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

{"title":"Colchicine-enzalutamide interaction: clinical implications and multi-disciplinary management.","authors":"Ana Isabel Cachafeiro Pin, Lucía Grandío Leivas, Francisco Caramés Masana, Alicia Folgar Torres, Maria Alejandra Naranjo Sánchez","doi":"10.1136/ejhpharm-2024-004459","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004459","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364156","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":"Managing refractory cytomegalovirus in an immunosuppressed patient with sarcoidosis: a case report on maribavir therapy.","authors":"Maria Antonia Meroño Saura, María Garcia Coronel, Lorena Rentero-Redondo, Elena Urbieta-Sanz","doi":"10.1136/ejhpharm-2024-004445","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004445","url":null,"abstract":"<p><p>Cytomegalovirus (CMV) is a common herpesvirus that can cause severe infections in immunocompromised patients. Standard treatments, such as ganciclovir and valganciclovir, are usually effective, but refractory CMV requires alternatives like foscarnet, cidofovir, or immunotherapies. New treatments, such as maribavir, have shown promise for refractory cases. This report discusses a woman in her 50s with sarcoidosis, previously treated with infliximab, leflunomide, and hydroxychloroquine, who developed refractory CMV. Initial treatment with ganciclovir and intravenous immunoglobulin (IVIG) was discontinued due to severe pancytopenia, leading to the initiation of foscarnet. Despite this, CMV viremia persisted, leading to off-label use of maribavir, which reduced the viral load with mild gastrointestinal side effects. The patient also developed haemophagocytic syndrome, complicating her condition.Unfortunately, she succumbed to an opportunistic infection, leaving the complete efficacy of maribavir unconfirmed. This case highlights the potential of novel antiviral agents and underscores the need for further research on refractory CMV management.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364186","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":"https://doi.org/10.1136/ejhpharm-2024-004463","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","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":"Improve quality of care in hospital-at-home by implementing medication reconciliation on admission: a retrospective observational study.","authors":"Julien Billotte, Carmichäel Ramambason, Daniela Marquet, Laura Foucault-Fruchard","doi":"10.1136/ejhpharm-2024-004326","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004326","url":null,"abstract":"<p><strong>Objectives: </strong>Medication reconciliation (MR) has been identified by the French High Health Authority (HHA) as an advanced criterion for improving the quality of care. Although this activity has been widely developed and evaluated in conventional establishments, few studies have looked at its implementation in 'hospitalisation at home' (HAH) settings. HAH is considered to be an alternative to conventional hospitalisation that requires slight changes to be made to the medication process, such as the prominent role of the patient and their caregivers, the intermittent presence of numerous members of multidisciplinary staff in the home environment, and the patient's own home. So, this study aims to provide an overview of the implementation of MR in our HAH using activity indicators, and to measure the clinical impact of the pharmaceutical procedures carried out as part of this activity.</p><p><strong>Methods: </strong>A retrospective observational study was conducted. A process and MR materials were developed based on HHA tools. The clinical impact of the pharmaceutical procedure was determined using the Clinical Economic and Organisational (CLEO) scale.</p><p><strong>Results: </strong>29 patients benefited from MR on admission, carried out by a pharmacy intern with a pharmacy assistant. A total of 38 unintentional discrepancies were identified. The average number of unintentional discrepancies per patient with at least one unintentional discrepancy in their MR was 2.1. The mean time to complete MR was 2.5 hours. 30 (79%) pharmaceutical procedures were accepted by the clinicians, of which 6 (20%) were considered to have a major clinical impact.</p><p><strong>Conclusion: </strong>MR for hospitalised patients at home is valuable to ensure safe medication management at this stage of the care pathway. Despite the small sample size of our study, each pharmaceutical procedure has a significant clinical impact. This activity contributed to the certification of our home care facility by the French HHA.