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BackgroundHospital pharmacists must be focused on patient safety. Consequently, it is important to evaluate the impact of the occurrence of medicines errors (MEs).PurposeTo analyse MEs taking place in a General Hospital over a period of 5 years (2009–2013).Material and methodsDescriptive observational study of MEs reported in a General Hospital over a period of 5 years (2009–2013). Variables analysed: place, stage, drug, type, causes, consequences.Results422 MEs were notified in 5 years: 47, 51, 75, 111, 138. Annual growth: 8.51%, 47.06%, 48%, 24.32% respectively; overall growth: 193.62%.Place of detection: 33.65%, Hospital Pharmacy Service; 27.73%, Hospitalisation Units; 17.30%, Day Case Unit; 17.06%, Outpatient Clinics.Stage: prescription (63.74%); transcription (28.44%); dispensing, processing, supply manufacturer, validation, administration or labelling (7.82%)Drug (Anatomical Therapeutic Chemical classification): 41%, group L (Antineoplastic and immunomodulating agents); 14.22%, group J (Anti-infectives for systemic use); 11.14%, group N (Nervous system); 8.06%, group B (Blood and blood forming organs); 7.35%, group A (Alimentary tract and metabolism); 7.11%, group C (Cardiovascular system).Type: errors in dosage (36.02%), inappropriate medicine (24.64%) or patient (22.27%).Causes: lack of staff training (29.86%), lack of compliance of work procedures (27.25%), incorrect patient identified (14.93%), insufficient staff, without experience or under stress conditions (13.51%), problems in interpreting the prescription (11.85%).Consequences: the error did not reach the patient (70.14%); the error came to the patient but did not cause any damage (16.35%); circumstances or events which may cause error (10.19%).ConclusionReporting of MEs is increasing significantly, although the corresponding data are undervalued. Therefore, it is important to continue working on this aspect. It is crucial to report and analyse in detail the MEs taking place in hospitals. This way, the real conditions in which they occur can be known, and improvement strategies can be adopted to improve the safety.References and/or acknowledgementsNo 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.

Background Treatment simplification with protease inhibitors (PI) boosted with ritonavir in HIV-infected adults is a growing strategy with a number of considerable advantages: it is a well-tolerated treatment that reduces side effects such as lipodystrophy and peripheral neuropathy associated with other antiretroviral therapy (ART). Other advantages include the reduced number of tablets to be taken, improved adherence and decreased healthcare cost. The disadvantage of this strategy is virological failure (VF) defined as a plasma HIV-1 RNA >50 copies/ml six months after starting treatment. Possible reasons for VF include poor adherence, low CD4 nadir, and the possibility of pre-existing PI resistance (mutations). Purpose To analyse the efficacy and safety as well as the cost savings that PI simplification strategy provides in a General Hospital. Materials and methods Retrospective study conducted of patients who changed from ART to PI from January to July 2012 with follow up until March 2013. The following parameters were obtained from the electronic medical record: age, gender, adherence and HIV RNA before and after the change of treatment, reason for change, failure of monotherapy, annual healthcare cost saving. Results A total of 85 patients were eligible (median age 47.5 years (IQR:10.5) and 69% men). These patients were long-term virologically suppressed (>80% patients with negative viral load at at least 6 months,) good adherence to ART (average 92%) and had no history of PI failure. The reasons for treatment change were: simplification of ART (73%), lipodystrophy (21%) and hepatic and renal toxicity (6%). Monotherapy consisted of darunavir/ritonavir for 79% and lopinavir/ritonavir for 21% Only 12 patients discontinued treatment: 4 of them due to interactions with tuberculosis drugs and addition of telaprevir to the treatment, 1 dropped out of treatment and 7 due to VF due to adherence rate less than 90% in monotherapy. All recovered virological control by adding nucleoside analogues, HIV RNA becoming undetectable in the 3 months following. The monotherapy improved adherence in 19 patients and represented a total annual saving of 3,703 € per patient and 311,084 € in total. Conclusions Treatment with boosted PI monotherapy appears to be a promising strategy that has proven to be effective in clinical practice: 85.8% of our patients remained virologically controlled. The simplified treatment improves compliance and contains costs, becoming a cost effective therapeutic option in selected patients. No conflict of interest.