, H. V. (2020). Availability, prices, and affordability of selected essential cancer medicines in... more , H. V. (2020). Availability, prices, and affordability of selected essential cancer medicines in a middle-income country-the case of Mexico. BMC Health Services Research, 20(1), [424].
Background: More alternatives have become available for the diagnosis and treatment of cancer in ... more Background: More alternatives have become available for the diagnosis and treatment of cancer in low-and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.
Latin american journal of clinical sciences and medical technology
Background. Chlorine dioxide (ClO2) and its related compounds have been proposed as a treatment f... more Background. Chlorine dioxide (ClO2) and its related compounds have been proposed as a treatment for several diseases; their popularity increased during the COVID-19 pandemic. This study aimed to identify, characterize, and synthesize the existing publications regarding ClO2 and its related compounds' toxicity and efficacy as a treatment. Material and Methods. A scoping systematic review of animal and human studies was carried out in PubMed and EMBASE from their origin to October 20, 2020. Outcomes of interest were toxicity and efficacy of ClO2 and related compounds. After title, abstract, and full-text peered-review screening, data was extracted and synthesized. Methodological and reporting bias was analyzed in order to identify low-quality studies. Results. We identified 15 animal and 19 human studies out of 752 articles found in academic literature. The latter selection included 13 toxicity case reports and 6 clinical studies reporting on the topical and systemic administratio...
Consultorios adyacentes a farmacias privadas en México: infraestructura y características del per... more Consultorios adyacentes a farmacias privadas en México: infraestructura y características del personal médico y su remuneración. Salud Publica Mex 2015;57:320-328. Resumen Objetivo. Analizar las características del personal médico y su remuneración, así como la infraestructura, apego a la regulación y servicios ofrecidos en consultorios adyacentes a farmacias (CAF), y compararlos con consultorios médicos independientes (CMI). Material y métodos. Cuestionario aplicado a 239 médicos generales en 18 entidades federativas, incluido el Distrito Federal, en México en 2012. Resultados. Los médicos en CAF tenían menor experiencia profesional (5 vs 12 años), menos estudios de posgrado (61.2% vs 81.8%) y menor salario base promedio mensual (MXN 5 500 vs MXN 8 500) que en CMI. En CAF hubo menor cumplimiento de la regulación en relación con la historia clínica y la receta médica. Conclusiones. Los aspectos laborales explorados de médicos en CAF son más precarios que en CMI. Es necesario fortalecer la aplicación de la regulación vigente para consultorios y generar políticas a partir del monitoreo de su funcionamiento, particularmente, pero no de forma exclusiva, en CAF. Palabras clave: atención primaria; prescripción; médicos; conflicto de intereses; farmacias; México Díaz-Portillo SP, Idrovo AJ, Dreser A, Bonilla FR, Matías-Juan B, Wirtz VJ. Clinics adjacent to private pharmacies in Mexico: infrastructure and characteristics of the physicians and their remuneration.
TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospita... more TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospital-wide implementation of DigitalAMS TM , the appropriateness and limitation of such an application needs to be evaluated. TM (APP), the regimen recommended by the independent infectious disease (ID) physicians before and after knowing the culture results (Emp-ID and Def-ID) were compared. TM application could improve appropriateness of antibiotic regimens for empirical therapy for four common infections among adult hospitalized patients at Siriraj Hospital. However, some revisions need to be done to improve the appropriateness of antibiotic regimens in the APP, especially for subjects with pneumonia.
TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospita... more TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospital-wide implementation of DigitalAMS TM , the appropriateness and limitation of such an application needs to be evaluated. TM (APP), the regimen recommended by the independent infectious disease (ID) physicians before and after knowing the culture results (Emp-ID and Def-ID) were compared. TM application could improve appropriateness of antibiotic regimens for empirical therapy for four common infections among adult hospitalized patients at Siriraj Hospital. However, some revisions need to be done to improve the appropriateness of antibiotic regimens in the APP, especially for subjects with pneumonia.
