Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions. The aim of our study was to examine the prevalence and characteristics of DRP in regular clinical pharmacy, as well as to determine those factors associated with a higher risk of DRP in the hospital setting. We analyzed data from a standardized registry database of regular pharmacy practice (2015- 2016). DRP were classified according to the Pharmaceutical Care Network Europe v6.2 classification. Cross-sectional data were obtained from 1602 adults admitted to medical wards. Crude and adjusted binary logistic regressions were performed to identify associations between potential risk factors and DRP. Overall DRP prevalence was high across medical specialties (45,1%), in a population characterized by advanced age, polypharmacy and multimorbidity. Problems leading to DRP were mainly classified into two domains (effectiveness and adverse reactions), being drug and dose selection the most frequent causes. Interventions were accepted and DRP were totally or partially solved in 74.1% and 4.81% of cases, respectively. In the adjusted model polypharmacy, allergies, BMI > 25 kg/m2 and clearance < 30 mL/min were associated with a higher risk of DRP. The participation of clinical pharmacists into multidisciplinary teams promotes the detection and solution of DRP. Polypharmacy, obesity, renal impairment and allergy are associated with a higher risk of DRP during admission.
The prevalence of LTBI was very high in this study, and systematic screening of all inmates at the time of entry into the prison is therefore recommended. Excluding those who do not fall in any of the high-risk prevalence groups from the evaluation complicates the screening and is not very effective.
Objective: To study the prevalence of latent tuberculosis infection (LTBI) and the predictive factors amongst immigrants entering prison.Methods: prospective study conducted in May and June of 2009. The tuberculin skin test (TST) was performed, with induration of ≥ 10 mm being regarded as positive. Variables collected were: age, origin, number of incarcerations, duration of stay in Spain, heroin and cocaine consumption, intravenous drug use and HIV infection. The rate of LTBI was calculated and the overall infection rate (ITL and history of TB). To study predictable factors, bivariate and multivariate analysis was carried out using logistic regression.Results: 152 male immigrants. Average age: 31.9 years ± 7.8; 37.2% of them with heroin or cocaine consumption and 7.5% IDU. 12 patients were previously TST positive and 6 patients had history of TB. TST was performed on 134 people, 63 with positive results and 71 with negative ones. ITL rate: 49.3. Overall infection rate: 53.3%. Bivariate associated with LTBI: more than one incarceration (67.4% vs. 36.4% in primary, p=0.001), age (76% ≥ 40 vs. 40.4% under this age and heroin and cocaine consumption (60% consumers vs. 39.3% non consumers; p=0.02. Multivariate analysis only confirmed the association with age (p=0.001; OR: 2.34, IC=1.39-3.94).
Conclusions:The LTBI rate amongst immigrants entering prison is very high. A complete study is recommended for all of them, with special attention being paid to the most vulnerable ones, such as older people.
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