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188631","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":"Extravasation of enfortumab vedotin: a case report and literature review on antibody-drug conjugates.","authors":"Stefania Pipitone, Maria Giuseppa Vitale, Cinzia Baldessari, Roberto Sabbatini, Massimo Dominici, Carla Porretta Serapiglia, Lucia Ricchi, Marianna Rivasi","doi":"10.1136/ejhpharm-2024-004323","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004323","url":null,"abstract":"<p><p>Enfortumab vedotin (EV) is an antibody-drug conjugate (ADC) indicated for advanced or metastatic urothelial carcinoma. We describe a case of EV extravasation in a patient with metastatic bladder cancer. The extravasation area appeared swollen without clinical evidence of acute severe toxicity. Guided by the presence of monomethyl-auristatin E (MMAE) component in EV's structure, prompt management of extravasation includes the administration of a subcutaneous injection of the enzyme hyaluronidase, along with the application of warm compresses and elevation of the affected limb. Due to EV vesicant properties, special precautions should be taken in cases of extravasation. Based on the positive outcomes observed, immediate infiltration of hyaluronidase, application of a warm compress, and limb elevation are recommended. Timely recognition of extravasation and prompt initiation of treatment help to minimise the occurrence of severe complications for patients. Further comprehensive guidelines with clear instructions for managing ADC extravasation are necessary for optimal patient care.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188626","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":"K-means clustering to identify high risk of early revisits in patients with drug-related problems attending the emergency department.","authors":"Jesus Ruiz-Ramos, Adrián Plaza-Diáz, Mireia Puig-Campmany, Caterina Sampol-Mayol, Marta Blázquez-Andión, Alicia Serrano-García-Calvo, Natalia Sanz-López, Xenia Acebes-Roldán, Ana Juanes-Borrego","doi":"10.1136/ejhpharm-2024-004414","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004414","url":null,"abstract":"<p><strong>Objective: </strong>Drug-related problems (DRPs) are a frequent reason for visits to the emergency department (ED). However, data about the characteristics associated with early revisits are limited. We aimed to identify clinical phenotype clusters of patients admitted to emergency rooms due DRPs to identify those patients with the highest risk of new visits.</p><p><strong>Methods: </strong>We included consecutive patients admitted to EDs due DRPs (February 2021 to December 2022), including DRP admissions in 2023 as validation cohort. We employed K-means clustering to group patients according to adjusted morbidity groups (GMA), age, and number of drugs at admission. To determine the optimal number of cluster centres, we used the elbow method. The impact of 30-day revisits in each cluster was assessed.</p><p><strong>Results: </strong>1611 patients (mean (SD) age 75.0 (15.1) years) were included. We identified six clusters, with 30-day revisits rates ranging from 14.8% to 24.5%. The main groups of drugs implicated in the DRP episodes were diuretics (190 patients; 11.8%). The most common DRP diagnoses were constipation (191; 11.9%) and gastrointestinal bleeding (158; 9.8%). Six clusters of patients were identified. Significantly higher 30-day revisits in patients identified in cluster 4 (24.5% vs 17.5%; p=0.007). The highest revisit rate was observed in the cluster including patients with a higher number of drugs and GMA status.</p><p><strong>Conclusions: </strong>Patients admitted to the ED due DRPs exhibit varying revisit rates across different clinical phenotypes. K-means clustering aids in identifying patients who derive the greatest rates of readmission, and is a useful tool to prioritise interventions in these units.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188639","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":"Monitoring of occupational exposure to hazardous medicinal products in robotic compounding.","authors":"Ana C Riestra, Mikel Urretavizcaya, Alexander Ferro Uriguen, Olatz Olariaga Sarasola, Ainara Iglesias, Yoana Camba, Ainhoa Asensio Bermejo, Maria Jose Tames","doi":"10.1136/ejhpharm-2024-004294","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004294","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the risk of occupational exposure to hazardous medicinal products (HMPs) when utilising robotic compounding systems for the preparation of antineoplastic sterile medications. Specifically, it assesses the levels of HMPs present on the surfaces of ready-to-use preparations and on the gloves worn by personnel involved in the compounding process.</p><p><strong>Methods: </strong>The study was conducted over three consecutive days during routine production with a robotic compounding system. Each day, wipe samples were collected from the surfaces of 20 HMPs preparations and from the gloves of the operator involved in the compounding process. Analyses were performed using an Ultra-High Performance Liquid Chromatography (UHPLC) system to detect and quantify 25 commonly used anticancer molecules in hospital pharmacies.</p><p><strong>Results: </strong>Throughout the study, the robot compounded 60 bags of 19 different drugs, including 5-fluorouracil, bevacizumab, carboplatin, cisplatin, cyclophosphamide, docetaxel, doxorubicin, eribulin, etoposide, gemcitabine, irinotecan, nivolumab, oxaliplatin, paclitaxel, panitumumab, pembrolizumab, pemetrexed, trastuzumab, and vinorelbine. Only negligible amounts of gemcitabine, below the quantification limit (<0.0025 ng/cm²), were detected on the surfaces of 10 out of the 60 bags and on two of the operator's gloves.</p><p><strong>Conclusion: </strong>The results demonstrate that surface contamination levels of HMPs in robotic compounding are exceedingly low and, in most cases, undetectable. Occupational exposure to HMPs remains consistently below 0.1 ng/cm², a threshold deemed safe according to various studies. These findings assure the safety of compounding personnel and other hospital staff involved in cancer treatment.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074359","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":"2025-01-31","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}

