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5PSQ-204 Difference in adherence associated with the route of administration 5PSQ-204与给药途径相关的依从性差异
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.323
O. I. Barrueta, E. P. Diez, E. I. García, U. A. Larracoechea
Background and importance Adherence to medication is crucial to achieve outcomes in health. Aim and objectives To assess annual adherence to medications in the outpatient pharmacy during 2019. Material and methods We selected all patients on chronic therapy in our outpatient pharmacy, and the medication possession rate (MPR) during 2019 was measured based on the pharmacy refill record. To assess the relationship between variables and adherence, the non-parametric Wilcoxon signed rank test and the Kruskal–Wallis test were applied. A p value Results 131 patients on chronic treatment were selected. Mean age of the study group was 55.8 years (SD 16.9; range 17–92) and 51.2% were women. 51.2% of patients were on adalimumab, 7.6% baricitinib, 6.1% colistimetato and 4.6% etanercept, certolizumab and secukinumab. Patients were treated for rheumatic arthritis (34.4%), axial spondylitis (15.3%), psoriatic arthritis (14.5%) and Crohn’s disease (12.2%). For route of administration, the principal route was the subcutaneous route (76.3%), oral in 16.8% and inhalation in 6.9%. Mean MPR in the study population was 96.1% (SD 9.2%) and the median days to assess adherence was 289.2 (IQR25–75 223–360). The number of patients with MPR We indicated in the patient medical record any adherence problems in order to assess adherence and improve it at next visit or appointment. We found no relationship between adherence and gender (97.2% in women versus 94.9% in men, p=0.33) or age (p=0.81). Mean adherence regarding route of administration was 90.3% (SD 18.8%; n=9) for the inhalation route, 95.9% (SD 8.7%; n=100) for the subcutaneous route and 99.3% (SD 3%; n=22) for the oral route, with a statistical difference between them (p=0.0064). This difference was confirmed between the inhaled and oral routes (p=0.002) and subcutaneous and oral routes (p=0.004). Conclusion and relevance The adherence level was high in our population and only 11 patients had an adherence level References and/or acknowledgements Conflict of interest No conflict of interest
背景和重要性坚持用药对取得健康结果至关重要。目的和目的评估2019年门诊药房年度药物依从性。材料与方法选择我院门诊药房所有慢性治疗患者,根据其续药记录测量2019年的药物持有率(MPR)。为了评估变量与依从性之间的关系,采用了非参数Wilcoxon符号秩检验和Kruskal-Wallis检验。结果选择慢性治疗患者131例。研究组平均年龄为55.8岁(SD 16.9;范围17-92),女性占51.2%。51.2%的患者使用阿达木单抗、7.6%的巴西替尼、6.1%的粘菌替土和4.6%的依那西普、certolizumab和secukinumab。其中风湿性关节炎(34.4%)、轴性脊柱炎(15.3%)、银屑病关节炎(14.5%)和克罗恩病(12.2%)。给药途径以皮下给药为主(76.3%),口服给药占16.8%,吸入给药占6.9%。研究人群的平均MPR为96.1% (SD为9.2%),评估依从性的中位天数为289.2天(IQR25-75 223-360)。我们在患者病历中指出任何依从性问题,以便评估依从性并在下次就诊或预约时加以改善。我们发现依从性与性别(97.2%的女性对94.9%的男性,p=0.33)或年龄(p=0.81)没有关系。给药途径的平均依从性为90.3% (SD 18.8%;n=9),吸入途径为95.9% (SD 8.7%;n=100), 99.3% (SD 3%;N =22),两组间差异有统计学意义(p=0.0064)。这种差异在吸入和口服途径(p=0.002)以及皮下和口服途径(p=0.004)之间得到证实。结论和相关性在我们的人群中依从性水平很高,只有11例患者达到依从性水平参考文献和/或致谢利益冲突无利益冲突
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引用次数: 0
6ER-033 Pharmacist led deprescribing and follow-up in a subacute multidisciplinary outpatient clinic: a pilot randomised controlled trial 6ER-033药剂师主导的亚急性多学科门诊开处方和随访:一项试点随机对照试验
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.357
A. Aharaz, J. H. Rasmussen, H. Mcnulty, A. Cyron, A. Bengaard, RR Løvig Simonsen, Charlotte Treldal, M. B. Houlind
Background and importance Medication deprescribing is essential to prevent inappropriate medication prescribing. However, the experiences of deprescribing in Danish outpatient clinics are limited. Aim and objectives Our objective was to determine the feasibility of a pharmacist led deprescribing intervention in subacute multimorbid patients in a multidisciplinary outpatient clinic. Material and methods Participants were randomised 1:1 to the intervention or standard care. A senior pharmacist performed a systematic deprescribing intervention, including a patient interview with follow-up 7 and 30 days after inclusion. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 sustained medication deprescribed between inclusion and the 30 day follow-up. Results Of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% men; mean age 73 years and mean number of prescribed medications 10). In total, 37 medications were deprescribed in the intervention group and 5 in the control group. 19 patients (56%) in the intervention group and 4 (12%) in the control group had ≥1 sustained medications deprescribed 30 days after the intervention (p=0.015). The three most frequent deprescribed medication groups were analgesics, and cardiovascular and gastrointestinal medications. Conclusion and relevance In conclusion, a pharmacist led deprescribing intervention to subacute multimorbid patients is feasible to perform in a multidisciplinary outpatient clinic. References and/or acknowledgements Conflict of interest No conflict of interest
