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5PSQ-183 Concomitant use of acetylcholinesterase inhibitors and drugs with anticholinergic properties at admission by emergency department 5PSQ-183急诊入院时乙酰胆碱酯酶抑制剂和抗胆碱能药物的合用
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.302
M. Pérez, Á. Escolano, L. Cazorla, A. Pinilla, A. Magallón, J. Bueno, R. Abad
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引用次数: 0
4CPS-293 Efficacy and safety of cyclin dependent kinase inhibitors in metastatic breast cancer 细胞周期蛋白依赖性激酶抑制剂治疗转移性乳腺癌的疗效和安全性
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.125
L. Cantarelli, J. Barrios, S. G. Gil, B. García, Gj Nazco Casariego, F. G. Nicolás
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引用次数: 0
4CPS-390 Dispensing of anticancer investigational drugs during lockdown for the SARS-CoV-2 pandemic: experience in an oncological centre 在SARS-CoV-2大流行封锁期间分配抗癌研究药物:在肿瘤中心的经验
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.222
J. Villa, C. Jemos, M. Milani, E. O. Salé
Background and importance Patients enrolled in oncology clinical trials are frequently at risk and often live far from the oncology centre. Starting from 21 February 2020, during the lockdown caused by SARS-CoV-2, oncological patients were allowed to travel for health reasons, but their clinical conditions, organisational difficulties and the risk of COVID-19 suggested adopting prudential solutions. Aim and objectives The AIFA and EMA authorised centres to adopt exceptional measures, promoting the dispensation of more cycles and the delivery of therapies to patients at home. This work aims to verify the impact of these solutions in an oncological centre. Material and methods The number of experimental drugs dispensed from January to 3 June were analysed using an Excel database. Dispensations were divided in three periods to evaluate the trend: daily intravenous (IV) and oral (PO) dispensations before 21 February 2020 (P1), between 22 February and 3 March (P2) and from 19 March (start of shipments) until the end of lockdown (P3), analysing the main issues noticed and the percentage of therapies shipped. Results Therapies in the entire period were 4154; mean daily dispensations in P1 was 39.46 (16.03 PO, 23.43 IV), in P2 40.06 (16.12 PO, 23.94 IV) and in P3 38.71 (14.71 PO, 24.00 IV). During P3, 109 shipments of PO medications were delivered, representing 13.72% of the total therapies. The slight increase in dispensations in P2 was due to the anticipation of visits due to the fear of an imminent closure; the subsequent decrease was due to a higher drug quantity dispensed/shipped per single dispensation. PO therapies decreased slightly (−8.23%) compared with the pre-lockdown period, while IV therapies remained steady over the three periods. Seven transport issues occurred, leading to therapeutic discontinuity in 4 of 109 cases. No therapeutic error was detected during the period analysed, probably due to telephone feedback on the arrival of the drugs. Conclusion and relevance Investigational drug shipment was effective in lowering the impact of the pandemic on the therapeutic continuity, without however becoming the most frequently used model. Logistical difficulties produced four cases of therapeutic discontinuity and the telephone feedback mechanism limited the risk of errors in therapy. References and/or acknowledgements Conflict of interest No conflict of interest
