FARMACIA HOSPITALARIA最新文献

{"title":"Pharmaceutical intervention for the reduction of risks associated with medications in patients with liver cirrhosis in primary care.","authors":"Andrea Rodríguez Esquíroz, Amaya Echeverría Gorriti, Marta Marín Marín, Lorea Sanz Álvarez, Patricia García González, Javier Gorricho Mendivil, Juan Úriz Otano, Javier Garjón Parra, Inés Aguinaga Ontoso","doi":"10.1016/j.farma.2026.04.012","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.012","url":null,"abstract":"<p><strong>Introduction: </strong>The presence of cirrhosis may require adjustment of medication doses or substitution with safer alternatives. Inadequate treatment can lead to medication-related problems, which in most cases are preventable. The objectives are to describe the implementation of a safety strategy involving a comprehensive medication review for patients with cirrhosis, and to evaluate the acceptance rate of the intervention.</p><p><strong>Methods: </strong>It is a study of the implementation of a medication risk minimization strategy. It consisted of a medication review by hospital pharmacists, with clinical advice from a physician specializing in hepatology to patients in Primary Care.</p><p><strong>Results: </strong>307 patients were included, of whom 76.2% had at least one potentially inappropriate medication prescribed, with a safer alternative available in 87.2% of cases. Benzodiazepines and related drugs, proton pump inhibitors, and lipid-lowering drugs were the most frequently proposed, being benzodiazepines and related drugs the least modified by the physician. 48.1% of the 405 proposals were accepted.</p><p><strong>Conclusions: </strong>A high percentage of patients with cirrhosis were receiving inadequate treatments for their hepatic pathology, despite the availability of alternatives to minimize risks in most cases. Half of the pharmacists' recommendations were accepted and patient characteristics did not influence the acceptance rate of these proposals.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of immune checkpoint inhibitors for non-small cell lung cancer in a third level hospital.","authors":"Ana Álvarez-Yuste, María Pérez-Abánades, Ramón Colomer-Bosch, Irene Cuadrado-Berrocal, Jacobo Rogado-Revuelta, Tomás Gallego-Aranda, Ainhoa Aranguren-Oyarzábal","doi":"10.1016/j.farma.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.015","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effectiveness and cost-effectiveness of immune checkpoint inhibitors in patients with non-small cell lung cancer (NSCLC) in real-world clinical practice.</p><p><strong>Methods: </strong>A retrospective, single-center observational study including NSCLC patients treated with atezolizumab, durvalumab, nivolumab, and pembrolizumab between 2015 and 2023. Demographic, clinical, and treatment data, as well as adverse events, were recorded. Statistical analysis was performed using the R Core Team (2024) software.</p><p><strong>Results: </strong>In stage IV, pembrolizumab demonstrated the longest median overall survival (OS) at 15.49 months, compared to nivolumab (10.26 months) and atezolizumab (9.24 months). In stage III, pembrolizumab reached an OS median of 34.64 months, nivolumab 17.03 months, and atezolizumab 10.62 months. Durvalumab reached an OS median of 30.18 months. In stage IV, the Incremental Cost-Effectiveness Ratio (ICER) of pembrolizumab versus atezolizumab was €517.92 per month of life gained, and the ICER of pembrolizumab versus nivolumab was €512.66 per month of life gained. In stage III with palliative intent, the ICER of pembrolizumab versus atezolizumab was €135.76 per month of life gained, and the ICER of pembrolizumab versus nivolumab was €152.26 per month of life gained.</p><p><strong>Conclusions: </strong>Although real-world survival outcomes are lower than those reported in pivotal clinical trials, immunotherapy is established as an efficient strategy for the National Health System. All analyzed drugs were cost-effective in the hospital setting studied, falling below the efficiency thresholds proposed by the WHO for Spain (<€65,180/year). The sustainability of these high-budget-impact treatments depends on precise patient selection based on biomarkers and the implementation of dosage optimization strategies. There is a need for local economic evaluations to guide clinical and management decision-making.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence on the impact of treatment optimization on the safety of patients with liver cirrhosis.","authors":"Andrea Rodríguez Esquíroz, Javier Garjón Parra, Amaya Echeverría Gorriti, Lorea Sanz Álvarez, Marta Marín Marín, Inés Aguinaga Ontoso","doi":"10.1016/j.farma.2026.03.015","DOIUrl":"https://doi.org/10.1016/j.farma.2026.03.015","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of therapy optimization on medication-related safety in patients with liver cirrhosis.</p><p><strong>Method: </strong>Systematic review of clinical trials and before-and-after studies with time series analysis in CENTRAL, MEDLINE, and INAHTA databases. The certainty of the evidence was assessed using the GRADE approach, and the risk of bias was evaluated with the ROBUST-RCT tool.