背景和重要性药物处方化是防止不当用药的必要措施。然而,在丹麦门诊诊所的经验是有限的。目的和目的我们的目的是确定在多学科门诊亚急性多病患者中由药剂师主导的处方干预的可行性。材料和方法参与者按1:1随机分为干预组或标准治疗组。一名高级药剂师进行了系统的处方干预,包括在纳入后7天和30天对患者进行随访。一位资深医生收到了建议,并决定实施哪些建议。主要结局是纳入研究至30天随访期间持续服用≥1种药物的患者数量。76例符合条件的患者中,72例(95%)被纳入研究,67例(93%)完成了研究(57%为男性;平均年龄73岁,平均处方药物数10)。干预组共开了37种药物,对照组开了5种药物。干预组19例(56%),对照组4例(12%)在干预后30天持续服药1次以上(p=0.015)。三个最常见的处方药物组是镇痛药、心血管和胃肠道药物。结论及相关性综上所述,药师主导的亚急性多病患者处方干预在多学科门诊是可行的。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
5PSQ-205 Manipulating tablets containing poorly soluble prednisolone to obtain paediatric doses 5PSQ-205操纵含有难溶性强的松龙的片剂以获得儿科剂量
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.324
RH Svendsen, J. Brustugun, I. Tho, K. Bjerknes
Background and importance Manipulation of tablets is often necessary to achieve an appropriate dose in the paediatric ward.1 However, previous studies have shown a difference in dose accuracy obtained on manipulation for different tablets, in particular for the slightly soluble drug substance aspirin.2 Prednisolone is a very slightly soluble drug substance, and prednisolone tablets are frequently manipulated in paediatric care. Aim and objectives To investigate the dose accuracy and dose precision attained after manipulation of a commercially available prednisolone tablet, and to compare the results with those previously found for aspirin, a drug substance where solubility may similarly be challenging. Material and methods Prednisolone tablets: Prednisolon Alternova 5 mg, Alternova A/S. Instrument: UHPLC-system from Shimadzu Corp (Nexera, with prominence DAD detector). Analytical column: ACE Excel 2 μm C18-AR, 2.1 × 100 mm (Advanced Chromatography Technologies Ltd). The analytical method was validated for linearity, precision and specificity. Dosing accuracy study: six tablets were dissolved in 10 mL water. After 4 min of intermittent stirring, samples of 1 mL, a 10th of the tablet, were withdrawn. Dosing accuracy was recorded and compared with previous findings for aspirin. Results After manipulation of Prednisolon Alternova 5 mg tablets, 92.2% (85.3–95.1%) of the intended dose was retrieved. Conclusion and relevance After manipulation by dispersion and dose extraction, the prednisolone tablets were found to give doses within the limits of tablet fractions according to the European Pharmacopeia (85–115%). In contrast, conventional tablets containing aspirin (Aspirin ‘Bayer’ 500 mg), a slightly soluble drug substance, has previously been shown to have never exceeded 55% of the intended dose when a 10th of the tablet was extracted.2 This shows that knowledge about solubility is not always sufficient for estimating the suitability for manipulation of tablets. References and/or acknowledgements Bjerknes K, Boyum S, Kristensen S, et al. Manipulating tablets and capsules given to hospitalised children in Norway is common practice. Acta Paediatr 2017;106:503–8. Brustugun J, Notaker N, Paetz LH, et al. Adjusting the dose in paediatric care: Dispersing four different aspirin tablets and taking a proportion. Eur J Hosp Pharm 2019. https://doi.org/10.1136/ejhpharm-2019-001903 Conflict of interest No conflict of interest
背景和重要性:在儿科病房,为了达到适当的剂量,通常需要对药片进行操作然而,先前的研究表明,不同片剂,特别是微溶性药物阿斯匹林,通过操作获得的剂量准确性存在差异强的松龙是一种非常微溶的药物物质,强的松龙片剂在儿科护理中经常被操纵。目的和目的研究市售强的松龙片剂操作后获得的剂量准确性和剂量精度,并将结果与先前在阿司匹林中发现的结果进行比较,阿司匹林是一种溶解度同样具有挑战性的药物。材料与方法泼尼松龙片:Alternova泼尼松龙5mg, Alternova A/S。仪器:岛津公司(Nexera) uhplc系统,带显著DAD检测器。分析柱:ACE Excel 2 μm C18-AR, 2.1 × 100 mm (Advanced Chromatography Technologies Ltd)。该方法具有良好的线性、精密度和特异性。剂量准确性研究:6片溶解于10 mL水中。间歇搅拌4分钟后,取出1 mL的样品,为片剂的十分之一。记录了阿司匹林的给药准确性,并与之前的研究结果进行了比较。结果强的松龙5 mg片经操作后,回收率为92.2%(85.3 ~ 95.1%)。结论及相关性经分散和剂量提取操作后,所制强的松龙片的给药剂量在欧洲药典(85-115%)规定的片剂组分限定范围内。相比之下,含有阿司匹林(阿司匹林'拜耳' 500毫克)的传统片剂,是一种微溶性药物物质,以前的研究表明,提取片剂的十分之一时,从未超过预期剂量的55%这表明,关于溶解度的知识并不总是足以估计对片剂操作的适宜性。Bjerknes K, Boyum S, Kristensen S等。在挪威,操纵给住院儿童服用的药片和胶囊是常见的做法。儿科学报,2017;106:503-8。Brustugun J, Notaker N, Paetz LH,等。调整儿科护理中的剂量:分散四种不同的阿司匹林片并按比例服用。欧洲J医院药房2019。https://doi.org/10.1136/ejhpharm-2019-001903利益冲突无利益冲突
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引用次数: 0
6ER-029 Impact of a medicines information app on medication knowledge and worry in post-myocardial infarction patients 6ER-029某药品信息app对心肌梗死后患者用药知识及担忧的影响
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.353
Gayle Campbell, C. Devaney, V. Auyeung, T. Ismail, J. Weinman
