Introduction: Opioids (except for tramadol) have not been shown to be effective in patients with ... more Introduction: Opioids (except for tramadol) have not been shown to be effective in patients with fibromyalgia, but they can increase the risk of adverse drug reactions. Objective: To determine the treatment patterns of a group of patients with fibromyalgia and to identify the factors associated with the use of opioids in Colombia. Materials and methods: This was a cross-sectional study of a group of patients with fibromyalgia from a pain clinic in Colombia. Sociodemographic, clinical and pharmacological variables were identified. Descriptive, bivariate and multivariate analyses were performed. Results: A total of 559 patients were analyzed, 88.6% of whom were women, and the mean age was 53.4±12.6 years. A total of 40.6% received nonpharmacological management, and the majority were treated with acetaminophen (96.1%) and pregabalin (62.8%). A total of 69.6% received opioids, the most common of which was hydrocodone (36.3%). The average morphine equivalent milligrams was 36.9±91.2 (ran...
Introduction: The induction and inhibition of cytochrome P450 are associated with multiple pharma... more Introduction: The induction and inhibition of cytochrome P450 are associated with multiple pharmacological interactions, which can lead to loss of efficacy or increase the risk of adverse drug reactions. Objective: To determine the prescription patterns of cytochrome P450-inducing and -inhibiting drugs and their contraindicated and major pharmacological interactions in a group of patients from Colombia. Materials and methods: This cross-sectional study included patients who received drugs that induce or inhibit metabolism and examined their contraindicated and major pharmacological interactions. The patients were identified from a population database and the Micromedex® tool. Results: A total of 63,433 patients were analyzed, with a median age of 61 years, and 63.1% were women. Antiepileptics (35.9%) and antifungals (27.6%) were the most commonly used inducers and inhibitors. A total of 30.1% of patients had potential contraindicated or greater interactions. The following factors we...
Introduction. Child vaccination is one of the most cost-effective processes and interventions in ... more Introduction. Child vaccination is one of the most cost-effective processes and interventions in public health. Objective. To determine coverage and timeliness of immunization in a sample of children under 6 years of age from a region of Colombia. Methods. Retrospective cohort study that evaluated the vaccination coverage and timeliness verification survey conducted in 2019 to a population of 2457 children under 6 years of age from Risaralda, Colombia. Variables such as age, municipality of residence, record of vaccines included in the national expanded program of immunization (EPI: BCG, hepatitis-B [HBV], diphtheria/pertussis/tetanus [DTP], Haemophilus influenzae [Hib], polio, rotavirus, pneumococcus, influenza, measles/mumps/rubella [MMR], Varicella, hepatitis-A [HAV], yellow fever), date of immunization were considered. Vaccination was defined as timely until 29 days after the day established by the EPI. Results. Survey evaluated children from 14 municipalities, with a mean age o...
Background. Analgesics provide multiple clinical benefits, but they are not without risks. Object... more Background. Analgesics provide multiple clinical benefits, but they are not without risks. Objective. To compare the outpatient prescribing pattern of analgesics between cities and municipalities in Colombia and to identify the variables associated with prescribing opioid analgesics. Methods. A cross-sectional study that identified the prescription of analgesics for outpatient use from a population database of 8.5 million Colombians. A descriptive, bivariate and multivariate analysis was performed. Results. A total of 573,248 patients were identified who had received prescriptions for some analgesic; they had a mean age of 46.5±23.6 years, and 65.7% were women. The most commonly prescribed analgesics were nonopioid analgesics, antispasmodics and opioid analgesics. The average milligram equivalent of morphine was higher in capital cities than in municipalities. Age ≥65 years (OR:2.60, 95%CI:2.54-2.67), being male (OR:1.09, 95%CI:1.07-1.11), dispensing in cities (OR:2.25; 95%CI:2.20-2...
Objective. Acromegaly and neuroendocrine tumors are rare diseases that, under certain conditions,... more Objective. Acromegaly and neuroendocrine tumors are rare diseases that, under certain conditions, can be treated with somatostatin analogues. The aim was to determine the prescription patterns of somatostatin analogues in a group of patients with acromegaly and neuroendocrine tumors affiliated with the Colombian Health System. Design. A retrospective study. Methods: A cohort of patients from a drug dispensing database that collected all prescriptions of long-acting somatostatin analogues (octreotide, lanreotide, pasireotide). Sociodemographic variables, clinical variables (diagnosis and comorbidities) and pharmacological therapy variables (dose, changes, persistence of use, comedications) were considered. Results: A total of 213 patients were identified, including 139 (65.3%) with acromegaly and 74 (34.7%) with neuroendocrine tumors. There was a predominance of women (58.7%) and a mean age of 59.7 ± 14.5 years. The most commonly used medications were lanreotide autogel (n = 107; 50....