The initiative including an Act Project for reforming the Ley General de Salud of Mexico, submitt... more The initiative including an Act Project for reforming the Ley General de Salud of Mexico, submitted in 2019 to the Congress of the Union, proposes the creation of a system of universal and free access to health services and associated medicines for the population lacking of social security benefits, and the creation of the Instituto de Salud para el Bienestar. This article analyzes the substantive aspects of the project, with the aim of motivating the reflection of the proposed reform and its most important components, to contribute to achieving its aim. The conclusion is that the main themes of the Project require precision in relevant areas, such as the transformation of the financing scheme for care, the strengthening of stewardship and governance, the responsibility in the provision of services, and the regulation and access to medicines. The contributions of academics, decision makers and social organizations will be essential to create a public health policy based on evidence and social equity.
Revista panamericana de salud pública (Impresa), Sep 23, 2020
Objectives. To examine published antimicrobial stewardship (AMS) initiatives in hospitals in Lati... more Objectives. To examine published antimicrobial stewardship (AMS) initiatives in hospitals in Latin America and the Caribbean (LAC) in order to characterize AMS terminology usage, geotemporality, and elements of structure (human resources), process (interventions), and outcomes, and to set priority areas for improving AMS reporting. Methods. This was a scoping review that searched PubMed, LILACS, EMBASE, and 12 other databases, along with a manual search for academic and grey literature to identify documents on AMS initiatives in hospitals in 33 countries of LAC, up to August 2019. Keywords included 'antibiotic' or 'antimicrobial' AND 'stewardship, policy, strategies, management, control, rational use, appropriate use, surveillance, or interventions' and 33 country names. Results. Selected articles totalled 147 studies published in 1985-2019; of those, 22% used 'antimicrobial stewardship' in the title. Eighteen countries published AMS hospital initiatives, one-half of which were implemented in capital cities. Brazil, Argentina, Colombia, Cuba, Mexico, and Chile, in descending frequency, made up > 59% of published initiatives. Educational interventions were the most frequently reported, followed by persuasive and restrictive strategies. Antimicrobial consumption was the most common outcome measure reported. About one-third of the studies (35%) referred to baseline measures-only in preparation for AMS interventions. Fifty-nine studies from 6 countries reported AMS comprehensively, using structure, process, and outcome (SPO) elements. Conclusions. Published hospital AMS initiatives have increased over time and have expanded across LAC. However, more programs need to be developed. Complete reporting of SPO elements is imperative to evaluating and replicating AMS actions.
Background: More alternatives have become available for the diagnosis and treatment of cancer in ... more Background: More alternatives have become available for the diagnosis and treatment of cancer in low-and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2 and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.
Research in Social & Administrative Pharmacy, Sep 1, 2020
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Journal of Antimicrobial Chemotherapy, Dec 27, 2021
Background: Point prevalence surveys (PPSs) on antibiotic use are useful for understanding differ... more Background: Point prevalence surveys (PPSs) on antibiotic use are useful for understanding different aspects related to prescription patterns in hospitals. Methods: An adaptation of the WHO methodology for a PPS on antibiotic use was applied. Hospital wards were divided into medical (MED), surgical (SUR), ICUs, gynaecology and obstetrics (GO), high-risk (HR) and mixed wards (MIX). A web application (RedCap V C) through a mobile device was used for data collection. Results: Between December 2018 and August 2019, 5444 patients in 33 hospitals in five countries were included (10 hospitals in Cuba, 7 in Paraguay, 6 in El Salvador, 5 in Mexico and 5 in Peru). Of these patients, 54.6% received at least one antibiotic, with variations between and within hospitals and countries. Antibiotics were more frequently used in ICUs (67.2%), SUR (64.5%) and MED wards (54.2%), with 51.2% of antibiotics prescribed for community-acquired infections (CAIs), 22.9% for healthcare-associated infections (HAIs), 11.1% for surgical prophylaxis and 6.1% for unknown reasons. Adherence to guidelines was observed in 68.6% of cases (72.8% for CAIs, 72.4% for HAIs and 44.3% for prophylaxis). Third-generation cephalosporins were the class of antibiotics most frequently used (26.8%), followed by carbapenems (10.3%) and fluoroquinolones (8%). Targeted treatments were achieved in 17.3% of cases. Conclusions: Antibiotic use was generally higher than that published in other studies. There is an urgent need to promote and strengthen the antimicrobial stewardship programmes in Latin America. addressing the need to implement antimicrobial stewardship programmes (ASPs) both in hospitals and primary care settings. Surveillance systems of antimicrobial consumption and AMR provide essential data for implementing ASPs. Continuous data collection on antibiotic prescribing is not easy due to the high workload and level of resources needed. 3 A viable alternative is to collect data at a specific point in time, which can be done by using the point prevalence survey (PPS) methodology. This type of survey permits (i) the measurement of antimicrobial use along time, assessing changes in prescribing trends; (ii) the identification of
Tropical Medicine & International Health, 2013
ObjectivesTo describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico ... more ObjectivesTo describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico (1995–2009) to prohibit antibiotic OTC sales and explore limitations in available data.MethodsWe searched and analysed legislation, grey literature and peer‐reviewed publications on regulatory interventions and implementation strategies to enforce prohibition of OTC antibiotic sales. We also assessed the impact using private sector retail sales data of antibiotics studying changes in level and consumption trends before and after the policy change using segmented time series analysis. Finally, we assessed the completeness and data quality through an established checklist to test the suitability of the data for analysis of the interventions.ResultsWhereas Chile implemented a comprehensive package of interventions to accompany regulation changes, Colombia's reform was limited to the capital district and Venezuela's limited to only some antibiotics and without awareness campaigns. In...
