclusions. The visit of 1 in 3 patients to the emergency department is associated with a NOM, while 1 in 20 is associated with an ADR. Further studies are needed.

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          Most cited references28

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          Focusing on the preventability of adverse drug reactions.

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            Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis.

            It is currently admitted that adverse drug reactions (ADRs) account for a great burden of disease. Of particular concern are ADR-induced hospital admissions, particularly in the elderly; they receive most of the medications and they are the most prone to develop ADRs. Therefore, our aim was to carry out a study of ADR-induced hospital admissions focused on the elderly population.
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              Impact of low health literacy on patients’ health outcomes: a multicenter cohort study

              Background This study aims to assess the health literacy of medical patients admitted to hospitals and examine its correlation with patients’ emergency department visits, hospital readmissions, and durations of hospital stay. Methods This prospective cohort study recruited patients admitted to the general internal medicine units at the two urban tertiary care hospitals. Health literacy was measured using the full-length Test of Functional Health Literacy in Adults. Logistic regression analyses were performed to examine the correlation between health literacy and the desired outcomes. The primary outcome of interest of this study was to determine the correlation between health literacy and emergency department revisit within 90 days of discharge. The secondary outcomes of interest were to assess the correlation between health literacy and length of stay and hospital readmission within 90 days of discharge. Results We found that 50% had adequate health literacy, 32% had inadequate, and 18% of patients had marginal health literacy. Patients with inadequate health literacy were more likely to revisit the emergency department as compared to patients with adequate health literacy (odds ratio: 3.0; 95% Confidence Interval: 1.3–6.9, p = 0.01). In patients with inadequate health literacy, the mean predicted probability of emergency department revisits was 0.22 ± 0.11 if their education level was some high school or less and 0.57 ± 0.18 if they had completed college. No significant correlation was noted between health literacy and duration of hospital stay or readmission. Conclusions Only half of the patients admitted to the general internal medicine unit had adequate health literacy. Patients with low health literacy, but high education, had a higher probability of emergency department revisits.
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                Author and article information

                Journal
                ars
                Ars Pharmaceutica (Internet)
                Ars Pharm
                Universidad de Granada (Granada, Granada, Spain )
                2340-9894
                September 2023
                : 64
                : 3
                : 266-285
                Affiliations
                [1] San José orgnameCaja Costarricense de Seguro Social orgdiv1Clínica Dr Ricardo Jiménez Nuñez orgdiv2Servicio de Farmacia Costa Rica
                [2] San José orgnameUniversidad de Costa Rica orgdiv1Centro Nacional de Información de Medicamentos orgdiv2Facultad de Farmacia, Instituto de Investigaciones Farmacéuticas Costa Rica
                [3] San José orgnameUniversidad de Costa Rica orgdiv1Facultad de Farmacia orgdiv2Departamento de Atención Farmacéutica y Farmacia Clínica Costa Rica
                Article
                S2340-98942023000300006 S2340-9894(23)06400300006
                10.30827/ars.v64i3.27677
                7f7214a1-1f73-4199-839d-f3e5f05e730b

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 22 March 2023
                : 02 April 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 20
                Product

                SciELO Spain

                Categories
                Artículos Originales

                medication review,emergencies,adverse drug reactions,pharmaceutical services,urgencias médicas,reacciones adversas relacionadas con medicamentos,revisión de medicación,Atención farmacéutica

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