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Background: In Mexico, the epidemiology of heart failure is still not well understood. However, it is known that the primary cause of hospital admissions in patients with heart failure is pulmonary and systemic congestion. Objective: To estimate congestion status and assess cardiac function using portable ultrasound in patients with heart failure. Method: A cross-sectional observational study was conducted. Patients who attended the Heart Failure Clinic at the Ignacio Chávez National Cardiology Institute in Mexico City between May and August 2022 were selected. They underwent ultrasonographic evaluation using a portable device to assess pulmonary and systemic congestion, as well as cardiac function and structure. Results: One-hundred patients diagnosed with heart failure were prospectively included during the study period; 76% were male, with an average age of 59 years (range: 50-68 years). The recorded LVEF median was 34% (IQR: 27-43.5%). When evaluating pulmonary congestion, 78% of the patients showed a pattern A and 22% a pattern B. Following the VExUS protocol, 92% of the patients were at grade 0, 2% at grade 1, and 6% at grade 2. Conclusions: The use of the portable ultrasound facilitated the quantitative characterization of the echocardiographic features of the studied population. This device could provide better clinical characterization which, in turn, might allow for optimized drug prescription for heart failure and dose adjustments of diuretics based on echocardiographic congestion findings. [ABSTRACT FROM AUTHOR]

Objective: To determine whether an educational intervention strategy would improve the frequency of medical prescriptions for adequate thromboprophylaxis in a medicine service. Methods: Quasi-experimental study, in which in the pre-intervention phase the frequencies of indication of appropriate thromboprophylaxis by physicians from the medicine service were obtained. An 8-week educational intervention was carried out with this same group of doctors. In the post-intervention phase, the frequency of adequate thromboprophylaxis was measured at 2 and 4 months after the intervention. Results: The educational intervention was implemented in 112 resident physicians in medicine specialties. All prescriptions were made by the first-year resident physicians and endorsed by their supervising physician. Prior to the intervention, 47 (44.35%) adequate prescriptions were obtained, 13 (12.26%) suboptimal, 4 (3.77%) inadequate, and 42 (39, 62%) no prescription. After the intervention, the following 2 months were obtained: 78 (75.72%) adequate prescriptions, 7 (6.79%) suboptimal, 4 (2.91%) inadequate and 15 (14.58%) no prescriptions, there being a significant difference with the baseline level. At the subsequent 4 months post-intervention, the following were obtained: 86 (83.49%) adequate, 5 (4.85%) suboptimal, 2 (1.94%) inadequate and 10 (9.72%) no prescription, with a difference significant with the baseline level. There was no increase in the frequency of overuse. Conclusions: The application of an educational strategy to medical personnel was effective in increasing correctly indicated thromboprophylaxis prescriptions in a medical service. No overuse of thromboprophylaxis was found after the intervention. [ABSTRACT FROM AUTHOR]

Background: This work analyzed the impact of COVID-19 on antidepressant consumption during the first year of the pandemic (2020) taking as a baseline the prescribing trends during the previous 4 years (2016-2019). For this, the province of Santa Cruz de Tenerife and the 4 islands that make it up were taken as a geographical area. Methods: Sales data in community pharmacies were taken as an aggregated database. The dose per inhabitant and day was used as an indicator of consumption. Results: In the islands of EL Hierro and La Gomera, the increase in population does not in itself justify the relevant increases observed in the consumption of antidepressants and possibly COVID-19 and its consequences on the health of the population could be responsible for these increases. On the island of Tenerife, the increase in population could justify, to a large extent, the slight increase in consumption observed. The island of La Palma presents an increase of 1.40%, but lower than the expected value taking as baseline the prescribing trends in the last 4 years, despite an increase in population of 0,95%. All the islands present the same trends in the consumption of the different subgroups of antidepressants and active pharmaceutical ingredients, although with slight variations, with the exception of the island of La Palma which presents a statistically different behavior and trends. Conclusions: These differences could be related to the socio-sanitary and demographic characteristics of each of the islands. [ABSTRACT FROM AUTHOR]

