Medicamentos

  • 文章类型: Journal Article
    背景:这项研究的主要目的是描述用于追踪药学部门复合制剂的移动应用程序(App)的设计和实现。次要目标包括:i)评估解决与实施前后的准备工作分配有关的事件所花费的时间,ii)评估用户对应用程序的满意度,和iii)基于从App中提取的数据建立质量指标组。
    方法:1)定义应用程序要求,确定要包含在软件中的药物,并概述不同的工作流程。2)与供应商合作开发应用程序,并将其与处方和验证中涉及的计算机程序集成。此外,创建QR码以识别目的地单位的交付点,并获得了合适的移动设备。初始阶段涉及应用程序中的用户培训和在医院病房中进行的试点测试。3)后续阶段集中于扩张和整合。
    结果:该系统包括医院药房准备的所有无菌制剂的86.9%,包括化疗,成人肠外营养,和其他无危险的无菌制剂。此外,该应用程序已在所有住院病房实施,日托单位和两个外部站点。平均而言,每月跟踪5403种制剂(SD=297.3)。处理与制剂分发有关的事件所需的时间减少了83%(从每天38.9分钟减少到6.6分钟)。该应用程序定期提供有价值的管理数据,用于优化复合区域的工作流程。此外,用户对应用程序表示满意。
    结论:拟议的应用程序使医院工作人员能够轻松直观地跟踪药房中复合的制剂,不管用于处方的计算机程序。它大大减少了人工保存记录的需要,并减少了与分发无菌制剂有关的事件。
    The primary objective of this study is to describe the design and implementation of a mobile application (App) for tracking preparations compounded in the Pharmacy Department. Secondary objectives include: i) evaluating the time spent on resolving incidents related to the distribution of preparations before and after implementation, ii) assessing users satisfaction with the application, and iii) establishing a panel of quality indicators based on the data extracted from the App.
    1) Defining application requirements, identifying drugs to be included in the software and outlining different workflows. 2) Developing the App in collaboration with the supplier and integrating it with the computer programs involved in prescription and validation. Additionally, QR codes were created to identify delivery points at destination units, and suitable mobile devices were acquired. The initial phase involved user training in the application and a pilot test conducted in a hospital ward. 3) The subsequent phase focused on expansion and consolidation.
    The system includes 86.9% of all sterile preparations prepared in the Hospital Pharmacy, encompassing chemotherapy, adult parenteral nutrition, and other non-hazardous sterile preparations. Furthermore, the application has been implemented in all hospitalisation wards, day care units and two external sites. On average, 5403 preparations were tracked per month (SD = 297.3). The time required to address incidents related to the distribution of preparations has decreased by 83% (from 38.9 to 6.6 min per day). The App regularly provides valuable management data for optimising workflow in the compounding area. Additionally, users have expressed satisfaction with the application.
    The proposed application enables hospital staff to easily and intuitively track preparations compounded in the Pharmacy, irrespective of the computer program used for prescription. It has significantly reduced the need for manual record-keeping and has mitigated incidents associated with the distribution of sterile preparations.
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  • 文章类型: Journal Article
    目的:患者对药物的作用和副作用的看法可以用药物感知敏感性(PSM)量表来衡量。这项研究的目的是翻译和调整PSM量表以用于西班牙人口。
    方法:对50名接受各种专科门诊护理的患者进行了PSM量表的翻译和文化适应以及西班牙语版本的预测试。
    结果:翻译和适应过程的各个阶段没有困难。在认知访谈中,参与者发现这5个项目易于理解(4项的平均得分为3.86±0.24).
    结论:鉴于其简洁,西班牙语版的PSM量表是一种易于应用于研究和临床目的的工具.
    Patients\' views regarding the actions and side effects of medicines can be measured with the Perceived Sensitivity to Medicines (PSM) scale. The aim of this study was to translate and adapt the PSM scale for use in the Spanish population.
    The translation and cultural adaptation of the PSM scale and a pretest of the Spanish version were carried out with 50 patients receiving outpatient care in various specialties.
    There were no difficulties in the stages of the translation and adaptation process. In the cognitive interview, participants found the five items easy to understand (mean score of 3.86±0.24 out of 4).
    Given its brevity, the Spanish version of the PSM scale represents an easily applicable tool for both research and clinical purposes.
