Suplementacija s antioksidansima u terapiji Graves-ove bolesti: učinak na ekstracelularne antioksidativne parametre

In this study, the effect of supplementation with a fixed combination of antioxidants (vitamins C and E, beta-carotene and selenium) on concentrations of antioxidative parameters in serum was monitored. Measurements were performed prior to the commencement of therapy and after 30 and 60 days in patients with Graves\u27 disease treated with methimazole. Patients who received extra supplementation with antioxidants (group A, n = 29) attained euthyroidism faster than the patients treated only with methimazole (group B, n = 28). Statistically significant differences were achieved after supplementation with antioxidants for all investigated parameters (uric acid, transferrin, ferritin), except TAS and glucose. Nevertheless, due to the fact that all measured parameters remained within the range of referent values, they may not be proposed as reliable indicators of the level of oxidative stress in Graves\u27 disease.U ovom istraživanju promatran jw učinak suplementacije fiksnom kombinacijom antioksidansa (vitamini C i E, β-karoten i selen) na koncentracije pokazatelja antioksidacijske obrane u serume. Mjerenja su obavljena u bolesnika s Graves-ovom bolešću liječenih metilmazolom (tiamazolom) prije početka terapije, te nakon 30 i 60 dana. Bolesnici, koji su uz metimazol imali i dodatnu terapiju s antioksidansima (skupina A, n=29), postizali su eutireozu brže od bolesnika koji su bili samo na terapiji metimazolom (skupina B, n=28). Koncencentracije svim mjernih parametara (urata, feritina i transferina), (osim koncentracije TAS-a i glukoze), značajno su se razlikovale među skupinama. Unatoč tomu, rezultati ove studije ukazuju na to kako se određivani parametri ne mogu smatrati dovoljno pouzdanim pokazateljima razine oksidacijskog stresa u Graves-ovoj bolesti, radi činjenice da su njihove koncentracije tijekom ispitivanja ostale unutar granica referentnih vrijednosti

Propisivačke medikacijske pogreške za hospitalizirane bolesnike: Prospektivna studija

The aims of this prospective study were to determine the incidence and types of prescribing medication errors and ways to prevent them from reaching patients. Data were collected from 4951 prescriptions over a 25 week period in 2002. Medication errors were classified as: incorrect dose, incorrect dose interval, duplication of therapy and drug interactions. The medical record analysis was used to compare prescribing with Croatian literature drug data and AHFS first Web version 2 (American Society of Health System Pharmacists). The incidence of medication errors in the entire sample, including all potential drug interactions, was 14.7%. However, as only 8 interactions (out of 356 potentially possible interactions) were assessed as clinically significant, then the total number of all types of medication errors equals 379. This resulted in an incidence of 7.7%. Dosage errors were the most frequent errors, followed by incorrect interval, drug duplication and drug interaction. The difference between the incidence of potentially possible and clinically significant drug interactions was quite large (7.2 vs. 0.2%). Thus, a critical attitude is necessary when evaluating data on drug interactions. Our findings point to the need of systematic control of prescribed therapies, which could be ensured by the application of the Unit Dose Drug Distribution System. A medication errors reporting program should be established both at hospital and at national levels in Croatia.Svrha ove prospektivne studije je ispitivanje pojavnosti i vrsta medikacijskih pogrešaka u propisivanju i prevenciji njihovog nastanka. Podaci ispitivanja odnose se na 4951 propisani lijek, u razdoblju od 25 tjedana 2002. godine. Ispitivane medikacijske pogreške definirane su kao: pogrešna doza, pogrešan interval doziranja, dupliciranje terapije, te interakcija lijekova. Pojavnost medikacijskih pogrešaka propisivanja na ispitivanom uzorku, ukljucujuci sve teoretski moguce interakcije lijekova, iznosila je 14.7%. Medutim, kako je samo 8 interakcija (od ukupno 356 teoretski mogucih) ocijenjeno klinicki znacajnim, ukupan broj medikacijskih pogrešaka iznosio je 379 (od 4951 zapisa), što odgovara pojavnosti od 7.7%. Pogreška doziranja lijeka bila je najcešca vrsta uocenih medikacijskih pogrešaka. Utvrdena je velika razlika izmedu incidencije teoretski mogucih i klinicki znacajnih interakcija lijekova (7.2 vs. 0.2%). Nužan je kriticki pristup procjeni dostupnih podataka vezanih za interakcije lijekova. Rezultati našeg istraživanja upucuju na nužnost sustavnog nadzora propisane terapije, koji bi se mogao osigurati primjenom sustava raspodjele jedinicne terapije. U Hrvatskoj bi se trebao uspostaviti program pracenja medikacijskih pogrešaka, kako u bolnicama tako i na nacionalnoj razini