Journal of Pharmaceutical Policy and Practice, 2021
Background The implementation of pharmaceutical services in hospitals contributes to the appropri... more Background The implementation of pharmaceutical services in hospitals contributes to the appropriate use of medicines and patient safety. However, the relationship of implementation with the legal framework and organizational practice has not been studied in depth. The objective of this research is to determine the role of these two factors (the legal framework and organizational practice) in the implementation of pharmaceutical services in public hospitals of the Ministry of Health of Mexico. Methods Semi-structured interviews were conducted with four groups of actors involved. The analysis focused on the legal framework, defined as the rules, laws and regulations, and on organizational practice, defined as the implementation of the legal framework by related individuals, that is, how they put it into practice. Results The main problems identified were the lack of alignment between the rules and the incentives for compliance. Decision-makers identified the lack of managerial capaci...
Little is known about the role of WhatsApp in spreading misinformation during the start of the CO... more Little is known about the role of WhatsApp in spreading misinformation during the start of the COVID-19 pandemic in Mexico. The aim of this study is to analyze the message content, format, authorship, time trends and social media distribution channels of misinformation in WhatsApp messages in Mexico. From March 18 to June 30, 2020 the authors collected all WhatsApp messages received via their personal contacts and their social networks that contained information about COVID-19. Descriptive and inferential statistics were used to analyze the scientifically inaccurate messages and the relationship between variables, respectively. Google image and video searches were carried out to identify sharing on other social media. Out of a total of 106 messages, the most frequently mentioned COVID-19 related message topics were prevention (20.0%), conspiracy (18.5%), therapy (15.4%) and origin of the virus (10.3%), changing throughout the pandemic according to users’ concerns. Half of all WhatsA...
Drug utilization research (DUR) contributes to inform policymaking and to strengthen health syste... more Drug utilization research (DUR) contributes to inform policymaking and to strengthen health systems. The availability of data sources is the first step for conducting DUR. However, documents that systematize these data sources in Latin American (LatAm) countries are not known. We compiled the potential data sources for DUR in the LatAm region. A network of DUR experts from nine LatAm countries was assembled and experts conducted: (i) a website search of the government, academic, and private health institutions; (ii) screening of eligible data sources, and (iii) liaising with national experts in pharmacoepidemiology (via an on-line survey). The data sources were characterized by accessibility, geographic granularity, setting, sector of the data, sources and type of the data. Descriptive analyses were performed. We identified 125 data sources for DUR in nine LatAm countries. Thirty-eight (30%) of them were publicly and conveniently available; 89 (71%) were accessible with limitations, and 18 (14%) were not accessible or lacked clear rules for data access. From the 125 data sources, 76 (61%) were from the public sector only; 46 (37%) were from pharmacy records; 43 (34%) came from ambulatory settings and; 85 (68%) gave access to individual patient-level data. Although multiple sources for DUR are available in LatAm countries, the accessibility is a major challenge. The procedures for accessing DUR data should be transparent, feasible, affordable and protocol-driven. This inventory could permit a comparison of drug utilization between countries identifying potential medication-related problems that need further exploration.