Introduction:Greater patient satisfaction with his or her inhalation device is associated with be... more Introduction:Greater patient satisfaction with his or her inhalation device is associated with better adherence to pharmacological therapy and better clinical outcomes, such as improved quality of life, greater asthma control and fewer exacerbations. Objective: To determine the satisfaction level of a group of patients diagnosed with bronchial asthma with respect to their devices for inhalation of bronchodilators and glucocorticoids. Methods: This was a cross-sectional study of patients treated in the Colombian health system. Satisfaction with inhalation devices was evaluated with the FSI-10 instrument (Evaluation of Satisfaction with the Inhaler). A score of ≥ 44 points indicated high satisfaction. Results: In total, 362 patients from 59 cities were identified, their median age was 55 years, and 74.6% were women. The average score was 44.6; 68.5% of patients showed high satisfaction, especially with metered-dose inhalers, and 63.4% did not use them with an inhalocamera. Users of me...
Background: Chronic pain can trigger both physical and mental health complications. During the CO... more Background: Chronic pain can trigger both physical and mental health complications. During the COVID-19 pandemic, patients with chronic diseases have had reduced access to some medications. The objective was to determine the pharmacological management of patients with chronic pain and its continuity during the COVID-19 pandemic. Methods: This was a longitudinal study of the continuity of analgesic use in patients with chronic pain between September 1, 2019, and February 28, 2021, based on a drug dispensing database. A survival analysis was performed until the discontinuation of chronic analgesics. Results: A total of 12,701 patients who were being treated for chronic pain were identified. Their median age was 70.3 years, and 74.4% were women. Pain of rheumatological origin was the most frequent etiology (46.1%); the most commonly used medications were nonopioid analgesics (78.9%), pain modulators (24.8%) and opioid analgesics (23.3%). A total of 76.1% of the patients experienced int...
Introduction: The impact of COVID-19 prompted a race to find a treatment that would reduce its mo... more Introduction: The impact of COVID-19 prompted a race to find a treatment that would reduce its mortality. Most studies have not shown favorable results for many of these drugs, but they are still used. Objective: To determine the differences and similarities in the hospital pharmacological management of patients with COVID-19 according to sex, age group, and geographical region of Colombia, 2020-2021. Materials and methods: Descriptive cross-sectional study. We identified the prescription patterns of the medications given to patients diagnosed with COVID-19 treated in eight clinics in Colombia between March 6, 2020 and May 31, 2021. We performed a descriptive analysis of the sociodemographic, clinical, and pharmacological variables of the patients. Results: A total of 8596 patients from 170 cities were identified, with a median age of 53.0 years and 53.3% of them men. A total of 24.3% required care in the intensive care unit, and 18.7% required invasive mechanical ventilation. The m...
Introduction:Autoimmune idiopathic inflammatory myopathies (IIMs) are a group of pathologies that... more Introduction:Autoimmune idiopathic inflammatory myopathies (IIMs) are a group of pathologies that are generally characterized by muscle weakness. Their treatment involves glucocorticoids and immunosuppressants. Objective: To determine the differences and similarities in the pharmacological management of a group of patients with autoimmune IIM according to the type of disease, sex, age group, and city of residence in Colombia from 2020-2021. Materials and methods: This cross-sectional study identified prescription patterns of medications for outpatient use in patients with autoimmune IIM between 2020 and 2021 based from a population database of 8.5 million Colombians affiliated with the Colombian Health System. Sociodemographic and pharmacological variables were considered. Results: A total of 671 patients with autoimmune MMI were identified, with a median age of 57 years and 70.9% women. overlap myositis was the most frequent (31.4%). A total of 91.5% received pharmacological treatm...
Objective: Hemophilia A and B are disorders associated with the deficit of coagulation factors VI... more Objective: Hemophilia A and B are disorders associated with the deficit of coagulation factors VIII and IX that increase the risk of bleeding and complications (clotting factor inhibitor antibodies, severe bleedings, hospitalizations and anaphylactic reactions) depending on the severity of the disorder. The objective of this study was to determine the incidence of complications in a cohort of patients diagnosed with moderate and severe hemophilia A or B under treatment in a specialized institution. Methods: A retrospective study of a cohort of patients with replacement therapy for hemophilia A or B, evaluating treatment and complications between January/2012 and July/2019. The characteristics associated to disease management, sociodemographic and clinical variables were extracted from the medical records. Time to inhibitor development and rate associated to bleeding and hospitalizations were evaluated. Results: A total of 159 male patients were identified with hemophilia A (n=140; 8...
