Pub Date : 2021-03-01DOI: 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
{"title":"4CPS-388 Telepharmacy during SARS-CoV-2","authors":"R. Rodríguez, R. M. Comas, C. R. Galán, M. Villanueva, D. G. Vaquero, Jf Rangel Mayoral","doi":"10.1136/EJHPHARM-2021-EAHPCONF.220","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.220","url":null,"abstract":"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","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75101778","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}
Pub Date : 2021-03-01DOI: 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
{"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}
Pub Date : 2021-03-01DOI: 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
{"title":"5PSQ-139 Prescriptive appropriateness of antibiotic therapies: crucial role of the hospital pharmacist","authors":"P. Sorice, S. Corridoni, L. Armillei, F. Gasbarri, G. Florio, S. Pizzica, C. Cinalli, G. D. Carlo, A. Romagnoli, L. Auriemma, A. Costantini","doi":"10.1136/EJHPHARM-2021-EAHPCONF.258","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.258","url":null,"abstract":"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","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80914798","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}
Pub Date : 2021-03-01DOI: 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
{"title":"6ER-033 Pharmacist led deprescribing and follow-up in a subacute multidisciplinary outpatient clinic: a pilot randomised controlled trial","authors":"A. Aharaz, J. H. Rasmussen, H. Mcnulty, A. Cyron, A. Bengaard, RR Løvig Simonsen, Charlotte Treldal, M. B. Houlind","doi":"10.1136/EJHPHARM-2021-EAHPCONF.357","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.357","url":null,"abstract":"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","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82650629","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}
Pub Date : 2021-03-01DOI: 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
{"title":"5PSQ-136 Disproportionality analysis of the skin toxicity of ingenol mebutate using the FDA Adverse Event Reporting System database","authors":"F. Pappalardo, V. Rocco, C. Polidori","doi":"10.1136/EJHPHARM-2021-EAHPCONF.255","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.255","url":null,"abstract":"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","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82868461","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}
Pub Date : 2021-03-01DOI: 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
{"title":"5PSQ-204 Difference in adherence associated with the route of administration","authors":"O. I. Barrueta, E. P. Diez, E. I. García, U. A. Larracoechea","doi":"10.1136/EJHPHARM-2021-EAHPCONF.323","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.323","url":null,"abstract":"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","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81684520","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}
Pub Date : 2021-03-01DOI: 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
{"title":"5PSQ-205 Manipulating tablets containing poorly soluble prednisolone to obtain paediatric doses","authors":"RH Svendsen, J. Brustugun, I. Tho, K. Bjerknes","doi":"10.1136/EJHPHARM-2021-EAHPCONF.324","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.324","url":null,"abstract":"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","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86906061","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}
Pub Date : 2021-03-01DOI: 10.1136/EJHPHARM-2021-EAHPCONF.206
Trh Andersen, MP Von Hallas, LM Weisbjerg, L. Petersen
Background and importance The National Health Authority calls for initiatives ensuring that relevant elderly polypharmacy patients receive medication reviews during hospital admission to reduce the risk of adverse events. Potentially inappropriate medications (PIMs) are one of the most frequent causes of adverse events in older people. Pharmacist led systematic medication reviews are time consuming, and while hospital length of stay has progressively reduced to an average of a few days, the effort has to be aimed at PIM interventions that are best suited to being carried out by a hospital physician. Aim and objectives The purpose of the study was to develop a screening model to identify patients who may benefit from a pharmacist led medication review in hospital. Material and methods A screening model was developed using PIMs described in the international literature and the workflow of pharmaconomists and clinical pharmacists in local hospitals. The screening model was applied to all elderly polypharmacy patients admitted to bed wards having pharmaconomist medicine management in five hospitals. Patients fitting the model were identified by pharmaconomists and referred to a pharmacist led medication review. The pharmacist led medication review was performed centrally with the aim of reducing the number of drugs, number of PIMs and complexity of the medication regimen. The primary outcome was the number of PIMs at discharge compared with the number