and review of the medical records from January until September in 2022. We used the data available in the ambulatory medical records and the itemised reporting interface of the National Health Insurance Fund. Drug interactions were analysed using UpToDate Lexicomp database. Results 35 female patients (average age: 63.53 years ± 13.82) and 23 male patients (average age: 53.54 ± 12.96) received biological or targeted therapy for an average of 7.17 years ( ± 4.12), while the average patient activity index DAS28 was 3.15 ( ± 1.17) and BASDAI was 5.29 ( ± 5.52). 87.93% (51/58) of the patients have used non-medication health products, mainly vitamin C or D. 34.48% of the patients were confirmed with coronavirus infection during the pandemic, while the vaccination rate was 87.89%. 83.45% of the patients received at least one mRNA vaccine. In our patient group, the influenza vaccination rate was 36.21%, while only 5.21% of the patients had been vaccinated against Pneumococcus in six months previous to our survey. The total number of serious (category X and D) interactions were 216, in 135 cases a vaccine and in 58 cases a monoclonal antibody or targeted therapy was included as interacting pair.
Conclusion and RelevanceDespite the growing number of new therapeutic approaches and vaccines, the screening methods for analysing potential drug interaction are lacking behind and the Summary of Product Characteristics are not suitable for comprehensive evaluations. The inclusion of these therapies and the optimisation in vaccination status in the medication review process and the understanding of immunological mechanism potentially influencing the therapy of patients is warranted.
BackgroundArtificial nutrition is an essential component in the management of critically ill patients. These patients are at risk of developing malnutrition, which occurs in up to 40% of patients and is associated with increased mortality and morbidity.PurposeTo evaluate the difference between the estimated energy requirements in those that were prescribed and those who actually received artificial nutrition, for patients admitted to an intensive care unit (ICU), and to identify the reasons for the discrepancies.Material and methodsThe study was conducted in a 12 bed ICU of a referral hospital, from May to July 2015. Patients with nutritional support (NS) and ICU stay >7 days were selected. Demographic and clinical data were collected, and energy requirements were calculated using the Harris-Benedict equation adjusted by the stress factor. For NS, the following data were collected during the first week of ICU admission: start date, type of nutrition, kilocalories prescribed and administered, and grams of protein prescribed and administered. Also taken into account were the calories provided by propofol if prescribed.Results27 patients were included, with a mean age of 62.8 ± 17.5 years.71.4% were men. 42.8% were prescribed enteral nutrition and 57.2% parenteral nutrition. The average delay in the start of the NS was 3.1 ± 1.3 days. The average estimated kilocalories per kilogram (kcal/kg) was 25.5, with 16.6 kcal/kg prescribed and 14.6 kcal/kg actually administered (60% of the theoretically estimated requirements), resulting in a calorie deficit accumulated over 7 days of – 4763 ± 2739 kcal. For proteins, the requirement was 1.4 g/kg, with 0.7 g/kg prescribed and 0.6 g/kg administered (40% of the theoretically estimated requirements), with an average protein accumulated deficit of – 297 ± 167 g. This was due to the following factors: tolerance of enteral feeding, delayed prescription (in 11% of patients nutritional support began on day 5), prescription below estimated requirements and pauses in administration due to intra/extra procedures in the ICU.ConclusionThe amount of calories that patients received was low, being more pronounced for administered proteins. With these results, measures directed to optimising nutritional support of our patients are needed.No conflict of interest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.