, H. V. (2020). Availability, prices, and affordability of selected essential cancer medicines in... more , H. V. (2020). Availability, prices, and affordability of selected essential cancer medicines in a middle-income country-the case of Mexico. BMC Health Services Research, 20(1), [424].
Background: More alternatives have become available for the diagnosis and treatment of cancer in ... more Background: More alternatives have become available for the diagnosis and treatment of cancer in low-and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.
Latin american journal of clinical sciences and medical technology
Background. Chlorine dioxide (ClO2) and its related compounds have been proposed as a treatment f... more Background. Chlorine dioxide (ClO2) and its related compounds have been proposed as a treatment for several diseases; their popularity increased during the COVID-19 pandemic. This study aimed to identify, characterize, and synthesize the existing publications regarding ClO2 and its related compounds' toxicity and efficacy as a treatment. Material and Methods. A scoping systematic review of animal and human studies was carried out in PubMed and EMBASE from their origin to October 20, 2020. Outcomes of interest were toxicity and efficacy of ClO2 and related compounds. After title, abstract, and full-text peered-review screening, data was extracted and synthesized. Methodological and reporting bias was analyzed in order to identify low-quality studies. Results. We identified 15 animal and 19 human studies out of 752 articles found in academic literature. The latter selection included 13 toxicity case reports and 6 clinical studies reporting on the topical and systemic administratio...
Consultorios adyacentes a farmacias privadas en México: infraestructura y características del per... more Consultorios adyacentes a farmacias privadas en México: infraestructura y características del personal médico y su remuneración. Salud Publica Mex 2015;57:320-328. Resumen Objetivo. Analizar las características del personal médico y su remuneración, así como la infraestructura, apego a la regulación y servicios ofrecidos en consultorios adyacentes a farmacias (CAF), y compararlos con consultorios médicos independientes (CMI). Material y métodos. Cuestionario aplicado a 239 médicos generales en 18 entidades federativas, incluido el Distrito Federal, en México en 2012. Resultados. Los médicos en CAF tenían menor experiencia profesional (5 vs 12 años), menos estudios de posgrado (61.2% vs 81.8%) y menor salario base promedio mensual (MXN 5 500 vs MXN 8 500) que en CMI. En CAF hubo menor cumplimiento de la regulación en relación con la historia clínica y la receta médica. Conclusiones. Los aspectos laborales explorados de médicos en CAF son más precarios que en CMI. Es necesario fortalecer la aplicación de la regulación vigente para consultorios y generar políticas a partir del monitoreo de su funcionamiento, particularmente, pero no de forma exclusiva, en CAF. Palabras clave: atención primaria; prescripción; médicos; conflicto de intereses; farmacias; México Díaz-Portillo SP, Idrovo AJ, Dreser A, Bonilla FR, Matías-Juan B, Wirtz VJ. Clinics adjacent to private pharmacies in Mexico: infrastructure and characteristics of the physicians and their remuneration.
TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospita... more TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospital-wide implementation of DigitalAMS TM , the appropriateness and limitation of such an application needs to be evaluated. TM (APP), the regimen recommended by the independent infectious disease (ID) physicians before and after knowing the culture results (Emp-ID and Def-ID) were compared. TM application could improve appropriateness of antibiotic regimens for empirical therapy for four common infections among adult hospitalized patients at Siriraj Hospital. However, some revisions need to be done to improve the appropriateness of antibiotic regimens in the APP, especially for subjects with pneumonia.
TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospita... more TM is a mobile-based application used to guide choosing empirical antibiotics. Before the hospital-wide implementation of DigitalAMS TM , the appropriateness and limitation of such an application needs to be evaluated. TM (APP), the regimen recommended by the independent infectious disease (ID) physicians before and after knowing the culture results (Emp-ID and Def-ID) were compared. TM application could improve appropriateness of antibiotic regimens for empirical therapy for four common infections among adult hospitalized patients at Siriraj Hospital. However, some revisions need to be done to improve the appropriateness of antibiotic regimens in the APP, especially for subjects with pneumonia.