背景和重要性参加肿瘤临床试验的患者经常处于危险之中,并且通常居住在远离肿瘤中心的地方。从2020年2月21日起,在SARS-CoV-2造成的封锁期间,肿瘤患者因健康原因被允许旅行,但他们的临床状况、组织困难和COVID-19的风险建议采取审慎的解决方案。AIFA和EMA授权中心采取特殊措施,促进更多周期的分配,并在家中向患者提供治疗。这项工作旨在验证这些解决方案在肿瘤中心的影响。材料与方法采用Excel数据库对1月至6月3日的实验用药数量进行统计分析。分配情况分为三个时期,以评估趋势:2020年2月21日之前(P1)、2月22日至3月3日(P2)和3月19日(开始发货)至封锁结束(P3)的每日静脉(IV)和口服(PO)分配情况,分析注意到的主要问题和发运的治疗药物百分比。结果全期治疗4154例;P1区平均日配药量为39.46 (16.03 PO, 23.43 IV), P2区平均日配药量为40.06 (16.12 PO, 23.94 IV), P3区平均日配药量为38.71 (14.71 PO, 24.00 IV)。P3区平均日配药量为109批,占总配药量的13.72%。P2区的分配人数略有增加,原因是由于担心即将关闭,预计会有访问;随后的减少是由于单次分配/运输的药品数量增加。与封锁前相比,PO治疗略有下降(- 8.23%),而静脉注射治疗在三个时期保持稳定。发生7例转运问题,109例中有4例导致治疗中断。在分析期间未发现治疗错误,可能是由于药物到达时的电话反馈。结论和相关性研究药物运输在降低大流行对治疗连续性的影响方面是有效的,但没有成为最常用的模式。后勤困难造成了4例治疗中断,电话反馈机制限制了治疗错误的风险。参考文献和/或致谢利益冲突无利益冲突
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引用次数: 0
4CPS-287 Impact of SARS-CoV-2 infection in acute myeloid leukaemia patients: experience of the Pethema registry SARS-CoV-2感染对急性髓性白血病患者的影响:Pethema登记的经验
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.119
T. Pastor, Je Megías Vericat, Pilar Martínez, J. C. Navascues, JlB Lorenzo, G. Rodríguez, I. Cano, M. A. Sangerman, J. P. Andrés, P. Montestinos
Background and importance SARS-CoV-2 infection can impact the survival of patients with acute myeloid leukaemia (AML) but there is little published evidence in AML. Aim and objectives To analyse the clinical futures and outcome of SARS-CoV-2 infection in AML patients. Material and methods An observational multicentre study was conducted between March and May 2020 with 117 patients reported from 47 Spanish centres. Leukaemic and viral infections were studied, and inter-relationships were established. Results Median age was 68 years, men (56.7% vs 43.3%), median time from AML diagnosis to SARS-CoV-2 was 4 months and mean number of comorbidities was 1.2. Cytogenetic risk was low in 16.9%, intermediate in 57.1% and high in 26.0%; 55.7% had active disease, 39.2% complete remission and 5.1% partial response. 29.4% were off-therapy and 70.6% were receiving anti-leukaemic treatment: induction chemotherapy (25.3%), hypomethylating (19.3%), clinical trial (17.0%), consolidation chemotherapy (14.8%), venetoclax (3.4%), FLT3 inhibitors (3.4%) and/or maintenance (1.1%). Overall, 3.7% were newly diagnosed, 77.8% had received one line of treatment, 14.8% two and 3.7% four. 15.4% had prior allogeneic transplantation. Only 4.0% of patients were asymptomatic, while the main signs and symptoms were fever (77.8%), pneumonia (75.0%), cough (65.3%), dyspnoea (52.0%), diarrhoea (20.4%), nausea/vomiting (12.2%), rhinorrhoea (10.2%) and headache (7.4%). Analytical parameters were: neutrophils 3112 cells/μL (1900–7300), lymphocytes 1090 cells/μL (1000–3000), interleukin 6 118 pg/mL (0–100), ferritin 4505 ng/mL (15–150) and D-dimer 2823 ng/mL (20–500), with liver enzymes altered in 23.9% of cases. 