Abstract Objective: To analyze the results of sentinel patient program to monitoring the quality pharmacoterapeutic process in the hospitalized patient through medication errors. Method: Design: Observational, prospective and transversal study. Ambit: General hospital of 1,000 beds. Period: From May 2011 to June 2016. Sample: Patients with treatment prescribe within 24 hours of being admitted with 4 or more medications. Variables: Medication error, drugs prescribed, medications and doses dispensing, drugs administered. Safety indicators were defined based on medication errors at each stage of the pharmacotherapeutic process. Results: Of the 746 patients studied, 334 had at least 1 medication error (44.8%; IC95%: 41.7-47.8). In the 746 treatments, 564 medication errors were detected (0.75 errors by patient; IC95%: 0.7-0.8). The safety indicators (medication error by stage) were: 5.1% (38/746 patients) for omission of allergy record; 2.3% (156/6 724 drugs) for prescription; 0.6% (38/6 724 drugs) for validation, 2.6% for dispensing (142/5 465 drugs) y 3.7% (190/5 111 administered drugs observed) for administration. The temporal evolution of the indicators, with graphs of statistical control showed stable processes, except for the administration. The proposed improvement actions were of a training, standardization and organizational type. Conclusions: The sentinel patient program provides an overview of the quality of the pharmacotherapeutic process and promotes the safety culture at the center. Statistical control charts have been a useful tool for monitoring medication errors. The analysis of medication errors has served to propose improvement actions in each stage of the pharmacotherapeutic process.

Resumen Objetivo: Analizar los resultados del programa paciente centinela para la monitorización de la calidad del proceso farmacoterapéutico en el paciente hospitalizado mediante indicadores basados en errores de medicación. Método: Diseño: Estudio observacional, transversal y prospectivo. Ámbito: Hospital general de 1.000 camas. Periodo: mayo 2011-junio 2016. Muestra: Pacientes con cuatro o más medicamentos. Variables: Error de medicación, medicamentos prescritos, medicamentos y dosis preparadas, medicamentos administrados. Se definieron indicadores de seguridad a partir de los errores de medicación en cada fase del proceso farmacoterapéutico. Resultados: Durante el periodo de estudio, 334 de 746 pacientes presentaron algún error, lo que supuso un 44,8% (IC95%: 41,7 a 47,8). Se detectaron 564 errores de medicación (0,75 errores por paciente; IC95%: 0,7 a 0,8). Los indicadores de seguridad (errores de medicación por fase): omisión de registro de alergia 5,1% (38/746 pacientes); prescripción 2,3% (156/6.724 medicamentos); validación 0,6% (38/6.724 medicamentos), preparación: 2,6% (142/5.465 medicamentos) y administración: 3,7% (190/5.111 administraciones observadas). La evolución temporal de los indicadores, con gráficos de control estadístico, mostró procesos estables, excepto para la fase de administración. Las acciones de mejora propuestas fueron de normalización, formación y organización. Conclusiones: El programa paciente centinela proporciona una visión global de la calidad del proceso farmacoterapéutico y fomenta la cultura de seguridad en el centro. Los gráficos de control estadístico han sido una herramienta útil para monitorizar los errores de medicación. El análisis de los errores de medicación ha servido para plantear acciones de mejora en cada una de las fases del proceso farmacoterapéutico.

AbstractVicenin-2 (apigenin-6,8-di-C-β-d-glucopyranoside) is present in hydroalcoholic extracts of the Brazilian species Lychnophora ericoides Mart., Asteraceae, leaves, and the biological effects of this compound have been demonstrated including anti-inflammatory, antioxidant and anti-tumor effects in rat models. Given the potential of this compound as a pharmacological agent, the aims of this investigation were to evaluate the extent of intestinal absorption of vicenin-2, and to determine the intestinal permeation profile using an in situ single-pass intestinal perfusion technique. A validated HPLC–UV method was applied to measure the amount of unabsorbed vicenin-2 in the gut after an oral administration of 180 mg kg-1 in five rats. A nonlinear mixed effects model was used to determine the absorption pharmacokinetic parameters assuming a first order absorption and active secretion processes for this compound, wherein the active secretion was characterized by a zero-order process. The population pharmacokinetic parameters obtained were 0.274 min-1 for the first-order absorption rate constant, 16.3% min-1 for the zero-order rate constant; the final percentage of the original dose that was absorbed in vivo was 40.2 ± 2.5%. These parameters indicated that vicenin-2 was rapidly absorbed in the small intestine. In contrast to literature information indicating no absorption of vicenin-2 in Caco-2 cells, our results suggested that vicenin-2 can be absorbed in the small intestine of rats. The finding supports further investigation of vicenin-2 as a viable oral phytopharmaceutical agent for digestive diseases.