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Biomedical subjects

J L Poveda Andrés

Publications and source records attributed to J L Poveda Andrés.

14 recordsLinked to original sources
PubMed1996

[Profile of primary care physicians in a health area: a cluster analysis].

OBJECTIVES: To discover characteristics of primary care doctors. To find homogeneous groups of doctors. DESIGN: A basically descriptive crossover observational study. SETTING: Primary care doctors from a health area. PARTICIPANTS: The following variables were recorded on the 99 doctors who worked in Castellon Area 03 during 1992: age, gender, fixed or temporary post, rural or urban area, MIR training, primary care model, patient load, sole employment, drugs expenditure, number of pensioners and total number of patients registered. MEASUREMENTS AND MAIN RESULTS: We found a first group of older doctors, working mainly in the old model, for whom PC was not their sole employment; another younger group without MIR training and with an average patient load; the third group was women in temporary posts with a somewhat higher drugs expenditure; the fourth was doctors working in rural areas with a very low patient load; the fifth, final and youngest group was family doctors, with an average patient load, low expenditure and a high number of patients registered. We observed highly significant differences between groups. CONCLUSIONS: Doctors' age and gender divide them into different groupings; family doctors form one group. Multivariable, descriptive methods proved useful in finding, describing and classifying doctors and centres, etc., and could be of use in resource and action planning.

Age Factors↗
PubMed1995

[Factors determining costs of drug prescriptions in primary health care].

OBJECTIVE: To describe and explain the annual pharmaceutical expenditure generated by the professionals in a Health Area. DESIGN: An observational crossover study. SETTING: Primary Care. Doctors in a Health Area. PARTICIPANTS: 99 general practitioners who worked during 1992 in Area 3, Castellón. INTERVENTIONS: We used as a variable reply the pharmaceutical expenditure of each doctor during 1992, the expenditure per inhabitant and the expenditure per inhabitant standardised for the percentage of passives. We gathered as explanatory variables of the same: age, gender, whether the post was provisional or permanent, rural or urban area, MIR (resident) training or not, the model of Primary Care, frequency of attendance, whether the doctors worked there exclusively, the number of pensioners and the number of patients at work registered. MEASUREMENTS AND RESULTS: In the bivariant analysis we found a significant association of expenditure with being provisional in the post, the old model of primary care, an urban area, greater age of the doctor, greater frequency of attendance, non-exclusivity and the number of patients registered. These associations varied in line with the variable reply used. In the different models of multiple linear regression obtained, the influence of the number, non-exclusivity, gender and work-place characteristics predominated. CONCLUSIONS: Greater pharmaceutical expenditure appears to be related to the number of patients registered, the absence of exclusivity, doctors being women and the features of the town where they work.

Adult↗
PubMedDate not supplied

[Designing a module for the prevention of hypersensitivity reactions in an assisted electronic prescription system].

OBJECTIVE: To develop a module for the prevention of drug-related allergies to be integrated within the assisted electronic prescription software PRISMA. METHOD: On module design potential sources of medication errors regarding drug allergies were first analyzed, and ideal module characteristics were defined. Then a review of the literature was performed to define "group allergies", and last of all master archives were created, with their required relations being established. RESULTS: A module for the prevention of drug-related allergies in the setting of an assisted electronic prescription software was designed. By interrelating tables listing active ingredients, excipients, chemical structures/functional groups, and "group allergies" prescriptions may be interactively checked, and useful information is provided to the prescribing practitioner--as well as the whole multidisciplinary team--to help him make his/her decisions.

Drug Hypersensitivity↗
PubMedDate not supplied

[Leflunomide: assessing teratogenic risk during the first trimester of pregnancy].

