European journal of hospital pharmacy : science and practice最新文献

{"title":"Correspondence on: 'Patient reported medication-related problems, adherence and waste of oral anticancer medication over time' by van den Bemt <i>et al</i>.","authors":"Jinming Cao, Zhicong Chen, Feng Xu","doi":"10.1136/ejhpharm-2024-004424","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004424","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixed or weight-adjusted dose in immunotherapy?","authors":"Marca Diaz-Rangel, Francisca Sanchez-Rubio, Andrea Drozdz-Vergara, Juan Manuel Collado-Sanz, Sonia Ruiz-Sanchez, Ana Valladolid-Walsh, Ana Cristina Cercos-Lleti","doi":"10.1136/ejhpharm-2024-004324","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004324","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the economic impact of the use of immune checkpoint inhibitors in fixed-dose regimens and to determine the potential economic savings of using weight-adjusted dosing, as well as to describe the current situation in Spanish hospitals.</p><p><strong>Methods: </strong>Observational, descriptive, retrospective and multicentre study that included all patients treated with pembrolizumab, nivolumab, avelumab, durvalumab and cemiplimab in fixed-dose regimens from 2020 to 2022 in four hospitals in a Spanish province (Albacete). Clinical variables: drug, therapeutic indication, body weight, percentage of overdose and number of cycles received. Economic variables studied included: cost per cycle (fixed-dose and weight-adjusted dosing), total cost and opportunity cost. The dosage regimen chosen for immune checkpoint inhibitors in Spain was carried out by means of an anonymous survey. The survey was sent out using a distribution list of the Oncology Pharmacy Working Group (GEDEFO) of the Spanish Society of Hospital Pharmacy (SEFH).</p><p><strong>Results: </strong>The study included 297 patients (155 pembrolizumab, 115 nivolumab, 12 avelumab, 11 durvalumab and 4 cemiplimab). The opportunity cost: pembrolizumab €615,316, nivolumab €486,327, avelumab €19,974, durvalumab €28,367 and cemiplimab €4,008. A total of 53 responses to the survey were received. In 54.7% of cases the weight-adjusted dosing regimen had been partially implemented in the prescription of some drugs and/or indications. In those hospitals that used weight-adjusted dosing, the decision was mainly made by the Pharmacy Service in consensus with Oncology (70.5%).</p><p><strong>Conclusions: </strong>Our study showed a percentage of overdose of all drugs when using a fixed-dose regimen. This translates into a considerable increase in the budgetary impact versus the weight-adjusted dosing. The survey shows the scenario of our healthcare practice at the national level, confirming the variability in dosage regimens used in Spanish hospitals and the possible budgetary impact that therapeutic optimisation would entail.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The frequency and impact of drug-related problems with postoperative medication reported by orthopaedic patients after discharge.","authors":"Eward J Melis, Bart Jf van den Bemt, Dirk E Schrander, Johanna E Vriezekolk","doi":"10.1136/ejhpharm-2024-004328","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004328","url":null,"abstract":"<p><p>Following orthopaedic surgery, medication is vital for recovery and preventing complications, however drug-related problems (DRPs) can hinder medication use. The prevalence, types, and impact of DRPs on patients' activities of daily living (ADL) and the medication involved are unknown. Insight is needed for targeted interventions.</p><p><strong>Aim: </strong>Our study had four aims to assess 1) the prevalence and types of DRPs with postoperative medication in orthopeadic patients 6 weeks after discharge; 2) the perceived impact of the reported DRPs on patients' ADL; 3) the postoperative medication most frequently causing DRPs; and 4) the association between DRP numbers and patient- and disease-related characteristics.</p><p><strong>Methods: </strong>A cross-sectional study at a tertiary centre surveyed adult orthopaedic surgery patients 6 weeks post-surgery. Patients reported on demographics, DRPs and their ADL impact, health literacy, and medication beliefs. Clinical factors and medication use were extracted from medical records. Descriptive statistics and linear hierarchical regression analysis were conducted.</p><p><strong>Results: </strong>Out of 484 patients (mean (standard deviation (SD)) age 61.1 (±12.7) years, 61.6% female), 87.4% reported at least one DRP, with 39.7% indicating it impacted ADL. The most frequent DRPs involved inadequate drug use, including intentionally used less (49.8%) and stopped earlier (44.6%). The most impactful DRPs involved negative experiences, including insufficient effect (69.3%) and side effect (57.6%). Opioids caused the most DRPs, averaging 1.8 per patient. Impactful DRPs were associated with female sex, knee and spine surgery, medication concerns, and younger age.</p><p><strong>Conclusion: </strong>Most patients experienced at least one DRP within 6 weeks post-discharge, with nearly half reporting an impact on ADL. Inadequate drug use and negative experiences, particularly with opioids, are the most urgent DRPs to address.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of hospital clinical pharmacy services in Finland in the period 2017-2022: the third nationwide follow-up survey.","authors":"Lotta Linnea Schepel, Eva Kunnola, Marja Airaksinen, Kirsi Aronpuro, Kirsi Kvarnström","doi":"10.1136/ejhpharm-2024-004312","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004312","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pharmacists' involvement in patient care became more common in Finnish hospitals during the period of 2011-2016. The first national survey was conducted in 2011 and repeated using the same method in 2016. This development was in accordance with patient safety policy initiatives and European hospital pharmacy statements. This study aimed to conduct the third national follow-up survey on hospital clinical pharmacy services in Finland in 2022 and compare the results with those in 2016.