The 1st World Telehealth Congress took place in Torre del Mar (Malaga) in 2022. It was organised by the Spanish Association of Health Communication and brought together participants from 43 countries. The congress included round tables on topics such as Tele-Pharmacy, Cybersecurity in Health, Tele-Nursing, Tele-Physiotherapy, Tele-Occupational Therapy and Tele-Psychology. The conclusions highlighted key aspects. In Tele-Pharmacy, the need to improve the use of the pharmaceutical network and the implementation of the E-prescription was pointed out. In Tele-Occupational Therapy, the importance of ICTs to get closer to people's health needs and to promote empowerment and training was highlighted. In Tele-Medicine, it was emphasised that care must be human, and the risks and benefits of new technologies were addressed. In Tele-Nursing, the usefulness of ICTs as a complementary tool was mentioned, but the digital divide and data protection were cautioned against. In Tele-Physiotherapy, the benefit of ICTs in patient assessment and treatment was highlighted. In Tele-Psychology, the advantages and disadvantages of remote psychological care were discussed. Overall, the congress highlighted the potential of new technologies in healthcare, but also pointed out challenges and areas for improvement. [ABSTRACT FROM AUTHOR]

Copyright of Acta Odontológica Colombiana is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Influencers are gaining more and more prominence on social networks such as Instagram. With millions of followers, these new opinion leaders often recommend and advertise certain products, including medicines. Objectives: This text aims to point out the risks that the recommendation of a drug by an influencer may entail. Methodology: To do this, a qualitative analysis of a real case is used, in which the influencer Paula Gonu recommends Eridosis wipes as a treatment for acne. Results: It is observed that influencers such as the one studied herein treat a drug containing antibiotics as if it were an aesthetic product, generating alarm in the medical and pharmaceutical sector. Conclusion: Drug advertising on Instagram is a complex issue that needs to be further addressed due to its relationship with health, and, above all, greater regulation by institutions. [ABSTRACT FROM AUTHOR]

Purpose: To assess potentially inappropriate medication (PIMs) prescribing pattern in geriatric patients attending the outpatient department (OPD) of the General Hospital in Addis Ababa, Ethiopia. Methods: The study was conducted retrospectively for geriatric patients sixty years of age and above, who visited an Outpatient Department of Tirunesh Beijing General Hospital. Data were gathered for a duration of one month from prescriptions/encounters at the Outpatient Pharmacy, and analysis was carried out using SPSS (Statistical Packages for Social Sciences) version 20, while and drug prescribing indicators, and potentially inappropriate medications were calculated based on WHO prescribed indicators and Beer's criteria. Results: Of the 400 encounters assessed, 218 (55%) were male and 182 (45%) were female. Four hundred prescriptions contained 1,003 drugs. Out of the mean drug per prescription of 2.51, drugs prescribed by generic names were 91.62%, those prescribed from NLEM (national list of essential medicine) were 91.53%; prescriptions with an antibiotic injection were 27.75% and 16.25% respectively, and more than 5 drugs were prescribed only for 10.8% of geriatrics patients. Cardiovascular drugs constituted about a quarter of the prescribed medications with 271 (27.02%); others were analgesics, anti-inflammatory, anti-infective, endocrine drugs, gastrointestinal drugs, and other drugs, accounting for 116 (11.6%), 112 (11.2%), 96 (9.6%), 94 (9.4%) and 187 (18.6%), respectively. Potentially inappropriate drugs occurred in 46.9% of the cases. Conclusion: Potentially inappropriate medication (PIMs) prescribing in geriatric is highest in percentage. Proper interventions are needed from all concerned bodies to avoid drug-related complications. [ABSTRACT FROM AUTHOR]

Copyright of Revista Virtual Universidad Católica del Norte is the property of Revista Virtual Universidad Catolica del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Presupuesto y Gasto Publico is the property of Instituto de Estudios Fiscales, Ministerio de Hacienda y Funcion Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rational prescription is a necessary process in the elderly. Their integral formation and the acquisition of good prescription habits by the student of medical sciences is a concern for those responsible for their training. The aim is to identify the level of knowledge about polypharmacy and consequences to the health of the elderly in medical students of the clinical area. A didactic material was designed about the topics identified with knowledge deficit. A research has two stages, first stage: prospective cross-sectional study to identify the level of knowledge, second stage: design of a didactic foldable on topics with knowledge deficit using a tool from the Microsoft Publisher 2013 package. Results: 63% of the students were unaware of the topics investigated, the third year students omitted on the danger of the number of pharmacological interactions. The 4th year students (56%) were the ones who showed the most knowledge. Conclusions: The insufficiency of knowledge led to design a didactic foldable that offers the student a tool easy to consult and simple interpretation, which ensures from the undergraduate strengthen the rational use of medicines in the elderly population. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Reflect about Nursing and the use of psychoactive drugs in children and adolescents in situations of violation of rights and / or criminal situation, who are in the care of the Servicio Nacional de Menores, in the context of deaths in recent years. Methodology: Analytical-synthetic method; Bibliographical review, comprehensive reading, personal reflection and definition of concepts. Results: There are described the current situation of mental health of children and adolescents, the relationship with the Social Determinants of Health and related ethical perspectives for conflict resolution. Conclusions: The use of psychosocial interventions as the first line of treatment is considered in the reflection, besides the fact that the use of psychoactive drugs, if necessary, should be administered and supervised by professionals according to current regulations. [ABSTRACT FROM AUTHOR]