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  • 文章类型: Journal Article
    背景:这项研究的主要目的是描述用于追踪药学部门复合制剂的移动应用程序(App)的设计和实现。次要目标包括评估解决与实施前后的准备工作分配有关的事件所花费的时间,评估用户对应用程序的满意度,并根据从App中提取的数据建立质量指标面板。
    方法:定义应用程序要求,确定要包含在软件中的药物,并概述不同的工作流程。与供应商合作开发应用程序,并将其与处方和验证中涉及的计算机程序集成。此外,创建QR码以识别目的地单位的交付点,并获得了合适的移动设备。初始阶段涉及应用程序中的用户培训和在医院病房中进行的试点测试。随后的阶段集中在扩张和整合上。
    结果:该系统包括医院药房准备的所有无菌制剂的86.9%,包括化疗,成人肠外营养,和其他无危险的无菌制剂。此外,该应用程序已在所有住院病房中实施,日托单位和两个外部站点。平均而言,每月跟踪5,403种制剂(SD=297.3)。处理与分发制剂有关的事件所需的时间减少了83%(从每天38.9分钟减少到6.6分钟)。该应用程序定期提供有价值的管理数据,用于优化复合区域的工作流程。此外,用户对应用程序表示满意。
    结论:拟议的应用程序使医院工作人员能够轻松直观地跟踪药房中复合的制剂,不管用于处方的计算机程序。它大大减少了人工保存记录的需要,并减少了与分发无菌制剂有关的事件。
    The primary objective of this study is to describe the design and implementation of a mobile application (App) for tracking preparations compounded in the Pharmacy Department. Secondary objectives include evaluating the time spent on resolving incidents related to the distribution of preparations before and after implementation, assessing users satisfaction with the application, and establishing a panel of quality indicators based on the data extracted from the App.
    Defining application requirements, identifying drugs to be included in the software and outlining different workflows. Developing the App in collaboration with the supplier and integrating it with the computer programs involved in prescription and validation. Additionally, QR codes were created to identify delivery points at destination units, and suitable mobile devices were acquired. The initial phase involved user training in the application and a pilot test conducted in a hospital ward. The subsequent phase focused on expansion and consolidation.
    The system includes 86.9% of all sterile preparations prepared in the Hospital Pharmacy, encompassing chemotherapy, adult parenteral nutrition, and other non-hazardous sterile preparations. Furthermore, the application has been implemented in all hospitalization wards, day care units and two external sites. On average, 5,403 preparations were tracked per month (SD = 297.3). The time required to address incidents related to the distribution of preparations has decreased by 83% (from 38.9 to 6.6 minutes per day). The App regularly provides valuable management data for optimizing workflow in the compounding area. Additionally, users have expressed satisfaction with the application.
    The proposed application enables hospital staff to easily and intuitively track preparations compounded in the pharmacy, irrespective of the computer program used for prescription. It has significantly reduced the need for manual record-keeping and has mitigated incidents associated with the distribution of sterile preparations.
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  • 文章类型: Journal Article
    Writing a prescription or indicating a treatment is usually the last part of medical consultation. This crucial process can be undermined by multiple factors such as limited prescriptive ability, overwork, and lack of reflection or time. Insufficient information about the patient or the treatment affects the prescriptive process and leads to errors that can be serious for patient health. The National Academy of Medicine, in line with the World Health Organization, emphasizes the relevance of making the prescriptive process a reflective exercise.
    Extender una receta o indicar un tratamiento suele ser la última parte de la consulta médica. Este proceso crucial puede desvirtuarse debido a múltiples factores como capacidad prescriptiva limitada, exceso de trabajo y falta de reflexión o tiempo. La información insuficiente acerca del paciente o del tratamiento afecta el proceso prescriptivo y propicia errores que pueden ser graves para la salud del enfermo. La Academia Nacional de Medicina, en consonancia con la Organización Mundial de la Salud, hace énfasis en hacer del proceso prescriptivo un ejercicio de reflexión.