Introduction:Conjunctivitis is one of the most common ocular pathologies. Its treatment depends o... more Introduction:Conjunctivitis is one of the most common ocular pathologies. Its treatment depends on its etiology, but an excessive use of antibiotics and corticosteroids, which in many cases are contraindicated, has been described. Objective: To describe the prescription patterns of medications used to treat conjunctivitis in a Colombian population. Methods: This was a cross-sectional study on the pharmacological treatment of patients diagnosed with conjunctivitis based on a drug-dispensing database of approximately 8.5 million people affiliated with the Colombian Health System. Some sociodemographic and pharmacological variables and comorbidities were considered. A descriptive analysis was performed. Results: A total of 8,708 patients were identified; they had a median age of 44.7 years, and 59.3% were women. The most common causes of conjunctivitis were unspecified (53.1%) and allergic (37.4%). The most commonly used drug was olopatadine (26.1%), followed by dexamethasone with neom...
Introduction:Patients with rheumatoid arthritis (RA) have an increased risk of SARS-CoV-2 infecti... more Introduction:Patients with rheumatoid arthritis (RA) have an increased risk of SARS-CoV-2 infection due to intrinsic characteristics of the pathology and the medications used to treat it. Objective: To evaluate the incidence of and factors related to SARS-CoV-2 infection in patients with RA in Colombia. Materials and methods: This was an observational study of patients diagnosed with RA who were treated at a health care institution in Colombia. The study evaluated whether the patients presented SARS-CoV-2 infection and other clinical variables. Variables associated with the risk of SARS-CoV-2 infection were identified. Results: A total of 2,566 patients with RA were identified. They had a median age of 61.9 years, and 81.1% were women. They were mainly treated with synthetic disease-modifying antirheumatic drugs (DMARDs) (85.3%), glucocorticoids (52.2%) and biological DMARDs (26.8%). The incidence of SARS-CoV-2 infection was 5.1%, and the factors that increased the risk included tre...
Introduction:Animal bites have a high probability of becoming infected. In high-risk wounds, the ... more Introduction:Animal bites have a high probability of becoming infected. In high-risk wounds, the use of antibiotics that kill the associated microorganisms is recommended. Objective: To determine the use of antibiotics in patients in different regions of Colombia who were attacked in 2020 by animals that can transmit rabies. Materials and methods: This was a retrospective follow-up study of a cohort of patients with wounds caused by animals; the patients were affiliated with the Colombian Health System. Sociodemographic, clinical and pharmacological data were collected. Results: A total of 280 patients were analyzed. The median age was 28.0 years, and 52.1% were men. The attacks were attributed to dogs (85.0%) and cats (15.0%), and 9.6% were classified as severe exposure. Antibiotics were used in 71.1% of cases for prophylaxis and in 4.3% of the cases for the treatment of superinfection; cephalexin (37.5%), amoxicillin/clavulanic acid (15.7%) and dicloxacillin (10.4%) were the predo...
Aims:To determine the time elapsed between the start of treatment with antiparkinson agents and t... more Aims:To determine the time elapsed between the start of treatment with antiparkinson agents and the modification of the pharmacological therapy, and to establish its related factors, in a group of patients with Parkinson's disease from Colombia. Methods: Retrospective cohort study that collected information about the treatment of patients with Parkinson's disease who started drug therapy between June-2011 and December-2013; a 5-year follow-up was performed. Survival analyses for time to therapy modification were generated, and factors related to these changes were determined using Cox regression models. Results: A total of 3,224 patients (51.8% men) with a mean age of 73.1 ± 13.5 years started treatment with antiparkinson agents. After 5 years, 2,046 patients (63.5%) had modifications in drug therapy, in a mean time of 36.4 months (95% CI: 35.7-37.1). A total of 1,216 patients (37.8%) required the addition of another active principle, while 830 (25.7%) had a switch to anothe...