Introduction. Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in childhood, which is frequently maintained in adolescent and adult age. It presents great clinical heterogeneity, significantly affecting the functioning of those who suffer it. Although drug treatments obtain results by themselves, the approach should be multidisciplinary and be adapted to the specific needs of each patient and his/her family. Given the variety of drugs currently available to treat ADHD, there are diverse opinions on the most effective way to approach this disorder. The objective of this work is to study the opinion of an expert clinical panel and to know the professional criteria used to define key concepts and therapeutic guidelines of ADHD in Spain. Methodology. The project was carried out in four phases: 1) Constitution of a Scientific Committee, responsible for the preliminary biographic review and the formulation of the questionnaire; 2) selection of an expert panel of specialists with special interest and/or experience in the treatment of ADHD; 3) Likert type structured survey (online platform) in two rounds with interim processing of opinions; and 4) collection and final analysis of results. Results. The experts' panel achieved a consensus in 55 of the 58 items making up the questionnaire, finding 3 items in which sufficient unanimity of criteria was not achieved because of the high number of experts were found in positions of non-certainty. Conclusions. Overall, the experts of this study reached a high level of agreement in the criteria proposed in the survey, which could be generalized as indications for the clinical practice in the management of ADHD. Similarly, and given the dispersion of the results in some of the items and the lack of consensus in others, some points remain as object of discussion. [ABSTRACT FROM AUTHOR]

The article reports that development and pilot testing of a personalized digital intervention to support adherence to antihypertensive medications as a complement to primary care consultations. Topics include use of interactive voice response technology helps patients take prescribed medications; and medication as prescribed is vital to managing long-term health conditions, such as high blood pressure, type 2 diabetes, or multiple conditions.

Copyright of Investigaciones ANDINA is the property of Fundacion Universitaria del Area Andina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the distribution, mechanisms, treatment and clinical evolution of patients with peripheral vascular trauma attended at a general hospital. Methods: Retrospective study among patients admitted to HNCH between 2010 and 2012.The information was gathered from clinical charts. Results: A total of 46 patients were included; 55 vascular lesions were observed, of which 43 involved arteries and 12 involved veins. The most frequent mechanism of injury was gunshot (43.5%), the most frequent reason was aggression (57%). Of all arterial lesions, 27 were on upper limbs and 16 in the lower limbs. The most frequent type of lesion was complete section (61%), and the most frequent treatment was saphenous vein graft in the sectioned arteries in 40%. A total of 12 vein lesions were observed, half of them in each upper and lower limbs; complete section was the most common lesion (59%), and ligation was the repair method more used. Out of 30 patients who suffered arterial lesions and were treated promptly, 14 had no functional limitation, 13 had some degree of limitation and 3 were amputated. Conclusions: including selection of antimicrobials, dosing and dosing regimens, but most of the prescriptions are not based on microbiologic documentation. [ABSTRACT FROM AUTHOR]

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute diarrheal disease is usually probably multifactorial and the use of antiemetic drugs and antispasmodics for treatment has been a controversial topic and not recommended. We reviewed 49 prescriptions written by doctors in private consultation to children below the age of 10 years, who were studying EDA. It was found that metoclopramide was the most used in them, followed by the butilhioscina, difenidol, butilshioscina-metamizol, and meclizine; three of these children were hospitalized because of intoxication to metoclopramide. Oral hydration, to demand free was prescribed to 11 of them (22 %). In this study was particularly notorious the high frequency of prescriptions of antiemetics and antispasmodics and contrasts the low prescription oral rehydration, so that it is desirable to have more training in the first level of medical care. [ABSTRACT FROM AUTHOR]

