Bernardo Santos-Ramos

Hospital Universitario Virgen del Rocío | HUVR · Unidad de Farmacia

Objectives To determine the incidence of medication errors when admitting patients with multiple chronic conditions to hospital, using a standard method.Material and methodA prospective, observational study was conducted on patients with multiple chronic conditions admitted to a tertiary hospital. The medication reconciliation was performed using t...

Background: The place of monoclonal antibodies in metastatic colorectal cancer has not been clearly defined. Objective: To determine the treatment pattern of monoclonal antibodies in colorectal cancer patients in the Andalusian Public Healthcare System. Method: Data were collected from all patients treated with these drugs from July 2009 to De...

Background: The original Medication Appropriateness Index was validated for elderly and polymedicated patients, both in hospital and outpatient contexts. However, no studies have applied this questionnaire in patients with multiple chronic conditions. The objective of this study is to assess the reliability of a modified Medication Appropriateness...

Background: Computerized clinical decision support systems are used by clinicians at the point of care to improve quality of healthcare processes (prescribing error prevention, adherence to clinical guidelines, etc.) and clinical outcomes (preventive, therapeutic, and diagnostics). Attempts to summarize results of computerized clinical decision su...

Purpose The aim of this work was to investigate the association between anticholinergic burden or anticholinergic drug use and xerostomia and/or xerophtalmia in elderly through a systematic review of the published literature. Methods A search was carried out in 3 databases (CINAHL, Embase and Pubmed). Studies conducted in people ≥65 years of age,...

Background and objective In 2017, a questionnaire was developed in Italian with the aim of determining clinicians' perceptions of deprescription in the elderly population. The objective was to translate and cross-culturally adapt this deprescription questionnaire to Spanish. Methods Forward and blind-back translations, followed by a synthesis and...

Anticholinergic burden (AB) is related to cognitive impairment (CI) and older complex chronic patients (OCCP) are more susceptible. Our objective was to evaluate the predictive value of ten anticholinergic scales to predict a potential CI due to anticholinergic pharmacotherapy in OCCP. An eight-month longitudinal multicentre study was carried out i...

Background and objective: In 2017, a questionnaire was developed in Italian with the aim of determining clinicians' perceptions of deprescription in the elderly population. The objective was to translate and cross-culturally adapt this deprescription questionnaire to Spanish. Methods: Forward and blind-back translations, followed by a synthesis...

We describe the technological development of a web platform named CHRONIC-PHARMA that integrates three prescription support tools for patients with chronic diseases: Anticholinergic Burden Calculator (ABC), LESS-CHRON criteria and TRIGGER-CHRON. They focus on the optimization and evaluation of pharmacotherapy in patients with chronic diseases, resu...

Objective: The aim of the study was to evaluate the concordance among 10 anticholinergic scales for the measurement of anticholinergic drug exposure in at-risk elderly complex chronic patients in primary care. Methods: An 8-month cross-sectional, multicenter study was carried out in a cohort of complex chronic patients older than 65 years in tre...

Background Elderly patients with multiple chronic conditions are closely linked to polymedication, a condition that is also highly associated with the presence of adverse effects, such as those observed by anticholinergic activity. Anticholinergic burden is defined in a very variable way and is described inconsistently using different scores and pr...

The association between anticholinergic burden and constipation is not well defined and documented; for this reason, a systematic review was carried out in five databases (Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and Scopus), including studies assessing the correlation between anticholinergic burden, and constipation...

Background Computerized clinical decision support systems are used by clinicians at the point-of-care to improve quality of healthcare processes (prescribing error prevention, adherence to clinical guidelines...) and clinical outcomes (preventive, therapeutic, and diagnostics). Attempts to summarize results of computerized clinical decision support...

This paper evaluates gender bias in the published clinical trials of Vortioxetine. We conducted a systematic review of controlled clinical trials of Vortioxetine for the treatment of depression. The literature search was performed using MEDLINE and following the corresponding international recommendations. We identified 42 articles, of which 23 wer...