Introduction: A high percentage of people who have suffered from COVID-19 present clinical manife... more Introduction: A high percentage of people who have suffered from COVID-19 present clinical manifestations that persist long after recovery from the acute phase. Objective: To determine the proportion of patients who presented post-COVID-19 syndrome, its clinical picture, and its risk factors in a group of patients from Colombia. Methods: This was an observational, longitudinal study of patients with SARS-CoV-2 treated in a network of clinics in Colombia. Over the telephone, after they gave prior informed consent, we evaluated whether the patients had post-COVID-19 syndrome and other clinical variables. Descriptive, bivariate, and multivariate analyses were performed. Results: A total of 311 patients (50.2% women) from 19 different cities were identified, with a median age of 47.0 years. In 63.0% of cases, symptoms persisted more than 3 months after recovery from the acute phase of the disease. Most common were dyspnea (54.1%), fatigue (42.9%), and muscle pain (36.2%). Greater age (3...
Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million peop... more Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million people worldwide.The objective was to determine the trends of the use of medications for COPD in a group of Colombian patients. Methods: This was a retrospective study on prescription patterns of bronchodilators and other medications used in COPD from a population database with follow-up at 12 and 24 months. Patients older than 18 years of age of any sex who had COPD between 2017 and 2019 were included. Sociodemographic variables, medications, treatment schedules for COPD, comorbidities, comedications, and the specialty of the prescriber were considered. Results: A total of 9,476 people with a diagnosis of COPD were evaluated. They had a mean age of 75.9 ± 10.7 years, 50.1% were men, and 86.8% were prescribed by a general practitioner. At the beginning of the follow-up, on average, they received 1.6 medications/patient, mainly short-acting antimuscarinics (3784; 39.9%), followed by short-act...
Introduction/objectives: To describe the clinical characteristics and health care resource utiliz... more Introduction/objectives: To describe the clinical characteristics and health care resource utilization in a Colombian systemic lupus erythematosus (SLE) outpatient cohort. Method: Retrospective descriptive study. Clinical records and claims data of SLE patients from ten specialized primary care centers in Colombia between July 2017 and June 2018 were reviewed. Baseline clinical variables, SLE activity (SLEDAI), drugs use, and direct costs were measured. Results: A total of413 patients were included, 361 (87.4%) female; mean age was 42±14 years. Mean disease evolution was 8.9±6.0 years; 174 patients (42.1%) had a systemic manifestation at baseline, mostly lupus nephritis (105; 25.4%). 334 patients (80.9%) had at least one comorbidity, mainly antiphospholipid syndrome (90; 21.8%) and hypertension (76; 18.4%). Baseline SLEDAI score was 0 in 215 patients (52.0%), 1-5 in 154 (37.3%), 6-10 in 41 (9.9%) and 11+ in 3 (0.7%). All patients received pharmacological therapy, the most common wer...
Aim: Quarantine due to the COVID-19 pandemic altered the supply and demand of health services. Th... more Aim: Quarantine due to the COVID-19 pandemic altered the supply and demand of health services. This, together with the “infodemic” and generalized panic, could alter the patterns of self-medication in the population. The objective was tocharacterize the patterns of self-medication in four municipalities of Colombia during mandatory preventive isolation in 2020. Methods: This was a cross-sectional study done in the municipality of Pereira and its metropolitan area during mandatory national preventive isolation between June and September 2020. A sample of 397 adults who responded to an online survey, based on the Instrument for Systematic Data Collection for Self-medication (Instrumento de Recolección Sistemática de Datos para la Automedicación - IRIS-AM), was obtained. The use of social networks (including WhatsApp) as the source of information about medications was explored. Results: The 397 people surveyed had a median age of 31.0 years, and 58.2% were women. The prevalence of self...
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, Oct 27, 2017
The objective of this study was to assess international trends in antipsychotic use, using a stan... more The objective of this study was to assess international trends in antipsychotic use, using a standardised methodology. A repeated cross-sectional design was applied to data extracts from the years 2005 to 2014 from 16 countries worldwide. During the study period, the overall prevalence of antipsychotic use increased in 10 of the 16 studied countries. In 2014, the overall prevalence of antipsychotic use was highest in Taiwan (78.2/1000 persons), and lowest in Colombia (3.2/1000). In children and adolescents (0-19 years), antipsychotic use ranged from 0.5/1000 (Lithuania) to 30.8/1000 (Taiwan). In adults (20-64 years), the range was 2.8/1000 (Colombia) to 78.9/1000 (publicly insured US population), and in older adults (65+ years), antipsychotic use ranged from 19.0/1000 (Colombia) to 149.0/1000 (Taiwan). Atypical antipsychotic use increased in all populations (range of atypical/typical ratio: 0.7 (Taiwan) to 6.1 (New Zealand, Australia)). Quetiapine, risperidone, and olanzapine were m...