The initiative including an Act Project for reforming the Ley General de Salud of Mexico, submitt... more The initiative including an Act Project for reforming the Ley General de Salud of Mexico, submitted in 2019 to the Congress of the Union, proposes the creation of a system of universal and free access to health services and associated medicines for the population lacking of social security benefits, and the creation of the Instituto de Salud para el Bienestar. This article analyzes the substantive aspects of the project, with the aim of motivating the reflection of the proposed reform and its most important components, to contribute to achieving its aim. The conclusion is that the main themes of the Project require precision in relevant areas, such as the transformation of the financing scheme for care, the strengthening of stewardship and governance, the responsibility in the provision of services, and the regulation and access to medicines. The contributions of academics, decision makers and social organizations will be essential to create a public health policy based on evidence and social equity.
Revista panamericana de salud pública (Impresa), Sep 23, 2020
Objectives. To examine published antimicrobial stewardship (AMS) initiatives in hospitals in Lati... more Objectives. To examine published antimicrobial stewardship (AMS) initiatives in hospitals in Latin America and the Caribbean (LAC) in order to characterize AMS terminology usage, geotemporality, and elements of structure (human resources), process (interventions), and outcomes, and to set priority areas for improving AMS reporting. Methods. This was a scoping review that searched PubMed, LILACS, EMBASE, and 12 other databases, along with a manual search for academic and grey literature to identify documents on AMS initiatives in hospitals in 33 countries of LAC, up to August 2019. Keywords included 'antibiotic' or 'antimicrobial' AND 'stewardship, policy, strategies, management, control, rational use, appropriate use, surveillance, or interventions' and 33 country names. Results. Selected articles totalled 147 studies published in 1985-2019; of those, 22% used 'antimicrobial stewardship' in the title. Eighteen countries published AMS hospital initiatives, one-half of which were implemented in capital cities. Brazil, Argentina, Colombia, Cuba, Mexico, and Chile, in descending frequency, made up > 59% of published initiatives. Educational interventions were the most frequently reported, followed by persuasive and restrictive strategies. Antimicrobial consumption was the most common outcome measure reported. About one-third of the studies (35%) referred to baseline measures-only in preparation for AMS interventions. Fifty-nine studies from 6 countries reported AMS comprehensively, using structure, process, and outcome (SPO) elements. Conclusions. Published hospital AMS initiatives have increased over time and have expanded across LAC. However, more programs need to be developed. Complete reporting of SPO elements is imperative to evaluating and replicating AMS actions.
Background: More alternatives have become available for the diagnosis and treatment of cancer in ... more Background: More alternatives have become available for the diagnosis and treatment of cancer in low-and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. We assessed the availability and affordability of essential cancer medicines in Mexico, and compared their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2 and 67.5%, respectively. In the public sector, medicines covered by the public health insurance "People's Health Insurance" were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.
Research in Social & Administrative Pharmacy, Sep 1, 2020
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Journal of Antimicrobial Chemotherapy, Dec 27, 2021
Background: Point prevalence surveys (PPSs) on antibiotic use are useful for understanding differ... more Background: Point prevalence surveys (PPSs) on antibiotic use are useful for understanding different aspects related to prescription patterns in hospitals. Methods: An adaptation of the WHO methodology for a PPS on antibiotic use was applied. Hospital wards were divided into medical (MED), surgical (SUR), ICUs, gynaecology and obstetrics (GO), high-risk (HR) and mixed wards (MIX). A web application (RedCap V C) through a mobile device was used for data collection. Results: Between December 2018 and August 2019, 5444 patients in 33 hospitals in five countries were included (10 hospitals in Cuba, 7 in Paraguay, 6 in El Salvador, 5 in Mexico and 5 in Peru). Of these patients, 54.6% received at least one antibiotic, with variations between and within hospitals and countries. Antibiotics were more frequently used in ICUs (67.2%), SUR (64.5%) and MED wards (54.2%), with 51.2% of antibiotics prescribed for community-acquired infections (CAIs), 22.9% for healthcare-associated infections (HAIs), 11.1% for surgical prophylaxis and 6.1% for unknown reasons. Adherence to guidelines was observed in 68.6% of cases (72.8% for CAIs, 72.4% for HAIs and 44.3% for prophylaxis). Third-generation cephalosporins were the class of antibiotics most frequently used (26.8%), followed by carbapenems (10.3%) and fluoroquinolones (8%). Targeted treatments were achieved in 17.3% of cases. Conclusions: Antibiotic use was generally higher than that published in other studies. There is an urgent need to promote and strengthen the antimicrobial stewardship programmes in Latin America. addressing the need to implement antimicrobial stewardship programmes (ASPs) both in hospitals and primary care settings. Surveillance systems of antimicrobial consumption and AMR provide essential data for implementing ASPs. Continuous data collection on antibiotic prescribing is not easy due to the high workload and level of resources needed. 3 A viable alternative is to collect data at a specific point in time, which can be done by using the point prevalence survey (PPS) methodology. This type of survey permits (i) the measurement of antimicrobial use along time, assessing changes in prescribing trends; (ii) the identification of
Tropical Medicine & International Health, 2013
ObjectivesTo describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico ... more ObjectivesTo describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico (1995–2009) to prohibit antibiotic OTC sales and explore limitations in available data.MethodsWe searched and analysed legislation, grey literature and peer‐reviewed publications on regulatory interventions and implementation strategies to enforce prohibition of OTC antibiotic sales. We also assessed the impact using private sector retail sales data of antibiotics studying changes in level and consumption trends before and after the policy change using segmented time series analysis. Finally, we assessed the completeness and data quality through an established checklist to test the suitability of the data for analysis of the interventions.ResultsWhereas Chile implemented a comprehensive package of interventions to accompany regulation changes, Colombia's reform was limited to the capital district and Venezuela's limited to only some antibiotics and without awareness campaigns. In...
