European Journal of Hospital Pharmacy最新文献

{"title":"5PSQ-146 ‘Real life’ effectiveness and safety assessment of foscarnet","authors":"A. Perez, A. Pueyo, J. P. Pascual, A. C. Navasal, L. C. Poderoso, M. Moreno, A. P. Rello, A. Martínez, R. A. Sazatornil","doi":"10.1136/EJHPHARM-2021-EAHPCONF.265","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.265","url":null,"abstract":"Background and importance Cytomegalovirus (CMV) infection is an important cause of mortality, especially in haematological patients. Foscarnet has been used to treat ganciclovir resistant CMV infections. Only a few studies assessing safety and effectiveness of foscarnet have been reported so far. Aim and objectives To evaluate the effectiveness and safety of foscarnet in the treatment of CMV infection in a third level hospital. Material and methods A retrospective observational study was conducted in patients who received foscarnet as treatment for CMV viraemia from January 2018 to April 2020. Variables collected were: age, sex, pathology, time of treatment, pattern, basal (start of foscarnet) and final (when foscarnet was suspended) viral load (VL), basal and nadir glomerular filtrate (GF) and metabolic toxicity (basal and nadir serum electrolytes). The results were obtained from the electronic history and prescription software (Farmatools). Results 39 patients, 22 men, were included, and mean age was 55.8±14.9 years (26–82). 71.8% were haematological patients, of whom 41.0% had received bone marrow transplantation. Mean time in treatment was 11±6.6 days (1–27). The dosage pattern was 90 mg/kg/12 hours in 69.2%. 23.0% started treatment as prophylaxis with undetectable VL. In the remaining patients, median basal VL was 1135 IU/mL (3.34–65400), final VL was undetectable in 46.1% and in those who did not negatively affect the median final VL was 215 IU/mL (34.5–6690). Mean reduction in VL was 90.4±17.9% (18–100). There was a 64.1% reduction in GF (mean reduction of 25.6±21.2% and 36.7±22.0% over >65 years). Metabolic toxicity, according to the CTCAE classification (V.4.0), hypokalaemia (grade 1 in 10.2% patients, grades 2 and 3 in 33.3%, grade 4 in 5.1% and the rest were not altered) and hypophosphataemia (grade 1 in 10.2%, grades 2 and 3 in 33.3% and grade 4 in 2.5%) were studied. In addition, hypomagnesaemia (grade 1 in 12.8%) and hypocalcaemia (grade 2 in 28.2% and grade 3 in 33.3%) were also observed. 41.0% of patients died during or immediately after treatment with foscarnet. Their average age was 61±14.4 (27–82) years and 81.2% presented haematological pathologies. Conclusion and relevance Despite the high mortality observed, foscarnet effectively reduced viraemia due to CMV infection, with a high rate of viral negativisation. Further studies are needed to extend the toxicity data and improve the quality of care. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86784644","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":"5PSQ-196 Association between phosphodiesterase 5 inhibitor use and incident dementia in prostate cancer patients treated with androgen deprivation therapy","authors":"Kc Chang, SC Shao, Jm Liu, E. Lai","doi":"10.1136/EJHPHARM-2021-EAHPCONF.315","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.315","url":null,"abstract":"Background and importance Recent studies have indicated that androgen deprivation therapy (ADT) increased the dementia risk in prostate cancer (PCa) patients. Phosphodiesterase 5 inhibitors (PDE5i) with nitric oxide mediated vasodilation can increase blood flow in the brain. However, no current studies have explored the association between PDE5i exposure and dementia in PCa patients treated with ADT. Aim and objectives To determine the association between PDE5i exposure and incident dementia in PCa patients treated with ADT. Material and methods We conducted a retrospective cohort study using the Chang Gung Research Database (CGRD) in Taiwan. We included PCa patients newly receiving ADT between 2009 and 2016. We conducted a three step matching and modified landmark approach to identify PDE5i users and non-users after ADT use. The landmark date was defined as 1 year following the start of ADT, and we defined PDE5i users as patients initiating PDE5i before and after the landmark date. We matched PDE5i users to non-users by (1) age, (2) prostatic specific antigen and (3) 1:4 propensity scores for comorbidity and co-medication. We followed the patients from the landmark date until the incident diagnosis of dementia, last date of clinical visit or 31 December 2019. We performed multivariate Cox proportional hazard models to compare the dementia risk between PDE5i users and non-users. Results We included 4557 PCa patients starting ADT treatment, with a mean age of 69.5 (SD 7.0) years. After matching, we identified 161 PDE5i users and 644 non-PDE5i users. A total of 5.1 person years of PDE5i users and 4.6 person years of PDE5i non-users were included. Compared with non-users of PDE5i, PCa patients treated with ADT initiating PDE5i had a lower risk of dementia (adjusted HR=0.17, 95% CI 0.04 to 0.70) in the modified landmark analyses. Conclusion and relevance PDE5i use in PCa patients treated with ADT was associated with a decreased risk of subsequent dementia. Future large scale studies are suggested to confirm our findings. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83405378","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":"NP-019 Development of a conversion factor between defined daily doses of adults and neonates","authors":"C. Bueno, M. G. Navarro, E. Alonso, F. Parrilla, MJ Cabañas Poy, M. G. López, C. M. F. Llamazares, O. Neth","doi":"10.1136/EJHPHARM-2021-EAHPCONF.366","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.366","url":null,"abstract":"Background and importance Absence of a standardised method to measure antimicrobial consumption in the neonatal population Aim and objectives Establish a conversion factor that makes possible to relate the defined daily dose (DDD) of the adult population and the DDD of the neonatal population. Materials and methods National, multicentre and retrospective study. It had the participation of 10 third-second level hospitals and a multidisciplinary team: hospital pharmacists, paediatricians, neonatologists and infectious disease experts. First, after selecting the antimicrobials for study based on the literature and routine clinical practice, the Delphi methodology was used to agree on the recommended dose for its most common indication in the neonatal population. Two rounds of consultation with the group of experts were carried out. For those antimicrobials whose dose was not agreed upon, the dose established in Pediamecum was selected. The weight and gestational age of the neonates ( Subsequently, the DDD in grams of each antimicrobial were calculated. Finally, the conversion factor was obtained by comparing the DDD designed for neonates (DDDn) with the DDD validated by the WHO for adults (DDDa). For the analysis of the results, the statistical package IBM SPSS Statistics version 19 was used. Results 4820 neonates were selected. The mean weight was 2687 g(6080–440). The conversion factor (DDDn/DDDa) of the parenterally administered antimicrobials were: amikacin (0.04), amoxicillin (0.03), amoxicillin-clavulanate (0.09), ampicillin (0.04), liposomal amphotericin B (0.38), azithromycin (0.05), aztreonam (0.06), cefazolin (0.04), cefepime (0.07), cefotaxime (0.07), ceftazidime (0.07), ceftriaxone (0.07), ciprofloxacin(0.05), erythromycin(0.13), fluconazole(0.08), gentamicin (0.04), imipenem-cilastatin (0.07), linezolid (0.07), meropenem (0.04), metronidazole (0.03), micafungin (0.05), penicillin G sodium (0.03), piperacillin-tazobactam (0.04), teicoplanin (0.04), and vancomycin (0.04) Those obtained from oral antimicrobials were: amoxicillin (0.05), amoxicillin-clavulanate (0.08), azithromycin (0.09), cefadrozil (0.04), cefixime (0.05), ciprofloxacin (0.05), clindamycin (0.03), cloxacillin (0.07), erythromycin (0.13), fluconazole (0.08), Fosfomycin (0.09), itraconazole (0.04), linezolid (0.07), metronidazole (0.04) and vancomycin (0.05). Conclusion and relevance Analysing the demographic characteristics of the neonatal population, the DDD of the antimicrobial group can be standardised, this allows establishing a conversion factor with respect to the adult DDD. A new study to confirm the validity of designed neonatal DDD and hence the conversion factor between neonatal DDD and adult DDD is underway.","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81034809","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":"5PSQ-130 Intravenous potassium chloride: is the medication use process secure?","authors":"F. Charbonneau, A. Desbuquois, A. Liebbe, M. Boisgontier","doi":"10.1136/EJHPHARM-2021-EAHPCONF.249","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.249","url":null,"abstract":"Background and importance Potassium chloride (KCl) for injection is identified as a high risk medicine and a ‘never events’. The development of quality assurance strategies for the KCl use process is essential to minimise risk. Aim and objectives To assess compliance with guidelines for KCl prescription, pharmaceutical evaluation and administration for KCl use to identify priorities for improvement. Material and methods A prospective observational study was conducted including patients treated with intravenous KCl (outside the intensive care unit) over 4 non-consecutive days from February to March 2020. The KCl use guidelines of the French National Agency for Medicines and Products Safety was considered as a reference. Data collected were: for the prescribing stage: indication, information that must appear on the prescription, concentration and flow rate; for the pharmaceutical evaluation stage: entry of pharmaceutical intervention (PI) for a non-compliant prescription; and for the administration stage: labelling, administered concentration and flow rate. Data were collected from the electronic medical records and the observation of KCl administration. Results During the study period, 34 patients (53% men) were included, with a median age of 76 years (range 26–94). The KCl use process was compliant for 6% (2/34). The prescribing stage was non-compliant (NC) for 88% (30/34): 76% (26/34) with NC indication, 53% (18/34) with incomplete prescription and 12% (4/34) too concentrated. The pharmaceutical evaluation stage was NC for 83% (25/30): it was missing in 58% (15/26) of non-indication PI, 89% (16/18) of missed information PI and 75% (3/4) of NC concentration PI. The administration stage was NC for 68% (23/34): 53% (18/34) with incomplete labelling and 15% (5/34) too concentrated. The flow rate was 100% compliant. Conclusion and relevance This study highlights a lack of compliance with recommendations. Because of this audit, we have identified an action plan for improvement: raising awareness of KCl good practices among physicians, pharmacists and nurses; identification of high risk medicines by a specific logo on software; and setting up intravenous KCl prescription protocols and an automatic reassessment request after 2 days. For pharmacists, it will be necessary to set up a simulation for pharmaceutical evaluation on fictional cases. For nurses, the labelling rules should be recalled. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74771653","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":"5PSQ-172 Experience with tocilizumab in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection","authors":"C. Galan, M. Villanueva, D. G. Vaquero, R. Rodríguez, Jf Rangel Mayoral","doi":"10.1136/EJHPHARM-2021-EAHPCONF.291","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.291","url":null,"abstract":"Background and importance Tocilizumab is an immunosuppressive agent which has demonstrated high efficacy in clinical trials for the treatment of coronavirus because its mechanism of action seems to inhibit the inflammatory cascade. Aim and objectives To evaluate the efficacy and safety of tocilizumab during the global pandemic. Material and methods A descriptive, observational, prospective study was conducted in patients receiving treatment with tocilizumab for SARS-CoV-2 during the pandemic in March 2020. Clinical data were collected: sex, age, medical history, diagnosis, hospitalisation days, patients admitted to the intensive care unit (ICU), patients who required mechanical ventilation, dose of tocilizumab, time from onset of symptoms to administration, concomitant drugs for SARS-CoV-2, final situation and adverse reactions. The data were obtained from the electronic medical records. All patients met the criteria established by the Spanish Agency of Medicines and Medical Devices (AEMPS): adequate biochemical parameters and absence of ongoing infections. Results 130 patients were included in the study, 8 patients met the criteria of AEMPS, 75% were men and mean age was 70 (57–83) years. Background: 50% had arterial hypertension, 37.5% heart disease, 25% diabetes, 25% chronic obstructive pulmonary disease and 12.5% active neoplasia. The diagnosis was severe pneumonia in all cases. The average duration of hospitalisation was 29 (4–73) days. 50% of patients were admitted to the ICU and required mechanical ventilation. In 75%, the dose was 600 mg and the rest required 400 mg, all single doses. The average time from symptom onset to drug administration was 15 (10–30) days. Concomitant drug therapy for SARS-CoV-2: 100% hydroxychloroquine with azithromycin, 87.5% lopinavir/ritonavir, 37.5% methylprednisolone boluses, 25% oral methylprednisolone and 12.5% interferon-s-1b. 87.5% of patients were discharged. No adverse reactions were reported. Conclusion and relevance Treatment with tocilizumab could be considered a safe and effective option in patients with severe SARS-CoV-2 pneumonia. Further studies are necessary to confirm these preliminary results. Adjustment of the treatments to the criteria established by the regulatory agencies and the recording of health outcomes could contribute to more efficient therapies. