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Background The recently marketed anti-diabetic drugs are considered new options without great innovation. Purpose To determine the prescription profile and economic impact of these drugs to make a more efficient use of resources. Materials and methods Retrospective study of six months of oral anti-diabetics (therapeutic subgroup A10B of the Anatomical, Therapeutic, Chemical classification system (ATC)) that were prescribed by the AdN application. One of the aims of the management contract in this health area is to limit prescription of recently marketed anti-diabetics. These drugs are included in the C group, setting them against cheaper agents such as metformin and sulfonylureas with which there is a great deal of experience. Results During this study period 33,458 packs of oral anti-diabetics were prescribed at a cost of 876,382 €. The prescription of new oral agents accounted for 34.4% of packs at a cost of 739,545€, 84.4% of total expenditure. Prescription rates are as follows: metformin/sitagliptin 41.9%, metformin/vildagliptin 33.4%, sitagliptin 11.1%, vildagliptin 4.5%, saxagliptin 3.3%, liraglutide 2.3% and linagliptin 2.3%. Over this period 12,293 patients were treated with anti-diabetic drugs and 49.1% of them used one of these new drugs. Making an approximation of the average cost per patient treated, in the case of the new ones this is 122.4 €/patient compared to 71.3 euros in the classic ones. 96.5% of prescriptions came from primary care physicians and only 3% from cardiology and 2.0% from endocrinology and nutrition specialists. Conclusions The new oral anti-diabetics represent a high rate of current treatment considering the number of patients as well as the health spending, so it is necessary to justify their use. Among the new anti-diabetics without a relevant contribution the most prescribed were metformin/sitagliptin and metformin/vildagliptin. Another important point is the high number of prescriptions from general practitioners versus specialists in this sample. No conflict of interest.

BackgroundIncluding a pharmacist within the multidisciplinary teams has been a basic objective in many hospitals in recent years.PurposeTo assess the efficiency of pharmaceutical care in the internal medicine service, based on an analysis of the pharmaceutical interventions (PIs) made and their impact on duration of hospital stay.Material and methodsAnalysis of the interventions was derived from a prospective observational study between December 2014 and March 2015, involving a pharmacist integrated into the healthcare team with a working schedule from 09:00 to 14:00.The level of risk associated with the PI was defined as a percentage risk of the patient’s hospital stay being prolonged had the intervention not been made (classification adapted from Overhage et al. and Bates et al.): fatal (60%), serious (40%), significant (10%) and non-significant (0%).ResultsA total of 52 PIs were accepted and implemented in 60 patients: change of proposed dose 32%, change of proposed medicine 24.5%, proposed drug suspension 17%, complete/update medical order and medical report information 11.3%, proposed start of treatment 7.6% and monitoring recommendation 7.6%.The therapeutic groups involved were mainly the following: group N (neurological) 32.2%, group C (cardiovascular) 26.4%, group J (anti-infectives for systemic use) 18.9% and group A (gastrointestinal and metabolic) 11.3%.The risk of prolonging hospital stay according to PI was: serious 17%, significant 45.3% and non-significant 37.7%.ConclusionAccording to severity, more than half of the PIs accepted implied a reduction in the duration of hospital stay (62.3%), resulting not only in increased patient safety but also in cost savings, thus demonstrating the efficiency of including a pharmacist in the internal medical service.References and/or AcknowledgementsOverhage JM, Lukes A. Practical, reliable, comprehensive method for characterizing pharmacists clinical activities. Am J Health Systm Pharm 1999;56:2444-50Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. JAMA 1995;274:29-34No conflict of interest.

Background Including a pharmacist within the multidisciplinary Emergency Service (ES) team has been a basic objective in many hospitals in recent years. Purpose To assess the efficiency of pharmaceutical care in the ES, based on an analysis of the pharmaceutical interventions (PIs) made and their impact upon the duration of hospital stay. Materials and methods Analysis of the interventions was derived from a prospective observational study between October 2012 and March 2013, involving a pharmacist integrated in the healthcare team with a working schedule from 8:30 a.m. to 15:00 p.m. All patient information, PIs, resolution and data to do with the treatment were collected and analysed using a sheet developed for this purpose, using an Excel database. The level of risk associated with the pharmaceutical intervention was defined as a percentage risk of the patient’s hospital stay being prolonged had the intervention not been made (classification adapted from Overhage et al. and Bates et al.): fatal (60%), serious (40%), significant (10%) and nonsignificant (0%). Results A total of 1176 PIs were accepted and implemented: complete/update medical order and medical report information 33.1%, change of proposed medicine 30.9%, change of proposed dose 12.2%, proposed drug suspension 7.3%, proposed start of treatment 4.9%, detection of incorrect practices or transcription/administration error 4.5%, monitoring recommendation 2.5%, change of frequency proposal 0.7%, and others 3.9%. The therapeutic groups involved were mainly the following: group C(cardiovascular) 31.8%, group N(neurological) 17.5%, group A(gastrointestinal and metabolic) 9.8%, and group B(blood and hematopoietic organs, particularly heparins)12.9%. The risk of prolonging hospital stay according to PI was: fatal 2.12%, serious 14.70%, significant 33.48%, and non-significant 49.69%. Conclusions The most common PIs were: Complete/update information and change medicine. Group C was the main category involved in the PIs. According to severity, over half of the PIs accepted implied a reduction in the duration of hospital stay (50.31%), resulting not only in increased patient safety but also in cost savings – thus demonstrating the efficiency of including a pharmacist in the ES. No conflict of interest.

BackgroundPharmaceutical interventions are a key strategy to ensure proper drug prescription and the effectiveness and safety of any treatment.PurposeTo study the pharmaceutical interventions made in hospitalised patients between 2010 and 2015.Material and methodsAnalysis of the interventions was derived from a retrospective observational study between 2010 and 2015 in hospitalised patients. Type of pharmaceutical intervention, resolution of the intervention and data on treatment were collected and analysed using a sheet developed for this purpose, and using an Access database.Results23 232 pharmaceutical interventions were reported. The most common were: change of other drug included in hospital pharmacotherapeutic guide 50.85%, change of proposed dose 30.67%, administration error 3.5%, possible adverse events 2.95%, interactions 2.4%, monitoring recommendation 1.5% change and other 8.13%. Resolution of the recommendations were: accepted 43.19%, home medication (provided by the patient) 26.81%, no evaluation due to insufficient information 24.76% and rejected 5.24%. The therapeutic groups involved were mainly the following: group C (cardiovascular) 29.78%, group N (neurological) 25.06%, group B (blood and haematopoietic organs, particularly heparins) 9.43%, group J (anti-infectives) 9.18% and group A (gastrointestinal and metabolic) 6.45%.ConclusionThe most common interventions were change of other drug included in the hospital pharmacotherapeutic guide and change of proposed dose. The percentage of interventions rejected was very low. The most common therapeutic groups were cardiovascular and neurologic.References and/or AcknowledgementsOverhage JM, Lukes A. Practical, reliable, comprehensive method for characterizing pharmacists clinical activities. Am J Health Syst Pharm 1999;56:2444-50Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. JAMA 1995;274:29-34No conflict of interest.