European Journal of Hospital Pharmacy最新文献

{"title":"5PSQ-181 Is instant always better? Pharmacokinetics of tablet versus granulate formulation of paracetamol in frail older adults","authors":"J. Hias, K. Walgraeve, L. Linden, P. Mian, B. Koch, K. Allegaert, P. Annaert, J. Tournoy, I. Spriet","doi":"10.1136/EJHPHARM-2021-EAHPCONF.300","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.300","url":null,"abstract":"Background and importance Pain is highly prevalent in old, frail adults with paracetamol as the mainstay treatment. Pain management is regularly suboptimal and using different paracetamol formulations might improve pain control. It is not known whether faster dissolving formulations of paracetamol granulate result in improved exposure. Aim and objectives Our objective was to determine the pharmacokinetics (PK) of two different formulations of oral paracetamol in old, frail adults. Material and methods Geriatric inpatients aged 80 years or older were eligible for inclusion if they received 1000 mg of paracetamol as a tablet or a granulate formulation at 8am, 2pm and 8pm. Samples were collected at trough levels (T0) and at +0.5 (T0.5), +1 (T1), +2 (T2), +4 (T4), +5 (T5) and +6 hours (T6). PK parameters were evaluated for both paracetamol formulations. Results 36 patients were included, with a mean age (±SD) of 86.78 (±4.20) years. Most of the patients (n=26/36, 72%) received the tablet; 10 patients (28%) were prescribed the granulate formulation. Seven (21%) patients achieved an average plasma concentration (Css) above the analgesic target of 10 mg/L. Median Css (IQR) for the tablet group was 7.76 (6.31–9.08) mg/L and 9.27 (4.94–11.03) mg/L for the granulate group. Tmax was 50.5 (31.50–92.50) min and 42.50 (33.75–106.75) min for the tablet and granulate formulation, respectively (p=1.00). Cmax for tablet users was 15.95 (12.38–21.19) mg/L and 15.59 (10.80–21.77) mg/L for the granulate users (p=0.698). Conclusion and relevance Large interindividual differences in PK parameters were found in a very old patient sample. Absorption parameters such as Tmax and Cmax were not significantly different between the tablet and granulate formulation. A trend for a higher Css was observed for patients in the granulate group. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90941549","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":"6ER-036 Deprescribing tools for the elderly: a systematic review","authors":"M. M. Trueba, A. R. Pérez, B. Rubio, S. S. Fidalgo","doi":"10.1136/EJHPHARM-2021-EAHPCONF.360","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.360","url":null,"abstract":"Background and importance Deprescription is the revision of the therapeutic plan with the aim of simplifying it, taking into account the preferences of the patient, prognosis and the environment. This strategy acquires special relevance in elderly patients as they are exposed to numerous adverse effects and interactions. Aim and objectives To identify the deprescribing tools (DT) aimed at elderly patients available in the scientific literature and their main characteristics. Material and methods A systematic search was conducted in PubMed and EMBASE for relevant literature published up to April 2020, applying the PRISMA method. The search strategy included terms for deprescribing, study population (aged OR elderly) and deprescribing strategies (tool OR process OR criteria OR algorithm). Inclusion criteria were: observational/experimental studies which created or developed a DT in elderly patients. Exclusion criteria were: studies where the DT was aimed at a specific medication, pharmacological group or pathology. Tools identified were analysed according to whether they were criterion/algorithm type. Results 13/485 papers met the inclusion criteria, and 11 tools were identified: 5 ‘algorithm based tools’ and 6 ‘criterion based tools’ (2 of the articles developed the validation of 2 criterion based tools). All tools were aimed at elderly patients, with peculiarities regarding their design, population, setting of application and items that formed the tool. Algorithm based tools The methodology used for its development was not specified. Population: two of them focused specifically on patients with limited life expectancy. Settings of application: two algorithms were applied to institutionalised patients, one to hospitalised patients and the remaining two did not specify the scenario. Criterion based tools Five used the Delphi method for their design and development. Population: one was focused on patients with multimorbidity or similar characteristics and two were aimed at patients with limited life expectancy. Settings of application: three tools were aimed at institutionalised patients, two other tools were aimed at all healthcare settings and the other one to outpatients. It is important to emphasise that most of the tools agreed on the pharmacological groups that were likely to be deprescribed (statins, antipsychotics, proton pump inhibitors and antidepressants). Conclusion and relevance Knowing and being able to use DT aimed at hospitalised or multimorbidity patients could be very useful for hospital pharmacists, allowing them to carry out this activity as part of their healthcare activity. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85923257","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-135 Adequacy of hypolipemiant treatment in primary healthcare","authors":"C. Salom, C. Campabadal, F. Bejarano, N. Marco, L. Castillo, S. Conde, A. Marcos, M. Roch, A. Sanjuan, L. Canadell","doi":"10.1136/EJHPHARM-2021-EAHPCONF.254","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.254","url":null,"abstract":"Background and importance Based on the criteria lipid lowering efficacy, safety, experience of use and cost, the statins simvastatin, pravastatin and ≥40 mg atorvastatin, and gemfibrozil fibrate, are prioritised in our territory. Aim and objectives To optimise lipid lowering treatment in primary healthcare (PH) patients. Material and methods A prospective study (June to July 2020) was carried out in a PH centre, with data obtained from the ECAP computerised medical record. Patients on lipid lowering treatment not considered firstline were included. Data were collected for demographic variables (age and sex), patient adherence and therapeutic effectiveness, drugs involved and interventions (proposal, acceptance and implementation). The prescription was validated by the pharmacist and the interventions were proposed to the physician. Results 300 patients were included, aged 68 (11.4) years (157 (52.3%) men), assigned to eight physicians. 44 (14.7%) patients were not adherent, and the therapeutic objective was not reached in 62 (20.7%) patients. 296 (86.5%) interventions were suggested on 342 active principles: change in therapeutic equivalent, 29.4%; intensify the dosage, 27.3%; interrupt the drug, 24.7%; reassess the indication, 9.8%; change the active principle, 7.1%; and reduce the dosage, 1.7%. Interventions involved: atorvastatin, 38.7%; rosuvastatin, 17.7%; fenofibrate, 16.3%; ezetimibe, 15.9%; pitavastatin, 9.2%; lovastatin, 1.1%; and fluvastatin, 1.1%. The final drugs were: atorvastatin, 54.3%; simvastatin, 34.7%; gemfibrozil, 7.5%; and pravastatin, 3.5%. Physicians accepted 289 (97.6%) interventions. At the 2–3 month follow-up, the implementation carried out lowered the percentage of drugs not considered firstline from 27.49% to 22.07% (19.71% reduction). Conclusion and relevance The prescription of hypolipemiant drugs was not in accordance with the recommended standards, possibly due to ignorance of institutional recommendations, magnification in the perception of adverse effects of classic treatments and therapeutic inertia. Review of the prescriptions by the specialist pharmacist was an added value in optimising the treatment of these patients by means of a multidisciplinary team. It will be interesting to analyse the results at the 1 year follow-up when all patients should have received a visit: the changes implemented, control of the lipid profile after the intervention as well as the savings in drug costs. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87494881","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-259 One year with bictegravir/emtricitabine/tenofovir alafenamide","authors":"M. Lorenzo, J Urda Romacho, D. R. Calvo, M. Vida, CM Pinto Nieto","doi":"10.1136/EJHPHARM-2021-EAHPCONF.91","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.91","url":null,"abstract":"Background and importance Bictegravir (BIC), a second generation integrase strand transfer inhibitor, approved for HIV treatment in fixed dose combination with emtricitabine (FTC) and tenofovir alafenamide (TAF), has potent antiviral activity in vitro to wild-type virus. Aim and objectives To assess the virological and immunological efficacy and to evaluate safety at 24 weeks of BIC/FTC/TAF in naive patients and patients switching to BIC/FTC/TAF, and to analyse, by subgroup, the results in the switch group. Material and methods This was a multicentre, observational, retrospective study in naive patients and patients switching to BIC/FTC/TAF in 2019, treated for at least 24 weeks. At the beginning of the study, population data (sex and age) and analytical data were collected at baseline and at 24 weeks: viral load (VL), CD4 lymphocytes and any adverse event (AE) produced by BIC/FTC/TAF. Results During the study period, 95 patients were included: 25 naive (76% men) with an average of 40 years and 70 patients who switched (66% men) with an average of 43 years. Results for immunovirological efficacy were naive group: median VL and CD4 at the beginning were 764 026 copies/mL and 402 cells/mL, respectively. After 24 weeks, 22 (88%) patients had undetectable VL ( switched group: median VL and CD4 lymphocytes at baseline were 120 413 copies/mL and 639 cells/mL, respectively. After 24 weeks, 65 (93%) patients had undetectable VL with median CD4 lymphocytes in these patients of 728 cells/mL. In total, there were four patients (4.2%) who had insomnia during treatment with BIC/FTC/TAF. Also reported were: 3 (3.2%) patients with headache, 1 (1.1%) patient with osteoarticular pain, 1 (1.1%) patient with increased menstrual bleeding and 1 (1.1%) patient with gastrointestinal pain. None of these AE was a reason for treatment interruption. Conclusion and relevance BIC/FTC/TAF was safe (mild AE with a low incidence rate) and effective (high percentages of undetectable VL and good results for CD4 lymphocytes). References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84060921","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-339 