Background and importance Non-adherence to medications post-myocardial infarction (MI) is well documented. This can lead to inappropriate therapeutic escalation and early mortality. Identifying effective interventions to support patients with the management of medications is therefore of paramount importance. Aim and objectives MedTap is a medicines information app developed by clinicians for patients and carers. The objective of this study was to evaluate whether utilising MedTap had any impact on patient knowledge and worry. Material and methods Patients admitted to a cardiology ward at a tertiary hospital with an MI completed a baseline questionnaire to assess medication knowledge and worry before discharge. They were given access to medicine information via MedTap. A post-use questionnaire was completed via telephone 2 weeks later. The questionnaire was developed utilising existing validated adherence questions. Questions were grouped into ‘knowledge’ (n=5) and ‘worry’ (n=3) for analysis. A score of 1 was assigned to yes responses and a score of 0 for no, and change over time was assessed with a paired Wilcoxon test. Results 54 patients were recruited (mean age 63 years, 4 women), with 10 (18.5%) lost to follow-up. Of the 44 patients interviewed, 22 (50%) used the app. For users, the median pre-knowledge score was 3 (range 1–5) with a median change of 1 (range −1 to 4). There was a significant increase in knowledge (p=0.003) at the 2 week follow-up. For users, the median pre-worry score was 0 (range 0–2) with a median change of 0 (range −2 to 0). However, this still translated into a net reduction in worry (p=0.011). For non-users, the median pre-knowledge score was 3 (range 0–5) with a median change of 1.5 (range −4 to 4). There was an increase in knowledge (p=0.009) at follow up. For non-users, the median worry score was 0 (range 0–2) with a median change of 0 (range −1 to 2). There was no significant change in worry (p=0.739). Conclusion and relevance This study has shown that a digital app can be used as an additional tool to deliver medicines information, improve patient knowledge and decrease patient medication worry. A reduction in worry is significant as this is known to significantly influence adherence behaviour. Further work will assess adherence and determine whether using MedTap has an impact on clinical outcomes. References and/or acknowledgements Conflict of interest No conflict of interest
背景和重要性心肌梗死(MI)后药物不依从性有很好的记录。这可能导致不适当的治疗升级和早期死亡。因此,确定有效的干预措施来支持患者的药物管理是至关重要的。MedTap是一个由临床医生为患者和护理人员开发的药物信息应用程序。本研究的目的是评估使用MedTap是否对患者的知识和担忧有任何影响。材料与方法某三级医院心内科收治的心肌梗死患者在出院前完成一份基线调查问卷,以评估其用药知识和担忧程度。他们可以通过MedTap获取医学信息。2周后通过电话填写使用后问卷。问卷是利用现有的有效的依从性问题开发的。问题被分为“知识”(n=5)和“担忧”(n=3)进行分析。“是”的得分为1分,“否”的得分为0分,并通过配对Wilcoxon测试评估随时间的变化。结果入选患者54例(平均年龄63岁,女性4例),失访10例(18.5%)。在接受采访的44名患者中,22名(50%)使用了该应用程序。对于用户来说,预知识得分中位数为3(范围为1 - 5),中位数变化为1(范围为- 1至4)。在2周的随访中,知识显著增加(p=0.003)。对于用户来说,担忧前得分中位数为0(范围0 - 2),中位数变化为0(范围- 2到0)。然而,这仍然转化为担忧的净减少(p=0.011)。对于非使用者,预知识得分中位数为3(范围为0-5),中位数变化为1.5(范围为- 4至4)。随访时知识增加(p=0.009)。对于非用户,担忧得分中位数为0(范围0 - 2),中位数变化为0(范围- 1至2)。担忧没有显著变化(p=0.739)。本研究表明,数字应用程序可以作为一种额外的工具来传递药物信息,提高患者的知识,减少患者的用药担忧。减少担忧是很重要的,因为这对坚持行为有很大的影响。进一步的工作将评估依从性,并确定使用MedTap是否对临床结果有影响。参考文献和/或致谢利益冲突无利益冲突
{"title":"6ER-029 Impact of a medicines information app on medication knowledge and worry in post-myocardial infarction patients","authors":"Gayle Campbell, C. Devaney, V. Auyeung, T. Ismail, J. Weinman","doi":"10.1136/EJHPHARM-2021-EAHPCONF.353","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.353","url":null,"abstract":"Background and importance Non-adherence to medications post-myocardial infarction (MI) is well documented. This can lead to inappropriate therapeutic escalation and early mortality. Identifying effective interventions to support patients with the management of medications is therefore of paramount importance. Aim and objectives MedTap is a medicines information app developed by clinicians for patients and carers. The objective of this study was to evaluate whether utilising MedTap had any impact on patient knowledge and worry. Material and methods Patients admitted to a cardiology ward at a tertiary hospital with an MI completed a baseline questionnaire to assess medication knowledge and worry before discharge. They were given access to medicine information via MedTap. A post-use questionnaire was completed via telephone 2 weeks later. The questionnaire was developed utilising existing validated adherence questions. Questions were grouped into ‘knowledge’ (n=5) and ‘worry’ (n=3) for analysis. A score of 1 was assigned to yes responses and a score of 0 for no, and change over time was assessed with a paired Wilcoxon test. Results 54 patients were recruited (mean age 63 years, 4 women), with 10 (18.5%) lost to follow-up. Of the 44 patients interviewed, 22 (50%) used the app. For users, the median pre-knowledge score was 3 (range 1–5) with a median change of 1 (range −1 to 4). There was a significant increase in knowledge (p=0.003) at the 2 week follow-up. For users, the median pre-worry score was 0 (range 0–2) with a median change of 0 (range −2 to 0). However, this still translated into a net reduction in worry (p=0.011). For non-users, the median pre-knowledge score was 3 (range 0–5) with a median change of 1.5 (range −4 to 4). There was an increase in knowledge (p=0.009) at follow up. For non-users, the median worry score was 0 (range 0–2) with a median change of 0 (range −1 to 2). There was no significant change in worry (p=0.739). Conclusion and relevance This study has shown that a digital app can be used as an additional tool to deliver medicines information, improve patient knowledge and decrease patient medication worry. A reduction in worry is significant as this is known to significantly influence adherence behaviour. Further work will assess adherence and determine whether using MedTap has an impact on clinical outcomes. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85153269","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}
