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

{"title":"Why are we still overlooking adherence in clinical trials? A call to extend medication adherence-enhancing interventions and monitoring beyond real-world practice.","authors":"Andrej Belančić, Almir Fajkić, Ines Potočnjak","doi":"10.1136/ejhpharm-2025-004709","DOIUrl":"https://doi.org/10.1136/ejhpharm-2025-004709","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947831","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":"Realising potential and addressing risk: a UK survey of adult hepatology pharmacy services.","authors":"Sital Shah, Claire Bullen, Dane Howard, Fatema Jessa, Georgina Tucker, Helen Boothman","doi":"10.1136/ejhpharm-2025-004625","DOIUrl":"https://doi.org/10.1136/ejhpharm-2025-004625","url":null,"abstract":"<p><strong>Objective: </strong>The pharmacy workforce in areas such as critical care and renal services has been well described, but little is known about the UK hepatology pharmacy workforce, service provision and capability. Our objective was to understand the current workforce in terms of staffing levels, skill mix, roles and risks.</p><p><strong>Method: </strong>We conducted a multicentre, cross-sectional electronic survey inviting one pharmacy professional response per UK centre providing hepatology pharmacy services. We collated information on workforce, service provision and pharmaceutical care activities provided by pharmacy teams in hepatology specialities.</p><p><strong>Results: </strong>Seventeen centres responded to this survey, which was composed of five (29%) district general hospitals, two (12%) providing both secondary and tertiary level hepatology services, three (18%) secondary care centres and seven (41%) centres providing tertiary level care. There are a greater number of posts in tertiary level care centres irrespective of inpatient beds covered. Consultant pharmacists were only present in tertiary level care centres. A large portion of pharmacy time is spent on indirect pharmaceutical care, which ranged from 10% to 50%. Overall, 75% of respondents felt that their team's workload was safe, though this was only 45% in district general hospitals.</p><p><strong>Conclusion: </strong>Clinical hepatology pharmacy staffing levels vary across the UK. Recognition and benchmarking are key across all levels of care to ensure this workforce remains sustainable given the increasing incidence of liver disease in the UK.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947870","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":"Insights on afatinib and toxic epidermal necrolysis/Stevens-Johnson syndrome.","authors":"Eleonora Castellana, Maria Rachele Chiappetta","doi":"10.1136/ejhpharm-2024-004463","DOIUrl":"10.1136/ejhpharm-2024-004463","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"491"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188635","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":"Comparison of sodium zirconium cyclosilicate and sodium polystyrene sulfonate in the treatment of acute hyperkalaemia.","authors":"Tommy Thai, Lisa Hong, Christopher Hauschild, Tomona Iso","doi":"10.1136/ejhpharm-2024-004374","DOIUrl":"10.1136/ejhpharm-2024-004374","url":null,"abstract":"<p><strong>Objective: </strong>Sodium polystyrene sulfonate (SPS) and sodium zirconium cyclosilicate (SZC) have been used for treating acute hyperkalaemia. The pharmacodynamic properties of SZC suggest greater theoretical utility in the acute setting than SPS, but there is no clear guidance on an optimal potassium binder. This study evaluated the efficacy of SZC and SPS in the treatment of acute hyperkalaemia.</p><p><strong>Methods: </strong>This retrospective cohort study included adult hospitalised patients who had acute hyperkalaemia (serum potassium level ≥5.5 mmol/L) and were treated with either SZC or SPS from April 2021 to August 2023. The primary outcome was time to first occurrence of potassium normalisation which was evaluated using Cox regression analysis. Secondary outcomes included potassium normalisation, serum potassium level trends, newly initiated dialysis following acute hyperkalaemia, in-hospital death and adverse events.</p><p><strong>Results: </strong>The study included 46 patients with 17 in the SZC group and 29 in the SPS group. Potassium normalisation was attained in 16 (94%) in the SZC group and 27 (93%) in the SPS group and, of those, five (29%) in the SZC group and five (17%) in the SPS group attained normal potassium levels within 8 hours (HR 1.91, 95% CI 0.55 to 6.56).</p><p><strong>Conclusion: </strong>Statistically, neither SZC nor SPS was more efficacious; however, the quicker onset of SZC could provide a clinically meaningful difference in the treatment of acute hyperkalaemia.