of PIMs at admission to hospital. Results The screening tool in the model comprised 10 medication focus points and demonstrated a specificity of 78% and sensitivity of 80% in detecting the relevant patients when applied to a cohort of elderly polypharmacy patients. From April to June 2018, 17 631 patients were screened using the tool. The pharmaconomists referred 396 patients to the pharmacists (average age 78 years, 52% women). Of these, 229 received a pharmacist led medication review (average of 2.78 interventions/patient). For the 115 patients with a possible follow-up, the average number of PIMs/patient was significantly reduced (p Conclusion and relevance The screening model developed detected relevant elderly polypharmacy patients for a pharmacist led medication review during hospital admission. The model was easily implemented, low resource and resulted in a significantly reduced number of potentially inappropriate medications. References and/or acknowledgements Conflict of interest No conflict of interest
{"title":"4CPS-374 A screening model to identify elderly polypharmacy patients that may benefit from pharmacist led medication review during hospital admission","authors":"Trh Andersen, MP Von Hallas, LM Weisbjerg, L. Petersen","doi":"10.1136/EJHPHARM-2021-EAHPCONF.206","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.206","url":null,"abstract":"Background and importance The National Health Authority calls for initiatives ensuring that relevant elderly polypharmacy patients receive medication reviews during hospital admission to reduce the risk of adverse events. Potentially inappropriate medications (PIMs) are one of the most frequent causes of adverse events in older people. Pharmacist led systematic medication reviews are time consuming, and while hospital length of stay has progressively reduced to an average of a few days, the effort has to be aimed at PIM interventions that are best suited to being carried out by a hospital physician. Aim and objectives The purpose of the study was to develop a screening model to identify patients who may benefit from a pharmacist led medication review in hospital. Material and methods A screening model was developed using PIMs described in the international literature and the workflow of pharmaconomists and clinical pharmacists in local hospitals. The screening model was applied to all elderly polypharmacy patients admitted to bed wards having pharmaconomist medicine management in five hospitals. Patients fitting the model were identified by pharmaconomists and referred to a pharmacist led medication review. The pharmacist led medication review was performed centrally with the aim of reducing the number of drugs, number of PIMs and complexity of the medication regimen. The primary outcome was the number of PIMs at discharge compared with the number of PIMs at admission to hospital. Results The screening tool in the model comprised 10 medication focus points and demonstrated a specificity of 78% and sensitivity of 80% in detecting the relevant patients when applied to a cohort of elderly polypharmacy patients. From April to June 2018, 17 631 patients were screened using the tool. The pharmaconomists referred 396 patients to the pharmacists (average age 78 years, 52% women). Of these, 229 received a pharmacist led medication review (average of 2.78 interventions/patient). For the 115 patients with a possible follow-up, the average number of PIMs/patient was significantly reduced (p Conclusion and relevance The screening model developed detected relevant elderly polypharmacy patients for a pharmacist led medication review during hospital admission. The model was easily implemented, low resource and resulted in a significantly reduced number of potentially inappropriate medications. 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":"89636157","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}
Pub Date : 2021-03-01DOI: 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
{"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}
Pub Date : 2021-03-01DOI: 10.1136/EJHPHARM-2021-EAHPCONF.77
CM Pinto-Nieto, P. C. Baena, J. C. Mangana, A. M. Rosa, B. C. Robles, MA Garre Gonzalvez, G. Corral, M. H. Expósito, J. Plata, M. Vida
Background and importance Shortening the duration of antibiotic treatment is one of the cornerstones to reduce antibiotic pressure and, therefore, the appearance of antimicrobial resistance Aim and objectives To describe the duration of antibiotic treatment in patients discharged from a short stay hospitalisation unit and to analyse the duration of antibiotic treatment with regards to the current evidence based recommendations. Material and methods A descriptive, retrospective, cross sectional study was carried out in a short stay hospitalisation unit in January 2020. Patients ≥14 years old with an antibiotic prescription at discharge were included. Data collected were: age, gender, average number of admission days, antibiotic prescribed and antibiotic clinical indication. Data were collected from patients’ electronic health records. Pubmed database review was performed regarding the current evidence based recommendations for optimising the duration of antibiotic treatment. Results 98 patients were admitted in January 2020; 63 patients met the study inclusion criteria and 40 were men. Average age was 74 years (18–92) and average number of admission days was 3.4 (1–11). 