引用次数: 0
5PSQ-136 Disproportionality analysis of the skin toxicity of ingenol mebutate using the FDA Adverse Event Reporting System database 5PSQ-136使用FDA不良事件报告系统数据库对戊烯醇酯皮肤毒性进行歧化分析
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.255
F. Pappalardo, V. Rocco, C. Polidori
Background and importance Ingenol mebutate was granted a marketing authorisation from European Medicines Agency (EMA) to treat actinic keratosis. On 30 April 2020, due to an increased risk in provoking skin cancer in treated patients compared with imiquimod, the EMA withdrawn it after a safety data review. The final results of the 3 year safety study (NCT01926496) in 484 patients showed that, among skin malignancies, squamous cell carcinoma (SCC) had a higher incidence with ingenol mebutate gel compared with imiquimod (3.3% versus 0.4% of patients). Aim and objectives This study aimed to evaluate the safety issue (signal) of increased occurrence of skin malignancy (eg, SCC of the skin) during therapy with ingenol mebutate by mining of the FDA Adverse Event Reporting System (FAERS) database. Material and methods By querying the FAERS database, we searched for cases of SCC associated with ingenol mebutate using the following MedDRA preferred terms (PTs) ‘squamous cell carcinoma of skin’, ‘skin squamous cell carcinoma metastatic’ and ‘skin squamous cell carcinoma recurrent’. With a contingency table, we computed the PRR to evaluate the strength of association between SCC and ingenol mebutate. Results We found the following co-occurrence data: ingenol mebutate/SCC (DE)=90 reports, ingenol mebutate/other ADR (De)=5128, other drugs/SCC (dE)=2882 and other drugs/other ADR (de)=13 899 084 from 2012 to 2020. The two by two contingency table showed a value for PRR of 44.4105 (95% CI 33.332 to 59.1711, p 85 years (7.7%) and not specified (12.2%); 75.6% were men and 23.3% women. Conclusion and relevance Disproportionality analysis showed that the ingenol mebutate–SCC pair was reported more often than expected. Based on this statistical association, our data confirmed the safety signal evaluated by the EMA that led to the withdrawal of ingenol mebutate from the EU market. In addition, it raises the question of why the FDA has not revoked the marketing authorisation of the drug in the USA. References and/or acknowledgements https://clinicaltrials.gov/ct2/show/NCT01926496 https://www.ema.europa.eu/en/documents/referral/picato-article-20-referral-risks-picato-actinic-keratosis-outweigh-benefits_en.pdf Conflict of interest No conflict of interest
背景和重要性Ingenol mebutate已获得欧洲药品管理局(EMA)上市许可,用于治疗光化性角化病。2020年4月30日,由于与咪喹莫特相比,接受治疗的患者引发皮肤癌的风险增加,EMA在对安全性数据进行审查后将其撤回。在484例患者中进行的为期3年的安全性研究(NCT01926496)的最终结果显示,在皮肤恶性肿瘤中,与咪喹莫特相比,ingenol mebutate凝胶的鳞状细胞癌(SCC)发病率更高(3.3%对0.4%)。目的和目的本研究旨在通过挖掘FDA不良事件报告系统(FAERS)数据库,评估戊烯醇酯治疗期间皮肤恶性肿瘤(如皮肤SCC)发生率增加的安全性问题(信号)。材料和方法通过查询FAERS数据库,我们使用以下MedDRA首选术语(PTs)“皮肤鳞状细胞癌”、“皮肤鳞状细胞癌转移”和“皮肤鳞状细胞癌复发”搜索与戊烯醇相关的SCC病例。通过列联表,我们计算了PRR,以评估SCC与戊烯醇酯之间的关联强度。结果2012 - 2020年共发生数据为:戊酸ingenol /SCC (DE)=90例,戊酸ingenol /其他ADR (DE)= 5128例,其他药物/SCC (DE)= 2882例,其他药物/其他ADR (DE)= 13 899 084例。2 × 2列联表显示PRR值为44.4105 (95% CI 33.332 ~ 59.1711, p 85年(7.7%)和未指定(12.2%);男性占75.6%,女性占23.3%。结论与相关的歧化分析显示,戊烯醇- scc对的报道频率高于预期。基于这一统计关联,我们的数据证实了EMA评估的安全信号,导致戊烯醇从欧盟市场撤回。此外,它还提出了一个问题,即为什么FDA没有撤销该药物在美国的上市许可。参考文献和/或致谢https://clinicaltrials.gov/ct2/show/NCT01926496 https://www.ema.europa.eu/en/documents/referral/picato-article-20-referral-risks-picato-actinic-keratosis-outweigh-benefits_en.pdf利益冲突无利益冲突
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引用次数: 0
5PSQ-133 Evaluation of a quality monitoring programme for intravenous fluid management 5PSQ-133静脉输液管理质量监测方案评价
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.252
S. Wuyts, P. Landuyt, Pieter-Jan Cortoos, P. Cornu
Background and importance Intravenous fluid stewardship can support caregivers to optimise the patient’s outcome, avoid fluid overload or electrolyte disorders, and control costs. Implementing a stewardship initiative requires monitoring to guarantee guideline adherence. Aim and objectives To evaluate the impact of an internal audit on intravenous fluid use and identify opportunities to improve quality monitoring. Material and methods To evaluate fluid guideline adherence in a Belgian university hospital, an internal audit was organised comprising five QIs, developed by the fluid stewardship programme. The QIs were calculated every 2 weeks over a 6 month period (August 2019 to January 2020), focusing on prescription and labelling, documentation of indication and monitoring of body weight and electrolytes. Every ward steward (22 physicians, 16 nurses) received the results of the first 3 months (T1) in an electronic report. The report’s impact on the QIs between T1 and the following 3 months (T2) was assessed