{"title":"Influence of volume and citrate on perceived pain in patients treated with adalimumab.","authors":"Aron Misa-Garcia, Sara Ferro-Rodríguez, Lola Haro-Martín, Iván Cavero-Redondo","doi":"10.1136/ejhpharm-2024-004379","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004379","url":null,"abstract":"<p><strong>Background: </strong>Immune-mediated inflammatory diseases (IMIDs) are a group of disorders characterised by acute or chronic inflammation. Adalimumab and infliximab are the cornerstones of their pharmacotherapy. This study aimed to determine whether variations in the volume and citrate content of different subcutaneous adalimumab formulations result in differences in pain perception during administration.</p><p><strong>Methods: </strong>A retrospective, cross-cohort study was conducted. Patients who had experienced a change in subcutaneous adalimumab formulation in the past year were recruited. Pain perception was evaluated using a visual analogue scale ranging from 1 to 10 points. Patients were assigned to three groups based on the type of formulation change they experienced: reduction in citrate and volume, reduction in volume only or reduction in citrate only. Data were analysed via ANOVA to determine if there were differences in perceived pain among the three patient groups.</p><p><strong>Results: </strong>A total of 68 patients were included, of whom 39 (57.4%) experienced a reduction in both volume and citrate, 20 (29.4%) experienced only a reduction in volume and 9 (13.2%) experienced only a reduction in citrate. Analysis showed that all three groups experienced a reduction in perceived pain during administration: 2.46±0.24, 0.3±0.57 and 0.66±1.11 points, respectively (p<0.001).</p><p><strong>Conclusions: </strong>Our results show that in all three scenarios, perceived pain was reduced. If both volume and citrate are reduced, this effect is greater. Therefore, it is recommended to use formulations with the lowest citrate buffer concentration and the lowest possible volume to minimise pain during adalimumab administration.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074358","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":"Physical compatibility of insulin aspart, lidocaine, alprostadil and vancomycin with individualised two-in-one parenteral nutrition used in the neonatal intensive care unit.","authors":"Thomas G Van Gelder, Daniël Vergoossen, Inge A Zonnenberg, Arief Lalmohamed, Marloes I Koole-Oostveen, Elisabeth M L van Reij, Arjen van Loon, Toine C G Egberts","doi":"10.1136/ejhpharm-2024-004300","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004300","url":null,"abstract":"<p><strong>Objectives: </strong>Critically ill newborn infants often require simultaneous administration of multiple intravenous (IV) solutions through the same catheter lumen, making compatibility of these solutions crucial in neonatal intensive care units (NICUs). This study aimed to investigate the physical compatibility of insulin aspart, lidocaine, alprostadil and vancomycin with individualised two-in-one parenteral nutrition (PN).</p><p><strong>Methods: </strong>The study was conducted at the hospital pharmacy's drug compounding facility of the University Medical Centre Utrecht. Two PN formulations were prepared with different electrolyte concentrations (PN1 with high electrolytes and PN2 with low electrolytes), each with either 0% or 30% w/v glucose, resulting in four solutions for testing. Each solution was then mixed with the selected IV drugs in a 1:1 ratio. Compatibility was assessed through visible particle testing, pH measurements and subvisible particle testing at multiple time points (T=0, T=1, T=4 hours).</p><p><strong>Results: </strong>No visible particles were detected in any combinations. However, insulin and lidocaine combinations exceeded the subvisible particle threshold of 6000 particles ≥10 µm per container volume at T=0 hours, with insulin also exceeding the threshold in a specific PN combination at T=4 hours. pH measurements indicated minimal shifts in the PN solutions, suggesting significant buffering capacity.</p><p><strong>Conclusion: </strong>Alprostadil and vancomycin IV solutions are physically compatible with two individualised neonatal PN solutions, with high as well as low glucose concentrations. Combinations of PN with lidocaine or insulin form subvisible particles, which could have clinical implications if administered in large volumes over extended periods of time. In clinical scenarios where there is no other option but to administer lidocaine or insulin through the same catheter lumen as PN using a Y-site connector, the use of an in-line filter is advised. Our study adds important compatibility data that can guide clinical practice in NICU settings. However, the broader application of these results requires careful consideration of the unique characteristics of each neonatal PN solution and drug combination.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037668","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}