Intrathecal administration of baclofen for the reduction of spasticity","authors":"I. Barbato, B. Esposito, Miranda, A. D’Avino, L. Columbano, M. Spatarella","doi":"10.1136/EJHPHARM-2021-EAHPCONF.171","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.171","url":null,"abstract":"Background and importance Muscle spasticity is a consequence of traumatic brain and spinal cord injuries, stroke, cerebral paralysis and multiple sclerosis. It interferes with mobility and causes pain. There are numerous approaches in the treatment of spasticity. Intrathecal baclofen administration, through the positioning of a programmable pump in the abdomen and a catheter near the spinal column, is an option to reduce spasticity. The pump releases the liquid form of baclofen directly into the intrathecal space of the spinal cord, obtaining higher concentrations than oral therapy. Aim and objectives To evaluate the long term efficacy on the decrease in spasticity and improvement in patients’ quality of life treated by neurosurgery until September 2020. Material and methods An analysis was made of medical records of patients treated until September 2020. Data were collected on: diagnosis, baclofen dosage, complications and/or side effects, degree of spasticity and improvement in quality of life. To evaluate spasticity, the Ashworth scale was used, from grade 0 (no increase of tone) to grade 5 (rigid limb in flexion and extension), by measuring the value obtained before implantation of the pump and at follow-up. The care and comfort caregiver survey was used to measure the patient’s ability to perform personal care activities. Results Neurosurgery treated 91 patients, 39 women and 52 men, with an average age of 42 years. The diagnoses are: 31 perinatal hypoxia, 15 multiple sclerosis, 18 post-trauma, 5 surgical complications, 4 transverse myelitis, 4 haemorrhagic events, 3 ischaemic events, 2 genetic causes, 2 cardiac arrests, 2 complications in childbirth, 1 PKAN syndrome, 1 overdose in a drug addict, 1 poliomyelitis, 1 vertebral collapse and 1 post vaccine. Patients received a daily baclofen dosage of 40–1.350 µg. Side effects such as skin rashes were recorded due to overdose, and the appearance of itching and agitation due to too low a dose. Complications related to the pump were pressure sores, infections and reservoir malfunction. Ashworth’s score at follow-up decreased by an average of 2.5 points with a consequent improvement in quality of life, confirmed by the results of the questionnaire. Conclusion and relevance Intrathecal administration of baclofen was an effective system in the treatment of spasticity and had a positive impact on improving quality of life. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86207145","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-380 An integrated pharmacist led medication review service for elective surgery patients at the pre-anaesthesia outpatient clinic","authors":"W. Kappaun, G. Stemer, D. Baron, M. Anditsch","doi":"10.1136/EJHPHARM-2021-EAHPCONF.212","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.212","url":null,"abstract":"Background and importance Drug related problems (DRPs) (eg, untreated indication, drug–drug interactions (DDIs) and contraindicated medicines) significantly contribute to patient harm. Especially in surgical departments, DRPs often represent a significant threat to patient safety. Therefore, an integrated pharmacist led medication review service was initiated at the pre-anaesthesia outpatient clinic of a 1700 bed tertiary care centre. Aim and objectives The aim was to evaluate the impact of medication reviews prior to elective surgery, quantitatively and qualitatively, by describing DRPs, pharmaceutical interventions and their acceptance rate. Material and methods During the 5 month study period, patients undergoing elective surgery were prioritised by age and anaesthesia risk score, after their preoperative evaluation. Their medication regimens and further relevant data (eg, laboratory values, comorbidities) were reviewed. In the case of inconsistencies, patients were called to amend and verify their current regimens. Identified DRPs and corresponding interventions were suggested in written form to the respective surgical department. A follow-up of interventions was performed by retrospective analysis of patients’ discharge letters. Results Medication reviews were performed in 1281 patients (51% women, 64±18 years of age). A total of 1742 DRPs were identified in 700 (54,6%) patients, accounting for an average of 2.5 DRPs per patient. The three most common DRPs, apart from the need for specific medication information (27% of patients), were potential DDIs (7.1%), non-conformity to therapeutic guidelines (5.6%) and untreated indications (5.5%). The three most common interventions were the provision of medication related information (49.7%), the recommendation of additional medicines (11.1%) and patient monitoring (10%). 52% of interventions were accepted, while a high proportion of interventions were lost to follow-up. Conclusion and relevance The study results showed that pharmacist led medication reviews prior to surgery significantly contributed to the prevention of DRPs. Inappropriate and incomplete information in the medical record was commonly encountered as a barrier to the interventions. The moderate acceptance rate needs to be analysed further (eg, acceptance rate per intervention categories) and strategies to optimise approval of recommendations need to be discussed with different surgery departments. References and/or acknowledgements The performance of medication reviews by all pharmacists of the clinical pharmacy department is acknowledged. Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81043100","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":"1ISG-021 Indirect comparison of brigatinib versus alectinib in ALK positive non-small cell lung cancer","authors":"FJ Salmeron Navas, S. Fénix-Caballero, C. Moreno-Ramos, M. D. Cantero, EM Barreiro-Fernandez, E. A. Rey","doi":"10.1136/EJHPHARM-2021-EAHPCONF.2","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.2","url":null,"abstract":"Background and importance ALK gene mutation occurs in 3–5% of patients with non-small cell lung cancer (NSCLC). Brigatinib and alectinib are potent ALK tyrosine kinase inhibitors, indicated in NSCLC. Aim and objectives The aim of this study was to perform an adjusted indirect treatment comparison (ITC) of the efficacy of brigatinib and alectinib in patients with NSCLC using a common comparator, and to establish whether both ALK inhibitors can be declared equivalent therapeutic alternatives (ETA). Material and methods A search was carried out to detect clinical trials (CTs) with brigatinib or alectinib with similar populations, endpoints and follow-up periods. If multiple studies were found for the same drug, the results were combined in a meta-analysis using the Metasurv calculator. ITC was done according to Bucher’s method. To establish the positioning, ETA guidelines were applied. Delta value, maximum acceptable difference as a clinical criterion of non-inferiority, was set at 0.64 (and its inverse, 1.57) (the value used in the calculation of the sample size) for progression free survival (PFS). Shakespeare´s calculator was used to calculate the probability of the 95% confidence interval exceeding the delta margin. Results Four CTs were included in the ITC for brigatinib (n=1) and alectinib (n=3). The CTs included were: phase III, randomised, open label, crizotinib controlled and ALK positive NSCLC. The endpoint was PFS (for Asian and non-Asian patients). Alectinib trials were pooled for Asian patients for PFS. The results of each trial, the combination and the conducted ITC are summarised in table 1. The probability of the result being above or below the delta margin was, respectively, 10.28% and 15.7% for Asian patients, and 5.92% and 14.43% for non-Asian patients. Conclusion and relevance ITC showed no statistically significant differences in PFS between brigatinib and alectinib for Asian and non-Asian patients. The extent of the 95% CI values showed some uncertainty. According to the ETA guidelines, as the percentage outside the delta margin was small, both drugs could be considered as ETA in most patients with ALK positive NSCLC. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77556415","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":"6ER-027 Improvement in self-management of biological DMARDS for patients with chronic inflammatory arthritis when a pharmacist participates in a multidisciplinary consultation","authors":"C. Bottois, J. Hubert, C. López-Medina, S. Dumas, S. Belo, C. Roux, M. Dougados, O. Conort","doi":"10.1136/EJHPHARM-2021-EAHPCONF.351","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.351","url":null,"abstract":"Background and importance Enhancement of information for patients with chronic inflammatory arthritis (IA) on the management of subcutaneous (SC) biological DMARDs (bDMARDs) by the intervention of several successive health professionals should improve their necessary safety knowledge and skills for optimised self-management of their treatments. Aim and objectives To assess the pharmacist’s contribution to improving knowledge and skills of patients with IA treated with SC bDMARDs during multidisciplinary consultations (MC). The secondary objectives were to assess the impact on therapeutic adherence and patient satisfaction. Material and methods This was a prospective, single centre, 6 month trial, approved by the ethics committee. Inclusion criteria were patient with IA receiving SC bDMARDs. The intervention was an interview aimed at enhancing the patient’s knowledge and adherence. At baseline (M0), 3 months (M3) and 6 months (M6), knowledge and adherence were assessed using self-administered questionnaires, respectively, Biosecure and CQR-5. A patient satisfaction questionnaire was sent at M3. The main outcome was comparison of the Biosecure score at baseline, M3 and M6. Secondary outcomes were comparison of the rate of patients with a high level of knowledge and high adherence at baseline, M3 and M6, and patient satisfaction. For statistical analysis, different tests were used: repeated measures ANOVA, Bonferroni and generalised estimating equation. Results The study was conducted from October 2019 to July 2020. 