Background and importance Parenteral nutrition (PN) is an intravenous formulation composed of a wide variety of nutrients. Adding drugs to PN have certain advantages although associated drawbacks have been described, such as the risk of instability and incompatibility with macro or micronutrients. Aim and objectives To evaluate if the addition of...

Objective: Patients included in MAINRITSAN2 trial received either an individually tailored or a fixed-schedule therapy with rituximab as maintenance treatment of antineutrophil cytoplasm antibody associated vasculitides. The aim of this study was to compare the real-world costs of both arms. Method: We performed a cost-minimization analysis over...

Nowadays, scientific communication is enriched by the use of new ways of storing, publishing and disseminating research findings. Said new ways of scientific communication are known as the so-called academic profile platforms, which include Scopus author ID, ORCID, Publons and Kudos and -on the other hand- social research networks, including Resear...

Background: Nowadays, it is difficult to establish a specific method of intervention by the pharmacist and its clinical repercussions. Our aim was to identify interventions by pharmacists integrated within an interdisciplinary team for chronic complex patients (CCPs) and determine which of them produce the best results. Methods: A systematic rev...

Background and objective The objective of the study was to evaluate the effects of a multidisciplinary intervention on the outcomes of polypathological patients (PP). Methods A multicenter quasi-experimental pre-post study with a 12-month follow up was performed. In-hospital, at discharge and outpatient clinics patients who met criteria of PP betw...

Background and objective: The objective of the study was to evaluate the effects of a multidisciplinary intervention on the outcomes of polypathological patients (PP). Methods: A multicenter quasi-experimental pre-post study with a 12-month follow up was performed. In-hospital, at discharge and outpatient clinics patients who met criteria of PP...

Background The use of rituximab as maintenance treatment of antineutrophil cytoplasm antibody-associated vasculitides (AAVs) was supported by the MAINRITSAN trial. MAINRITSAN2 was a randomised, open-label, multicentre phase III trial which evaluated the difference between an individually tailored and a fixed-schedule maintenance therapy with rituxi...

Objective The ‘LESS-CHRON criteria’ (List of Evidence-Based Deprescribing for Chronic Patients criteria) is a newly created tool with 27 criteria to guide deprescribing. It was developed using a Delphi methodology. Each criterion consists of drugs and their indications, conditions under which deprescribing would be considered, a health variable to...

Objectives: To examine the effects of specific interventions on biosimilar glargine insulin (BGI) prescribing in general practices and to analyse the influence of prescriber and economic impact. Design: Non randomized controlled study. Setting: General practices in 2 health areas of Seville, intervention and control group. Participants: 220...

Background: Anticholinergic and sedative drugs are associated with adverse events such as cognitive and functional impairment in elderly. The Drug Burden Index (DBI) is a measure of an individual's total exposure to anticholinergic and sedative drugs. Objetive: To evaluate the association between the total DBI and cognitive and functional impairme...

Objectives To select interventions aimed at improving medication adherence in patients with multimorbidity by means of a standardised methodology. Methods A modified Delphi methodology was used to reach consensus. Interventions that had demonstrated their efficacy in improving medication adherence in patients with multimorbidity or in similar popu...

Purpose: Elderly patients with multimorbidity are especially vulnerable to adverse drug events (ADEs) and had high prevalence rates. Identifying ADEs is essential for enabling timely interventions that can mitigate the adverse events detected and for developing targeted strategies to prevent their occurrence as well as to monitor implementation. T...

Aim: To create a tool to identify drugs and clinical situations that offers an opportunity of deprescribing in patients with multimorbidity. Methods: A literature review completed with electronic brainstorming, and subsequently, a panel of experts using the Delphi methodology were applied. The experts assessed the criteria identified in the lite...