Prescribing medication errors in hospitalised patients: A prospective study

Svrha ove prospektivne studije je ispitivanje pojavnosti i vrsta medikacijskih pogrešaka u propisivanju i prevenciji njihovog nastanka. Podaci ispitivanja odnose se na 4951 propisani lijek, u razdoblju od 25 tjedana 2002. godine. Ispitivane medikacijske pogreške definirane su kao: pogrešna doza, pogrešan interval doziranja, dupliciranje terapije, te interakcija lijekova. Pojavnost medikacijskih pogrešaka propisivanja na ispitivanom uzorku, ukljucujuci sve teoretski moguce interakcije lijekova, iznosila je 14.7%. Medutim, kako je samo 8 interakcija (od ukupno 356 teoretski mogucih) ocijenjeno klinicki znacajnim, ukupan broj medikacijskih pogrešaka iznosio je 379 (od 4951 zapisa), što odgovara pojavnosti od 7.7%. Pogreška doziranja lijeka bila je najcešca vrsta uocenih medikacijskih pogrešaka. Utvrdena je velika razlika izmedu incidencije teoretski mogucih i klinicki znacajnih interakcija lijekova (7.2 vs. 0.2%). Nužan je kriticki pristup procjeni dostupnih podataka vezanih za interakcije lijekova. Rezultati našeg istraživanja upucuju na nužnost sustavnog nadzora propisane terapije, koji bi se mogao osigurati primjenom sustava raspodjele jedinicne terapije. U Hrvatskoj bi se trebao uspostaviti program pracenja medikacijskih pogrešaka, kako u bolnicama tako i na nacionalnoj razini.The aims of this prospective study were to determine the incidence and types of prescribing medication errors and ways to prevent them from reaching patients. Data were collected from 4951 prescriptions over a 25 week period in 2002. Medication errors were classified as: incorrect dose, incorrect dose interval, duplication of therapy and drug interactions. The medical record analysis was used to compare prescribing with Croatian literature drug data and AHFS first Web version 2 (American Society of Health System Pharmacists). The incidence of medication errors in the entire sample, including all potential drug interactions, was 14.7%. However, as only 8 interactions (out of 356 potentially possible interactions) were assessed as clinically significant, then the total number of all types of medication errors equals 379. This resulted in an incidence of 7.7%. Dosage errors were the most frequent errors, followed by incorrect interval, drug duplication and drug interaction. The difference between the incidence of potentially possible and clinically significant drug interactions was quite large (7.2 vs. 0.2%). Thus, a critical attitude is necessary when evaluating data on drug interactions. Our findings point to the need of systematic control of prescribed therapies, which could be ensured by the application of the Unit Dose Drug Distribution System. A medication errors reporting program should be established both at hospital and at national levels in Croatia

Patients perspectives on drug shortages in six European hospital settings : a cross sectional study

BACKGROUND: It is known that drug shortages represent a major challenge for all stakeholders involved in the process, but there is little evidence regarding insights into patients′ awareness and perspectives. This study aimed to investigate the patients-perceived drug shortages experience and their view on outcomes in different European hospital settings. Furthermore, we wanted to explore information preferences on drug shortages. METHODS: A retrospective, cross sectional, a mixed method study was conducted in six European hospital settings. One hospital (H) from each of this country agreed to participate: Bosnia and Herzegovina (H-BiH), Croatia (H-CR), Germany (H-GE), Greece (H-GR), Serbia (H-SE) and Poland (H-PO). Recruitment and data collection was conducted over 27 months from November 2017 until January 2020. Overall, we surveyed 607 patients which completed paper-based questionnaire. Questions related to: general information (demographic data), basic knowledge on drug shortages, drug shortages experienced during hospitalization and information preferences on drug shortage. Differences between hospital settings were analyzed using Chi-squared test or Fisher’s exact test. For more complex contingency tables, Monte Carlo simulations (N = 2000) were applied for Fisher’s test. Post-hoc hospital-wise analyses were performed using Fisher’s exact tests. False discovery rate was controlled using the Bonferroni method. Analyses were performed using R: a language and environment for statistical computing (v 3.6.3). RESULTS: 6 % of patients reported experiences with drug shortages while hospitalized which led to a deterioration of their health. The majority of affected patients were hospitalized at hematology and/or oncology wards in H-BiH, H-PO and H-GE. H-BiH had the highest number of affected patients (18.1 %, N = 19/105, p < 0.001) while the fewest patients were in H-SE (1 %, N = 1/100, p = 0.001). In addition, 82.5 %, (N = 501/607) of respondents wanted to be informed of alternative treatment options if there was a drug shortage without a generic substitute available. Majority of these patients (66.4 %, N = 386/501) prefer to be informed by a healthcare professional. CONCLUSIONS: Although drug shortages led to serious medical consequences, our findings show that most of the patients did not perceive shortages as a problem. One possible interpretation is that good hospital management practices by healthcare professionals helped to mitigate the perceived impact of shortages. Our study highlights the importance of a good communication especially between patients and healthcare professionals in whom our patients have the greatest trust. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06721-9