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"456-460"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964291","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":"Losartan potassium liquid formulation for paediatric hospital use: development and stability evaluation.","authors":"Augusto César Corte, Caren Gobetti, Graciela Carlos, Sílvia Helena de Oliveira Almeida, Márcio Vinícius Ayres, Martin Steppe, Cassia Virginia Garcia","doi":"10.1136/ejhpharm-2023-004026","DOIUrl":"10.1136/ejhpharm-2023-004026","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop a liquid oral formulation containing losartan potassium, an angiotensin II receptor antagonist drug used for its antihypertensive activity, and to perform a preliminary stability assessment under different temperatures and packages to ensure paediatric therapeutic adherence and facilitate the hospital routine.</p><p><strong>Methods: </strong>A syrup containing losartan potassium (1.0 and 2.5 mg/mL) (excipients: potassium sorbate, sucrose (85%), water, citric acid and raspberry flavouring) was prepared. The packaging was carried out in amber polyethylene terephthalate (PET) and amber glass bottles (in triplicate) under the following conditions: (a) room temperature (15-30°C); (b) refrigeration (2-8°C); and (c) oven temperature (40°C) for 28 days. An analytical method by high performance liquid chromatography using a reverse-phase column was also developed and validated for quantitative determination of the drug in the formulations.</p><p><strong>Results: </strong>The analytical method showed satisfactory linearity, detection and quantification limits, precision, accuracy and robustness. Samples at room temperature maintained content values between 90% and 110% for 7 days, while those stored under refrigeration maintained a homogeneous appearance and content between 90% and 110% for a period of 21 days. Values of pH stayed in a narrow range. Viscosity results were between 40.1 and 49.2 centipoise (cp) for glass bottles and 42.4 and 54.7 cp for PET bottles.</p><p><strong>Conclusions: </strong>A simple and economical losartan potassium liquid formulation was produced and was shown to be stable under refrigeration for 21 days in both PET and glass packages.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"474-478"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896411","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":"Patient reported medication-related problems, adherence and waste of oral anticancer medication over time.","authors":"Patricia M L A van den Bemt, Margriet Y Blijham, Laura Ten Broek, Jacqueline G Hugtenburg, Bart P H Pouls, Job F M van Boven, Charlotte L Bekker, Bart van den Bemt, Liset van Dijk","doi":"10.1136/ejhpharm-2024-004205","DOIUrl":"10.1136/ejhpharm-2024-004205","url":null,"abstract":"<p><strong>Objectives: </strong>Patients on oral anticancer therapy regularly experience medication-related problems (MRPs), potentially leading to non-adherence and medication waste. Most studies reporting these experiences have cross-sectional designs. The aim of our study was to explore patient reported MRPs, adherence and waste of oral anticancer medication over time.</p><p><strong>Methods: </strong>A prospective longitudinal quantitative interview study with 4 months follow-up was performed among patients on oral anticancer medication (mainly tyrosine kinase inhibitors, (anti)hormonal therapy, pyrimidine antagonists) using a semi-structured questionnaire. Patients from two Dutch university medical centres were included from March to December 2022 after informed consent was given. Four interviews were performed with 1 month in between. All interviews were audiotaped, after which the data were entered into an electronic case report form. The primary outcome was the mean number of MRPs per patient per interview round. Secondary outcomes were the proportion of patients with at least one MRP, types of MRPs, perceived non-adherence, medication waste (both in general and specifically for anticancer medication), costs of anticancer medication waste, and factors associated with medication waste as mentioned by the patient. Descriptive statistics were used to analyse the data.</p><p><strong>Results: </strong>Forty patients were included with a mean (SD) age of 64 (9) years; 43% were male. The mean number of MRPs per patient was 2.1 in the first interview and 1.2, 1.0 and 0.9 in the second, third and fourth interviews, respectively. Adverse drug reactions were the most frequently reported type of MRPs (30 (75%) patients in the first interview and 19 (65%) in the last interview). Unintentional non-adherence was regularly reported, especially in the first interview. Medication changes were frequent and associated medication waste was mentioned in all interviews.</p><p><strong>Conclusions: </strong>Many patients using oral anticancer treatment report MRPs and this number remains substantial over time.