using a χ2 test and interrupted time series (ITS) analysis. Afterwards, stewards were surveyed on how to further optimise fluid management monitoring. Results In total, 729 patients (T1: 361; T2: 368) receiving 758 intravenous fluid bags (T1: 381; T2: 377) were screened. QIs on prescription and labelling were close to the target value. The QI ‘documented indication’ was low (21%). ‘Availability of electrolyte values’ increased significantly between T1 and T2 (90.3% vs 96.2%, p Conclusion and relevance Awareness of electrolyte disorders increased among physicians, but the direct impact of our feedback remains unclear. Other QIs showed little room for improvement and need re-evaluation. Overall results suggested a persistent need for training on intravenous fluids, especially on surgery wards, and feedback should include tailored communication with staff. References and/or acknowledgements Conflict of interest No conflict of interest
背景和重要性静脉液体管理可以帮助护理人员优化患者的预后,避免液体超载或电解质紊乱,并控制成本。实施管理计划需要监控,以保证遵循指导方针。目的和目标评价内部审计对静脉输液使用的影响,找出改进质量监测的机会。材料和方法为了评估比利时某大学医院的液体指南遵守情况,组织了一项内部审计,包括五个质量指标,由液体管理计划制定。在6个月期间(2019年8月至2020年1月),每2周计算一次QIs,重点关注处方和标签、适应症记录以及体重和电解质监测。每个病区管理员(22名医生,16名护士)以电子报告的形式收到前3个月(T1)的结果。采用χ2检验和中断时间序列(ITS)分析评估该报告对T1至随后3个月(T2)间QIs的影响。之后,管理人员就如何进一步优化流体管理监测进行了调查。结果共729例患者(T1: 361;T2: 368)接受758个静脉输液袋(T1: 381;T2: 377)。处方和标签QIs接近目标值。QI“文献指征”较低(21%)。“电解质值的可用性”在T1和T2之间显著增加(90.3% vs 96.2%)。结论和相关意识在医生中增加了电解质紊乱,但我们的反馈的直接影响尚不清楚。其他质量指标显示改善空间不大,需要重新评估。总体结果表明,持续需要进行静脉输液培训,特别是在外科病房,反馈应包括与工作人员进行有针对性的沟通。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-295 Immunotherapy for cancer therapeutic positioning reports: knowledge, expectations and experiences through a national survey 4CPS-295免疫疗法对癌症的治疗定位报告:通过全国调查得出的认识、期望和经验
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.127
M. González, J. M. Pozo, E. G. Peña, A. C. Lleti
Background and importance In our country, considerable progress has been made in recent years since the establishment of the clinical therapeutic position reports (TPR) in 2013, but more research is needed about their impact on decision making. Aim and objectives To determine the value of immunotherapy for cancer therapeutic positioning reports (ITc-TPR) in clinical practice. Material and methods A nationwide survey was designed for hospital pharmacists and clinical oncologists of the ITc-TPR, published between May 2013 and March 2020. The main variables collected were: sociodemographics of the hospitals and health professionals, approval criteria and variables related to the acceptance of the ITc-TPR recommendations. Results During the study period, 46 ITc-TPR of 22 active substances were published. 27 health professionals answered the survey, 81.5% hospital pharmacists and 18.5% oncologists, ascribed to 24 hospitals in the national territory. 33.3% of the professionals had participated in the development of some TPR-ITc. In 45.8% of hospitals, incorporation of ITc was decided at the regional level, and in 66.7% of hospitals the drug and therapeutic indication with ITc-TPR published should be re-evaluated by the pharmacy and therapeutics hospital commission. In 50%, the authorised indications were the same as those of the ITc-TPR and 70.8% followed the recommendations of the ITc-TPR. 48.1% of the professionals who responded to the survey believed that ITc-TPR have eliminated barriers for access of patients to ITc, have decreased the variability of clinical care and promoted equity in the national territory. 66.7% believed the incorporation of the drug into clinical practice was faster if there was a published ITc-TPR. The main limitations for patients to access ITc were: not financed by the national health system (55.6%), high cost (37.1%) and the restrictions at the autonomic level (29.6%). The aspects of the ITc-TPR that should be improved were: pharmacoeconomic evaluation (66.7%), conclusions useful for clinical practice (70.4%), a single evaluation at the national level (70.4%) and decisions binding (80.5%). Conclusion and relevance ITc-TPR is a useful and well established tool at the national level for the positioning of a new drug. The results of the survey will allow the development of strategies to improve ITc-TPR. References and/or acknowledgements Acknowledgements: AEMPS, GEDEFO, participants, directors, teachers and tutors of Master Inmunoterapia del Cancer. Conflict of interest No conflict of interest
背景与重要性在我国,自2013年建立临床医位报告制度以来,近年来取得了相当大的进展,但其对决策的影响尚待进一步研究。目的和目的探讨免疫治疗在肿瘤治疗定位报告(tc - tpr)中的临床应用价值。材料与方法在2013年5月至2020年3月期间,对ITc-TPR的医院药剂师和临床肿瘤学家进行全国性调查。收集的主要变量是:医院和保健专业人员的社会人口统计数据、批准标准以及与接受技术咨询委员会-技术咨询和方案建议有关的变量。结果研究期间共发表了22种活性物质的46种tc - tpr。27名卫生专业人员回答了调查,其中81.5%是医院药剂师,18.5%是肿瘤学家,来自全国24家医院。33.3%的专业人员参与了一些TPR-ITc的开发。45.8%的医院在区域一级决定纳入ITc, 66.7%的医院公布的ITc- tpr的药物和治疗指征需由药学和治疗学医院委员会重新评估。50%的临床适应症与ITc-TPR相同,70.8%的临床适应症遵循了ITc-TPR的建议。48.1%接受调查的专业人员认为,ITc- tpr消除了患者获得ITc的障碍,减少了临床护理的可变性,促进了国家范围内的公平。66.7%的人认为如果有已公布的tc - tpr,药物进入临床实践的速度会更快。患者获得ITc的主要限制是:没有国家卫生系统资助(55.6%)、费用高(37.1%)和自主层面的限制(29.6%)。ITc-TPR需要改进的方面为:药物经济学评价(66.7%)、结论对临床有用(70.4%)、国家层面的单一评价(70.4%)和决策约束性(80.5%)。在国家一级,ITc-TPR是一种有用且成熟的新药定位工具。调查的结果将有助于制定战略,以改善信息技术- tpr。致谢:AEMPS、GEDEFO、参与者、董事、教师和导师。利益冲突无利益冲突