Introduction: Opioids (except for tramadol) have not been shown to be effective in patients with ... more Introduction: Opioids (except for tramadol) have not been shown to be effective in patients with fibromyalgia, but they can increase the risk of adverse drug reactions. Objective: To determine the treatment patterns of a group of patients with fibromyalgia and to identify the factors associated with the use of opioids in Colombia. Materials and methods: This was a cross-sectional study of a group of patients with fibromyalgia from a pain clinic in Colombia. Sociodemographic, clinical and pharmacological variables were identified. Descriptive, bivariate and multivariate analyses were performed. Results: A total of 559 patients were analyzed, 88.6% of whom were women, and the mean age was 53.4±12.6 years. A total of 40.6% received nonpharmacological management, and the majority were treated with acetaminophen (96.1%) and pregabalin (62.8%). A total of 69.6% received opioids, the most common of which was hydrocodone (36.3%). The average morphine equivalent milligrams was 36.9±91.2 (ran...
Introduction: The induction and inhibition of cytochrome P450 are associated with multiple pharma... more Introduction: The induction and inhibition of cytochrome P450 are associated with multiple pharmacological interactions, which can lead to loss of efficacy or increase the risk of adverse drug reactions. Objective: To determine the prescription patterns of cytochrome P450-inducing and -inhibiting drugs and their contraindicated and major pharmacological interactions in a group of patients from Colombia. Materials and methods: This cross-sectional study included patients who received drugs that induce or inhibit metabolism and examined their contraindicated and major pharmacological interactions. The patients were identified from a population database and the Micromedex® tool. Results: A total of 63,433 patients were analyzed, with a median age of 61 years, and 63.1% were women. Antiepileptics (35.9%) and antifungals (27.6%) were the most commonly used inducers and inhibitors. A total of 30.1% of patients had potential contraindicated or greater interactions. The following factors we...
Introduction. Child vaccination is one of the most cost-effective processes and interventions in ... more Introduction. Child vaccination is one of the most cost-effective processes and interventions in public health. Objective. To determine coverage and timeliness of immunization in a sample of children under 6 years of age from a region of Colombia. Methods. Retrospective cohort study that evaluated the vaccination coverage and timeliness verification survey conducted in 2019 to a population of 2457 children under 6 years of age from Risaralda, Colombia. Variables such as age, municipality of residence, record of vaccines included in the national expanded program of immunization (EPI: BCG, hepatitis-B [HBV], diphtheria/pertussis/tetanus [DTP], Haemophilus influenzae [Hib], polio, rotavirus, pneumococcus, influenza, measles/mumps/rubella [MMR], Varicella, hepatitis-A [HAV], yellow fever), date of immunization were considered. Vaccination was defined as timely until 29 days after the day established by the EPI. Results. Survey evaluated children from 14 municipalities, with a mean age o...
Background. Analgesics provide multiple clinical benefits, but they are not without risks. Object... more Background. Analgesics provide multiple clinical benefits, but they are not without risks. Objective. To compare the outpatient prescribing pattern of analgesics between cities and municipalities in Colombia and to identify the variables associated with prescribing opioid analgesics. Methods. A cross-sectional study that identified the prescription of analgesics for outpatient use from a population database of 8.5 million Colombians. A descriptive, bivariate and multivariate analysis was performed. Results. A total of 573,248 patients were identified who had received prescriptions for some analgesic; they had a mean age of 46.5±23.6 years, and 65.7% were women. The most commonly prescribed analgesics were nonopioid analgesics, antispasmodics and opioid analgesics. The average milligram equivalent of morphine was higher in capital cities than in municipalities. Age ≥65 years (OR:2.60, 95%CI:2.54-2.67), being male (OR:1.09, 95%CI:1.07-1.11), dispensing in cities (OR:2.25; 95%CI:2.20-2...
Objective. Acromegaly and neuroendocrine tumors are rare diseases that, under certain conditions,... more Objective. Acromegaly and neuroendocrine tumors are rare diseases that, under certain conditions, can be treated with somatostatin analogues. The aim was to determine the prescription patterns of somatostatin analogues in a group of patients with acromegaly and neuroendocrine tumors affiliated with the Colombian Health System. Design. A retrospective study. Methods: A cohort of patients from a drug dispensing database that collected all prescriptions of long-acting somatostatin analogues (octreotide, lanreotide, pasireotide). Sociodemographic variables, clinical variables (diagnosis and comorbidities) and pharmacological therapy variables (dose, changes, persistence of use, comedications) were considered. Results: A total of 213 patients were identified, including 139 (65.3%) with acromegaly and 74 (34.7%) with neuroendocrine tumors. There was a predominance of women (58.7%) and a mean age of 59.7 ± 14.5 years. The most commonly used medications were lanreotide autogel (n = 107; 50....