Elderly people are particularly vulnerable to adverse drug reactions (ADR) due to polypathology and polypharmacy and the changes in pharmacokinetics and pharmacodynamics of medications induced by aging. It is very important to evaluate the safety aspects and appropriate use of medications in this population. For this purpose, a checklist is proposed consisting of a list of medications (including herbal medicine), detecting and treating geriatric syndromes induced by medications, overprescription, unprescription and underprescription; measuring and treating drug adhesion, measuring parameters for geriatric posology, preventing adverse reactions due to inadequate drug recalls, evaluating aging people's capacity to take their medications and using the minimum datasheet regarding the medication prescribed to the patient. This checklist is developed based on validated instruments. It is a proposal which application in the outpatient and inpatient context is possible and feasible. [ABSTRACT FROM AUTHOR]

The process of prescribing a medication is complex and includes: deciding whether it is indicated, choosing the best option, determining the dose and the appropriate management scheme to the physiological condition of the patient, and monitoring effectiveness and toxicity. We have to inform patients about the expected side effects and indications for requesting a consultation. Specific clinical questions were designed based on the acronym PICOST. The search was made in the specific websites of clinical practice guidelines, was limited to the population of older adults, in English or Spanish. We used 10 related clinical practice guidelines, eight systematic reviews and five meta-analyses. Finally, we made a search of original articles or clinical reviews for specific topics. The development and validation of clinical practice guidelines for "rational drug prescriptions in the elderly" is intended to promote an improvement in the quality of prescription through the prevention and detection of inappropriate prescribing in the elderly and, as a result of this, a decrease in the adverse events by drugs, deterioration of health of patients and expenditure of resources. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To identify the frequency of drug use for the prevention of corticosteroid induced osteoporosis (CIO) among patients using corticosteroids for more than three months affiliated to the General Social Health Security System of Colombia. Materials and methods. Cross-sectional study. Information about people affiliated to the General Social Health Security System of Colombia (3.7 million) was used. This study included men and women of all ages having been prescribed any glucocorticoid from August 1 to November 30, 2011. Sociodemographic variables and the characteristics of of the glucocorticoid prescription and CIO prophylaxis drugs in a defined daily dose (DDD) were identified. Results. A database of 255,568 prescriptions of glucocorticoids was obtained, with a total of 1,837 patients receiving some glucocorticoid chronically. The majority of participants were females (60.2%), with an average age of 55.2±16.9 years distributed in 65 cities of the country. Prednisolone was the most commonly used glucocorticoid (1,546 patients, 84.1%), whereas the most prescribed prophylaxis drug used was calcitriol (67.1%). Despite the need to receive prophylaxis, 994 cases (54.2%) were not receiving it. Conclusions. There is a poor utilization of CIO prophylaxis. The implementation of drug surveillance actions that allow the identification of problems related to these drugs in order to prevent adverse events and optimize resources is recommended, thus anticipating the emergence of complications in the patients. [ABSTRACT FROM AUTHOR]

Antibiotic use in Mexico is characterized by high levels of consumption, irrational use in primary care services, and high rates of bacterial resistance that cause hospital infections. Changes are needed in the recommended method for reporting antimicrobial drug use, so that quantification can be carried out through drug utilization studies. Such studies, which make it possible to know which drugs are used in hospitals, require an accessible source of data on antimicrobial drug use with the least risk of biases, a single drug identification system, and the adoption of units of measure that can be extrapolated. The methodology developed by the WHO Collaborating Centre for Drug Statistics Methodology, based on the anatomical, therapeutic, and chemical classification (ATC) system and the daily defined dosage (DDD), is proposed. Despite its limitations, employing this methodology to monitor local antimicrobial drug use will make it possible to detect differences in usage patterns among institutions, and, especially, trends within a given institution. This would facilitate timely alerts about potential problems related to the use of antimicrobial drugs and the need for specific interventions. [ABSTRACT FROM AUTHOR]