</p><p><strong>Methods: </strong>The study was conducted in 2022 as a national online survey targeting hospital pharmacies (n=22) and smaller-scale, independently operating medicine dispensaries (n=23). Descriptive statistics and qualitative content analysis were used for the data analysis.</p><p><strong>Results: </strong>The response rate was 64% (n=29/45), accounting for 19/22 hospital pharmacies and 10/23 medicine dispensaries. Clinical pharmacy services were provided in 83% (n=24/29) of the responding units. The clinical pharmacy staff increased between 2017 and 2022 and services became more common, particularly at admission units (eg, emergency departments) and outpatient clinics. In some units (25%, n=6/24), services were also available in the evenings and in one unit during weekends. Similar to 2016, system-based medication safety risk management was also highlighted in this survey, and the first medication safety officer positions (n=8/24) were created. The most increased tasks were medication reviews and medication safety audits, while in 2016 the most increased task was medication reconciliation. Pharmacist participation in patient discharge had decreased. Despite the increasing prevalence of automation technology and pharmacy assistants, logistical tasks decreased only slightly.</p><p><strong>Conclusions: </strong>Finnish hospital clinical pharmacy services have continued to expand in accordance with national and international guidelines, and have become increasingly concentrated on medication safety risk management. They currently engage in admission and outpatient units, but effort should also be put into discharge.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of potentially inappropriate prescriptions identified using screening tools in paediatric patients: a systematic review.","authors":"Shamala Balan, Norkasihan Ibrahim","doi":"10.1136/ejhpharm-2024-004169","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004169","url":null,"abstract":"<p><strong>Objectives: </strong>Inappropriate prescriptions are known to cause medication-related problems, but little is known about the prevalence of this issue in paediatric patients. This systematic review provides an overview of the prevalence of potentially inappropriate prescriptions identified through tools developed for the paediatric population and delineates the strengths and limitations of the identification tools.</p><p><strong>Methods: </strong>Literature from PubMed, CINAHL, Cochrane database and Google Scholar was searched with a combination of medical subject headings (MeSH) and free-text terms related to inappropriate prescriptions, paediatrics and potentially inappropriate prescription tools. Studies reported in English and published from inception of the databases until May 2023 were selected based on fulfilment of eligibility criteria. All eligible articles were assessed for methodological quality and examined using thematic analysis.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria. The majority of the studies were of high quality. Four themes emerged-namely, evaluation tools and calculation methods of inappropriate prescriptions, prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), and predictors of PIM and PPO in children. Among the nine tools identified, the original and modified version of the POPI tool was most commonly used. The prevalence of PIM and PPO ranged from 0.04% to 69% and from 1.5% to 55.9%, respectively. Age was the most common predictor reported, whereby PIMs and PPOs were more likely in children aged 2-6 and 6-12 years, respectively.</p><p><strong>Conclusions: </strong>Potentially inappropriate prescriptions in paediatric patients is highly prevalent, despite the wide variation in the reported prevalence range and limited implementation of the available tools in practice. Future efforts need to be focused on the development and implementation of age-, disease- or country-specific tools to effectively evaluate and further determine the economic impact of PIMs in children.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of authorship integrity in scientific publications within healthcare and hospital pharmacy.","authors":"Eleonora Castellana","doi":"10.1136/ejhpharm-2024-004409","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004409","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pharmaceutical care on hospital readmissions for heart failure: a randomised trial.","authors":"Beatriz Montero-Llorente, Covadonga Pérez Menéndez-Conde, Eduardo González Ferrer, Genoveva Teresa López Castellanos, Luis Miguel Bedoya Del Olmo, Teresa Bermejo Vicedo","doi":"10.1136/ejhpharm-2024-004218","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004218","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of pharmaceutical care on the number of readmissions and visits to the emergency department due to heart failure 30 days after hospital discharge, based on a programme of continuous pharmaceutical care throughout the care process, and to assess the differences between the control and intervention groups at 90 days after discharge (number of readmissions and visits to the emergency department, time from discharge to new readmission or visit to the emergency department).</p><p><strong>Methods: </strong>A single-centre experimental longitudinal prospective open and parallel-group study with balanced randomisation (1:1) was carried out in a tertiary hospital in Spain. Patients with a diagnosis of primary or decompensated heart failure admitted to the Cardiology Service or the Heart Failure and Vascular Risk Unit were recruited between March 2019 and November 2021 and randomly assigned, using a randomised block model, to the control (standard care) or intervention (continuing care model) groups. Epidemiological, clinical and pharmacology data were recorded. As a measure of association, we used the mean difference and the Student's t-test. A p value of <0.05 was considered significant.