</p><p><strong>Results: </strong>Six articles were identified, all corresponding to a single randomized controlled trial (116 patients) that evaluated the effectiveness of a pharmacist-led intervention (medication reconciliation and individualized health education) compared to usual care. Although no significant differences were found in all-cause mortality or the crude relative risk of hospitalization, the adjusted incidence rate analysis revealed that the intervention significantly reduced unplanned hospitalizations by 48%. Furthermore, within the intervention group, each unit increase in the rate of high-risk medication-related problems was associated with more than three-fold higher odds of mortality, independently of disease severity.</p><p><strong>Conclusions: </strong>There is a current scarcity of high-quality studies in this field. Nevertheless, the available evidence suggests that pharmaceutical follow-up is an effective strategy to reduce preventable hospitalizations in outpatients with decompensated cirrhosis. Pharmacological safety is vital for survival, justifying the integration of the pharmacist into the clinical team.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Possible severe gastrointestinal toxicity following the first cycle of mirvetuximab soravtansine in a patient with high-grade serous ovarian carcinoma.","authors":"Carlota Rodríguez-Tenreiro Rodríguez, Alicia Caso González, Marina Muñoz Villasur, Lucía Roncero Sánchez, Ana Lozano Blázquez","doi":"10.1016/j.farma.2026.05.001","DOIUrl":"https://doi.org/10.1016/j.farma.2026.05.001","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the pharmacist in antimicrobial stewardship programs in critically ill patients.","authors":"Miguel Ángel Amor García, Irene Aquerreta González, Carla Bastida Fernández, Amaia Egüés Lugea, Sara Cobo Sacristán, Fernando Becerril Moreno, María Martín-Cerezuela, Esther Domingo Chiva, Tatiana Betancor García, Marta Albanell Fernández, Laura Doménech-Moral, Sara Ortiz Pérez, Aurora Fernández Polo","doi":"10.1016/j.farma.2026.04.014","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.014","url":null,"abstract":"<p><p>The design and implementation of antimicrobial stewardship programs for patients admitted to intensive care units must consider the specific characteristics of this population, including infection severity, organ dysfunction, and pharmacokinetic/pharmacodynamic alterations. The creation of a multidisciplinary team and the establishment of clear, targeted objectives are essential to improve treatment appropriateness, reduce the emergence of antimicrobial resistance, and ensure the sustainability of healthcare system. Pharmaceutical care contributes to the optimisation of antimicrobial use through antimicrobial therapy review, dose individualisation based on pharmacokinetic/pharmacodynamic parameters, and treatment monitoring, while also facilitating the development of systems for monitoring clinical outcomes, microbiology, and antimicrobial consumption.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Milrinone in aneurysmal subarachnoid hemorrhage: A long way ahead.","authors":"Begoña Guardiola, Jesús Antonio Sánchez-Martín, Jon Pérez-Bárcena, Juan Antonio Llompart-Pou","doi":"10.1016/j.farma.2026.04.016","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.016","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing strategies to mitigate psychotropic drug continuation post-ICU discharge: A critical perspective on the PSICU-ALTA protocol.","authors":"Parth Aphale, Himanshu Shekhar, Shashank Dokania","doi":"10.1016/j.farma.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.001","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guideline to radiopharmaceutical procedures for in vitro labeling of leukocytes.","authors":"Inmaculada Romero-Zayas, María de Arcocha-Torres, Iván Peñuelas, Elena Martínez Montalbán, María Carmen Plancha Masanet, Antonio de Jesús Fernández Sánchez, Juan Antonio Pérez Iruela","doi":"10.1016/j.farma.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.004","url":null,"abstract":"<p><p>This guide outlines the radiopharmaceutical procedure for the in vitro labelling of leukocytes. Scintigraphy using leukocytes labeled with [^99mTc]Tc-exametazime or [¹¹¹In]In-oxine is a highly valuable diagnostic tool in infectious and inflammatory diseases due to its high sensitivity and specificity. It is based on established guidelines and consensus protocols, which incorporate the recent Spanish regulations on the extemporaneous preparation of radiopharmaceuticals, this document provides detailed and precise instructions for the safe and effective preparation and quality control of in vitro labeled leukocytes. The clinical indications for leukocyte scintigraphy are described, along with the technical requirements for both facilities and equipment. The various stages of the radiolabelling procedure are developed and substantiated, including blood sample collection, leukocyte fraction separation and isolation, incubation and subsequent radiolabelling with either [^99mTc]Tc-exametazime or [¹¹¹In]In-oxine, radiopharmaceutical conditioning for administration, and the necessary quality control procedures. The document concludes with a section describing drug interactions reported in the literature. Two annexes are included, providing example labeling protocols for both radiopharmaceuticals.