OBJECTIVE: To assess the teratogenic risk associated with leflunomide during the first quarter of pregnancy, and to establish guidelines to minimize said risk. METHOD: Literature search using tertiary, secondary, and primary sources related to teratogenicity, including databases (MEDLINE and EMBASE) and specific webs. The information required for assessment, as well as for the establishment of criteria was collected. RESULTS: Leflunomide demonstrated an increased risk of fetal death and teratogenic effects in animals. No major or minor malformation cases have been reported in humans regarding leflunomide, which is classified within category X of fetal risk. A wash-out regimen may possibly reduce the risk for fetal harm. CONCLUSIONS: Conception scheduling or early pregnancy detection is required for better clinical counselling and the avoidance of unnecessary risk.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Effect of the concomitant administration of indomethacin or ibuprofen on amikacin pharmacokinetics in premature newborns].

OBJECTIVE: To evaluate whether the concomitant administration of ibuprofen or indomethacin plus amikacin may alter the latter drug s pharmacokinetic parameters, and hence amikacin plasma levels. METHOD: Retrospective cohort study performed by reviewing the medical records of premature children with persistent ductus arteriosus receiving amikacin and ibuprofen, or amikacin and indomethacin. They were divided up into three groups: group 1: treatment with amikacin went before indomethacin or ibuprofen; group 2: simultaneously treated with amikacin and indomethacin; group 3: simultaneously treated with amikacin and ibuprofen. Pharmacokinetic parameters, distribution volume, and amikacin clearance were measured using the PKS program (a non-linear regression method). Half life was determined from previous parameters. RESULTS: Twenty-eight patients were included. No statistically significant differences were found among pharmacokinetic parameters corresponding to each study group. CONCLUSIONS: Further studies are needed with a greater number of patients and currently recommended doses to assess the influence of indomethacin and ibuprofen in the pharmacokinetics of amikacin in premature children with persistent ductus arteriosus.

Amikacin↗
PubMedDate not supplied

[Pharmaceutical care self-assessment process for hospitalized patients through the Valor program].

OBJECTIVE: To assess the quality of pharmaceutical care for inpatients using qualitative criteria as established in the Valor program. METHOD: Evaluation study through 43 explicit structural, process, and outcome criteria within the Valor program, in which pharmacists in the Unit Dose Functional Unit may assess themselves along a compliance scale from 0 to 100%. This Unit provides daily individualized pharmaceutical care to 550 patients in an adult general and surgery hospital. Mean scores per pharmacist and item are estimated for the 2003-2005 period. RESULTS: Mean compliance assessments for all 14 interannual "structural items" were 53, 57, and 64%; those for all 13 "process items" were 52, 51, and 46%; and those for all 15 "outcome items" were 18, 28, and 26%. A variability of 20% was documented for structure and process evaluations, and of 50% for outcome assessments. CONCLUSIONS: Every autoevaluation raises to the equipment the necessity to establish improvements and to enhance communication, and the application of standardized procedures in the pharmaceutical care process.

Humans↗
PubMedDate not supplied

[Cost-benefit analysis of the implementation of automated drug-dispensing systems in Critical Care and Emergency Units].

OBJECTIVE: To determine monetary impact when traditional drug floor stocks are replaced by Automated Drug Dispensing Systems (ADDS) in the Medical Intensive Care Unit, Surgical Intensive Care Unit and the Emergency Room. METHODS: We analysed four different flows considered to be determinant when implementing ADDS in a hospital environment: capital investment, staff costs, inventory costs and costs related to drug use policies. RESULTS: Costs were estimated by calculation of the current net value. Its analysis shows that those expenses derived from initial investment are compensated by the three remaining flows, with costs related to drug use policies showing the most substantial savings. Five years after initial investment, global cash-flows have been estimated at 300.525 euros. CONCLUSION: Replacement of traditional floor stocks by ADDS in the Medical Intensive Care Unit, Surgery Intensive Care Unit and the Emergency Room produces a positive benefit/cost ratio (1.95).

Automation↗
PubMedDate not supplied

[Cost-benefit analysis of a semi-automated process in the preparation of unit-doses by the Pharmacy Department].

