0000000000012869
AUTHOR
N.v. Jiménez Torres
Calidad de la farmacoterapia y seguridad de los pacientes en hemodiálisis tratados con estimulantes eritropoyéticos
Objective: To assess an interdisciplinary programme for the improvement of pharmacotherapy quality and patient safety in patients with chronic renal disease who are treated with erythropoiesis-stimulating agents. Method: Observational, longitudinal study. Retrospective analysis (period A) and prospective analysis (period B) following implementation of the programme for haemoglobin values and monthly erythropoiesis- stimulating agent dosage. The proportion of patients with haemoglobin values within the target range (10-5-12.5 g/dl) and those with values above the safety limit (≥ 12.5g/dl) were compared every four months and the average percentage of time with haemoglobin values within the ta…
Evaluación de la calidad de dos modelos de atención farmacéutica en pacientes onco-hematológicos
Objective: To compare the quality of two pharmaceutical care models (with and without pharmacist participation in the clinical team), in hospitalised onco-haematological patients. Method: A prospective cohort study in the oncology and haematology departments of a university hospital over a 26-month period. A centralised model (model C) was used over 16 months and a decentralised integration model (model D) was used during the remaining 10 months. The Iaser© methodology was used to identify candidates for improved drug treatment and for the follow up of patients with drug-related problems (DRP). The results obtained were compared using a series of pharmaceutical care quality indicators. Resu…
Doctors’ acceptance of recommendations for patients with the opportunity for pharmacotherapy improvement
Abstract Objective To identify and quantify the influence of different variables on the implementation of pharmacotherapy optimisation measures in hospitalised patients. Method Descriptive transversal study. Period: 2000–2007. Environment: public university general hospital (25,000 patients admitted/year). The Programme implemented to improve pharmacotherapy quality and patient safety covers 30% of all patients. Using records from the Atefarm ® Farmis application, we analysed pharmacotherapy recommendations (PRs) made by pharmacists to doctors. The selected variables were the following: Risk of the medication for ADE (1-high, 0-low), ADE category, (0-indication, 1-effectiveness, 2-safety), …
Predicting risk of acute rejection in patients with kidney transplants
Objective: Create a model to predict the risk of acute rejection of kidney transplant considering variables related to the immunosuppressant agent used, the receiver, the donor, and the transplanted organ. Methods: Cohort study in a population of 68 patients with kidney transplants being treated with tacrolimus triple therapy. Predicting the risk of acute rejection was carried out with a logistic regression analysis using age, sex, retransplant status, number of HLA incompatibilities, cold ischaemia time, acute tubular necrosis, induction with basiliximab or thymoglobulin, and treatment type as explanatory variables. The contribution of variables associated with determining the blood concen…
Predicción de riesgo de rechazo agudo en pacientes con trasplante renal
Objective: Create a model to predict the risk of acute rejection of kidney transplant considering variables related to the immunosuppressant agent used, the receiver, the donor and the transplanted organ. Methods: Cohort study in a population of 68 patients with kidney transplants being treated with tacrolimus triple therapy. Predicting the risk of acute rejection was carried out with a logistic regression analysis using age, sex, re-transplant status, number of HLA incompatibilities, cold ischaemia time, acute tubular necrosis, induction with basiliximab or thymoglobulin and treatment type as explanatory variables. The contribution of variables associated with determining the blood concent…
Normalización del intercambio terapéutico de antagonistas del receptor de la angiotensina-II para el tratamiento de la hipertensión en el medio hospitalario
Resumen Introduccion La normalizacion del proceso de intercambio terapeutico de medicamentos en el medio hospitalario, mediante el establecimiento y difusion de criterios normalizados, se ha definido como una actividad que conduce a un incremento en la calidad asistencial y, consecuentemente, a una mejora en el cuidado del paciente. Objetivo Establecer un intercambio terapeutico normalizado para los antagonistas del receptor de angiotensina-II (ARA-II) en el tratamiento de la hipertension arterial y, evaluar la idoneidad de los intercambios terapeuticos realizados en un sistema integral de dispensacion individualizada de medicamentos. Material y metodos El intercambio terapeutico normalizad…
Modelo predictivo preliminar para la identificación de pacientes con oportunidades de mejora farmacoterapéutica
Objective: To develop a prediction model for identifying patients with the possibility of improving pharmacotherapy during the process of pharmaceutical validation of the prescription. Method: Cross-sectional study over two months, performed in the Internal Medicine and Infectious Disease divisions. Detecting opportunities for improving quality of pharmaco¬therapy is done by means of a pharmacist's validation of the prescription. Based on the information we obtained through this process, we performed a multivariate logistic regression analysis using as prognostic factors the demographic, pharmacotherapy and clinical variables related to identifying any drug-related problems (DRPs) in the pa…
Genetic Polymorphisms and Individualized Tacrolimus Dosing
Background. Genetic polymorphisms of metabolism enzymes or intestinal drug transporters may affect pharmacokinetic responses to immunosuppressive drugs in renal transplant recipients. We sought to identify the frequency of genetic polymorphisms and their importance for individualization of tacrolimus doses. Patients and Methods. We performed an observational study in 35 renal transplant recipients treated with tacrolimus, mycophenolate mofetil, and corticosteroids. Tacrolimus concentrations were determined by immunoanalysis (IMx method; Abbott Diagnostics, Abbott Park, Ill), on 11 blood samples per patient during the first 6 weeks after renal transplantation. For each patient, we calculated…