{"title":"4CPS-295 Immunotherapy for cancer therapeutic positioning reports: knowledge, expectations and experiences through a national survey","authors":"M. González, J. M. Pozo, E. G. Peña, A. C. Lleti","doi":"10.1136/EJHPHARM-2021-EAHPCONF.127","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.127","url":null,"abstract":"Background and importance In our country, considerable progress has been made in recent years since the establishment of the clinical therapeutic position reports (TPR) in 2013, but more research is needed about their impact on decision making. Aim and objectives To determine the value of immunotherapy for cancer therapeutic positioning reports (ITc-TPR) in clinical practice. Material and methods A nationwide survey was designed for hospital pharmacists and clinical oncologists of the ITc-TPR, published between May 2013 and March 2020. The main variables collected were: sociodemographics of the hospitals and health professionals, approval criteria and variables related to the acceptance of the ITc-TPR recommendations. Results During the study period, 46 ITc-TPR of 22 active substances were published. 27 health professionals answered the survey, 81.5% hospital pharmacists and 18.5% oncologists, ascribed to 24 hospitals in the national territory. 33.3% of the professionals had participated in the development of some TPR-ITc. In 45.8% of hospitals, incorporation of ITc was decided at the regional level, and in 66.7% of hospitals the drug and therapeutic indication with ITc-TPR published should be re-evaluated by the pharmacy and therapeutics hospital commission. In 50%, the authorised indications were the same as those of the ITc-TPR and 70.8% followed the recommendations of the ITc-TPR. 48.1% of the professionals who responded to the survey believed that ITc-TPR have eliminated barriers for access of patients to ITc, have decreased the variability of clinical care and promoted equity in the national territory. 66.7% believed the incorporation of the drug into clinical practice was faster if there was a published ITc-TPR. The main limitations for patients to access ITc were: not financed by the national health system (55.6%), high cost (37.1%) and the restrictions at the autonomic level (29.6%). The aspects of the ITc-TPR that should be improved were: pharmacoeconomic evaluation (66.7%), conclusions useful for clinical practice (70.4%), a single evaluation at the national level (70.4%) and decisions binding (80.5%). Conclusion and relevance ITc-TPR is a useful and well established tool at the national level for the positioning of a new drug. The results of the survey will allow the development of strategies to improve ITc-TPR. References and/or acknowledgements Acknowledgements: AEMPS, GEDEFO, participants, directors, teachers and tutors of Master Inmunoterapia del Cancer. 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":"90098669","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}
引用次数: 0
5PSQ-216 Implementation of a medication reconciliation programme as a patient safety strategy 5PSQ-216将药物和解方案作为患者安全战略的实施
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.335
M. M. Sevilla, B. Rubio-Cebrián, ML De La Cruz Conty, B. Bartolomé, C. Moriel-Sánchez
Background and importance Medication errors (ME) are especially frequent in hospital emergency departments (ED). To minimise these ME, medication reconciliation programmes are established, which analyse and resolve the discrepancies detected in the medication regimen of the patient. Aim and objectives To evaluate implementation of the reconciliation programme in the ED of a second level general hospital. Material and methods An observational retrospective study was conducted. Records from patients admitted to the observation area of the ED from 1 January 2018 to 31 March 2019 and whose chronic medication was reconciled were studied. Information related to their chronic medication was collected from the hospital medical records, the primary care prescriptions and/or through an interview with the patient. Discrepancies were classified according to the SEFH consensus document, and categorisation of the potential harm associated with these ME was based on the NCCMERP index; the pharmacotherapeutic groups involved in these ME were also analysed. Results 26.7% of patients admitted to the ED during the study period were reconciliated (780/2921), with a mean of 10.14 medications per patient. A mean of 1.6 discrepancies per patient were detected; 40.52% were ME, two thirds of which resulted from the omission of chronic medication and 72.15% of errors reached the patient but did not cause harm. The drugs involved in a higher proportion of ME were drugs to treat cardiovascular disorders. From the total amount of pharmaceutical interventions performed, 49.25% were accepted by physicians. Conclusion and relevance Due to the high average chronic drug intake of patients attending the ED and, therefore, the potential risk of ME, collaboration between physicians and pharmacists is crucial to ensure reconciled medication of patients, as a patient safeguard strategy and a standard of quality within the health system. References and/or acknowledgements No Conflict of interest No conflict of interest
