BackgroundNew oral anticoagulants are an alternative to acenocoumarol in the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation.PurposeTo assess the suitability of prescriptions for new oral anticoagulants for those diagnoses, in accordance with criteria established by the health organisation and to analyse pharmaceutical interventions.Material and methodsA prospective, observational and cross-sectional study of all patients admitted to our hospital who were prescribed dabigatran, rivaroxaban or apixaban from 01/02/2014 to 31/08/2014. Electronic medical records and electronic medical prescriptions were used as data sources. Demographics (age, gender), reason for admission, indication for anticoagulation, risk factors for complications such as renal and hepatic failure, concomitant drugs that increase the risk of bleeding (NSAIDs, platelet inhibitors, low molecular weight heparins) and adverse events were collected. In addition, adverse drug-related events avoided were also recorded.Results64 patients (36 men) with mean age of 76 years (range 35–95) were included. 24 patients were treated with dabigatran, 38 with rivaroxaban and 2 with apixaban. 4 of these treatments were used as off-label treatments.8 patients had renal failure and 23 had a risk of major bleeding due to concomitant treatments, mainly NSAIDs. Pharmaceutical interventions were performed in the 8 cases of renal failure because the doses needed adjustment. 14 patients with concomitant drugs that could increase the risk of bleeding were also monitored. 100% of recommendations were accepted by physicians.2 severe adverse events were recorded: 2 bleeding episodes.Conclusion94% of new oral anticoagulant prescriptions met the criteria established by the healthcare organisation. Pharmacists were involved in the optimisation of a third of the treatments, with total acceptance. It would be desirable to extend this activity, individualization of anticoagulant treatment, into primary medical care.ReferenceAgencia Española de Medicamentos y Productos Sanitarios. Informe de posicionamiento Terapéutico UT/V4/23122013No conflict of interest.
BackgroundRespiratory syncytial virus (RSV) infections can be prevented by good hygiene and prophylactic palivizumab, a monoclonal antibody against the fusion protein of VRS. The criteria for selecting patients for palivizumab prescription in our hospital are: <28 weeks preterm infants (PI) and age <12 months (criterion 1), <32 weeks PI and age <6 months (criterion 2), age <2 years with bronchopulmonary dysplasia (criterion 3), age <2 years with haemodynamically significant congenital heart disease (criterion 4).PurposeTo describe the use of palivizumab in the vaccination campaign in our hospital, evaluating the appropriateness of its use by the established criteria and its effectiveness.Material and methodsWe performed a retrospective observational study. All patients who received palivizumab between 01/10/2013 and 31/03/2014 were included. The data collected using the clinical records were: sex, gestational age, selection criteria, and number of hospitalizations due to acute bronchiolitis between 01/10/2013 and 30/09/2014. RSV was analysed in these patients by Polymerase Chain Reaction (PCR).ResultsPalivizumab was administered to 68 patients (48.5% female) with a median gestational age of 209 days (176–287). 24 patients (35.3%) fulfilled criterion 2, 14 (20.6%) criterion 1, 10 (14.7%) criterion 4, 5 (7.3%) criteria 1 and 3, 4 (5.9%) criteria 2 and 4, 3 (4.4%) criterion 3, 2 (2.9%) criteria 3 and 4. 4 patients did not meet any criteria and 2 had no data. Only 6 patients who received palivizumab were hospitalised with a diagnosis of acute bronchiolitis and their RSV PCRs were negative.ConclusionPalivizumab is used under the established criteria in our hospital. The study data show that immunising these at-risk patients with the palivizumab vaccine was an effective strategy for at least one year. Although the study period was 1 year, it would be desirable to measure effectiveness over a longer period.References and/or AcknowledgementsNo conflict of interest.
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