Aim: Translate the ARMS scale into Spanish ensuring cross-cultural equivalence for measuring medication adherence in polypathological patients. Design: Translation, cross-cultural adaptation and pilot testing. Location: Secondary hospital. Measurements: (i)Forward and blind-back translations followed by cross-cultural adaptation through qual...

Background Anticholinergic drugs may increase the risk of cognitive and functional disorders in older patients. Anticholinergic exposure quantified by anticholinergic scales (AS) can detect patients with a high risk of adverse events. Purpose Design, development and validation of a tool that calculates the anticholinergic burden. Material and met...

Background Drug interactions (DIs) are a significant cause of medication-related problems. The aging population, high chronic diseases prevalence and polypharmacy are closely associated factors. Aim of the review To study the prevalence, types and associated factors of DIs in multimorbidity patients of over 65 years of age in primary care. Methods...

Background The LESS-CHRON criteria is a new creation of a list of 27 items to guide deprescribing. It is the result of a literature review followed by DELPHI methodology. Each item consists of: drug and its indication, deprescribing condition, health variable to monitor after deprescribing and period of follow-up. Purpose To analyse the utility of...

Background The Adherence to Refill and Medications Scale (ARMS) is a tool for measuring adherence validated in an English speaking setting. The application of this scale into a different clinical practice setting requires a cross cultural translation and adaptation process. Purpose To design a methodology to translate and adapt the ARMS Scale to a...

Background Only 50–75% of patients are adherent to medications prescribed for the management of chronic illnesses. Adherence is influenced by several factors. We need to develop a means of assessing adherence and the factors that influence it. Purpose To determine the medication regimen adherence in polymedicated chronic patients aged ≥65 years, an...

Objetivo: Evaluar la evidencia disponible respecto a la eficacia de intervenciones destinadas a mejorar la adherencia al tratamiento que sean aplicables a pacientes pluripatológicos (PP). Diseño: Revisión de revisiones sistemáticas. Fuentes de datos: Se consultaron (septiembre de 2013): Pubmed, EMBASE, the Cochrane Library, CRD y WoS para detectar...

Background Drugs with anticholinergic and sedative effects carry significant risks in older people. An increased incidence of falls, impaired physical function and cognitive decline has been attributed to the use of these drugs. Purpose To estimate the Risk of Anticholinergic Effects (RAE) in patients with several conditions based on their pharmaco...

Background Non-adherence in patients with multiple chronic conditions (PMCC) is associated with poor disease control, reduced quality of life and increased risk of morbidity and mortality Purpose To assess the available scientific evidence regarding the efficacy of interventions aimed to improve medicines adherence that are applicable to PMCC. Mate...

Background In the context of population ageing, polypharmacy is strongly associated with multimorbidity. Studies have revealed the existence of multimorbidity patterns. No studies have evaluated whether the complexity of the medicines regimen varies with the multimorbidity patterns. Purpose To analyse the extent to which treatment complexity differ...

Background Atypical antipsychotics need a prescription check (visa), that is, a prior official authorisation of prescriptions, so as monitor patient safety. Purpose To describe the prescription of quetiapine in a health area and compare the indications for prescribing with the indications approved on the visa summaries from the perspective of patie...

Patients with chronic diseases often receive multiple medications and are associated with increased vulnerability to medication errors. Identifying high-alert medications for them would help to prioritize the interventions with greatest impact for improving medication safety. The aim of this study was to develop a list of high-alert medications for...

multipleconditionsAbstractObjective: To carry out a bibliographic review in order to identify the different methodologiesused along the reconciliation process of drug therapy applicable to polypathological patients.Design: We performed a literature review.Data sources The bibliographic review (February 2012) included the following databases: Pub-me...

Background The quality of studies assessing the effectiveness of interventions aimed at improving adherence in patients with multiple chronic conditions is variable so it is difficult to know if they reach valid conclusions. Purpose To describe the quality of systematic reviews studying the effectiveness of interventions to improve medicines adhere...