背景与重要性药物错误(ME)在医院急诊科尤为常见。为了尽量减少这些ME,建立了药物调和方案,分析和解决在患者的药物治疗方案中发现的差异。目的和目的评价某二级综合医院急诊科和解方案的实施情况。材料与方法采用观察性回顾性研究。研究了2018年1月1日至2019年3月31日入住急诊科观察区的患者记录,并对其慢性药物进行了调和。从医院医疗记录、初级保健处方和/或通过对患者的访谈收集与他们的慢性药物有关的信息。根据SEFH共识文件对差异进行分类,并根据NCCMERP指数对这些ME相关的潜在危害进行分类;并对这些ME所涉及的药物治疗组进行分析。结果在研究期间,26.7%的急诊科患者(780/2921)进行了调解,平均每位患者使用10.14种药物。平均每位患者检测到1.6个差异;40.52%为ME,其中三分之二是由于遗漏慢性用药造成的,72.15%的错误到达患者但未造成伤害。与ME相关的较高比例的药物是治疗心血管疾病的药物。在实施的药物干预措施总量中,医生接受的占49.25%。由于急诊科患者的平均慢性药物摄入量较高,因此存在ME的潜在风险,医生和药剂师之间的合作对于确保患者的协调用药至关重要,这是一种患者保障策略和卫生系统内的质量标准。无利益冲突无利益冲突
{"title":"5PSQ-216 Implementation of a medication reconciliation programme as a patient safety strategy","authors":"M. M. Sevilla, B. Rubio-Cebrián, ML De La Cruz Conty, B. Bartolomé, C. Moriel-Sánchez","doi":"10.1136/EJHPHARM-2021-EAHPCONF.335","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.335","url":null,"abstract":"Background and importance Medication errors (ME) are especially frequent in hospital emergency departments (ED). To minimise these ME, medication reconciliation programmes are established, which analyse and resolve the discrepancies detected in the medication regimen of the patient. Aim and objectives To evaluate implementation of the reconciliation programme in the ED of a second level general hospital. Material and methods An observational retrospective study was conducted. Records from patients admitted to the observation area of the ED from 1 January 2018 to 31 March 2019 and whose chronic medication was reconciled were studied. Information related to their chronic medication was collected from the hospital medical records, the primary care prescriptions and/or through an interview with the patient. Discrepancies were classified according to the SEFH consensus document, and categorisation of the potential harm associated with these ME was based on the NCCMERP index; the pharmacotherapeutic groups involved in these ME were also analysed. Results 26.7% of patients admitted to the ED during the study period were reconciliated (780/2921), with a mean of 10.14 medications per patient. A mean of 1.6 discrepancies per patient were detected; 40.52% were ME, two thirds of which resulted from the omission of chronic medication and 72.15% of errors reached the patient but did not cause harm. The drugs involved in a higher proportion of ME were drugs to treat cardiovascular disorders. From the total amount of pharmaceutical interventions performed, 49.25% were accepted by physicians. Conclusion and relevance Due to the high average chronic drug intake of patients attending the ED and, therefore, the potential risk of ME, collaboration between physicians and pharmacists is crucial to ensure reconciled medication of patients, as a patient safeguard strategy and a standard of quality within the health system. References and/or acknowledgements No Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86653630","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}
引用次数: 0
4CPS-388 Telepharmacy during SARS-CoV-2 SARS-CoV-2期间的远程医疗
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.220
R. Rodríguez, R. M. Comas, C. R. Galán, M. Villanueva, D. G. Vaquero, Jf Rangel Mayoral
Background and importance With the arrival of the global SARS-CoV-2 pandemic, hospital pharmacy services (HPS) have had to adapt to emerging needs. One of these measures has been the sending of medicines to vulnerable patients who, due to their pathologies, are discouraged from attending the hospital. Aim and objectives To analyse shipments and to evaluate the degree of patient satisfaction. Material and methods A retrospective study of shipments made between March and June 2020 in the outpatient department (OPD) of a tertiary hospital was conducted. Data were collected from the Farmatools drug dispensing programme and the citation lists of Jara Asistencial. The selected patients were those who were cited at the OPD, who did not have a face-to-face appointment with the doctor and accepted the referral. To measure the degree of user satisfaction, anonymous telephone surveys were made and evaluated by assigning a score from 0 to 10. The questions included aspects related to the attention received, schedule, information on the medication and overall satisfaction. A free field for suggestions for improvement was also included. A satisfied patient was defined as one whose global score was higher than 9. Results Of all the patients cited between March and June 2020 (2178 patients) by the HPS, 1284 (60%) were candidates for referral. Of the selected patients, 53% were finally sent the medication. 