</p><p><strong>Results: </strong>296 patients were included (150 randomised to the control group, 146 to the intervention group). The results showed no significant differences between the control and intervention groups in the number of readmissions and visits to the emergency department during the 30 days after discharge (p=0.092), but a statistically significant difference was seen at 90 days (p=0.043). The number of days until the first visit to the emergency department or readmission was higher in the intervention group (p=0.021).</p><p><strong>Conclusions: </strong>Continuous care and follow-up by the pharmacist 30 days after discharge has a neutral impact on hospital readmissions and visits to the emergency department of patients with heart failure, but it is positive in the 90 days following discharge.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile pharmacies of the Ukrainian chain 'Apteka 9-1-1': access to medicines during the war in Ukraine.","authors":"Oleg Klimov, Esteban Zavaleta","doi":"10.1136/ejhpharm-2024-004385","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004385","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating automated dispensing cabinets into the medication dispensing process: feedback from the practice in European hospitals.","authors":"Olivia Francois, Edith Hufschmid Thurnherr, Cedric Blatrie, Etienne Cousein, Ana Herranz, Farshid Sadeghipour, Pascal Bonnabry","doi":"10.1136/ejhpharm-2024-004195","DOIUrl":"10.1136/ejhpharm-2024-004195","url":null,"abstract":"<p><strong>Objectives: </strong>Automated dispensing cabinets (ADCs) offer improved medication safety, greater efficiency and return on investment. However, integrating ADCs into medication dispensing processes can be challenging in complex hospital environments. This study aimed to draft suggestions to help hospitals adopt ADCs.</p><p><strong>Methods: </strong>Two-day visits were organised in seven European hospitals operating ADCs. Investigators used an observational grid, a questionnaire and interviews, each divided into the themes of medication processes before and after the introduction of ADCs, the major steps followed and the resources involved, ergonomics and staff perceptions.</p><p><strong>Results: </strong>ADCs were integrated into four global hospital medication dispensing systems (packs of drugs are distributed from the central pharmacy to wards for dispensing) and three nominative systems-that is, patient-specific ones (drug doses prescribed for individuals are distributed from the central pharmacy to wards with ADC as supplementary stock). A general ADC project implementation timeline was shaped: main drivers of automation to initiate the project, visit of other sites, pilot test (with IT integration and staff training), and evaluation phase (satisfaction, safety, efficiency) to justify a possible expansion. Users (7 pharmacists, 21 nurses, 7 data engineers) identified facilitators (such as a dedicated project manager, a pilot phase, an intuitive device), barriers and any improvements needed (training for incoming staff, reorganisation of ward workflow, dynamic inventories).</p><p><strong>Conclusions: </strong>Despite their diverse pharmacy organisations, each hospital raised similar challenges and reported analogous major steps in project implementation. Although integration processes are complex, ADCs rapidly provide users with benefits. By following the practical advice and recommendations from these hospitals, new adopters might reduce the risks of failed ADC projects and accelerate their integration.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular events in eGFR-mutation non-small-cell lung cancer patients on osimertinib.","authors":"Samuel Akaakole Mensah, Syed Ahmad, Waleed Alruwaili, Rutu Raval, Karthik Gonuguntla, Brijesh Patel","doi":"10.1136/ejhpharm-2024-004319","DOIUrl":"10.1136/ejhpharm-2024-004319","url":null,"abstract":"<p><strong>Objectives: </strong>There have been cases of cardiotoxicity induced by osimertinib in patients with non-small-cell lung cancer (NSCLC). However, limited data exist for a comprehensive cardiotoxicity profile analysis for osimertinib use in NSCLC patients. The aim of this study was to report the entire profile of cardiotoxicities after the initiation of osimertinib in consecutive patients with epidermal growth factor receptor (EGFR) mutation at a single health system.</p><p><strong>Methods: </strong>The data were retrospectively collected from electronic medical records for all patients who were started on osimertinib for NSCLC at West Virginia University Health System. Prevalence of heart failure (HF), atrial fibrillation, and prolonged QT before and after starting osimertinib were calculated.</p><p><strong>Results: </strong>This study had 116 participants and the median age was 72 years. The frequency of each new cardiotoxicity was between 6% and 9%, and the overall percentage of patients who had developed any of the four cardiotoxicities while on osimertinib was 19.9%. The median time of follow-up was 477 days and the median time on osimertinib for all patients was 390 days. The strongest risk factor in predicting a new onset cardiac event was hypertension with a hazard ratio (HR) of 6.35 (confidence interval (CI) 1.48 to 27.23, p=0.013) and HR 5.36 (CI 1.23 to 23.39, p=0.025) in univariate and multivariate analysis respectively.</p><p><strong>Conclusion: </strong>Osimertinib appears to be associated with an increase in cardiac abnormalities. Given the association between this medication exposure and the observed cardiac toxicities, use of osimertinib may entail closer cardiac monitoring of electrocardiogram (ECG) and echocardiogram abnormalities.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}