Introduction:Greater patient satisfaction with his or her inhalation device is associated with be... more Introduction:Greater patient satisfaction with his or her inhalation device is associated with better adherence to pharmacological therapy and better clinical outcomes, such as improved quality of life, greater asthma control and fewer exacerbations. Objective: To determine the satisfaction level of a group of patients diagnosed with bronchial asthma with respect to their devices for inhalation of bronchodilators and glucocorticoids. Methods: This was a cross-sectional study of patients treated in the Colombian health system. Satisfaction with inhalation devices was evaluated with the FSI-10 instrument (Evaluation of Satisfaction with the Inhaler). A score of ≥ 44 points indicated high satisfaction. Results: In total, 362 patients from 59 cities were identified, their median age was 55 years, and 74.6% were women. The average score was 44.6; 68.5% of patients showed high satisfaction, especially with metered-dose inhalers, and 63.4% did not use them with an inhalocamera. Users of me...
Background: Chronic pain can trigger both physical and mental health complications. During the CO... more Background: Chronic pain can trigger both physical and mental health complications. During the COVID-19 pandemic, patients with chronic diseases have had reduced access to some medications. The objective was to determine the pharmacological management of patients with chronic pain and its continuity during the COVID-19 pandemic. Methods: This was a longitudinal study of the continuity of analgesic use in patients with chronic pain between September 1, 2019, and February 28, 2021, based on a drug dispensing database. A survival analysis was performed until the discontinuation of chronic analgesics. Results: A total of 12,701 patients who were being treated for chronic pain were identified. Their median age was 70.3 years, and 74.4% were women. Pain of rheumatological origin was the most frequent etiology (46.1%); the most commonly used medications were nonopioid analgesics (78.9%), pain modulators (24.8%) and opioid analgesics (23.3%). A total of 76.1% of the patients experienced int...
Introduction: The impact of COVID-19 prompted a race to find a treatment that would reduce its mo... more Introduction: The impact of COVID-19 prompted a race to find a treatment that would reduce its mortality. Most studies have not shown favorable results for many of these drugs, but they are still used. Objective: To determine the differences and similarities in the hospital pharmacological management of patients with COVID-19 according to sex, age group, and geographical region of Colombia, 2020-2021. Materials and methods: Descriptive cross-sectional study. We identified the prescription patterns of the medications given to patients diagnosed with COVID-19 treated in eight clinics in Colombia between March 6, 2020 and May 31, 2021. We performed a descriptive analysis of the sociodemographic, clinical, and pharmacological variables of the patients. Results: A total of 8596 patients from 170 cities were identified, with a median age of 53.0 years and 53.3% of them men. A total of 24.3% required care in the intensive care unit, and 18.7% required invasive mechanical ventilation. The m...
Introduction:Autoimmune idiopathic inflammatory myopathies (IIMs) are a group of pathologies that... more Introduction:Autoimmune idiopathic inflammatory myopathies (IIMs) are a group of pathologies that are generally characterized by muscle weakness. Their treatment involves glucocorticoids and immunosuppressants. Objective: To determine the differences and similarities in the pharmacological management of a group of patients with autoimmune IIM according to the type of disease, sex, age group, and city of residence in Colombia from 2020-2021. Materials and methods: This cross-sectional study identified prescription patterns of medications for outpatient use in patients with autoimmune IIM between 2020 and 2021 based from a population database of 8.5 million Colombians affiliated with the Colombian Health System. Sociodemographic and pharmacological variables were considered. Results: A total of 671 patients with autoimmune MMI were identified, with a median age of 57 years and 70.9% women. overlap myositis was the most frequent (31.4%). A total of 91.5% received pharmacological treatm...
Objective: Hemophilia A and B are disorders associated with the deficit of coagulation factors VI... more Objective: Hemophilia A and B are disorders associated with the deficit of coagulation factors VIII and IX that increase the risk of bleeding and complications (clotting factor inhibitor antibodies, severe bleedings, hospitalizations and anaphylactic reactions) depending on the severity of the disorder. The objective of this study was to determine the incidence of complications in a cohort of patients diagnosed with moderate and severe hemophilia A or B under treatment in a specialized institution. Methods: A retrospective study of a cohort of patients with replacement therapy for hemophilia A or B, evaluating treatment and complications between January/2012 and July/2019. The characteristics associated to disease management, sociodemographic and clinical variables were extracted from the medical records. Time to inhibitor development and rate associated to bleeding and hospitalizations were evaluated. Results: A total of 159 male patients were identified with hemophilia A (n=140; 8...