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  • 文章类型: Journal Article
    前列腺癌(PCa)是世界上第四大最常见的癌症,目前治疗基于手术切除和/或放射疗法和/或激素治疗。在过去的几年中,免疫治疗已成为一种重要的癌症治疗选择。随着免疫疗法原理的发展,只有sipuleucel-T获得了食品和药物管理局(FDA)的批准,这导致了与其他药物的进一步研究,开始免疫肿瘤学的新时代。许多疫苗以及检查点抑制剂正在临床研究中。尽管目前的热情,任何一种方法都不可能单独显著改变PCa结果,但是策略组合更有希望,并提供了乐观的理由。PCa免疫治疗的目标不一定是完全根除晚期疾病,而是恢复到具有惰性疾病状态的免疫平衡。在这样的共同努力下,PCa免疫疗法的未来看起来比以往任何时候都更加光明,许多临床试验结果即将公布。
    Prostate cancer (PCa) is the fourth most common cancer in the world and treatment is currently based on surgical removal and/or radiotherapy and/or hormone therapy. In the last few years\' immunotherapy has become an important cancer treatment option. While the principles of immunotherapy evolved, only sipuleucel-T was approved by the Food and Drug Administration (FDA) which lead to further studies with other agents, starting a new era in immuno-oncology. A number of vaccines are under clinical investigation as well as checkpoint inhibitors. Despite the current enthusiasm, it is unlikely that any of the approaches alone can dramatically change PCa outcomes, but strategies combination is more promising and provide a reason for optimism. The goal of immunotherapy in PCa does not have to be the complete eradication of advanced disease, but rather the return to an immunologic equilibrium with an indolent disease state. With such concerted efforts, the future of immunotherapy in PCa looks brighter than ever, with many clinical trial results being published soon.
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  • 文章类型: Journal Article
    Describe the characteristics of the therapeutic positioning reports (TPRs) published in Spain in the period 2013-2019.
    Systematic review of all TPRs published in the website of the Spanish Agency of Medicines and Health Products (AEMPS).
    All TPRs published since May 2013, until March 2019 DATA EXTRACTION: The main variables collected were the therapeutic groups assessed, the number of TPRs, the time of elaboration, the existence of restrictions versus the authorized indications and the information on the efficiency of medicines.
    During the period under review, 214 TPRs were carried out, with an average production time of 8.8 months, almost three times the objective of 3-month initially set. 57% of the TPRs established restrictions of use with respect to the approved indications. 26% of TPRs referred to the existence of economic data, although none included details on the efficiency. 10% of TPRs were updated.
    For TPRs to meet their objective of improving the efficiency of the assessment process and the consistency in the decisions on price, reimbursement and financing of medicines by the SNS, the deadlines established for publication must be met, incorporating systematically information on the efficiency of the drugs and including periodic updates with the new information generated.
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  • 文章类型: Journal Article
    Doctors require flexibility for prescription. However, some limits are laid down both by current knowledge and by restrictions imposed by access and rules and regulations. The Committee for Ethics and Transparency in the Physician-Industry Relationship (CETREMI) of the National Academy of Medicine proposes several suggestions to help patients, which include the selection of the best alternatives for each case, formalization of prescription standards variations (doses, drug indications, etc.) written down in the medical records, and avoidance of fashions, untested novelties, argumentations solely based on advertising or commercial promotion and conflicts of interest.
    Los médicos requieren flexibilidad para sus prescripciones. Sin embargo, algunos límites están marcados tanto por el conocimiento vigente como por las restricciones de acceso, normas y reglamentos. El Comité de Ética y Transparencia en la Relación Médico-Industria (CETREMI) propone varias sugerencias para ayudar a los pacientes, que incluyen la selección de las mejores alternativas para cada caso, la protocolización de variaciones a los estándares de prescripción (dosis, indicaciones, etcétera) por escrito en el expediente y eludir modas, novedades no probadas, argumentos simplemente publicitarios o promocionales y conflictos de interés.
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  • 文章类型: Journal Article
    La psoriasis es una enfermedad cutánea incurable que afecta a 2.9 % de la población mexicana, por lo que es trascendente analizar el impacto de la medicina traslacional en el desarrollo de medicamentos antipsoriásicos. En esta revisión se discuten conceptos etiopatogénicos de la enfermedad y se analizan artículos publicados entre 2005 y 2017 en torno a medicamentos en desarrollo, además, se presenta un análisis crítico sobre las perspectivas futuras en el desarrollo de nuevos tratamientos. El uso de estrategias bidireccionales de la medicina traslacional ha permitido incrementar significativamente el número de tratamientos antipsoriásicos disponibles. Se encontraron 18 nuevos fármacos en exploración. La caracterización de antígenos responsables de la activación inmunológica, la identificación de biomarcadores predictivos de eficacia farmacológica, el desarrollo de modelos más representativos de la enfermedad, así como la integración de aspectos farmacogenómicos a estrategias de medicina traslacional fueron identificados como elementos relevantes que deben ser incorporados en el desarrollo de nuevas opciones terapéuticas.