84.2% received specific treatment for coronavirus infection: chloroquine or hydroxychloroquine (82.2%), lopinavir/ritonavir (54.0%), corticosteroids (39.6%), azithromycin (33.0%), tocilizumab (15.8%), plasma convalescent (3.0%), clinical trial medication (3.0%), remdesivir (2.0%) and/or anakinra (1.0%). The course was mild in 14.7%, moderate in 32.0% and severe in 53.3%. Mean time to negativisation was 20.5 days, duration of symptoms 17.6 days and hospital stay 11.1 days. In 48.1% of cases treatment for AML was maintained, in 26.6% delayed and in 25.3% modified due to coronavirus disease. 47.5% died, establishing an association between mortality and age over 60 years (58.3% vs 36.4%, p=0.043), ≥2 lines of treatment (72.7% vs 44.3%, p=0.020), active disease (62.5% vs 29.4%, p=0.002) and pneumonia (61.2% vs 22.7%, p=0.002). Overall, 47.5% overcame the infection, and in 5.0% SARS-CoV-2 genetic material was still detected at the time of analysis. A non-significant lower mortality rate was observed among: previous transplantation (45.7% vs 64.3%, p=0.19), neutrophil >1900 cells/μL (41.1% vs 60.0%, p=0.09), lymphocyte >1000 cells/μL (42.9% vs 63.6%, p=0.09) and hydroxychloroquine or chloroquine plus azithromycin (35.3% vs 60.0%, p=0.10). Conclusion and relevance SARS-CoV-2 infection pr
背景和重要性SARS-CoV-2感染可影响急性髓性白血病(AML)患者的生存,但在AML中几乎没有已发表的证据。目的和目的分析急性髓性白血病患者SARS-CoV-2感染的临床前景和转归。材料和方法2020年3月至5月期间,对来自47个西班牙中心的117名患者进行了一项观察性多中心研究。研究了白血病和病毒感染,并建立了相互关系。结果中位年龄为68岁,男性(56.7% vs 43.3%),从AML诊断到SARS-CoV-2的中位时间为4个月,平均合并症数为1.2例。细胞遗传学风险低(16.9%)、中(57.1%)、高(26.0%);55.7%为活动性疾病,39.2%为完全缓解,5.1%为部分缓解。29.4%的患者停止治疗,70.6%的患者接受抗白血病治疗:诱导化疗(25.3%)、低甲基化(19.3%)、临床试验(17.0%)、巩固化疗(14.8%)、venetoclax(3.4%)、FLT3抑制剂(3.4%)和/或维持治疗(1.1%)。总体而言,3.7%的新诊断,77.8%的人接受过一次治疗,14.8%的人接受过两次治疗,3.7%的人接受过四次治疗。15.4%有同种异体移植史。无症状者仅占4.0%,主要体征和症状为发热(77.8%)、肺炎(75.0%)、咳嗽(65.3%)、呼吸困难(52.0%)、腹泻(20.4%)、恶心/呕吐(12.2%)、流鼻水(10.2%)、头痛(7.4%)。分析参数为:中性粒细胞3112个/μL(1900 ~ 7300),淋巴细胞1090个/μL(1000 ~ 3000),白细胞介素6 118 pg/mL(0 ~ 100),铁蛋白4505 ng/mL (15 ~ 150), d -二聚体2823 ng/mL(20 ~ 500),肝酶改变23.9%。84.2%接受了冠状病毒感染的特异性治疗:氯喹或羟氯喹(82.2%)、洛匹那韦/利托那韦(54.0%)、皮质类固醇(39.6%)、阿奇霉素(33.0%)、托珠单抗(15.8%)、血浆恢复期(3.0%)、临床试验用药(3.0%)、瑞德西韦(2.0%)和/或阿那金那(1.0%)。病程轻者占14.7%,中度者占32.0%,重度者占53.3%。平均阴性时间为20.5天,症状持续时间为17.6天,住院时间为11.1天。48.1%的AML病例维持治疗,26.6%的病例因冠状病毒疾病而延迟治疗,25.3%的病例因冠状病毒疾病而改变治疗。47.5%死亡,死亡率与60岁以上(58.3% vs 36.4%, p=0.043)、≥2种治疗方案(72.7% vs 44.3%, p=0.020)、活动性疾病(62.5% vs 29.4%, p=0.002)和肺炎(61.2% vs 22.7%, p=0.002)相关。总体而言,47.5%的人克服了感染,在分析时仍有5.0%的人检测到SARS-CoV-2遗传物质。既往移植组死亡率(45.7% vs 64.3%, p=0.19)、中性粒细胞>1900个细胞/μL (41.1% vs 60.0%, p=0.09)、淋巴细胞>1000个细胞/μL (42.9% vs 63.6%, p=0.09)、羟氯喹或氯喹加阿奇霉素组死亡率(35.3% vs 60.0%, p=0.10)均无显著降低。结论及相关性SARS-CoV-2感染在急性髓性白血病患者中具有较高的死亡率。死亡率与年龄、活动性疾病和肺炎相关。参考文献和/或致谢致谢:Pethema基金会利益冲突无利益冲突
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引用次数: 2
5PSQ-228 Pharmacist medicines optimisation and error mitigation at paediatric critical care discharge: a human solution to an electronic risk 5PSQ-228儿科重症监护出院时药剂师药物优化和错误缓解:电子风险的人为解决方案
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.347
C. Jones, H. Cowley
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引用次数: 0
4CPS-364 Personalised QT risk assessment—to inform medication prescribing? 4CPS-364个体化QT间期风险评估——为药物处方提供信息?
