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

{"title":"Maintaining appropriate stocks in an operating room pharmaceutical unit: risk mapping of the supply chain.","authors":"Caroline Figeac, Cordélia Salomez-Ihl, Rémi Toth, Virginie Filisetti, Assia Daikh, Philippe Py, Delphine Schmitt, Pierrick Bedouch","doi":"10.1136/ejhpharm-2025-004588","DOIUrl":"10.1136/ejhpharm-2025-004588","url":null,"abstract":"<p><strong>Objectives: </strong>Supply chain management is a major challenge for hospital pharmacists, particularly in minimising stock-outs and their impact on patient care. This study aimed to map the risks associated with the supply chain of sterile medical devices in the operating room using a patient-centred approach.</p><p><strong>Methods: </strong>Risk analysis, conducted using the 'failure modes and effects analysis' approach, took place in 2024. It focused on the sterile medical devices supply chain within an operating room pharmaceutical unit. A multidisciplinary working group developed a risk map for stock discrepancies in four stages: identification of risks, risk rating based on occurrence and severity, listing of control measures and prioritisation of risks.</p><p><strong>Results: </strong>The risk analysis identified 52 risks across seven subprocesses, with 10% of these risks classified as priority. These priority risks mainly involved the emergency dispensing of equipment in the operating room, the scheduled provision of medical devices through the preparation of case carts, and the storage of products in the pharmaceutical unit. Key areas for improvement included staff training, enhancing software expertise and strengthening quality assurance.</p><p><strong>Conclusions: </strong>This study presents the first risk map of stock errors for health products in a hospital setting. This approach is applicable to other supply chains in healthcare. Effective risk management depends on a collective effort and the engagement of all stakeholders. Optimising stock management is critical in enhancing the quality and safety of care provided to patients.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872143","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":"Safeguarding drug safety: addressing duplicates in pharmacovigilance reporting.","authors":"Eleonora Castellana, Maria Rachele Chiappetta","doi":"10.1136/ejhpharm-2025-004663","DOIUrl":"10.1136/ejhpharm-2025-004663","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872144","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":"Stability of alglucosidase alfa in 0.9% sodium chloride for enzyme replacement therapy in patients with Pompe disease: insights from enzyme activity and cellular uptake measurements.","authors":"Ina Barzel, Jan-Dietert C Brugma, Edwin H Jacobs, Marianne Hoogeveen-Westerveld, P Hugo M van der Kuy, Tim Preijers","doi":"10.1136/ejhpharm-2025-004516","DOIUrl":"https://doi.org/10.1136/ejhpharm-2025-004516","url":null,"abstract":"<p><strong>Objectives: </strong>Enzyme replacement therapy (ERT) with alglucosidase alfa is the cornerstone of treatment for Pompe disease, a rare disorder caused by acid α-glucosidase (GAA) deficiency. Since 2008, home infusions have been provided in the Netherlands. However, the short shelf-life of the ready-to-administer infusions poses challenges for manufacturing and dispensing pharmacies. This study assessed the stability of ready-to-administer alglucosidase alfa infusions by determining enzyme activity and cellular uptake of two concentrations during 11 days of storage.</p><p><strong>Methods: </strong>Alglucosidase alfa infusions (2 and 4 mg/mL in 0.9% sodium chloride) were prepared and samples were drawn on days 1 to 7 and 11. Enzyme activity was determined using 4-methylumbelliferyl-α-D-glucoside (4MU-αGlc) and glycogen as substrates. Additionally, enzyme uptake in cultured fibroblasts was investigated.</p><p><strong>Results: </strong>There was no difference in enzyme activity after 11 days as compared with day 1 using 4MU-αGlc (2 mg/mL: 352 vs 331 nmol/h/mL; 4 mg/mL: 657 vs 662 nmol/h/mL) or glycogen (2 mg/mL: 183 vs 176 nmol/h/mL; 4 mg/mL: 352 vs 357 nmol/h/mL). Uptake of alglucosidase alfa in fibroblasts remained stable over 11 days, with activity ranging from 90 to 104 nmol/h/mL at 2 mg/mL and from 233 to 238 nmol/h/mL at 4 mg/mL. Linear regression analysis confirmed no statistically significant association between time and enzyme activity or uptake.</p><p><strong>Conclusions: </strong>Ready-to-administer alglucosidase alfa infusion in 0.9% sodium chloride at 2-4 mg/mL is stable for 11 days when stored at 2-8°C or -20°C and protected from light. Extending the stability could enhance efficiency and flexibility for infusion preparation and home delivery, while minimising pharmaceutical waste.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872145","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":"Optimisation of voriconazole treatment in paediatric patients with <i>Aspergillus flavus</i> fungal endocarditis: a pharmacokinetics case report.","authors":"Mario Rodenas-Rovira, Mayte Gil-Candel, Inés Burgos-Berjillos, Catalina Montoya-Tamayo, Javier Garcia-Pellicer, José Luis Poveda-Andrés","doi":"10.1136/ejhpharm-2024-004425","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004425","url":null,"abstract":"<p><p>The case study presented involves a paediatric patient treated with voriconazole for fungal endocarditis caused by <i>Aspergillus flavus</i> Therapeutic plasma concentrations of voriconazole could not be achieved with the established dosing regimen and administration frequency. In response to this situation, and after successive dose increases and a pharmacogenetic analysis that confirmed the patient was not a CYP2C19 or CYP2C9 rapid or ultra-rapid metaboliser, a new administration frequency of every 8 hours was proposed, with limited evidence, but which allowed achieving target concentrations and patient improvement. This study highlights the importance of voriconazole monitoring, especially in paediatric patients, given the wide variety of factors that can alter its plasma concentrations. The study also calls for future studies to evaluate the utility of an 8 hourly dosing regimen, providing the possibility of avoiding switching voriconazole to another antifungal with less evidence in the paediatric population, a relevant issue in terms of resistance.