BackgroundMedication errors are preventable events that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional or patient. Medication errors in hospitalised adults may cause harm, additional costs, and even death. ObjectivesTo determine the e ectiveness of interventions to reduce medication errors in adults in hospital settings. Search methodsWe searched CENTRAL, MEDLINE, Embase, five other databases and two trials registers on 16 January 2020. Selection criteriaWe included randomised controlled trials (RCTs) and interrupted time series (ITS) studies investigating interventions aimed at reducing medication errors in hospitalised adults, compared with usual care or other interventions. Outcome measures included adverse drug events (ADEs), potential ADEs, preventable ADEs, medication errors, mortality, morbidity, length of stay, quality of life and identified/ solved discrepancies. We included any hospital setting, such as inpatient care units, outpatient care settings, and accident and emergency departments. Data collection and analysisWe followed the standard methodological procedures expected by Cochrane and the E ective Practice and Organisation of Care (EPOC) Group. Where necessary, we extracted and reanalysed ITS study data using piecewise linear regression, corrected for autocorrelation and seasonality, where possible.
Introduction. Adverse events may be detected using different screening tools. In the pediatric population, the Pediatric Trigger Tool looks for triggers in the medical record to detect preventable and non-preventable care-associated harm. Objective. To measure the incidence of adverse events at the Department of Pediatrics using this tool. To know the types of events and associated outcome measures. Population and methods. Longitudinal cohort study. Results. A total of 318 patients were included; mean age: 2.99 years (range: 0-17); 164 (51.57 %) were girls. There were 11 % of events per 100 admissions, 15.5 events per 1000 patient-days. The most common events were associated with medication use: 48.57 % (n = 17); bacteriology (infections): 42.85 % (n = 15); and care: 8.57 % (n = 3). Nineteen events were mild (54.28 %), 14 (40 %) extended the length of stay (moderate), and 2 (5.71 %) required vital support (severe). A total of 168 triggers were detected; 0.53 triggers per patient, 74.4 triggers per 1000 patientdays, and 4.8 triggers per adverse event. In the multivariate logistic regression analysis, the outcome measures associated with the development of adverse events were high-risk medications, female sex, weight, number of transfers within the hospital, and length of stay longer than 5 days. Conclusions. Using the Pediatric Trigger Tool helped to identify adverse events in hospitalized pediatric patients and guide improvement measures based on associated outcome measures.
Older or elderly adults represent a population exposed to potentially inappropriate prescriptions, since medication is the most widely used intervention. The objective of this work is to analyze the type of medication schemes of the elderly and the relationship with their states of psychological well-being. It is a cross-sectional study.Results: inappropriate prescription is of the order of 12%, the rate adverse drug events is 7%, the average number of activities of daily living is 3.36. Conclusion:We have shown that there is a close relationship between the inappropriate medication in the elderly, adverse events and activities of daily living.
Organ transplantation is a medical treatment often used to restore the function of vital organs. Tacrolimus is one of the most widely used drugs in the immunosuppressive treatment of liver transplants. Aims: To analyze plasma concentrations of tacrolimus in adult liver transplant patients and to characterize adverse effects and drug interactions. Design: retrospective observational studies. The study included 32 patients, of whom 22 were male and 10 female. The average values and range of tacrolimus obtained showed a mean of 8.7 SD 3.2. Low values were found in seventy-five cases, with a percentage of 54.8%. The values within the expected had a frequency of fifty-three times with a percentage of 38.7%. Finally, the frequency of high values was nine times with a percentage of 6.5%. A total of 36 RAM types were found. It was determined that the majority of the ADRs were of moderate damage (13) of 46.4%, while 39.3% of the ADRs were of slight damage (11), 14.3% were of severe damage (4) and no ADR was incidental. Clinically relevant drug interactions in this group of patients were 16.7% contraindicated, 16.7% adjustments based on close follow-up, and 66.6% use with routine follow-up. Similar to the interactions present in the 2013 EMA data sheet. Plasma tacrolimus concentrations are within the range of 38.7% in male patients and 40.8% in female patients. 61.3% of male patients and 59.2% of female patients do not reach the expected tacrolimus plasma levels of 8.0−11.0 ng/ml, similar to those presented in the 2009 FDA data sheet. There were 220 ADRs in this sample of 32 liver transplant patients.
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