The accurate medical records avoid omissions and incomplete notes and / or mistaken notes, which contributes also to avoid a current problem within the hospitals called Medication Errors (ME), often caused because the low quality of the clinical files according to the NOM-168-SSA-1998 and therefore a poor medical attention to the patient, causing adverse drug reactions or even death and the possibility of lawsuits against people related to the health care. The aim of this study was to identify if there is a difference between registration and implementation of prescription drugs before and after the implementation of a drug monitoring system in the internal medicine specialty, it was developed in two periods with three years of difference between each one; the study was retrospective, descriptive and transversal and was realized in General Hospital "Dr. Miguel Silva "in the city of Morelia Michoacán. It included 107 medical indications from complete clinical records of October 2006 and 99 from January 2009; bearing in mind medicines prescribed but not applied, and applied medicines that were not prescribed as well. Incompatibility was found among the records of clinical prescription and implementation by nursing staff in both studied periods. However, the comparison between the first and the last period shows a significant difference of χ² (P = <0.0001), therefore is possible to assume that once and after the Pharmacological Vigilance System was introduced the mentioned incompatibility decreased, which suggests that after implementation of drug monitoring system this incompatibility decreased, providing an improved quality of patient care, as demonstrated by some authors in similar studies. The drugs involved in these two situations prevailed antibiotics, diuretics, NSAIDs and inhibitors of proton pump. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The trauma has one of the first sites of morbidity and mortality worldwide, produces severe impact bio-psycho-social, functional disability and severe social and financial implications. Has been treated with medications and nonpharmacologic methods without achieving effective relief, so we set the objective of identifying trends in prescription of painkillers in a hospital in trauma and orthopedics. Material and methods: A descriptive, longitudinal and prospective study assessing pain intensity in three stages, the demographics and prescription painkillers. Results: We studied 418 patients. The average pain intensity by VAS on admission was 5.33 ± 2.33, immediately after surgery and 5.97 ± 2.04 in the late postoperative 5.4 ± 2.02. According to the initial EVER 24.4% presented mild pain, moderate pain 40.4% and 35.2% severe pain, in the immediate postoperative mild pain 14.6%, 40.8% moderate and 44.4% severe and 20.3% in the late mild pain, 47.0% moderate and 32.5% severe, the most widely used analgesics were paracetamol, ketorolac, diclofenac and etofenamato; nalbuphine, buprenorphine and dextropropoxyphene. Conclusions: These results suggest that pain is poorly assessed and that despite several drugs used high numbers of persistent pain. [ABSTRACT FROM AUTHOR]

Objective: To describe the percentage of prescription of pharmacologic supplements in patients starting antiresorptive treatment (ART) for osteoporosis by specialists. Design: Cross-sectional, naturalistic, multicenter study with retrospective data collection. Patients and methods: 88 Spanish primary care (PC) physicians participated as well as those from Bone Metabolism Unit / Rheumatology and Gynecology units. Patients were females with osteoporosis who started ART in the 12 to 36 months prior to the visit. Main outcomes: General clinical variables and those related to osteoporosis treatment (both ART and pharmacologic supplements) and an opinion survey on pharmacologic supplements. Results: 480 patients were included. Mean age (SD) was 65.8 (9.2) years. Pharmacologic supplements were prescribed in 69.6% of patients and were more frequent in patients treated in Bone Metabolism/Rheumatology Units (89.1%) than patients treated by PC (60.3%) and Gynecology (55.6%). In the physician survey, 72% of the Bone Metabolism / Rheumatology Unit physicians responded that the Vitamin D supplements were necessary for treatment of osteoporosis vs. 38.5% of PC physicians (p=0.058). Conclusions: The use of pharmacologic supplements in the onset of treatment with ART represents more than 60% of the sample, although differences were seen between specialists, with a greater percentage of patients with supplements in the Bone Metabolism/Rheumatology Units than in PC and Gynecology, despite guidelines primarily recommend the use of pharmacologic supplements in these patients. [ABSTRACT FROM AUTHOR]

Beta-lactam antibiotics are among the most commonly prescribed drugs, grouped together based upon a shared structural feature, the beta-lactam ring. Cephalosporins cover a broad range of organism, are generally well tolerated, and are easy to administer. The classification, spectrum of activity, and pharmacology of the parenterally cephalosporins will be reviewed here. [ABSTRACT FROM AUTHOR]

Misuse of drugs in the elderly is a rampant public health problem. We conducted a cross-sectional study using a self-administered survey to assess drug use and inadedequate prescription among noninstotunilazed elderly patients in the city of La Plata, Argentina in 2009. The total number of respondents was 215. The average number of drugs used per person was 3.19 ± 2.02, polypharmacy was present in 24.1 % of subjects. Potentially inappropriate medications (MPI) were given in 25.5 %, 31.9 % and 30.0 % of the patients, according to Beers criteria, Priscus list, and STOPP criteria, respectively. This research found that potentially inappropriate prescribing is common and there is a growing need for a list of potentially inappropriate medications, as appropriate to each situation, that considers situations where treatment is suboptimal. [ABSTRACT FROM AUTHOR]