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84414428","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":"NP-020 Antineoplastic and other hazardous drugs: risk potential and exposure – less is more!","authors":"A. Burch, R. Pfeuti, J. Mack, G. Vella, F. Negrini","doi":"10.1136/EJHPHARM-2021-EAHPCONF.367","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.367","url":null,"abstract":"Background and importance Chemicals are subject to mandatory requirements for hazardous substances (GHS; Globally Harmonized System of Classification and Labelling of Chemicals). By contrast, references to measures to protect hospital staff from the hazardous aspects of drugs such as cancerogenicity, mutagenicity or reproductive toxicity (CMR) in the summaries of product characteristics (SPCs) are meagre; intuitive concepts for nurses in a hospital are scarce. Aim and objectives The aim of this project was first to establish a concept, which assessed the hazards to staff while handling CMR-drugs and second to define appropriate measures based on this, which minimise the exposure to substances with CMR-potential. Materials and methods To achieve this, an assessment of the intrinsic risk potential of the substances used therapeutically in the hospital was conducted (1; 2). After this, the activities using the different dosage forms of CMR-drugs were evaluated and measures for exposure minimisation were specified accordingly. Results The drugs with CMR-potential have been marked in the drug administration guides provided by the hospital pharmacy of the hospital pharmacy. Additionally, the activities, paired with the diverse dosage forms, have been classified in risk categories from 1 (highest) to 6 (lowest) (own classification; presented as pyramid and flow-chart). Measures to minimise the risk for staff while handling CMR-drugs were specified according to the STOP principle: substitution, technical/organisational/personal protection measures. The latter are dependent on the classification of the ‘dosage form/activity’ in the risk categories determined by the hospital pharmacy. Conclusion and relevance This procedure for the risk assessment of drugs with CMR-potential and the introduction of safety measures depending on the classification of dosage form/activity in risk categories results in a minimisation of the risk to staff while handling these drugs. The risk, which is per definition the product of the risk potential and exposure, tends towards zero with the introduced measures. References and/or acknowledgements We thank E Whittome for the very helpful translation of this abstract and B Kissling and P Massarotto for the intense discussions. IARC. Agents Classified by the IARC Monographs. volumes 1-123. [Online] https://monographs.iarc.fr/list-of-classifications-volumes/. National Institute for Occupational Safety and Health (NIOSH). List of Antineoplastic and Other Hazardous Drugs in Healtcare Settings. [Online] 2016. https://www.cdc.gov/niosh/docs/2016-161/.","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83825732","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":"3PC-058 Physicochemical stability of meropenem in polypropylene syringes at 41.7 mg/mL for intensive care units","authors":"G. Loeuille, J. Vigneron, E. D’huart, A. Charmillon, B. Demoré","doi":"10.1136/EJHPHARM-2021-EAHPCONF.33","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.33","url":null,"abstract":"Background and importance Meropenem is a broad spectrum antibiotic used to treat severe infectious. The maximum dose recommended is 6 g/day. A stability not exceeding 24 hours has been demonstrated by many research teams in different publications. Only two studies were performed at 40 mg/mL in polypropylene syringes with conflicting stability results: 4 hours and 8 hours. Meropenem is a time dependent antibiotic; its continuous administration improves its efficiency. Aim and objectives The objective of this work was to study the stability of meropenem solutions at 41.7 mg/mL (2 g in 48 mL), diluted in 0.9% sodium chloride (0.9% NaCl) or dextrose 5% (D5W), in polypropylene syringes not protected from light, after preparation and after 4 and 8 hours at 20–25°C. Material and methods Three syringes for each condition were prepared. At the time of analysis, one sample from each preparation was analysed by high performance liquid chromatography coupled to a photodiode array detector at 297 nm. The method was validated according to the ICH Q2 (R1). Physical stability was evaluated by visual and subvisual inspection (turbidimetry by UV spectrophotometry at 350, 410 and 550 nm, as recommended by the European Consensus Conference). pH values were measured. Results The method was validated with an r² of 0.9999. The coefficients of variation on repeatability and intermediate precision were Conclusion and relevance In D5W, meropenem was unstable, with chemical and physical instability. Meropenem was stable at 41.7 mg/mL in polypropylene syringes diluted in NaCl 0.9% for 8 hours. This new stability data allows continuous administration. References and/or acknowledgements Curti C, et al. Stability studies of antipyocyanic beta-lactam antibiotics used in continuous infusion. Pharmazie 2019. Carlier M, et al. Stability of generic brands of meropenem reconstituted in isotonic saline. Minerva Anestesiologica 2014. Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88687779","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":"4CPS-344 Prescription auditing of the 3 monthly formulation of paliperidone palmitate in adult patients with schizophrenia","authors":"S. Nobili, N. Rossetti, S. Davies, L. Gambitta, E. Calzavara, E. Magni, S. Vimercati","doi":"10.1136/EJHPHARM-2021-EAHPCONF.176","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.176","url":null,"abstract":"Background and importance The 3 monthly formulation of paliperidone palmitate (3MPP) was introduced to the Italian market in 2017 for the treatment of schizophrenia in adult patients. 3MPP is a useful treatment option for patients who are adequately treated with the 1 monthly formulation of paliperidone palmitate (PP) but who may benefit from longer dosing intervals. Aim and objectives To assess the appropriateness of 3MPP prescriptions and the effectiveness of treatment in our centre. Material and methods This was an observational retrospective study of patients with a 3MPP prescription between January 2018 and July 2020. The variables used to evaluate appropriateness were the number of switches from PP to 3MPP, dosage and administration time. Effectiveness was evaluated by recording treatment interruptions, dose variations and switch back to PP. Data were extracted from an administrative database and collected in Excel. Results 38 patients were included, 23 men (60.5%), with a mean age of 50±14 years. The dosages of 3MPP were: 175 mg in 5 patients (13.2%), 263 mg in 6 (15.8%), 350 mg in 18 (47.4%) and 525 mg in 9 (23.7%). In 30 patients (78.9%), the 3MPP prescription was appropriate. The number of switches was 35/38 (92.1%): 3 patients received a first prescription of 3MPP without a previous prescription of antipsychotic depot drugs from our centre. An appropriate dosage was selected in 33/35 patients (94.3%): 1 patient switched from PP 100 mg to 3MPP 263 mg and another from PP 150 mg to 3MPP 263 mg. An appropriate administration time was selected in 35/38 patients (92.1%): 1 patient took the drug every 4 months and two patients received only one administration of 3MPP. In total, six patients interrupted treatment (3 in 2019; 3 in 2020). Dose variation of 3MPP during treatment occurred in 2 patients: 1 switched from 3MPP 350 mg to 525 mg and the other from 3MPP 263 mg to 350 mg. Two patients returned to treatment with PP. Conclusion and relevance Most of the 3MPP prescriptions were appropriate. This treatment has been shown to be effective in this setting where clinical diagnosis and therapeutic choice are not simple and medication adherence is a clinical challenge. The intervention of the pharmacist by auditing prescriptions is important to further increase appropriate treatments in these patients. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77312191","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":"4CPS-318 Compounding tacrolimus ophthalmic ointment 0.02% in the treatment of inflammatory and autoimmune ophthalmic syndromes: effectiveness and safety assessment","authors":"S. Portillo-Haro, C. Castaño-Amores, E. Tejedor-Tejada","doi":"10.1136/EJHPHARM-2021-EAHPCONF.150","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.150","url":null,"abstract":"Background and importance Inflammatory/autoimmune ophthalmic syndromes (IAOS) are often treated with corticosteroids in severe cases. However, in some cases, corticosteroids can be contraindicated, poorly tolerated or ineffective. This situation is common in paediatric patients who have a worse risk–benefit balance. Currently, evidence about using ophthalmic tacrolimus in IAOS is based in studies with monitoring duration reaching at most 4 weeks. Aim and objectives To assess the effectiveness, tolerance and safety of compounded tacrolimus ophthalmic ointment 0.02% (CTOO) in the treatment of IAOS in paediatric and adult patients. Material and methods We conducted observational retrospective research in paediatric and adult patients, recruited in our hospital with IAOS. Patients started treatment with CTOO once–twice/day+adjuvant therapy (AT) in January 2016 to April 2020, for 1 year at least. Effectiveness was assessed with hyperaemia grade (none, mild, moderate, severe) at 3, 6, 12 months, and grade of change noticed (GCN) at 1 and 12 months as a patient reported outcome. Tolerance/safety was determined at 1 week and 1 year. Every discontinuation was notified. Results 30 patients (54 sick eyes) were recruited (27 women and 27 men). 