54% were from towns near Badajoz and the rest were from the capital city. Mean age was 53.5 years and 51.5% were women. The pathologies with the highest percentage of referrals with respect to the total number of patients registered in the OPD were: 83% primary biliary cirrhosis (5/6), 76% primary hyperparathyroidism (25/33), 73% inhibitors of PCSK9 (24/33) and 72% idiopathic pulmonary fibrosis (18/25). A total of 128 (64%) surveys were completed out of the 200 calls made. The average value of the responses obtained was higher than 9. Regarding the suggestions section, all survey respondents except one agreed to resume the medication delivery service. Conclusion and relevance Telepharmacy was a useful tool for the provision of pharmaceutical care, with a high acceptance rate by patients. It would be necessary to evaluate the inclusion of this service within the HPS. References and/or acknowledgements Conflict of interest No conflict of interest
随着全球SARS-CoV-2大流行的到来,医院药房服务(HPS)不得不适应新的需求。其中一项措施是向易受伤害的病人提供药品,这些病人由于其病况而不愿去医院。目的和目标分析装运情况并评估病人的满意度。材料与方法对某三级医院门诊2020年3月至6月的出货情况进行回顾性研究。数据收集自Farmatools药品调剂计划和Jara Asistencial的引文清单。选择的患者是那些在门诊被引用的,没有与医生面对面预约并接受转诊的患者。为了衡量用户满意度,进行了匿名电话调查,并通过分配从0到10的分数来评估。这些问题包括与所受到的关注、时间表、药物信息和总体满意度有关的方面。还包括提供改进建议的自由领域。一个满意的病人被定义为一个整体得分高于9。结果在2020年3月至6月HPS引用的所有患者(2178例)中,1284例(60%)为转诊候选人。在选定的患者中,53%的患者最终获得了药物。54%来自巴达霍斯附近的城镇,其余来自首都。平均年龄53.5岁,女性占51.5%。在OPD登记的患者总数中,转诊比例最高的病理是:83%的原发性胆汁性肝硬化(5/6),76%的原发性甲状旁腺功能亢进(25/33),73%的PCSK9抑制剂(24/33)和72%的特发性肺纤维化(18/25)。在200次电话调查中,共完成128次调查(64%)。得到的回答的平均值大于9。在建议部分,除一人外,其余受访者均同意恢复送药服务。结论:远程药房是提供药学服务的有效工具,患者接受率高。有必要评估将这项服务纳入HPS的情况。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
5PSQ-139 Prescriptive appropriateness of antibiotic therapies: crucial role of the hospital pharmacist 抗生素治疗的处方适宜性:医院药师的关键作用
Pub Date : 2021-03-01 DOI: 10.1136/EJHPHARM-2021-EAHPCONF.258
P. Sorice, S. Corridoni, L. Armillei, F. Gasbarri, G. Florio, S. Pizzica, C. Cinalli, G. D. Carlo, A. Romagnoli, L. Auriemma, A. Costantini
Background and importance In the context of the single dose, the pharmacist is involved in the validation of patients‘ personalised therapies, attempting to minimise errors in therapy. Aim and objectives The aim of this study was to evaluate, through the computerised prescription, the increase in prescribing appropriateness of antibiotic therapy, following notification by the pharmacist, with relative money saving costs. Material and methods The analysis was carried out by extrapolating, from the unit dose (UD) software, prescriptions of antibiotics subjected to a single request motivated (SRM) in the period from 1 January 2019 to 31 December 2019. We analysed inappropriate prescriptions where the hospital pharmacist affixed the ‘note’, sent immediately to the prescriber. These prescriptions were divided into inappropriate for: posology, duration of therapy and interaction/incompatibility. Subsequently, the variation in prescriptions due to the pharmacist’s intervention was evaluated (ie, the number of inappropriate prescriptions which were changed by the physician was extrapolated). In the pharmacoeconomic field, we evaluated the expenditure of inappropriate prescriptions without notification of the hospital pharmacist and the savings obtained following the change in therapy. Results During the study period, total prescriptions of antibiotics with SRM were 2067; 216 (10.45%) were not appropriate. The number of prescriptions modified following the pharmacist’s intervention was 104 (48%). Pharmacoeconomic analysis showed that the expenditure incurred for the dispensation of antibiotics related to inappropriate prescriptions changed by notification from the pharmacist was 77 537€ for 12 months. If the physician had not modified the therapies, the expenses would have been 162 762€ and therefore the amount of money saved was 85 225€ in 12 months. Conclusion and relevance The control and validation of medical prescriptions by the pharmacist produced an important added value to the risk management process, in that in almost 50% of cases the pharmacist’s notes led to an actual change in the medical prescription. The use of computerised prescriptions and single dose management contributed strongly to the objectives of verifying prescriptive appropriateness as a tool to govern effectiveness, efficiency and costs in healthcare. References and/or acknowledgements Conflict of interest No conflict of interest
背景和重要性在单剂量的情况下,药剂师参与患者个性化治疗的验证,试图减少治疗中的错误。目的和目的本研究的目的是评估,通过计算机化处方,增加抗生素治疗处方的适当性,在药剂师通知后,相对省钱的成本。材料与方法通过单位剂量(UD)软件外推2019年1月1日至2019年12月31日单次请求驱动(SRM)抗生素处方进行分析。我们分析了不合适的处方,医院药剂师贴了“说明”,立即发给处方者。这些处方被分为不适宜:病理、治疗时间和相互作用/不相容。随后,评估了由于药剂师干预而导致的处方变化(即,推断出由医生改变的不适当处方的数量)。在药物经济学领域,我们评估了在没有通知医院药剂师的情况下不适当处方的支出和改变治疗后获得的节省。结果研究期间,SRM类抗菌药物处方总数为2067张;216例(10.45%)不适宜。药师干预后修改处方104张(48%)。药物经济学分析显示,12个月内,因药剂师通知更改不适当处方而导致的抗生素调剂支出为77 537欧元。如果医生没有修改治疗方法,费用将是162 762欧元,因此在12个月内节省的金额为85 225欧元。药师对处方的控制和验证对风险管理过程产生了重要的附加价值,因为在近50%的情况下,药师的笔记导致了处方的实际更改。计算机化处方和单剂量管理的使用有力地促进了验证处方适当性的目标,将其作为管理医疗保健效力、效率和成本的工具。参考文献和/或致谢利益冲突无利益冲突
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European Journal of Hospital Pharmacy
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