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      Problemas relacionados con los medicamentos en pacientes de Santiago de Cuba hospitalizados Translated title: Drug related problems in inpatients of Santiago de Cuba

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          Abstract

          Resumen Introducción: Los problemas relacionados con los medicamentos constituyen una gran preocupación sanitaria por su elevado impacto en la morbilidad de pacientes hospitalizados. Método: Estudio observacional, descriptivo y transversal en los servicios clínicos de cinco instituciones de salud de Santiago de Cuba, durante el primer trimestre de 2020. Se revisaron los perfiles de 329 pacientes que recibieron seguimiento farmacoterapéutico. La muestra fue caracterizada según variables biosociales, clínicas y farmacoterapéuticas, la identificación de los problemas relacionados a la medicación fue realizada utilizando los criterios de Cipolle, Stramd y Morley, determinándose además los medicamentos implicados en los problemas relacionados a la medicación. Los datos fueron procesados a través de frecuencias absolutas y relativas representadas por medio de tablas y figuras. Resultados: Predominaron los pacientes mayores o iguales de 60 años representando un 38,6 %; respecto al género un 61,4 % perteneció al femenino. La mayoría de los pacientes presentaron hasta dos enfermedades (76,3 %), las infecciones respiratorias complicadas (35,6 %) fueron el motivo de ingreso más frecuente. El 36,5 % consumió entre cuatro y seis medicamentos, siendo los antibacterianos de usos sistémicos los más prescritos. Se identificaron 598 Problemas Relacionados con los Medicamentos para una proporción de 1,8 PRM/paciente, de estos un 42,8 % corresponde a los problemas de Seguridad, un 31,1 % de Indicación, seguido de 24,9 % de Efectividad y finalmente el 1,2 % de Adherencia. Conclusiones: Los antimicrobianos resultaron los más implicados en la aparición de los problemas relacionados a la medicación. La atención farmacéutica ofrece servicios que garantizan el uso adecuado de los medicamentos.

          Translated abstract

          Abstract Introduction: Drug-related problems are a major health concern because of their high impact on inpatient morbidity. Method: Descriptive and cross-sectional observational, study in the clinical services of five health institutions of Santiago de Cuba, during the first quarter of 2020. The profiles of 329 patients who received pharmacotherapeutic follow-up were reviewed. The sample was characterized according to biosocials, clinical and pharmacotherapeutic variables, the identification of medication-related problems was performed using the criteria of Cipolle, Stramd and Morley, also determining the drugs involved in medication-related problems. The data were processed through absolute and relative frequencies represented by means of tables and figures. Results: Patients over or equal to 60 years of age predominated, representing 38.6 %; 61.4 % of the patients were female. Most of the patients had up to two diseases (76.3 %); complicated respiratory infections (35.6 %) were the most frequent reason for admission. Between four and six medications were consumed by 36.5 %, with antibacterials for systemic use being the most prescribed. A total of 598 drug-related problems were identified for a ratio of 1.8 DRP/patient, of which 42.8 % corresponded to safety problems, 31.1 % to indication, followed by 24.9 % to effectiveness and finally 1.2 % to adherence. Conclusions: Antimicrobials were the most implicated in the occurrence of medication-related problems. Pharmaceutical care offers services that ensure the appropriate use of medications.

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          Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions

          Background Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients often excluded from premarketing trials that can further increase the occurrence of DRPs. This study aimed to identify drug related problems and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization. Methods A prospective interventional study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems. Results A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR] = 4.350, 95% C.I: 1.212–9.260, p = 0.020) and number of comorbidities (AOR = 1.588, 95% C.I: 1.029–2.450, p = 0.037). Conclusions Drug related problems were substantially high among geriatric inpatients. Patients with polypharmacy and co-morbidities had a much higher chance of developing DRPs. Hence, special attention is needed to prevent the occurrence of DRPs in these patients. Moreover, clinical pharmacists’ intervention was found to reduce DRPs in geriatric inpatients. The prescriber acceptance rate of clinical pharmacists’ intervention was also substantially high.
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            Adverse drug events in patients admitted to an emergency department: an analysis of direct costs.

            Several economic evaluations of adverse drug events (ADEs) exist, but the underlying methodology has not been standardized so far. The aim of the study was to combine prospective, intensive pharmacovigilance methods, and standardized accounting data to calculate direct costs of community-acquired ADEs (caADEs) contributing to emergency department (ED) admission and subsequent hospitalization.
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              Systemic review on drug related hospital admissions – A pubmed based search

              Drug related admissions have significantly increased over the past few decades. According to various studies on drug related hospital admissions, it was estimated that around 5-10% of hospital admissions were due to drug related problems (DRP), in which 50% of them are avoidable.
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                Author and article information

                Journal
                ars
                Ars Pharmaceutica (Internet)
                Ars Pharm
                Universidad de Granada (Granada, Granada, Spain )
                2340-9894
                June 2023
                : 64
                : 2
                : 89-99
                Affiliations
                [2] Santiago de Cuba orgnameHospital Materno Sur Mariana Grajales Coello orgdiv1Servicio de Farmacia Cuba
                [1] Santiago de Cuba Santiago de Cuba orgnameUniversidad de Oriente orgdiv1Facultad de Ciencias Naturales y Exactas orgdiv2Departamento de Farmacia Cuba
                Article
                S2340-98942023000200002 S2340-9894(23)06400200002
                10.30827/ars.v64i2.26902
                b934dc36-aee8-406a-86af-4968c96df0b3

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

                History
                : 20 December 2022
                : 17 February 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 11
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                SciELO Spain

                Categories
                Artículos Originales

                drug-related problems,hospitalized patients,seguimiento farmacoterapéutico,problemas relacionados con los medicamentos,pacientes hospitalizados,pharmacotherapeutic follow-up

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