HIV-positive women have higher prevalence of comorbidites and anticholinergic burden. Assessment of the HIV positive population from Menorca (Balearic Islands)

Currently, the management of comorbidities and polypharmacy in HIV-infected patients requires a coordinated action, with special focus on gender differences. Observational, cross-sectional study was conducted to study the HIV population from Menorca (Illes Balears). Adult HIV-positive individuals on antiretroviral treatment attending the pharmacy service from Hospital Mateu Orfila (Menorca) were included. In a single visit, demographical and clinical characteristics, comorbidities and cotreatments were collected. Anticholinergic burden (Drug Burden Index, DBI), drug-to-drug interactions (BOT PLUS database) and symptoms associated with HIV treatment (HIV-SI index) were assessed. A total of 223 patients were included, 68.2% men, with a median age of 53.00 (44.50-58.00) years, median BMI of 24.07, 47.73% smokers and 9.90% drug consumers. Women had more advanced stages of the disease and significantly more symptoms (cough and anxiety) versus men (p = .033 and p = .048, respectively). Moreover higher exposures to anticholinergic drugs (DBI 0.51 vs. 0.27) were reported, together with more frequency of drug-to-drug interactions (57.7% vs. 37.5%; p = .005) that increased with age. Red interactions were more frequently reported in PI (2.69%), NNRTIs (1.92%) and booster drugs (1.92%). These results support the need to implement specific measures for the management of HIV-infected women and tools to assess polypharmacy and risk of drug-to-drug interactions. Keywords: HIV infection; anticholinergic burden; anxiety; comorbidities; drug-to-drug interactions; women

Outpatients' opinion and experience regarding telepharmacy during the COVID-19 pandemic: the Enopex Project

[Abstract] Background: Telepharmacy, as a remote pharmaceutical care procedure, is being used worldwide during the COVID-19 pandemic, with the aim of preserving the health of patients and professionals. Its future development should incorporate the assessment of patient perception, but no research study has investigated it. Objective: The objective was to poll the opinions and experiences of outpatients with telepharmacy through a purpose-developed questionnaire and to assess it's quality through an internal validity and reliability analysis. Methods: Cross-sectional observational study of adult patients who used telepharmacy services during the COVID-19 lockdown period in Spain. The subjects answered a 24-item questionnaire, after giving their informed consent. Place of delivery, informed pharmacotherapeutic follow-up, opinion about telepharmacy, future development, ethics/satisfaction, and coordination constituted the six questionnaire categories. After assessing the adequate sample size with the Kaiser-Meyer-Olkin test, the Bartlett sphericity test analyzed the validity of the questionnaire. The intraclass correlation coefficient and Cronbach's α coefficient calculations verified the reliability and internal consistency. Results: A total of 9442 interviews were administered to patients from 81 hospitals, of which 8079 were valid (52.8% female). A 54.1% were aged between 41-65 years; 42.7% had been in treatment for more than 5 years; 42.8% lived between 6-31 miles from the hospital. As many as 96.7% of patients were "satisfied" or "very satisfied" with telepharmacy, 97.5% considering it complementary to their usual follow-up; 55.9% expressed a preference for being followed up face to face when visiting the hospital. 75.6% said they had rather receive their medication at home. The sample size obtained was deemed appropriate [the Kaiser-Meyer-Olkin test (0.789) and Bartlett's sphericity test (p<0.005)]. The reliability analysis resulted in a Cronbach α = 0.7. Conclusion: Patients have shown high satisfaction with telepharmacy and the ENOPEX questionnaire is a tool with sufficient validity and reliability to be used in the evaluation of the care that patients receive through telepharmacy

Profilaxis y tratamiento del angioedema hereditario y adquirido en el HUB; utilización del inhibidor de la C1-esterasa

Introducción: el angioedema hereditario o adquirido está producido por el déficit del inhibidor de la esterasa del primer componente del complemento (C1-INH). Se caracteriza por síntomas transitorios de hinchazón de tejidos subcutáneos, pared intestinal y vías respiratorias superiores, que puede derivar en muerte por asfixia. Se presenta la fisiopatología, clasificación, diagnóstico y tratamiento, así como un seguimiento de los pacientes diagnosticados, a los que se les entrega 1 vial de concentrado de C1-INH (Berinert ®), valorando la aportación del Servicio de Farmacia en el circuito de dispensación y control de dicho fármaco. Material y métodos: se realizó una búsqueda a través de PubMed y otras fuentes relevantes. Mediante las recetas controladas se tomaron los datos del paciente y de las dispensaciones e indicación de Berinert®; se completó el seguimiento mediante la historia clínica, los datos de laboratorio y la entrevista al paciente cuando fue preciso. Resultados: del total de 9 casos, 8 fueron angioedema hereditario y 1 adquirido. El danazol se utilizó como profilaxis a largo plazo en 8 casos, pero sus efectos secundarios obligaron a discontinuarlo en alguno de ellos. El concentrado de C1-INH fue efectivo en los 6 brotes agudos detectados en el estudio, así como en las 3 profilaxis quirúrgicas (consumo global de 6.500 U). Conclusión: el danazol fue un fármaco eficaz como profilaxis, pero con efectos secundarios importantes. El concentrado de C1-INH ha sido eficaz tanto en la profilaxis como en el tratamiento de los brotes agudos. El Servicio de Farmacia dispondrá de un stock suficiente de producto