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"421-426"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633075","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 the use of a drug-drug interaction checker on pharmacist interventions involving well-known strong interactors.","authors":"Fanny Moreau, Bertrand Décaudin, Michel Tod, Pascal Odou, Nicolas Simon","doi":"10.1136/ejhpharm-2023-004052","DOIUrl":"10.1136/ejhpharm-2023-004052","url":null,"abstract":"<p><strong>Objectives: </strong>Several drug-drug interaction (DDI) checkers such as DDI-Predictor have been developed to detect and grade DDIs. DDI-Predictor gives an estimate of the magnitude of an interaction based on the ratio of areas under the curve. The objective of the present study was to analyse the frequencies of DDIs involving well-known strong interactors such as rifampicin and selective serotonin reuptake inhibitors (SSRIs), as reported by a clinical pharmacy team using DDI-Predictor, and the pharmacist intervention acceptance rate.</p><p><strong>Methods: </strong>The pharmacist intervention rate and the physician acceptance rate were calculated for DDIs involving rifampicin or the SSRIs fluoxetine, paroxetine, duloxetine and sertraline. The rates were compared with a bilateral χ² test or Fisher's exact test.</p><p><strong>Results: </strong>Of the 284 DDIs recorded, 38 (13.4%) involved rifampicin and 78 (27.5%) involved SSRIs. The pharmacist intervention rate differed significantly (68.4% for rifampicin vs 48.8% for SSRIs; p=0.045) but the physician acceptance rate did not (84.6% for rifampicin vs 81.6% for SSRIs; p=1). Pharmaceutical interventions for SSRIs were more frequent when the ratio of the area under the drug concentration versus time curve in DDI-Predictor was >2. Pharmacists were more likely to issue a pharmacist intervention for DDIs involving rifampicin because of a high perceived risk of treatment failure and were less likely to issue a pharmacist intervention for DDIs involving an SSRI, except when the suspected interaction was strong.</p><p><strong>Conclusions: </strong>DDI checkers can help pharmacists to manage DDIs involving strong interactors. DDIs involving strong inhibitors versus a strong inducer differ with regard to their intervention and acceptance rates, notably due to the estimation of the magnitude of the DDI.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"439-443"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975443","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":"Development of hospital clinical pharmacy services in Denmark from 2008 to 2023.","authors":"Christine Flagstad Bech, Trine Kart, Lene Juel Kjeldsen, Marianne Brøndum Petersen, Trine Rune Høgh Andersen","doi":"10.1136/ejhpharm-2024-004226","DOIUrl":"10.1136/ejhpharm-2024-004226","url":null,"abstract":"<p><strong>Objectives: </strong>The role of the hospital pharmacist is evolving, and in many countries pharmacists play an increasingly patient-centred role in healthcare. This study aimed to investigate the development of Danish hospital clinical pharmacy services from 2008 to 2023 and compare their current state to the European Association of Hospital Pharmacists (EAHP) statements of clinical pharmacy services.</p><p><strong>Methods: </strong>Four Danish reports describing the current state of clinical pharmacy in Danish hospitals released in 2008, 2013, 2019 and 2023 were analysed and compared. The reports' data were obtained through questionnaires sent to all hospital pharmacies in Denmark. Data on staff resources and the clinical pharmacy services provided by all hospital pharmacies were extracted, analysed using descriptive statistics and compared with the EAHP statements of hospital clinical pharmacy services.</p><p><strong>Results: </strong>The number of clinical pharmacists increased by 85% from 2008 to 2023, and the number of pharmaconomists (Danish title of a healthcare professional with responsibilities comparable to a pharmacy technician) increased by 59% from 2013 to 2023. In 2023, there were 2.77 pharmaconomists for every pharmacist employed. The pharmaconomist ratio/100 beds increased from 1.93 in 2013 to 3.92 in 2023. The pharmacist ratio/100 beds increased from 0.54 in 2008 to 1.41 in 2023. In 2023, the main patient-level services provided by pharmacists were medication reviews, medication histories and reconciliation, and dispensing and administration. The main pharmaconomist services were dispensing and administration, medication histories and reconciliation, and prescription reviews. The time spent on clinical pharmacy services shifted towards patient-level services over the years. Furthermore, clinical pharmacy services shifted towards greater fulfilment of the EAHP statements.</p><p><strong>Conclusions: </strong>By providing an overview and comparing Danish clinical pharmacy services to the EAHP statements, we have identified areas for further development, such as the hospital pharmacist being an integral part of all patient care teams, to guide future research and practice.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"407-412"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105827","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":"Combination of a propofol emulsion with alpha-2 adrenergic receptor agonists used for multimodal analgesia or sedation in intensive care units: a physicochemical stability study.","authors":"Marine Roche, Damien Rousseleau, Cécile Danel, Héloïse Henry, Gilles Lebuffe, Pascal Odou, Damien Lannoy, Nicolas Simon","doi":"10.1136/ejhpharm-2023-004027","DOIUrl":"10.1136/ejhpharm-2023-004027","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the physicochemical stability of the combination of a propofol emulsion with an alpha-2 (α2) adrenergic receptor agonist (α2A; clonidine or dexmedetomidine) under conditions mimicking routine practice in an intensive care unit or in multimodal analgesia procedures.