    Psoriasis is an incurable cutaneous disease that affects 2.9% of the Mexican population, and it is therefore important for the impact of translational medicine on the development of anti-psoriatic drugs to be analyzed. In this review, current etiopathogenic concepts of the disease are discussed, and articles on drugs under development published between 2005 and 2017 are reviewed; in addition, a critical analysis on future perspectives for the development new treatments is presented. The use of translational medicine bi-directional strategies of has allowed to significantly increase the number of available anti-psoriatic therapies. Eighteen new investigational drugs were found. Characterization of antigens responsible for immune activation, identification of predictive biomarkers with pharmacologic efficacy, and the development of more representative disease models, as well as the integration of pharmacogenomic aspects to translational medicine strategies were identified as relevant aspects that should be incorporated in the development of new therapeutic options.
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  • 文章类型: Journal Article
    UNASSIGNED: Caracterizar el gasto de bolsillo privado en medicamentos en función de los determinantes sociodemográficos y socioeconómicos. MATERIALES Y MéTODOS: La fuente de datos es la Encuesta de Gasto de Bolsillo en Medicamentos de 2014. Se caracterizó el gasto de bolsillo privado mediante variables explicativas sociodemográficas (SOD) y socioeconómicas (SES). Se hizo análisis factorial por componentes principales, regresión logística y lineal simple.
    UNASSIGNED: Los Odds Ratio demuestran que la educación y la zona geográfica son determinantes fundamentales que inciden en el gasto de bolsillo. Los medicamentos son productos necesarios, en adición a que el gasto de bolsillo aumenta a un promedio del 2% por cada año de vida cronológica adicional.
    UNASSIGNED: Existe mayor vulnerabilidad en las zonas más pauperizadas respecto del acceso a medicamentos, en especial en las indígenas e implica un mayor riesgo de gasto catastrófico a menor ingreso ante la mayor prevalencia de enfermedades crónicas.
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  • 文章类型: English Abstract
    目的:当前的流行病学概况和新技术的引入所产生的高昂成本,对公共卫生系统的影响,这种情况是复杂的,当卫生预算是低的,并导致药物支付的病人的口袋。在这种情况下,有必要设计战略,以加强将在墨西哥公共卫生机构中使用的药物的批准。描述在公共卫生机构使用的药物批准程序的结果,以确保疗效,安全,以及墨西哥公共卫生机构使用的卫生技术的效率。
    方法:我们进行了一个跨部门的药物审批过程,从2011年9月至2012年12月,对过程中的每个阶段进行描述性分析。
    结果:在收到的394份卫生技术批准申请中,244人(62%)用于药物;其中,151(62%)符合评估要求(32%和68%是修改内含物),最终批准了42%(61%的变化和33%的夹杂物)。73%的申请是为了达成共识,12%的价格较低,6%的价格获得多数票通过。拒绝的主要原因是缺乏临床证据(31%)和经济学评估中的方法学问题(27%)。
    结论:在对科学证据进行批判性分析的基础上,以方法上的严谨进行了过程的加强,在法律框架下具有透明度和合法性,以促进资源优化。要求的比例最高的是药物,这是最常用的治疗技术;因此,它需要一个适当的选择过程,以确保更大的健康利益,确保有效利用经济资源。经济评估是除了价格之外要考虑的支持工具,健康的价值取决于证据的质量,将人均国内生产总值作为定义一种有效替代药物的门槛。
    OBJECTIVE: The high costs generated by the current epidemiological profile and the introduction of new technologies, impact on public health systems, this situation is complicated when the health budget is low and causes the drug to be paid by the patient\'s pocket. In this situation it is necessary to design strategies that strengthen the approval of drugs that will be used in public health institutions in Mexico. To describe the results of the drug approval process for use in public health institutions to ensure the efficacy, safety, and efficiency of health technologies used in public health institutions in Mexico.
    METHODS: We conducted a cross-sectional drug approval process, from September 2011 to December 2012, with a descriptive analysis for each stage in the process considered.
    RESULTS: Of the 394 applications received for approval of health technology, 244 (62%) were for drugs; of these, 151 (62%) met the requirements for evaluation (32% and 68% were modifications inclusions), finally was approved of 42% (61% of the changes and 33% of inclusions). The 73% of the applications were for consensus approval, 12% were conditioned at low price and 6% were approved by majority vote. The main reasons for refusal were lack of clinical evidence (31%) and methodological problems in the economic evaluation (27%).
    CONCLUSIONS: The strengthening of the process was conducted with methodological rigor based on critical analysis of scientific evidence, with transparency and legitimacy under a legal framework to promote resource optimization. The highest percentage of requests was for drugs which are the most commonly used therapeutic technology; for this reason it requires a proper selection process to ensure greater health benefit that ensures efficient use of economic resources. The economic evaluation was a support tool to consider in addition to price, the value of health determined by the quality of evidence, establishing a GDP per capita as a threshold to define a drug as an efficient alternative.
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