Journal of Pharmaceutical Policy and Practice, 2021
Background The implementation of pharmaceutical services in hospitals contributes to the appropri... more Background The implementation of pharmaceutical services in hospitals contributes to the appropriate use of medicines and patient safety. However, the relationship of implementation with the legal framework and organizational practice has not been studied in depth. The objective of this research is to determine the role of these two factors (the legal framework and organizational practice) in the implementation of pharmaceutical services in public hospitals of the Ministry of Health of Mexico. Methods Semi-structured interviews were conducted with four groups of actors involved. The analysis focused on the legal framework, defined as the rules, laws and regulations, and on organizational practice, defined as the implementation of the legal framework by related individuals, that is, how they put it into practice. Results The main problems identified were the lack of alignment between the rules and the incentives for compliance. Decision-makers identified the lack of managerial capaci...
Little is known about the role of WhatsApp in spreading misinformation during the start of the CO... more Little is known about the role of WhatsApp in spreading misinformation during the start of the COVID-19 pandemic in Mexico. The aim of this study is to analyze the message content, format, authorship, time trends and social media distribution channels of misinformation in WhatsApp messages in Mexico. From March 18 to June 30, 2020 the authors collected all WhatsApp messages received via their personal contacts and their social networks that contained information about COVID-19. Descriptive and inferential statistics were used to analyze the scientifically inaccurate messages and the relationship between variables, respectively. Google image and video searches were carried out to identify sharing on other social media. Out of a total of 106 messages, the most frequently mentioned COVID-19 related message topics were prevention (20.0%), conspiracy (18.5%), therapy (15.4%) and origin of the virus (10.3%), changing throughout the pandemic according to users’ concerns. Half of all WhatsA...
Drug utilization research (DUR) contributes to inform policymaking and to strengthen health syste... more Drug utilization research (DUR) contributes to inform policymaking and to strengthen health systems. The availability of data sources is the first step for conducting DUR. However, documents that systematize these data sources in Latin American (LatAm) countries are not known. We compiled the potential data sources for DUR in the LatAm region. A network of DUR experts from nine LatAm countries was assembled and experts conducted: (i) a website search of the government, academic, and private health institutions; (ii) screening of eligible data sources, and (iii) liaising with national experts in pharmacoepidemiology (via an on-line survey). The data sources were characterized by accessibility, geographic granularity, setting, sector of the data, sources and type of the data. Descriptive analyses were performed. We identified 125 data sources for DUR in nine LatAm countries. Thirty-eight (30%) of them were publicly and conveniently available; 89 (71%) were accessible with limitations, and 18 (14%) were not accessible or lacked clear rules for data access. From the 125 data sources, 76 (61%) were from the public sector only; 46 (37%) were from pharmacy records; 43 (34%) came from ambulatory settings and; 85 (68%) gave access to individual patient-level data. Although multiple sources for DUR are available in LatAm countries, the accessibility is a major challenge. The procedures for accessing DUR data should be transparent, feasible, affordable and protocol-driven. This inventory could permit a comparison of drug utilization between countries identifying potential medication-related problems that need further exploration.
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