Objective. To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. Material and Methods. Using the National Satisfaction and Responsiveness Survey (ENSATA) 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the day of visit, the proportion of prescriptions completely filled for patients when they are discharged and their out-of-pocket expenditure during their hospitalization were analyzed. Results. A total of 26 271 patients in 160 public hospitals were interviewed. The mean availability of drugs was 82% for all hospitals, with the lowest availability for the Ministry of Health (SESA) hospitals (77%, with a range of 30 to 96%). Patients discharged at social security hospitals received in 97% of cases a complete prescription filling, while in SESA hospitals the average was only 56.2%, with a large variance among states (13 to 94%). The median inpatient spending was 150 pesos in national currency (1% spent over 10 000 pesos). Conclusions. The lack of medicines in public hospitals may increase in-patient morbidity and mortality and has an economic impact on household spending, particularly in those with scarce resources. [ABSTRACT FROM AUTHOR]

Objective. To assess the consequences of private outsourcing on the overall supply and filling of prescriptions in state health services. Material and Methods. The research was conducted using quantitative and qualitative techniques in 13 states. The information was collected through interviews and direct observation. The interviews were carried on staff of state health services related to the drug supply chain and users of health services. The quantitative approach examined the percentage of stocked full recipes in a sample of users. Results. States that have opted for the fully outsourced model, and properly monitored this choice, have increased the supply of drugs to their users and guaranteed the supply in the care units in charge. Other states with the outsourced model have multiple problems: direct purchase of drugs not included in the basic drugs catalogue, failure of suppliers and shortage of supplies in the laboratories that provide the company. The main disadvantages identified in all models were: the subordination of the medical criteria to administrative criteria, insufficient planning based on local care needs, heterogeneous procedures, insufficient knowledge of regulations and lack of normativity. Conclusion. The results indicate that the incorporation of private providers in the drug supply chain may not be the solution to bring down the shortage faced by health services, especially at the hospital level. The shift to outsourcing models has developed without incorporating evaluation mechanisms and the consequences that this transition can have on state health systems must be investigated more deeply. [ABSTRACT FROM AUTHOR]

Copyright of Universitas Médica is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives. To diagnose drug-related problems (DRPs) in patients over 64 years of age at the time of hospitalization. Materials and methods. The detection of overprescription and misprescription of medications was done using the Index of Appropriate Drug Use, and for underprescription the Indication of Adequate Drug Use in Vulnerable Elderly Adults and the test of the Evaluation of the Underuse of Drugs were used. The evaluation of drug adherence and adverse drug reactions was completed using the Morisky-Green Questionnaire and the Karch and Lasgna Algorithm, respectively. Results. The study was conducted in 100 inpatients in a geriatric service in a multi-specialty hospital in Lima, Peru; the median age was 76.26 ± 6.91 and 55% were males. After evaluating 555 drugs with the Index of Appropriate Drug Use, 254 of them (45.8%) qualified for at least one or more of the criteria studied for inadequate prescription, corresponding to 89 of the studied patients. We found the underuse (21%) of Warfarin or aspirin by eligible patients with auricular fibrillation, and no use (59%) of beta blockers by patients with a history of acute myocardial infarction. The non-adherence and frequency of adverse reactions that motivated hospitalization were 63% and 24%, respectively. Conclusions. The diagnosis of DRPs in elderly adults at the time of hospitalization using valid instruments is extremely useful and should be part of the integral geriatric evaluation of the elderly. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: the purpose of the present study was to identify the number of adverse drug reactions in hospitalized patients, through active search for prescription of antihistamines, biperiden and vitamin K. Methods: we conducted an observational, descriptive study from July 2008-June 2009, by the search in medical records in the Clinica Universitaria Bolivariana, n=143. We estimated the frequency of probable or possible adverse drug reactions and spontaneous medical report. Results: we assessed 892 inpatient cases with antihistamines, biperiden or vitamin K prescription; 143 cases were included in the study for their relationship with treatment of possible or probable adverse drug reactions. We found a frequency of cases with no spontaneous medical report in 72.7% (n=104), the time for presentation of the latter was with a mean of 8.1 days, a median of 4 days, IQR (1-11) and a range in days of 0-37. Conclusion: we observed a low frequency of adverse drug reactions with spontaneous medical report and an average of eight days for notification when it was reported. Therefore, it is necessary to promote spontaneous and timely reporting that can help improve the safety in administered drugs. [ABSTRACT FROM AUTHOR]

Approaching the 25th anniversary of the definition of the concept of the rational drug use in Nairobi, the author makes a reflection about how it is possible to achieve a better use of them in the Andean Community from the discussion of three main issues: (1) drugs are not always needed to treat a disease; (2) to treat is more than to handle a written prescription with a brand name; and (3) it is necessary to involve the patient in his own treatment. [ABSTRACT FROM AUTHOR]