32/54 were paediatric patients. The most common syndromes were vernal keratoconjunctivitis (18 eyes; 33.3%); atopic keratoconjunctivitis (14 eyes; 25.9%) and allergic conjunctivitis (8 eyes; 14.8%). Hyperaemia was moderate–severe in 28 eyes (51.8%). It was reduced to 22.2% at 3 months, and to 9.3% at 12 months. No hyperaemia on day 0 was found in 21 eyes (38.9%) and which increased to 30 eyes (55.6%) at 3 months and to 41 (75.9%) at 12 months. After 1 month, 15 eyes (27.7%) had recovery of big or cleared grade, in 32 eyes (59.2%) recovery was mild–moderate and in 7 eyes (13.0%) no improvement was noticed. After a year, 15 eyes (27.7%) had reached the cleared grade. In contrast, 4 eyes had a deterioration after the treatment. Tolerance in the first week was: good (23 eyes; 42.6%), moderate (25 eyes; 46.3%) and poor in 6 eyes (11.1%) with no discontinuations. Tolerance at 1 year was good in 40 eyes (74.1%). However, in two eyes herpes virus infection was reported. Conclusion and relevance This study had strong limitations: lack of placebo group, patients belonged to the same geographic zone and different adjuvant treatments were used. Strengths of the study were a balanced population, high prevalence of paediatric patients and a long monitoring period. CTOO+AT have shown effectiveness and safety, based on the outcomes considered, in IAOS. It might be a good alternative in cases of contraindications, poor tolerance or inefficacy to corticosteroids, especially in paediatric patients. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90368120","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":"4CPS-370 Pharmacists’ interventions before and after the use of a clinical decision support tool to detect drug related problems","authors":"O. Urbina, P. Martín, Martinez, A. L. D. Torre, C. Blanco, Y. Llorens","doi":"10.1136/EJHPHARM-2021-EAHPCONF.202","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.202","url":null,"abstract":"Background and importance Drug related problems (DRP) and medication adverse events occur in hospitalised patients. Computer provider order entry (CPOE) systems with clinical decision support systems (CDSS) are a key process for the pharmacist’s routine prescription validation to improve medication prescribing and patient safety. Aim and objectives To evaluate the type and number of pharmacist interventions (PI) before and after the use of a CDSS tool added to the CPOE system. Material and methods A retrospective observational study was carried out in a 300 bed hospital between January 2019 and May 2020. Data collected were: DRG type, PI and detection method. First period (January–August 2019): pharmacist validation using CPOE and electronic health records (EHR) was performed. The CDSS was introduced in August 2019. The CDSS includes drug information related to dose adjustment according to renal function, monitoring of analytic parameters susceptible to being altered by the drug, and drug–drug/drug–food interactions that are continuously updated by pharmacists. When EHR and CPOE containing demographic, anthropometric and clinical data of the patient as well as pharmacological treatment are integrated with the CDSS, alerts are generated (potential DRP) in real time that are evaluated by pharmacists. When the alerts are considered relevant, pharmacists write a PI in the patient’s chart. Second period (August 2019 –May 2020): CDSS alerts were available for prescription validation. Results First period: 1574 PI. Second period: 1687 PI (1451 using the first period method and 236 using the CDSS alerts). PI as a result of the CDSS were about 14% of total PI, and their type and number comparing both periods are presented in table 1. Conclusion and relevance The number of PI made in the two periods was similar but the CDSS tool allowed pharmacists to detect certain types of DRP that use of the CPOE alone did not allow. Moreover, the use of this tool optimised the pharmacist’s medical prescription review time and facilitated the PI registration task. To increase the usefulness of the CDSS it is necessary to increase the number of relevant alerts introduced in this application. References and/or acknowledgements None. Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85550645","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}