Introduction:Conjunctivitis is one of the most common ocular pathologies. Its treatment depends o... more Introduction:Conjunctivitis is one of the most common ocular pathologies. Its treatment depends on its etiology, but an excessive use of antibiotics and corticosteroids, which in many cases are contraindicated, has been described. Objective: To describe the prescription patterns of medications used to treat conjunctivitis in a Colombian population. Methods: This was a cross-sectional study on the pharmacological treatment of patients diagnosed with conjunctivitis based on a drug-dispensing database of approximately 8.5 million people affiliated with the Colombian Health System. Some sociodemographic and pharmacological variables and comorbidities were considered. A descriptive analysis was performed. Results: A total of 8,708 patients were identified; they had a median age of 44.7 years, and 59.3% were women. The most common causes of conjunctivitis were unspecified (53.1%) and allergic (37.4%). The most commonly used drug was olopatadine (26.1%), followed by dexamethasone with neom...
Introduction:Patients with rheumatoid arthritis (RA) have an increased risk of SARS-CoV-2 infecti... more Introduction:Patients with rheumatoid arthritis (RA) have an increased risk of SARS-CoV-2 infection due to intrinsic characteristics of the pathology and the medications used to treat it. Objective: To evaluate the incidence of and factors related to SARS-CoV-2 infection in patients with RA in Colombia. Materials and methods: This was an observational study of patients diagnosed with RA who were treated at a health care institution in Colombia. The study evaluated whether the patients presented SARS-CoV-2 infection and other clinical variables. Variables associated with the risk of SARS-CoV-2 infection were identified. Results: A total of 2,566 patients with RA were identified. They had a median age of 61.9 years, and 81.1% were women. They were mainly treated with synthetic disease-modifying antirheumatic drugs (DMARDs) (85.3%), glucocorticoids (52.2%) and biological DMARDs (26.8%). The incidence of SARS-CoV-2 infection was 5.1%, and the factors that increased the risk included tre...
Introduction:Animal bites have a high probability of becoming infected. In high-risk wounds, the ... more Introduction:Animal bites have a high probability of becoming infected. In high-risk wounds, the use of antibiotics that kill the associated microorganisms is recommended. Objective: To determine the use of antibiotics in patients in different regions of Colombia who were attacked in 2020 by animals that can transmit rabies. Materials and methods: This was a retrospective follow-up study of a cohort of patients with wounds caused by animals; the patients were affiliated with the Colombian Health System. Sociodemographic, clinical and pharmacological data were collected. Results: A total of 280 patients were analyzed. The median age was 28.0 years, and 52.1% were men. The attacks were attributed to dogs (85.0%) and cats (15.0%), and 9.6% were classified as severe exposure. Antibiotics were used in 71.1% of cases for prophylaxis and in 4.3% of the cases for the treatment of superinfection; cephalexin (37.5%), amoxicillin/clavulanic acid (15.7%) and dicloxacillin (10.4%) were the predo...
Aims:To determine the time elapsed between the start of treatment with antiparkinson agents and t... more Aims:To determine the time elapsed between the start of treatment with antiparkinson agents and the modification of the pharmacological therapy, and to establish its related factors, in a group of patients with Parkinson's disease from Colombia. Methods: Retrospective cohort study that collected information about the treatment of patients with Parkinson's disease who started drug therapy between June-2011 and December-2013; a 5-year follow-up was performed. Survival analyses for time to therapy modification were generated, and factors related to these changes were determined using Cox regression models. Results: A total of 3,224 patients (51.8% men) with a mean age of 73.1 ± 13.5 years started treatment with antiparkinson agents. After 5 years, 2,046 patients (63.5%) had modifications in drug therapy, in a mean time of 36.4 months (95% CI: 35.7-37.1). A total of 1,216 patients (37.8%) required the addition of another active principle, while 830 (25.7%) had a switch to anothe...