Objectives. To describe the pharmaceutical services offered at the primary care level by Brazil's Sistema Único de Salud (Universal Health Care System). Methods. The study took place in Londrina, Paraná, in January-March 2003. The World Health Organization's recommended drug use indicators were employed. Included in the study were 13 primary health care facilities in which 390 patients were interviewed. Results. None of the facilities had a pharmacist. The average office visit lasted 8.6 minutes; the mean number of drugs prescribed was 2.2; and injections were given in 10.9%. Generic drugs were prescribed 66.5% of the time and 73% of the prescribed drugs were included in the Lista Municipal de Medicamentos Esenciales (Municipal List of Essential Drugs). Only 46.6% of the patients interviewed reported having the basic instructions required for appropriate use of the drug prescribed. Conclusions. These results can aid in restructuring the municipality's pharmaceutical services because they underscore the need to improve and to increase rational drug use as a therapeutic resource imperative to supporting health efforts. [ABSTRACT FROM AUTHOR]

El artículo discurre sobre la importancia de escuchar en la gestión de una empresa, con un enfoque en la industria farmacéutica. La autora comenta sobre la venta de los medicamentos correctos a los usuarios correctos. También se considera el gasto en la salud pública en Uruguay.

Objective. Measure and compare the percentage of prescriptions fully dispensed to persons with and without Popular Health Insurance (SPS in Spanish) who use ambulatory and general hospital services associated with the Mexico State Health Services (SESA in Spanish), and taking into account insurance status. SESA user satisfaction was also measured with respect to access to medication. Material and Methods. Information for the study was taken from four surveys of SESA ambulatory and hospital units that included probabilistic samples with state representativity. Samples of ambulatory units were selected by stratification according to level of care and association to the SPS service network. Results. The findings indicate that the percentage of prescriptions fully dispensed in SESA ambulatory units has improved, reaching approximately 90%, especially among those units offering services to persons affiliated with SPS. Nevertheless, these percentages continue to be lower than those of ambulatory units associated with social security institutions. Percentages of prescriptions fully dispensed have also improved in SESA hospital units, but continue to be relatively low. In nearly all states, as the percentage of prescriptions fully dispensed has increased, user satisfaction with access to medication has also improved. Conclusions. In 2006 more than 50% of the states had high levels of fully dispensed prescriptions among persons with SPS (≥ 90%). The more significant problem exists among hospitals, since only 44% of users who received a prescription in SESA hospitals in 2006 had their prescriptions fully dispensed. This finding requires a review of SPS medication policies, which have favored highly prescribed low-cost medications at ambulatory services at the expense of higher cost and more therapeutically effective medications for hospital care, the latter having a greater impact on household budgets. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the impact of a continuing medical education program on family doctors to improve prescription of hypoglycemic drugs. Material and Methods. An observational study was conducted with two groups of comparison (with-without program) and before-after periods. The unit of analysis was the visit. The period of evaluation comprised six months before and six after implementing the program. The outcome variable was the appropriateness of prescription that was based upon two criteria: appropriate selection and proper indication of the drug. Logistic regression models and the double differences technique were used to analyze the information. Models were adjusted by independent variables related with the patient, the visit and the PCC, the more relevant ones were: sex, obesity, conditions other than diabetes, number of visits in the analyzed period, number of drugs prescribed, size of the PCC and period. Results. the program increases 0.6% the probability of appropriate prescription and 11% the probability of appropriate choice of the hypoglycemic drug in obese patients. [ABSTRACT FROM AUTHOR]

It is worrisome the insufficient rate of the aspirin (ASA) prescription and use in type 2 diabetic patients, This is a field, trans-sectional study that included 47 type 2 diabetic patients, aimed to determine the ASA rate of indication and consumption for primary or secondary prevention (PP or SP) of CVD. 72% of the subjects did not refer CV events (n=34) and 38% (n=13) did refer them. There were two or more risk factors for ECV different from diabetes in 73% of the PP group and 85% in patients who need SP. 90% of the type 2 diabetics had formal aspirin indication. Only 50% received aspirin regularly and the rest were sub-utilizing this agent spite its low cost and well known benefits. [ABSTRACT FROM AUTHOR]