Objective: To describe the profile of new drugs evaluated by the Pharmacy and Therapeutics committee in a tertiary hospital using a standardized tool, the Guideline for the Introduction of New Drugs in the Formulary (GINF form), as main objective. Materials and methods: Retrospective observational study of drugs was assessed during 2008-2011. Va...

To carry out a bibliographic review in order to identify the different methodologies used along the reconciliation process of drug therapy applicable to polypathological patients. We performed a literature review. Data sources The bibliographic review (February 2012) included the following databases: Pubmed, EMBASE, CINAHL, PsycINFO and Spanish Med...

The purpose of this study is to describe the structure of the CFyT, the Pharmacy and Therapeutics Committee, and a tertiary hospital's selection process for new drugs. All annals of the P&TC and the New Drug Incorporation Guides (GINF) to incorporate new drugs received at Hospital Virgen del Rocío between 2004 and 2007 were reviewed. We carried out...

Objective To identify tools for measuring the appropriateness of drug therapy useful in patients with multiple chronic conditions.DesignWe performed a literature review.Data sourcesThe following database were consulted (December 2009): Pubmed, EMBASE, CINAHL, PsycINFO and Spanish Medical Index (IME) to detect tools for measuring the appropriateness...

What is known and objective: Psoriasis is a chronic skin disease for which there is an increasing range of treatment options. Biological agents (ustekinumab, adalimumab, infliximab and etanercept) are indicated for moderate-to-severe plaque-type psoriasis in adults who fail to respond to, have a contraindication to, or are intolerant to other syst...

OBJECTIVES: To determine the incidence of medication errors when admitting patients with multiple chronic conditions to hospital, using a standard method. MATERIAL AND METHOD: A prospective, observational study was conducted on patients with multiple chronic conditions admitted to a tertiary hospital. The medication reconciliation was performed usi...

Background and objectiveThe Pharmacy and Therapeutics Committee (PTC) evaluates the requests for off-label uses with an abbreviated report format. The aim of this study is to perform a descriptive analysis of this activity and to study the rate of approvals.Material and MethodsA descriptive study was performed on the PTC reports in a tertiary hospi...

Objective: [corrected] To analyze the appropriateness of pharmacotherapy and, if necessary, carry out interventions for its improvement in a cohort of patients with multiple chronic conditions. Design: Descriptive, prospective study of 21 months duration. Location: Hospital Universitario Virgen del Rocío. Participants: Patients with multiple...

Objetivo: Realizar una revisión bibliográfica para identificar las diferentes metodologías empleadas en el proceso de conciliación de los tratamientos farmacológicos que sean aplicables a pacientes pluripatológicos. Diseño: Revisión sistemática. Fuentes de datos: Se realizó una revisión bibliográfica (febrero de 2012) en las bases de datos Pubmed,...

OBJECTIVE To identify tools for measuring the appropriateness of drug therapy useful in patients with multiple chronic conditions. DESIGN We performed a literature review. DATA SOURCES The following database were consulted (December 2009): Pubmed, EMBASE, CINAHL, PsycINFO and Spanish Medical Index (IME) to detect tools for measuring the appropria...

Introduction: Managing care for patients with chronic conditions currently represents one of the greatest challenges to health care systems. As a subgroup of these patients, those with multiple chronic conditions are at greater risk for death or disability, and they consume more resources. They are characterized by the coexistence of two or more c...

Aim of the review: To study the prevalence of drug interactions in hospital healthcare by reviewing literature. Method: A review was carried out of studies written in Spanish and English on the prevalence of drug interactions in hospital care published in Pubmed between January 1990 and September 2008. The search strategy combined free text and...

The healthcare models developed for patients with multiple chronic diseases agree on the need for improving drug therapy in these patients. The issues of patient compliance, appropriateness of prescriptions and the reconciliation process are of vital importance for patients receiving multiple drug treatment. To identify and select the most appropri...

