Background A treatment exchange protocol (TEP) contains three ways of intervening: a) suspend the prescribed treatment (not very useful), b) keep the patient on his home medicines during the hospitalisation, c) exchange the treatment (TE) to another drug included in the hospital formulary. The protocol used not to be applied to multidose drugs commonly used by patients. Purpose To assess the prescription of drugs not included in the hospital formulary (NIDHF) and to know the acceptability of recommendations for a change of treatment. Materials and methods Observational, prospective, two-month study in a General Hospital. Every day The authors recorded new NIDHF prescriptions, age, sex and diagnosis. TEP was applied to everyone. When the recommendation wasn't accepted, The authors recorded the reason (eg, allergy). NIDHFs without a recommendation because of a lack of evaluation or agreement were quantified, knowing they were a therapeutic void in the hospital formulary (HF) and TEP. Results The authors identified 251 NIDHFs from 209 patients (average age 66, 46% male). The authors obtained an average of six new prescriptions daily; half of them were replaced according to the TEP. The analysis of the non-replaced NIDHF drugs was: 46% of NIDHF drugs were kept during hospitalisation. They were mainly oral antidiabetic and antidementia agents. In 12% the drug was acquired occasionally for a justified reason. In 7% they were multidose drugs. In 18% the TE was rejected. In 9% the TE wasn't available. In the remainder, the reason for rejection wasn't specified and patients provided treatment. Clinical services with more NIDHF prescriptions were: Internal Medicine (40%) and Traumatology (10%). The lowest acceptance of recommendations was in Home Hospitalisation (45%) and Surgery (33%). The greatest number of prescriptions for drugs without agreed therapeutic exchange was in Pneumology (23%) and Otorhinolaryngology (28%). Conclusions The adherence to the HF and acceptance of the TEP recommendations were high. Many of the requirements of NIDHF are solved with TEP. The study has enabled us to detect therapeutic areas in which the HF and TEP could be improved. Any changes must be reviewed and agreed with medical services to reduce the likelihood of adverse events and promote good-quality pharmacotherapy.

Background HIV infection is associated with increased risk of cancer: AIDS-defining cancers (ADC): Kaposi’s sarcoma (KS), non-Hodgkin lymphoma (NHL), cervix cancer. non-AIDS-defining cancers (NADC): Hodgkin lymphoma (HL), anal cancer, lung, head, neck, hepatocarcinoma. Purpose To analyse patients with antiretroviral therapy and chemotherapy, type of cancer and associated risk factors. Materials and Methods Descriptive study of patients with antiretroviral and chemotherapy between 2004–2011, extracting data from medical records and the Farmatools programme, analysing using SPSS 11.0. Results33 patients were obtained (3.7% of all HIV patients on antiretroviral treatment); 82% men: 16 with ADC (11 NHL, 3 KS, and 2 with NHL and KS) and 17 with NADC (5 HL, 3 lung cancer, 3 head-neck, 3 anal, 1 ovary, 1 gastric and 1 chronic lymphocytic leukaemia). When cancer was diagnosed patients presented: CD4<200 cells/microliter (27.3%), detectable viral load (VL) (33.3%), C3 category (63.6%), smokers (63.6%), human papillomavirus (HPV) (6.1%), Epstein Barr virus (21.2%), human herpes virus 8 (HHV8)(21.2%), hepatitis B-C (48.5%), intravenous drug addict (24.2%). 8 patients died. 80% KS patients and 66.7% head-neck cancer had CD4<200 (P = 0.036). 62.5% of those who died presented CD4<200 (P = 0.009). 66.6% of anal cancer patients presented HPV (P = 0.006). 100% of KS presented HHV8 (P = 0.002). Conclusions 3.7% of HIV patients on treatment developed neoplasms, more than 50% were NADC, of which 88% started in patients with an undetectable VL, confirming a nice immunological status when cancer was diagnosed. No conflict of interest.

Background Medicines errors are a major cause of adverse events in hospitalised elderly patients and increase morbidity, mortality and healthcare costs. Purpose To improve the reconciliation process in these patients, to establish the degree of risk of the discrepancies, to analyse potentially inappropriate prescriptions (STOPP criteria) and to identify drug interactions. Materials and methods Retrospective and descriptive study conducted at a general hospital from January to December 2012 on patients aged over 75. The patient’s usual medicines were recorded by HORUS (software application of outpatient clinic medicines records), medical history and interview with the patient. The patient’s chronic medicines were compared with the prescribed at admission to identify discrepancies classified according to the ‘Consensus Document on Terminology and Classification in Medication Reconciliation’. The potential risk of reconciliation errors (REs) was evaluated based on the NCCMERP index. We reviewed potentially inappropriate prescriptions (STOPP criteria) and drug interactions. Results Medicines reconciliation was performed in 1,530 patients, 59.71% were women. 13,117 drugs were evaluated (8.64/patient) and 2,722 discrepancies were detected (1.78/patient). More frequently justified discrepancies were not to prescribe a drug due to clinical and medical decisions (33.73%), and change of dose or route of administration of a drug based on new clinical situation (28.04%). Most common causes of REs were: omission of chronic medicines (73.53%) and incorrect dose, route or frequency (17.35%). The risk associated with REs was category C (71.76%), category D (25%), and category E (2.35%). There were 80 inappropriate prescriptions according to STOPP criteria (6.92% of patients). 187 clinically significant drug interactions were found (15.56% of patients). Conclusions The incorporation of the reconciliation process in the hospital has enabled us to detect and intercept REs. Before any prescriptions are written it is necessary to consider all aspects of elderly patients’ conditions that may affect the efficacy, safety and success of pharmacotherapy. No conflict of interest.