Objectives. To determine patterns in antilipidemic drug prescriptions among a group of patients covered by the General Social Security System (Sistema General de Seguridad Social) in Colombia. Methods. A descriptive, observational study was conducted of 41 580 hyperlipidemics of both sexes, who were over 20 years of age, undergoing treatment from at least April to June 2006, and were residents of one of 19 cities in Colombia. A database was created to track prescription data collected by the pharmaceutical company that dispenses medications to the patients. Results. The mean age was 58.4±13.5 years; 58.9% of the participants were women. Of the total number of patients, 95.6% were receiving monotherapy, while 4.4% were receiving two or more antilipidemics. Prescriptions were ranked as follows: statins (70.9%), fibrates (27.5%), bile acid sequestrant resins (0.9%), and others (0.7%), all at low dosage levels. The most common therapy combinations were lovastatin + gemfibrozil (n = 1 568), cholestyramine + gemfibrozil (n = 92), and cholestyramine + lovastatin (n = 78). Comedications most frequently prescribed were: antihypertensive (60.9%), antiinflammatory (56.5%), antiulcer (22.9%), and antidiabetes drugs (20.6%), and acetylsalicylic acid (ASA, 3.8%). Antianginals and ASA were being underused, while antiinflamatories and antiulcer drugs were being overused. Conclusions. Dyslipidemia is a primary risk factor for developing coronary heart disease and stroke, frequent causes of morbidity and mortality in Colombia and the world. All of the antilipidemics are being used at lower-than-recommended dosage levels. Clearly there is a need for creating educational strategies to address these prescribing habits and for exploring clinical results of the pharmaceuticals studied. [ABSTRACT FROM AUTHOR]

This study presents a general overview of the prescription habits and the resources which give information on the preferred drugs by Dentists in Pueblo, México. Antibiotics, anti-inflammatory and analgesics ore the most prescribed pharmacotherapeutic groups and the rationale of their use requires to be monitored. The Practitioners interviewed reported to prescribe medication mostly loosed on their experience rather than consulting medical reports and literature. The result of the study leads us to two major conclusions. The first, it is necessary to conduct a wider pharmacoepidemiologic study in this field and the second, the need for a pharmacotherapeutic guide focused on Dental practitioners. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Due to the lack of scientific studies in the psychopharmacological treatment of psychosis, the references advise against the use of antipsychotic polypharmacy (AP). This study investigates the situation of this matter and its relationship with the introduction of atypical antipsychotics (AA) in our daily out-patient practice. METHODS: The study group included 160 patients, with ICD-10 diagnosis of non-affective psychosis and illness evolution of at least two years, whose ages ranged from 18 to 65 years, without mental retardation, who came to the out patient clinic at least once during the first semester of 2002 and, in order to make a comparison, at least one other time 9 to 12 months before. The retrospective study was done using the clinical records. RESULTS: In both moments studied, more than 50 % of the patients (65 % and 63.4 % respectively) had AA as their only treatment. AP was 25.6 % and 26.9 % respectively, 19.4 % of all patients were always in AP. At the end of the study, patients on AP were being prescribed a higher dose of chlorpromazine equivalents per day (p < 0.001) and more anticholinergics (p < 0.001). CONCLUSIONS: Our results show that in out patient settings AA have been consolidated as the first treatment option and that AP is a very common and stable phenomenon. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency and quality of medical prescription of antibiotics in the outpatient clinic of Pediatric Department of the Cayetano Heredia National Hospital in Lima, Perú. Material and Methods: A descriptive, cross sectional study was carried out between august and september of 2002. We included all of the patients that using the services. A convenient sample of 164 people was determined to assess the quality of prescription. Data on antibiotic prescriptions was collected, revised and qualified by three experienced physicians, using as gold standard the United States Pharmacopeial Drug Information criteria. Results: The proportion of prescription was 8,9% (CI 9%: 8,3%- 9,6%). The most frequently diagnoses were: sinusitis, oxyuriasis and skin infections. The antibiotics more frequently prescribed were: amoxicillin, albendazole and erythromycin. Of the antibiotics, 82,8% were prescribed using generic names and 80,8% were registered in the National Formulary for Essential Drugs. We found that 42,8% (CI 95%: 35,3%-50,3%) of the prescriptions were inadequate with respect to: dose (25,1%), duration (16,7%) and use interval (15,5%) of the antibiotic treatment. Conclusions: The Proportion of antibiotic prescriptions obtained is lower compared to what is reported in the literature. Investigations in this field are still scarce. It is important to perform new research in order to know about prescriptions of antibiotics. [ABSTRACT FROM AUTHOR]