Quantify use of indirect comparisons (IC) in drug evaluation reports published on the GENESIS Group web page for new drug assessment, standardisation, and drug selection research. Retrospective study of drug reports written between 2008 and 2009. Data collected: presence of an active comparator and details from any direct and indirect comparative s...

Background Since pemetrexed was marketed for the treatment of non-squamous non-small cell lung cancer (NSCLC), several patients have been treated with the combination of platinum-pemetrexed instead of other cytotoxic regimens, which is much more expensive, although its efficacy is unknown. Purpose To describe the treatment of patients diagnosed wi...

Objetivo: Cuantificar el uso de comparaciones indirectas (CI) en los informes de evaluación de medicamentos publicados en internet por el Grupo de Evaluación de Novedades, Estandarización e Investigación en Selección de Medicamentos (GENESIS). Método: Estudio retrospectivo de los informes redactados en 2008-2009. Registro de la existencia de compar...

Introducción: La atención a los pacientes crónicos constituye actualmente el principal reto que afrontan los sistemas sanitarios. Dentro de estos pacientes, los pacientes pluripatológicos son aquellos que presentan una mayor tendencia a la discapacidad y a la muerte, y consumen mayores recursos. Se caracterizan por la coexistencia de dos o más enfe...

Objective To quantify the Spanish Pharmacy and Therapeutics Committees (P&TC) activity with regard to assessing and selecting drugs and describing variability in decisions made to include them.

To quantify the Spanish Pharmacy and Therapeutics Committees (P&TC) activity with regard to assessing and selecting drugs and describing variability in decisions made to include them. Descriptive, cross-sectional study based on a questionnaire aimed to 513 hospitals with more than 75 beds. We included questions referring to the P&TC resolutions, th...

To review the literature on the structure and operation of hospital Pharmacy and Therapeutics Committees from an international point of view and examine the factors that influence decision-making of these committees. We performed a literature search in the Medline and Embase databases from 1997 to January 2009 with the search terms: formulary syste...

To update the Guideline for the Introduction of New Drugs in the Formulary (GINF form) using the RAND/UCLA appropriateness method, which combines the best available evidence and an expert panel's judgement. Two procedures were employed to detect where improvements could be made to the former versions of the request form and to transform them into c...

To analyse the assessment reports published on the GENESIS webpage (Group for Innovation, Assessment, Standardisation and Research in the Selection of Drugs) and assess the variability of the group's proposals to include drugs in the Formulary. We analysed reports published by hospitals on the GENESIS webpage between 2004 and 2007. Data were collec...

Define the structure and working procedures of the Pharmacy and Therapeutic Committees (P&T Committees) in Spanish hospitals. Hospitals over 75 beds located in all regions of the Spanish State. A cross-sectional descriptive study based on the completion of a questionnaire that consisted of 138 questions. The participants were recruited by post, e-m...

Objectives To determine which social and individual factors may predict adherence to medication in patients with more than two chronic symptomatic diseases (polypathological patients) under polypharmacy.

Background and objectiveTo identify antiretrovirals drug interaction databases (ADID) and evaluate its structural quality.

To determine which social and individual factors may predict adherence to medication in patients with more than two chronic symptomatic diseases (polypathological patients) under polypharmacy. Cross-sectional observational study. In a primary care area assigned to our teaching hospital 265 patients with multiple chronic diseases and polypharmacy we...

To identify antiretrovirals drug interaction databases (ADID) and evaluate its structural quality. A literature search in Medline and a grey literature search were conducted. The identified ADID underwent scrutiny based on exclusion criteria and structural quality (4 minimum quality criteria: stratification by level of severity, classification by l...

Objective The purpose of this study is to describe the structure of the CFyT, the Pharmacy and Therapeutics Committee, and a tertiary hospital's selection process for new drugs.