11 (17.5%) patients visited the emergency department or general practice the following month due to an infectious process and 7 of these patients were readmitted. 36 (57%) patients had taken antibiotics within 3 months before the study. The most common illnesses were community acquired pneumonia (CAP) 16 (25.4%), acute bronchitis (AB) 15 (23.8%), COPD exacerbation 13 (20.6%) and influenza 7 (11.1%). The most common antimicrobials prescribed were: cephalosporins 24 (26.7%), co-amoxiclav 20 (22.2%) and quinolones 17 (18.9%). Patients with AB were not analysed because there is no optimal duration of antibiotic treatment recommended in the current scientific evidence. The remainder of the patients were analysed (48): 35 were given antibiotics for more days than the recommended evidence (15 CAP, 12 COPD exacerbation, 4 influenza, 4 other infections); 9 patients were given antibiotics as per the recommended duration (3 acute pyelonephritis, 3 influenza, 1 CAP, 1 hospital acquired pneumonia, 1 complicated cystitis); and 4 were given antibiotics for a shorter duration than recommended (1 complicated cystitis, 1 COPD exacerbation, 1 pharyngotonsillitis, 1 acute gastroenteritis). Conclusion and relevance Nearly 75% of patients had a longer antibiotic course than the recommended evidence. This should be a priority for intervention. It is important to create antibiotic awareness, where ‘shorter is better’ is a ‘prescriber mantra’ as far as the rational use of antibiotics is concerned. References and/or acknowledgements Conflict of interest No conflict of interest
{"title":"4CPS-245 Duration of antibiotic treatment in patients discharged from a short stay hospitalisation unit","authors":"CM Pinto-Nieto, P. C. Baena, J. C. Mangana, A. M. Rosa, B. C. Robles, MA Garre Gonzalvez, G. Corral, M. H. Expósito, J. Plata, M. Vida","doi":"10.1136/EJHPHARM-2021-EAHPCONF.77","DOIUrl":"https://doi.org/10.1136/EJHPHARM-2021-EAHPCONF.77","url":null,"abstract":"Background and importance Shortening the duration of antibiotic treatment is one of the cornerstones to reduce antibiotic pressure and, therefore, the appearance of antimicrobial resistance Aim and objectives To describe the duration of antibiotic treatment in patients discharged from a short stay hospitalisation unit and to analyse the duration of antibiotic treatment with regards to the current evidence based recommendations. Material and methods A descriptive, retrospective, cross sectional study was carried out in a short stay hospitalisation unit in January 2020. Patients ≥14 years old with an antibiotic prescription at discharge were included. Data collected were: age, gender, average number of admission days, antibiotic prescribed and antibiotic clinical indication. Data were collected from patients’ electronic health records. Pubmed database review was performed regarding the current evidence based recommendations for optimising the duration of antibiotic treatment. Results 98 patients were admitted in January 2020; 63 patients met the study inclusion criteria and 40 were men. Average age was 74 years (18–92) and average number of admission days was 3.4 (1–11). 11 (17.5%) patients visited the emergency department or general practice the following month due to an infectious process and 7 of these patients were readmitted. 36 (57%) patients had taken antibiotics within 3 months before the study. The most common illnesses were community acquired pneumonia (CAP) 16 (25.4%), acute bronchitis (AB) 15 (23.8%), COPD exacerbation 13 (20.6%) and influenza 7 (11.1%). The most common antimicrobials prescribed were: cephalosporins 24 (26.7%), co-amoxiclav 20 (22.2%) and quinolones 17 (18.9%). Patients with AB were not analysed because there is no optimal duration of antibiotic treatment recommended in the current scientific evidence. The remainder of the patients were analysed (48): 35 were given antibiotics for more days than the recommended evidence (15 CAP, 12 COPD exacerbation, 4 influenza, 4 other infections); 9 patients were given antibiotics as per the recommended duration (3 acute pyelonephritis, 3 influenza, 1 CAP, 1 hospital acquired pneumonia, 1 complicated cystitis); and 4 were given antibiotics for a shorter duration than recommended (1 complicated cystitis, 1 COPD exacerbation, 1 pharyngotonsillitis, 1 acute gastroenteritis). Conclusion and relevance Nearly 75% of patients had a longer antibiotic course than the recommended evidence. This should be a priority for intervention. It is important to create antibiotic awareness, where ‘shorter is better’ is a ‘prescriber mantra’ as far as the rational use of antibiotics is concerned. References and/or acknowledgements Conflict of interest No conflict of interest","PeriodicalId":11998,"journal":{"name":"European Journal of Hospital Pharmacy","volume":"644 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91511134","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}
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