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820991","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":"Organisational impact of in vivo gene therapies at two French injection centres.","authors":"Sylvain Auvity, Franck Bienvenot, Flavien Pallard, Nadir Mammar, Valentine Famelart, Jeremie Rudant, Nicolas Cormier","doi":"10.1136/ejhpharm-2024-004370","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004370","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to estimate the main hospital organisational impacts of in vivo gene therapy medicine (GTM) deployment, experienced during clinical trials, with a focus on hospital pharmacy.</p><p><strong>Methods: </strong>Interviews were performed with 11 healthcare professionals involved in three clinical trials, as was an active field observation.</p><p><strong>Results: </strong>Interviews showed high impact for the management of hospital beds and human resources. Moderate impact concerned facilities/equipment, coordination between stakeholders and training/software. The total cumulative working time of the pharmacy staff, estimated at 11.12 and 11.67 hours in the two centres for a single GTM, has been identified as the main limiting factor for the pharmacy.</p><p><strong>Conclusions: </strong>This study showed that major organisational impacts of in vivo GTMs in injection centres concern hospital bed and pharmaceutical staff management, rather than technical and operational aspects. Overall, no more than 150 GTMs could be prepared each year by one pharmacist and one technician.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729010","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":"Medication adherence interventions: where are we and where do we go?","authors":"Tommy Eriksson, Patrik Midlöv","doi":"10.1136/ejhpharm-2025-004650","DOIUrl":"https://doi.org/10.1136/ejhpharm-2025-004650","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706876","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":"Risk factors for unintentional medication discrepancies identified through pharmacy staff-led medication reconciliation to prioritise patients in the emergency department: a rapid review.","authors":"Busra Dinc, Charlotte Olesen, Faruk Coric, Helle Houlbjerg Carlsen","doi":"10.1136/ejhpharm-2025-004526","DOIUrl":"https://doi.org/10.1136/ejhpharm-2025-004526","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify the risk factors associated with unintentional medication discrepancies identified through pharmacy staff-led medication reconciliation in emergency departments across multiple countries. The long-term goal is to support the development of a model to systematically prioritise patients at high risk in these settings.</p><p><strong>Methods: </strong>This rapid review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A literature search of the PubMed database was performed on 8 October 2024. Studies were selected based on predefined eligibility criteria defined by the PICO framework- Population: adult emergency patients (aged ≥18 years) admitted to the emergency department; Intervention: medication reconciliation conducted by pharmacy staff; Comparator: standard medication reconciliation or standard care; Outcome: risk factors for unintentional medication discrepancies identified through pharmacy staff-led medication reconciliation in the emergency department. All included studies were qualitatively assessed.</p><p><strong>Results: </strong>The literature search yielded 433 citations, of which 15 studies met the eligibility criteria. The included studies primarily investigated patient, medication and setting-related risk factors, encompassing a total of 15 264 patients who received pharmacy staff-led medication reconciliation in emergency departments across seven countries. A consistent pattern of risk factors emerged, including advanced age and polypharmacy. Only one study found that admissions during night-time or weekend hours were significantly associated with medication discrepancies. Differences in health IT systems and reconciliation practices were also noted across countries.</p><p><strong>Conclusions: </strong>Advanced age and polypharmacy were consistently associated with unintentional medication discrepancies. Future research should address variations in health IT systems and focus on developing robust prioritisation models to optimise medication reconciliation processes and improve patient safety. Increasing pharmacy staff capacity may further support this goal.