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orphan drug regulation: a global comparison of the United States Food and Drug Administration, European Medicines Agency, and Japanese pharmaceuticals and medical devices agency approaches.","authors":"Robinraja Elango, Russell Martin, Shivanand K Mutta","doi":"10.1016/j.farma.2026.04.003","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.003","url":null,"abstract":"<p><strong>Objective: </strong>To perform a comparative review of orphan drug policies and designation criteria implemented by the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), and Japan's Pharmaceuticals and Medical Devices Agency (PMDA), assessing their influence on development, approval, and access.</p><p><strong>Method: </strong>A targeted review of legislation, guidance documents, and peer-reviewed analyses from each regulatory body was conducted.</p><p><strong>Results: </strong>The FDA accelerates development via robust tax credits and seven-year market exclusivity, though high pricing remains challenging. The EMA emphasizes unmet medical needs and ten-year exclusivity, ensuring more homogeneous pricing despite slower approvals. Japan's PMDA utilizes specific subsidies and the Sakigake designation to counter \"drug loss\" and encourage innovation. Despite expedited pathways globally, significant disparities in affordability and patient access persist.</p><p><strong>Conclusions: </strong>While national incentives successfully boost orphan drug approvals, global access inequities remain unresolved. Harmonizing regulatory criteria and promoting international collaboration on evidence requirements are essential for equitable and sustainable access to rare disease therapies worldwide.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in hospitalized patients receiving palliative care: Do current tools cover all their needs?","authors":"Ivis Vinicius de Oliveira Martins, Igor Massocatto Marques, Felipe Augusto Trinca Alves da Silva, Maria Eduarda Marques Trinca, Lais Beanucci Coelho, Ana Maria Rosa Freato Gonçalves, Albert Figueras, Maria Olívia Barboza Zanetti, Leonardo Regis Leira Pereira, Maria Teresa Herdeiro, Fabiana Rossi Varallo","doi":"10.1016/j.farma.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.farma.2026.04.002","url":null,"abstract":"<p><strong>Introduction: </strong>Quality of life (QoL) is a central outcome in palliative care (PC), particularly in hospital settings, where patients often present with advanced illness, complex symptoms, and multidimensional needs. Accurate QoL assessment is essential to support patient-centered and family-centered decision-making; however, the diversity of available instruments and limited validation beyond oncology populations pose challenges for their clinical and research use.</p><p><strong>Objectives: </strong>We aimed to identify tools measuring QoL in hospitalized PC patients, highlighting their domains and psychometric properties.</p><p><strong>Methods: </strong>A scoping review was conducted following Joanna Briggs Institute guidelines and the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched MEDLINE (PubMed), CINAHL, EMBASE, The Cochrane Library, Scopus, Web of Science, Google Scholar, and LILACS from inception until April 11, 2025. Independent reviewers assessed eligibility, extracted data, and evaluated risk of bias.</p><p><strong>Results: </strong>Of 6026 studies retrieved, after removing duplicates (n = 1680) and full-text screening (n = 17), 12 met inclusion criteria, including 5 validation, 5 observational studies and 2 clinical trials. Eight tools were identified, most originally developed for advanced-stage conditions and applied in high-income countries. Main domains included physical comfort (n = 7), psychological well-being (n = 7), and spiritual well-being (n = 7). Quality of death was assessed in one instrument. Two instruments were validated for Brazilian Portuguese, primarily for cancer patients. Frequently reported psychometric properties were face validity (n = 9), content validity (n = 6), and construct validity (n = 6).</p><p><strong>Conclusion: </strong>No gold-standard instrument exists for measuring QoL in PC. Selection should consider patient and family preferences, health status, prognosis, life expectancy, and intended use. Findings highlight the need for psychometrically robust instruments applicable across disease stages and conditions. Incorporation of death preparedness, quality of death, and patient- and family-centered outcomes remains limited but is important to guide individualized, safe, and equitable hospital-based PC.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}