Farmacia Hospitalaria (English Edition)最新文献

Objective

To quantify the Spanish Pharmacy and Therapeutics Commission (P&TC) activity with regard to assessing and selecting drugs and describing variability in decisions made to include them.

Method

Descriptive, cross-sectional study based on a questionnaire aimed at 513 hospitals with more than 75 beds. We included questions referring to the P&TC resolutions, the therapeutic positioning and assessment reports. Recruitment was carried out between November 2007 and January 2008. Variability among P&TC conclusions was presented in five categories or levels of coincidence.

Results

One hundred and seventy-five hospitals participated, with a response rate of 34% (54% of beds). The mean number of drug-indications assessed per hospital was 10.35 (7.45). The proportion of assessments that conclude with drug inclusion or rejection was 75.3% and 21.4%, respectively. 16.2% concluded with therapeutic equivalence. Conditions for use were established for 64% of them, and 33% were included in a clinical guide. With regard to variability, 81.0% of assessments coincided with the conclusion to include or reject the drug. A contradictory decision was made for 19.0%.

Conclusions

Drug assessment and selection in hospitals are considerable. The proportion of drugs approved is similar in different types of hospitals. There is extensive variability as regards deciding upon inclusion and is similar to studies conducted in other countries. They indicate that a standardising methodology would be recommendable.

Objective

To develop a Web 2.0 resource map and select those that may be useful in a Drug Information Centre at a Hospital Pharmacy Department (CIMSF).

Method

A multidisciplinary working group under the Biomedical Information Commission selected some of the Web 2.0 resources included in the Guía d’usos i estil a les xarxes Socials guide of the Catalonian Government.

Results

Six resources were selected: Netvibes, Delicious, Google groups, Google Docs, Slideshare and Twitter. These tools were used for 5 months to manage biomedical information for the medical staff, and to provide external visibility by providing information to other health professionals. More than a thousand hits were recorded on the portal Netvibes and more than 100 professionals followed CIMSF on Twitter.

Conclusions

The Web 2.0 offers useful, user-friendly and cost-efficient tools which could be implemented in a CIMSF, while also enabling participation in external networks of pharmacotherapeutic interest, increasing its visibility to other professionals.

Objective

To describe the efficacy, safety, compliance and cost savings of lopinavir/ritonavir monotherapy.

Method

Observational, descriptive and retrospective study evaluating monotherapy. Adherence was calculated using an objective method. We estimated the direct costs of dispensing non-triple therapy.

Results

We identified 17 patients. Interval adherence was >95% in 9 patients, 90%–95% in 2 patients, 90%–85% in 2 patients, and less than 85% in 4 patients. Viral load was undetectable during weeks 12, 24, 36, and 48, except in 2 patients. The CD4 count in most analytical tests remained at >350 cells/ml, only 1 patient had a lower figure. The average savings was 4819 Euros/patient/year (range 1116–8700).

Conclusions

In selected patients, monotherapy can be a cost-effective treatment option.

Objective

To describe the use and effectiveness of linezolid as an alternative treatment for methicillin-resistant Staphylococcus aureus.

Method

Demographic, clinical and safety data were collected from hospitalised patients. The information sources were the clinical records and the pharmacy programme.

Results

Thirty patients were treated with linezolid (median age 69.3, 63% male). The median duration of treatment was 8 days. The most prevalent indication was soft tissues and skin infections (46.7%). The indications were off-label in 40% of cases. Linezolid was used as a targeted therapy in 53%, especially for coagulase-negative Staphylococcus. Clinical healing occurred in 83.3% and microbiological healing in 40%. Three patients (10%) experienced side effects from using linezolid.

Conclusion

The effectiveness and safety of linezolid is similar to that described in the trials. Its off-label use and the high number of empirical treatments mean that new strategies must be developed.

Monitoring plasma levels of antiepileptic drugs for the treatment and prophylaxis of epilepsy is one of the strategies enabling clinical results to improve by reducing adverse affects and increasing effectiveness.

The objective of this article is to review the basic aspects in the monitoring of antiepileptic drugs using a consensus document prepared and endorsed by the pharmacokinetics and pharmacogenetics working group (PK.gen) of the Sociedad Española de Farmacia Hospitalaria (Spanish Society of Hospital Pharmacists).

Objective

To analyse the relationship between doses of gemcitabine–carboplatin (GEM-CARBO) administered and incidence and level of haematological and renal toxicity, and the adherence to the treatment in patients with non-small cell lung cancer.

Methods

Retrospective study, which lasted for 37 months. We were able to obtain the minimum set of data needed to carry out the follow-up with the help of Farmis-Oncofarm^® software and the medical and pharmacotherapeutic records.

The haematological toxicity was assessed in accordance with the Common Toxicity Criteria 3.0. Renal toxicity was evaluated using serum creatinine levels and creatinine clearance.