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689608","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 using different renal function estimation equations on vancomycin dosing.","authors":"Laura Gratacós, Dolors Soy-Muner","doi":"10.1136/ejhpharm-2025-004590","DOIUrl":"https://doi.org/10.1136/ejhpharm-2025-004590","url":null,"abstract":"<p><strong>Objectives: </strong>To assess which of the formulae for estimating renal function (Cockcroft-Gault (CG), Chronic Kidney Disease Epidemiology Collaboration CKD-EPI) and Modification of Diet in Renal Disease (MDRD)) provides the most accurate prediction of minimum vancomycin concentration (Cmin) and to evaluate whether they can be interchanged to optimise vancomycin dosage.</p><p><strong>Methods: </strong>An observational and retrospective study was undertaken in hospitalised adult patients treated with intravenous vancomycin. Patients with serum creatinine (Scr) >2 mg/dL and <0.5 mg/dL, body mass index >40 kg/m², need for extracorporeal clearance techniques and unstable renal function were excluded. Bayesian analysis was used to obtain individual pharmacokinetic parameters. Vancomycin clearance (CLvan) was calculated by means of CG (eCLvan_CG), CKD-EPI (eCLvan_CKD-EPI) and MDRD (eCLvan_MDRD) and used to obtain Cmin estimates (eCmin). eCmin and observed Cmin were compared using an intraclass correlation coefficient (ICC). A post-hoc analysis by subgroups (age, sex, weight, Scr and estimated glomerular filtration rate (eGFR)) was performed. From each eCLvan, the area under the curve (AUC) was calculated and categorised as AUC <400 mg*hour/L, AUC 400-600 mg*hour/L and AUC >600 mg*hour/L. The kappa coefficient was applied to study AUC concordance.</p><p><strong>Results: </strong>A total of 228 patients (69.3% men) were included. eCmin_CG had a statistically significant better agreement with Cmin (ICC >0.7) and showed good agreement in almost all subgroups. Patients with Scr >1.1 mg/dL were the only subgroup in which eCmin_MDRD and eCmin_CKD-EPI had an adequate ICC with no statistically significant differences compared with eCmin_CG. eCmin_MDRD had a similar ICC to eCmin_CG in the eGFR <60 mL/min and age 46-75 years subgroups. Kappa values showed regular agreement in all subgroups: 0.32 (AUC <400 mg*hour/L), 0.24 (AUC 400-600 mg*hour/L) and 0.41 (AUC >600 mg*hour/L).</p><p><strong>Conclusions: </strong>The CG formula provides the most accurate prediction of vancomycin Cmin. In patients with eGFR <60 mL/min and aged 46-75 years, MDRD also shows a good predictive capacity. However, in low weight and elderly patients, Cmin predictions are superior with CG. Therefore, renal function estimation equations should not be considered interchangeable for vancomycin dose adjustments.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667484","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 artificial intelligence into the hospital supply chain to ensure the availability of medications.","authors":"Esteban Zavaleta-Monestel, Sebastian Arguedas-Chacon, Ernesto Martinez-Vargas, Jeaustin Mora-Jimenez, Kevin Cruz-Mora, Jorge Arturo Villalobos-Madriz","doi":"10.1136/ejhpharm-2025-004635","DOIUrl":"https://doi.org/10.1136/ejhpharm-2025-004635","url":null,"abstract":"","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648902","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":"Therapeutic options carried out after hypersensitivity reactions to chemotherapy: the value of skin tests.","authors":"Auriane Blanchet, Julien Robert, Catherine Devys, Morgane Collet, Jeremy Sorrieul","doi":"10.1136/ejhpharm-2024-004387","DOIUrl":"https://doi.org/10.1136/ejhpharm-2024-004387","url":null,"abstract":"<p><strong>Introduction: </strong>Hypersensitivity reactions (HSRs) to chemotherapy agents constitute a real challenge for cancer treatment. Skin tests (STs) can help risk-stratify patients after initial HSRs and identify cross-reactions between chemotherapeutic agents.</p><p><strong>Objective: </strong>This study aimed to assess the value of STs in an integrative cancer centre to address the treatment of patients with suspicion of HSRs to platinum salts (carboplatin, oxaliplatin, cisplatin), and taxanes (paclitaxel, docetaxel).</p><p><strong>Methods: </strong>This single-centre, retrospective study was conducted on data collected from hospital medical records between August 2018 and December 2023. STs (prick tests and intradermal tests) were performed according to the recommendations of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology. The concordance between the allergist's recommendations and the therapeutic strategies implemented in clinical practice following ST results was evaluated.</p><p><strong>Results: </strong>Among the 105 patients included (76 females, 29 males), the positive ST rate was 61%. In total, 71% of the reactions to platinum salts (n=82) were identified as allergies versus 26% for taxane reactions (n=23). We found a cross-reactivity of 34.5% for platinum salts and 66.7% for taxanes. The allergist's recommendations were carried out in practice for a total of 56 patients (53%). For 47 patients (45%), a clinical reason justified not following the allergist's recommendations and discontinuing treatment.</p><p><strong>Conclusion: </strong>This study confirms the relevance of STs to help oncologists guide treatment strategies after a presumed allergy. As part of the allergological work-up, STs help prevent unnecessary changes to chemotherapy lines in patients with unproven allergies and facilitate the identification of alternative treatments following HSRs. In practice in our centre, allergists' propositions are carried out as much as possible to guide the re-exposure strategy in patient care.</p>","PeriodicalId":12050,"journal":{"name":"European journal of hospital pharmacy : science and practice","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636619","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}