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.196
M. Hallaert, V. Grootaert, S. Desmet
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引用次数: 0
4CPS-316 Multiple sclerosis outpatient pharmaceutical care by an implanted telepharmacy tool during SARS-CoV-2 pandemic SARS-CoV-2大流行期间植入式远程药房工具对多发性硬化症门诊药学服务的影响
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.148
C. G. Pérez, A. G. Sacristan, E. Sánchez, Javier Pedrosa, Á. L. Medina, M. Jimenez, M. Cabezas, A. Peña, Jm Martínez Sesmero
Background and importanceThe SARS-CoV-2 pandemic has highlighted the need to avoid exposure of patients to places with a high probability of transmission, such as hospitals Home delivery makes this possible, particularly in patients with disabilities and those especially vulnerable to coronavirus infection due to their drug therapy or previous pathology, such as multiple sclerosis (MS)Aim and objectivesTo describe the telepharmacy system implanted in a teaching hospital for MS outpatients, based on telephone consultations and home delivery medication, from 25 March to 30 September Material and methodsA logistic system was organised and implemented to ship medication to patient‘s residence, after a telephone pharmaceutical care interview The following data were recorded: total home deliveries made by the outpatients pharmacy department (OPD), total patients attended by this system, total home deliveries made by OPD for MS patients and total MS patients attended by telepharmacy All deliveries for MS patients requiring refrigeration conditions were also registered ResultsFrom 25 March to 30 September 2020, we performed 2166 home deliveries of 10 different MS medicines (24 0% of the total telepharmacy shipments made by OPD during this period) Up to 772 MS patients benefited from the telepharmacy system (75 0% of the total MS patients attended by our OPD) Almost 20% of these shipments required refrigeration At the beginning, when lockdown was imposed in Spain, shipments for MS outpatients accounted for 23 2% of the total Afterwards, with concrete conditions to maintain this system (reduced mobility, elderly, pluripathology), the percentage of MS patients attended by telepharmacy and also home delivery increased to 32 6% of the total Conclusion and relevanceThe development of telepharmacy has become a useful and necessary tool for the delivery of specialised pharmaceutical care, especially during the pandemic where patients with certain medical conditions, such as MS, were at risk This made it possible to guarantee continuity of care for a large number of MS patients, avoiding hospital visits, and therefore reducing SARS-CoV-2 transmissions Otherwise, to maintain the sustainability of the implanted telepharmacy system, using the resources efficiently, it is necessary to apply patient stratifications tools, which allows access to this service to those patients who need it the most References and/or acknowledgementsConflict of interestNo conflict of interest
背景和重要性SARS-CoV-2大流行强调了避免患者暴露于高传播可能性的地方(如医院)的必要性,特别是对于残疾患者和由于药物治疗或既往病理(如多发性硬化症)而特别容易感染冠状病毒的患者,家庭分娩使其成为可能。目的和目的描述在教学医院植入的MS门诊远程药房系统。3月25日至9月30日,根据电话咨询和上门送药,材料和方法在电话药学服务访谈后,组织并实施了物流系统,将药物运送到患者住所。门诊药房(OPD)在家分娩总次数、该系统服务的总次数、门诊药房为MS患者在家分娩总次数和远程药房服务的MS患者总次数也被登记。我们进行了2166次10种不同的多发性硬化症药物的家庭交付(在此期间由OPD提供的远程药房总出货量的24%),多达772名多发性硬化症患者受益于远程药房系统(占我们OPD参加的多发性硬化症患者总数的75%),几乎20%的这些货物需要冷藏。在西班牙开始实施封锁时,多发性硬化症门诊患者的出货量占总数的23.2%。有了维持这一系统的具体条件(行动不便、老年人、多种病理),接受远程药房治疗和在家接生的多发性硬化症患者的百分比增加到总数的32.6%结论和相关性远程药房的发展已成为提供专门药物护理的有用和必要的工具,特别是在大流行期间,患有某些疾病的患者,如多发性硬化症,这使得保证大量多发性硬化症患者的护理连续性成为可能,避免了住院就诊,从而减少了SARS-CoV-2的传播。否则,为了保持植入式远程药房系统的可持续性,有效地利用资源,有必要应用患者分层工具,使最需要这项服务的患者能够获得这项服务参考文献和/或确认利益冲突没有利益冲突
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引用次数: 0
4CPS-237 Feasibility of continuous administration of antimicrobials in hospital: nothing is ever as it seems? 医院持续使用抗微生物药物的可行性:凡事都不像看上去那样?