Results

Thirty-one patients were included in the study who were administered a total of 122 cycles. There was a 34.0% and 30.8% incidence of anaemia and grade 3 neutropenia, respectively. There was also a 3.8% and 7.7% incidence of grade 3 and grade 4 thrombocytopenia, respectively. No cases of renal toxicity were found. 65.0% of patients received more than 85.0% of the planned theoretical dosage of carboplatin and 58% of patients received more than 85.0% of the planned theoretical dosage of gemcitabine. Administration was delayed in 18.0% of the cycles prescribed.

Conclusions

The indication and prescription of the GEM-CARBO regimen was adjusted in accordance with solid scientific evidence, but its haematological toxicity limited its use and made it difficult to maintain the dose intensity foreseen in the study. This compromised the effectiveness of the treatment.

Objective

To design a therapeutic exchange protocol for antidepressants and clinically assess variables, such as compliance level, frequency of cases with clinically significant increase on the Udvalg-für-Kliniske-Undersogelser (UKU) psychopharmacological scale, adverse effects analysis, overall analysis of UKU rating development and patients’ level of acceptance. Secondary objectives were to correlate psychopharmacological treatment aspects with the pharmacological morbidity level, and evaluate the clinical impact of pharmacotherapeutic optimisation measures.

Method

The protocol is designed in accordance with a bibliographical review, which was approved by the Pharmacy and Therapeutics Commission. Sequential study was carried out with a sample of 30 patients. Three measurements were taken (base line, at 48–72 h and at 1–3 weeks) to calculate the pharmacotherapeutic morbidity with the UKU rating scale and the Global Clinical Impression. Pharmacotherapeutic optimisation measures were used for those patients with high pharmacotherapeutic morbidity levels.

Results

The compliance level was 73.3%. One patient experienced ≥25% increase on the UKU rating scale and another patient suffered from an adverse effect. The final UKU rating reached statistical significance compared with the measurements taken at 48–72 h (P=.032) and with the base line measurement (P=.007). Patient acceptance was 90%. The impact of optimisation measurements on the pharmacotherapeutic morbidity level was clinically and statistically significant (P<.001).

Conclusions

The proposed protocol has been widely accepted and it is quite certain that it is to be introduced in at a general hospital level.

Objective

The aim of this study is to determine the hospital's efficiency as regards neoadjuvant chemotherapy for the resection of initially unresectable metastases for patients with metastatic primary colorectal cancer and to describe the chemotherapy used.

Methods

Descriptive, retrospective study of patients with colorectal cancer from 2004 to 2007. The percentage of resection for metastases following neoadjuvant chemotherapy administration was studied.

Results

Clinical histories of 118 patients diagnosed with metastatic colorectal cancer were reviewed. Metastases were initially resectable in ten patients (8.5%) and unresectable in the remaining 108 patients (91.5%). Following neoadjuvant chemotherapy, metastatic resection was performed on 19 patients.

Conclusions

Neoadjuvant chemotherapy played an important role in treating patients with disseminated metastatic colorectal cancer by reducing, in some cases, tumour size and treating initially unresectable metastases susceptible to subsequent surgical resection.

FOLFOX scheme was the most used neoadjuvant chemotherapy treatment.

Objective

The pharmacist must work with the clinical team across the continuum of care to develop and therefore improve the patient's quality of life. In this study, we present the results from a continuous pharmaceutical care programme for patients admitted to an angiology and vascular surgery department.

Material and methods

A 5-month prospective study to evaluate the results of a pharmaceutical care programme in an angiology and vascular surgery department. The pharmacist went on the rounds with the clinical team from Monday to Friday and helped make decisions on treatment, and detect and resolve conciliation discrepancies upon admission and discharge, and drug-related problems during the hospital stay.

Results

We detected and resolved 273 conciliation discrepancies in 99 patients and 76 drug-related problems in 46 patients. Global acceptance of pharmacist interventions was 96%.

Conclusions

Seventy-four percent of patients presented conciliation discrepancies. Efficiency of pharmaceutical activity across the continuum of care is demonstrated by the high acceptance of the interventions.

Objective

To identify publishers of pharmacotherapeutic information not found in biomedical journals that focuses on evaluating and providing advice on medicines and to develop a search engine to access this information.

Methods

Compiling web sites that publish information on the rational use of medicines and have no commercial interests. Free-access web sites in Spanish, Galician, Catalan or English. Designing a search engine using the Google “custom search” application.

Results

Overall 159 Internet addresses were compiled and were classified into 9 labels. We were able to recover the information from the selected sources using a search engine, which is called “AlquimiA” and available from http://www.elcomprimido.com/FARHSD/AlquimiA.htm

Conclusions

The main sources of pharmacotherapeutic information not published in biomedical journals were identified. The search engine is a useful tool for searching and accessing “grey literature” on the Internet.