Introduction: A high percentage of people who have suffered from COVID-19 present clinical manife... more Introduction: A high percentage of people who have suffered from COVID-19 present clinical manifestations that persist long after recovery from the acute phase. Objective: To determine the proportion of patients who presented post-COVID-19 syndrome, its clinical picture, and its risk factors in a group of patients from Colombia. Methods: This was an observational, longitudinal study of patients with SARS-CoV-2 treated in a network of clinics in Colombia. Over the telephone, after they gave prior informed consent, we evaluated whether the patients had post-COVID-19 syndrome and other clinical variables. Descriptive, bivariate, and multivariate analyses were performed. Results: A total of 311 patients (50.2% women) from 19 different cities were identified, with a median age of 47.0 years. In 63.0% of cases, symptoms persisted more than 3 months after recovery from the acute phase of the disease. Most common were dyspnea (54.1%), fatigue (42.9%), and muscle pain (36.2%). Greater age (3...
Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million peop... more Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 174 million people worldwide.The objective was to determine the trends of the use of medications for COPD in a group of Colombian patients. Methods: This was a retrospective study on prescription patterns of bronchodilators and other medications used in COPD from a population database with follow-up at 12 and 24 months. Patients older than 18 years of age of any sex who had COPD between 2017 and 2019 were included. Sociodemographic variables, medications, treatment schedules for COPD, comorbidities, comedications, and the specialty of the prescriber were considered. Results: A total of 9,476 people with a diagnosis of COPD were evaluated. They had a mean age of 75.9 ± 10.7 years, 50.1% were men, and 86.8% were prescribed by a general practitioner. At the beginning of the follow-up, on average, they received 1.6 medications/patient, mainly short-acting antimuscarinics (3784; 39.9%), followed by short-act...
Introduction/objectives: To describe the clinical characteristics and health care resource utiliz... more Introduction/objectives: To describe the clinical characteristics and health care resource utilization in a Colombian systemic lupus erythematosus (SLE) outpatient cohort. Method: Retrospective descriptive study. Clinical records and claims data of SLE patients from ten specialized primary care centers in Colombia between July 2017 and June 2018 were reviewed. Baseline clinical variables, SLE activity (SLEDAI), drugs use, and direct costs were measured. Results: A total of413 patients were included, 361 (87.4%) female; mean age was 42±14 years. Mean disease evolution was 8.9±6.0 years; 174 patients (42.1%) had a systemic manifestation at baseline, mostly lupus nephritis (105; 25.4%). 334 patients (80.9%) had at least one comorbidity, mainly antiphospholipid syndrome (90; 21.8%) and hypertension (76; 18.4%). Baseline SLEDAI score was 0 in 215 patients (52.0%), 1-5 in 154 (37.3%), 6-10 in 41 (9.9%) and 11+ in 3 (0.7%). All patients received pharmacological therapy, the most common wer...
Aim: Quarantine due to the COVID-19 pandemic altered the supply and demand of health services. Th... more Aim: Quarantine due to the COVID-19 pandemic altered the supply and demand of health services. This, together with the “infodemic” and generalized panic, could alter the patterns of self-medication in the population. The objective was tocharacterize the patterns of self-medication in four municipalities of Colombia during mandatory preventive isolation in 2020. Methods: This was a cross-sectional study done in the municipality of Pereira and its metropolitan area during mandatory national preventive isolation between June and September 2020. A sample of 397 adults who responded to an online survey, based on the Instrument for Systematic Data Collection for Self-medication (Instrumento de Recolección Sistemática de Datos para la Automedicación - IRIS-AM), was obtained. The use of social networks (including WhatsApp) as the source of information about medications was explored. Results: The 397 people surveyed had a median age of 31.0 years, and 58.2% were women. The prevalence of self...
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, Oct 27, 2017
The objective of this study was to assess international trends in antipsychotic use, using a stan... more The objective of this study was to assess international trends in antipsychotic use, using a standardised methodology. A repeated cross-sectional design was applied to data extracts from the years 2005 to 2014 from 16 countries worldwide. During the study period, the overall prevalence of antipsychotic use increased in 10 of the 16 studied countries. In 2014, the overall prevalence of antipsychotic use was highest in Taiwan (78.2/1000 persons), and lowest in Colombia (3.2/1000). In children and adolescents (0-19 years), antipsychotic use ranged from 0.5/1000 (Lithuania) to 30.8/1000 (Taiwan). In adults (20-64 years), the range was 2.8/1000 (Colombia) to 78.9/1000 (publicly insured US population), and in older adults (65+ years), antipsychotic use ranged from 19.0/1000 (Colombia) to 149.0/1000 (Taiwan). Atypical antipsychotic use increased in all populations (range of atypical/typical ratio: 0.7 (Taiwan) to 6.1 (New Zealand, Australia)). Quetiapine, risperidone, and olanzapine were m...
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Papers by Jorge Machado-Alba