79 patients were included (aged 50.4±14.7 years; sex ratio 1.1). At M0, M3 and M6, Biosecure scores were 70.9±18.1, 81.7±15 and 84.3±13.7, respectively. A significant difference between scores was found as well as between each time point (p Conclusion and relevance Participation of the pharmacist in the MC allowed for a significant improvement in patient knowledge of their bDMARDs. Regarding adherence, no significant difference can be explained by the already high level. This study highlights the positive impact of MC on patient knowledge of their SC bDMARDs, as well as patient satisfaction. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"331 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76879909","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-185 Are adherence tests in asthma still reliable when the patient knows what we want to hear?","authors":"O. M. Pérez, E. S. Gómez, ME Rodriguez Molíns, A. Bejarano, I. G. Giménez","doi":"10.1136/EJHPHARM-2021-EAHPCONF.304","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.304","url":null,"abstract":"Background and importance Adherence to medication is very important in chronic diseases, such as asthma. According to the global initiative for asthma (GINA) guidelines, 50% of asthmatic patients on long term therapy fail to take medications as directed, at least some of the time. Furthermore, patients with poor adherence to medication are much more likely to suffer exacerbations. Aim and objectives To compare the results of subjective adherence tests, such as the validated test of adherence to inhalers (TAI) in asthma with the results of objective adherence tests, such as the dispensing records. Material and methods In the context of a doctoral thesis starting in January 2020 in a university hospital, every patient prescribed with a biologic agent for severe eosinophilic asthma had periodic interviews with a pharmacist during dispensation of the drugs. A total of 32 patients were recruited and, among other details, patients answered the TAI and their dispensing records for maintenance inhalers were checked by a pharmacist. The results of the TAI (0 to 50) and the dispensing records (0% to 100%) were compared, and the Pearson coefficient of correlation was calculated. Results All patients answered the TAI and the mean result was 49.25 (46–50). The mean result for the dispensing records was 59% (0–100%) in the previous 6 months. The Pearson coefficient of correlation for these variables was 0.22. Conclusion and relevance The coefficient was >0, which suggests a positive correlation, but it was also very close to 0, which indicates that the correlation was very week. Usually, asthmatic patients know the TAI as many pneumologists use it as a tool to calculate adherence, and therefore they know they are expected to get 50/50 in the test. However, the dispensing records are an objective method to measure adherence of patients and although it is not a substitute for the TAI, it should be complementary. When a patient with poor adherence is detected, pharmacists can play an important role with motivational interviews. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73733502","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-126 AVICENNE as a clinical decision support in thromboprophylaxis: just because the patient’s situation is improving doesn’t mean there’s no drug related problem!","authors":"A. Potier, T. Houssemand, P. Barreiros, M. Rodet, E. Divoux, E. Boschetti, MO Duffourc, A. Dony, B. Demoré, E. Dufay","doi":"10.1136/EJHPHARM-2021-EAHPCONF.245","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.245","url":null,"abstract":"Background and importance Pharmacological thromboprophylaxis reduces the risk of pulmonary embolism and deep vein thrombosis. Enoxaparin once a day is more relevant than unfractionated heparin (UFH) twice a day when glomerular filtration rate is >30 mL/min. The threefold alliance AVICENNE, as a real time clinical decision support system, works on the patient’s data, pharmaceutical algorithms (PA) and Pharmaclass (Keenturtle-F). Aim and objectives To show the value of one AVICENNE algorithm in detecting UFH which was not indicated, and the acceptance by the physician of the switch to enoxaparin proposed by the pharmacist. Material and methods A prospective study was carried out from March 2019 to September 2020 in two health facilities (1600 beds). One algorithm was encoded in Pharmaclass to detect patients with a UFH prescription and two glomerular filtration rate measurements >30 mL/min, the second higher than the first. A guideline detailed the pharmaceutical analysis, from history taking of detected DRPs to reporting of pharmaceutical interventions (PI). The first outcome was the number of detected DRPs and accepted PIs. The second outcome was the number of injections and hospital cost avoided. Results The data were collected over 250 non-consecutive days. First, the pharmacist confirmed 98 DRPs after anamnesis and 96 PIs proposing the switch from UFH and enoxaparin. A total of 41 PIs (43%) were accepted by physicians. The secondary outcome included savings of 353 injections, providing a minimal cost saving of 1700€. Conclusion and relevance AVICENNE optimises patients’ thromboprophylaxis management by triggering a pharmaceutical analysis on DRPs which are complex to detect. What is original is that this study showed that pharmaceutical analysis stayed relevant although the clinical and biological situation of the patient was improving. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83294352","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}