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.69
V. Grootaert, K. Bigler, A. Bervoet, J. V. Praet, E. Nulens
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引用次数: 0
4CPS-313 Experience of the use of baricitinib in COVID-19 pneumonia 巴比替尼在COVID-19肺炎中的应用体会
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.145
S. Sánchez, JL Sánchez Serrano, J. M. Río, C Del Pozo Carlavilla, B. Serrano, J. Sanz, E. Martínez, H. Ayllón, C. Gómez, M. S. Garrido
Background and importanceBaricitinib is an immunosuppressive agent included as one of the therapeutic options for COVID-19 in the Spanish protocol Agencia Española del Medicamento y Productos Sanitarios Aim and objectivesThe objective was to assess the effectiveness of this drug in hospitalised but non-critically ill patients Material and methodsAn observational retrospective study was conducted in a third level hospital from 26 March to 5 May Inclusion criteria were: hospitalised patients diagnosed with COVID-19 pneumonia and treated with baricitinib Data collected were: age, gender, comorbidities, severe pneumonia diagnosis, ferritin and interleukin 6 (IL-6) prior to the beginning of treatment with baricitinib, standard of care according to the hospital’s protocol, concomitant treatment with anakinra, duration of treatment with baricitinib, average hospital stay (AHS), deaths and hospital discharges The data were collected from the electronic medical records and the hospital’s management department Results171 patients treated with baricitinib were included, with an average age of 69 5 (34–96) years 71 3% (122) were men 87 1% (149) had comorbidities and 73 1% (125) were diagnosed with a severe pneumonia, with 25% of them dying (31) Median duration of treatment with baricitinib was 5 days (1–12) AHS for the baricitinib group was 14 60 (3–47) days, and AHS for the whole sample of patients diagnosed with COVID-19 pneumonia was 17 2 days 23 4% (40) of patients had high levels of ferritin (>2500 UI/L) Among them, 87 5% (35) were discharged and 12 5% (5) died IL-6 levels were high (>40 U/L) in 29 8% (51) of patients, 40 UI/L Hence IL-6 level appears to be a better prognostic factor of mortality than ferritin This could also be related to a greater patient’s immune response Regarding treatment effectiveness, mortality of patients who were treated with SoC plus baricitinib was similar to that of patients treated with anakinra plus baricitinib References and/or acknowledgementsConflict of interestNo conflict of interest
背景和重要性baricitinib是一种免疫抑制剂,在西班牙方案Española del Medicamento y Productos Sanitarios中被列入COVID-19的治疗方案之一目的和目的目的是评估该药物在住院但非危重患者中的有效性材料和方法观察性回顾性研究于3月26日至5月5日在一家三级医院进行。纳入标准为:诊断为COVID-19肺炎并接受巴西替尼治疗的住院患者:年龄、性别、合并症、重症肺炎诊断、巴西替尼治疗前铁蛋白和白细胞介素6 (IL-6)水平、医院方案规定的护理标准、阿那金的联合治疗、巴西替尼治疗持续时间、平均住院时间(AHS)、死亡和出院。数据收集于电子病历和医院管理部门。平均年龄69 5(34 - 96)71年的3%(122)是男性87 1%(149)并发症和73年的1%(125年)被诊断出患有一种严重的肺炎,其中25%死亡(31)baricitinib治疗时间中位数为5天(1 - 12)唯有baricitinib组60(3-47)14天,观众对整个样本的患者诊断为COVID-19肺炎17岁2天23 4%(40)的患者有高含量的铁蛋白(2500年在UI / L)其中,88.5%(35人)出院,12.5%(5人)死亡,29.8%(51人)患者IL-6水平高(40 U/L), 40 UI/L,因此IL-6水平似乎是比铁蛋白更好的死亡率预后因素,这也可能与患者更大的免疫反应有关。SoC + baricitinib治疗的患者死亡率与anakinra + baricitinib治疗的患者死亡率相似参考和/或承认利益冲突无利益冲突
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引用次数: 0
2SPD-034 Use of daratumumab based treatments in patients with multiple myeloma and hepatic impairment 基于daratumumab的治疗在多发性骨髓瘤和肝功能损害患者中的应用
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.17
Gil-Sierra, S. Fénix-Caballero, Mdp Briceño-Casado, M. Sánchez-Hidalgo, C. A. D. L. Lastra-Romero, B De La Calle-Riaguas, M. Domínguez-Cantero, E. A. Rey
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引用次数: 0
期刊
European Journal of Hospital Pharmacy: Science and Practice
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