OBJECTIVE: To determine in monetary terms the effect of implementing a semi-automated procedure for preparation of drugs for unit dose distribution. METHODS: The current net value was estimated for three different flows involved in the evaluation of semi-automated drug storage and retrieval systems used in the unit dose distribution area in a hospital: capital investment, staff costs and structural costs related to physical space occupied. RESULTS: Implantation of the new work procedure produced an annual saving of 32,390 euro in staff costs and 5,645 euro in structural costs. Global cash flow has been estimated in -96,565 euro for a five year amortization period, with a benefit/cost ratio of 2.19. CONCLUSION: Replacement of traditional unit dose cart filling systems by a semi automated procedure presents a positive benefit/cost ratio and initial investment is paid off in 44 months.

Automation↗
PubMedDate not supplied

[Therapeutic interchange of drugs not included in the hospitaĺs pharmacotherapeutic guide: a quality program].

BACKGROUND: Standardised substitution of those drugs not included in the hospitaĺs formulary constitutes one of several methods used to improve therapeutic efficiency, due to reduction of variability in pharmaceutical practice and prevention of potential medication errors. OBJECTIVES: To evaluate quality of drug substitution procedures in those drugs not included in the hospital's formulary. METHODS: Assessment study in a surgical hospital with 314 beds, using structural, process and outcome criteria from 1998 to 2002. RESULTS: Compliance degree for structure, process and outcome criteria were 100, 89 and 35%, respectively, while the established standards were 100%. Prevalence values for patients with substituted medication, increased from 2.9 (95%CI, 2.4-3.6) in 1998 to 11.1% (95%CI, 10.2-12.1) in 2002. Non-substituted drugs annual cost decreased from 20,199 in 1998 to 12,356 Euro in 2002. Drug substitution made by the pharmacist had an acceptance degree of 82.5%. No interchange errors were found in 126 replaced drugs. CONCLUSIONS: The development of quality programs to improve drug prescription adherence to the hospitaĺs formulary, specially those that promote therapeutic interchange under the Pharmacy Committee guidance, are helpful strategies to make a proficient management of patients pharmacotherapy.

Algorithms↗
PubMedDate not supplied

[Analyzing the evolution of a Pharmacy Department using a relative value unit system].

INTRODUCTION: This study proposes the use of relative value units (RVU) as a clinical management tool to evaluate departmental services. OBJECTIVES: To measure productivity from 2000 to 2002 by estimating RVU. To determine RVU cost in constant Euros and evaluate system efficiency during this period of time. METHODS: Retrospective, observational study of a pharmacy department s production. RVU assigned to each activity have been obtained from a standardized document drawn up by the Sociedad Española de Farmacia Hospitalaria. Cost of each RVU was determined based on total cost assigned to the pharmacy department and the total number of RVUs produced. RESULTS: Drug dispensation activities account for 76% of the total production, followed by elaboration activities (21%). CONCLUSIONS: Productivity in our department has increased 46.48% in this period of time, while efficiency has increased by 23.8%.

Costs and Cost Analysis↗
PubMedDate not supplied

[Approximation of a proposal of therapeutic criteria for parenteral nutrition].

The care of patients with parenteral nutrition is made up of the care provided by the different members of a multidisciplinary team. This cooperative participation is translated into the establishment and the application of a therapeutic protocol as a frame for the use of parenteral nutrition. It is usual for these protocols to include the normalization of the formulations of parenteral nutrition units, as well as containing logistical processes such as prescription, preparation, dispensation, and administration. Also, the classical review studies on the use of parenteral nutrition aim to know the degree of compliance with the protocols and/or the variability in the application of this therapy. However, this model aims to re-direct itself towards the improvement of the effectiveness and the therapeutic quality obtained in patients treated with parenteral nutrition. The objective of the present study is to present explicit criteria to be included in the parenteral nutrition protocols and the constitute action guidelines for the identification of problems and taking decisions in the resolution and prevention of the same. Also, they are elements for the evaluation of the applied processes and of therapeutic results obtained in patients fed intra-venously.

Evaluation Studies as Topic↗