</p><p><strong>Methods: </strong>We developed and validated three stability-indicating methods based on high-performance liquid chromatography with ultraviolet (HPLC-UV) detection. Eight different conditions per combination were evaluated in triplicate, with variations in the simulated, bodyweight-adjusted dose level and the drugs' flow rate. The drugs were mixed in clinically relevant concentrations and proportions and then stored unprotected from light, in clear glass vials at room temperature for 96 hours. At each sampling point, we assessed the chemical stability (the HPLC-UV drug level, pH, and osmolality) and physical compatibility (visual aspect, zeta potential (ZP), mean droplet diameter (MDD, Z-average) and polydispersity index (PDI)). We validated our stability findings in positive and negative control experiments.</p><p><strong>Results: </strong>Over the 96-hour test, the concentrations of propofol, clonidine and dexmedetomidine did not fall below 90% of the initial value, and the pH and osmolality were stable. The visual aspect of the mixed propofol emulsions did not change. The MDD remained below 500 nm (range 165-195 nm). The PDI was always below 0.4; 78.7% of the measurements were below 0.1 and 21.3% were between 0.1 and 0.4. The ZP measurements (-31.3 to -42.9 mV) suggested that the emulsion was stable. The MDD and PDI increased slightly at 96 hours under some conditions, which might indicate early destabilisation of the emulsion. Given that the MDD remained below 500 nm, these emulsions are compatible with intravenous administration.</p><p><strong>Conclusions: </strong>Our results demonstrate the chemical and physical compatibility of propofol-α2 agonist mixtures at concentrations and in proportions representative of standard protocols when stored unprotected from light at room temperature for 96 hours.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"461-467"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641857","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":"Evaluation of the appropriateness of vancomycin therapeutic drug monitoring in the intensive care unit with a clinical pharmacy approach, a cross-sectional study.","authors":"Sema Dinçel, Eren Demirpolat","doi":"10.1136/ejhpharm-2023-004073","DOIUrl":"10.1136/ejhpharm-2023-004073","url":null,"abstract":"<p><strong>Objectives: </strong>Vancomycin, a glycopeptide antibiotic has antibacterial activity against Gram-positive bacteria and is frequently used in the intensive care unit (ICU). Inappropriate therapeutic drug monitoring (TDM) of vancomycin is a common problem encountered in hospital daily practice. The aim of this study was to evaluate the appropriateness of vancomycin trough-guided TDM in patients treated in the ICU using a clinical pharmacy approach.</p><p><strong>Methods: </strong>The study was conducted retrospectively in patients over 18 years old who had at least one vancomycin trough level and who had received intravenous (IV) vancomycin for ≥3 days between 1 November 2020 and 1 April 2022. The study included 137 patients. Patient demographics and relevant vancomycin TDM data were collected from medical records. The appropriateness of TDM was evaluated according to the criteria established based on the monitoring recommendations specified in consensus guidelines for therapeutic drug monitoring of vancomycin published by the American Society of Health-System Pharmacists (ASHP) in 2009 and 2020.</p><p><strong>Results: </strong>Of a total of 238 vancomycin trough levels measured in patients, 32.4% were collected at an inappropriate time. When patients were evaluated in terms of TDM appropriateness according to vancomycin level ranges (<10 µg/mL, 10-20 µg/mL and >20 µg/mL), we found the appropriate TDM was significantly higher in the therapeutic range (10-20 µg/mL) (p <0.001). Of the total 238 vancomycin trough concentrations taken from patients, 77 (32.4%) were measured at an inappropriate time. This caused dose withholding, wrong adjustments and therapy failure. The total TDM appropriateness of vancomycin was significantly higher in the therapeutic range defined as 10-20 µg/mL when evaluated based on 'TDM appropriateness criteria' (p <0.001).</p><p><strong>Conclusion: </strong>Our study shows that appropriate vancomycin TDM increases the likelihood of achieving target trough concentrations. Involvement of clinical pharmacists in TDM management may prevent the development of adverse reactions by ensuring appropriate sampling time and appropriate interpretation of vancomycin levels.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":"468-473"},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247326","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}