Journal de pharmacie de Belgique最新文献

Introduction Pharmacists can be faced with pediatric patients treated for a hemato-oncological condition or patients who underwent a hematopoietic stem cell transplantation [HSCT). This study aims to identify the roLe of the pharmacist and master in pharmacy students as well as their knowLedge of pharmaceutical care for this specific patient population. In addition, their experiences of basic education and expectations of continued education in pediatric hemato-oncology and HSCT are analyzed. Methods Pharmacists in Flanders and pharmacy students [Ghent University] were requested to complete and online survey with (1) general questions, (2) questions about knowledge by means of theoretical examples and practical cases and (3) questions about education (past and future) related to this topic. Results A total of 156 pharmacists and 67 students completed the survey. Results demonstrated that 22.0% of pharmacists and students already delivered medication to this particular patient group. A total of 98.2% [pharmacists and students] found that they had insufficient knowledge and experience to give optimal pharmaceutical advice. The pharmacist scored only 34.0% [average] in the general knowledge section, students 44.0%. Both pharmacists [68.6%] and students [79.0%] agreed that this topic should be included in the basic curriculum. The vas majority [91.0% pharmacists, 89.6% of students] were asking for courses on this theme by means of and evening session or an e-learning tool. Conclusion Although the role of pharmacists and students in this patient group can be confirmed, the results of the survey demonstrate a lack of knowledge among pharmacists and students about pediatric hemato-oncology and HSCT. There is interest in education in the basic curriculum and the vast majority of pharmacists are interested in continuing education.

Essential oils are highly concentrated products of a complex composition, obtained from plants. Their therapeutic use relies mostly on tradition and experience. Often few clinical trials are available. The quality and efficacy of only several essential oils are described in the European pharmacopeia and in monographs of the EMA. In addition, essential oils on the Belgian market have different statutes [medicine, food supplement, raw material...]. This results in a complicated legislation. Furthermore, the general public wrongly assumes that essential oils, because of their vegetal origin, can be used at any time without any danger. However, toxicological reactions are described after oral, topical and other routes of administration. Certain precautions need to be taken before using potentially hazardous essential oils. Children and pregnant women are particularly vulnerable populations that need extra attention.

Compounded preparations are an additional therapeutic option besides registered medicines. Because of their <> they have a great value and thus an undeniable place in the therapeutic arsenal available to the physician. To maintain this position, however, they must be of unquestionable quality. Structuring and documenting the compounding operations, incorporating the necessary controls and respect for evident basic rules and precautions can reduce potential errors to a minimum. Pharmacists can rely for this on existing recommendations listed in the different reference books such as the Therapeutic Magistral Form and the Guidelines for Good Officinal Practices, but which aren't always commonly used by pharmacists.

Social sciences are important for training in pharmacy faculties. The course set up at the Faculty of Pharmacy of the University of Montreal in 2011 is a very innovative way to meet this challenge. The purpose of this report is to share this experience by providing a synthetic description. Many students were able to develop new skills and strengthen their skills, including leadership and critical thinking. The Faculty of Pharmacy was also able to achieve greater visibility in the Montreal community, that is to say from the associations, but also with what is out there called the "local health network" linking various health care professionals and institutions. Beyond the quantifiable results, this course is an evolving learning process in which the group interactions, individual and collective values and the task sharing allow students to build a working knowledge of social factors, which d.etermine health problems.

About 20% of the European population is older than 65 years. Because of multimorbidity (i.e. multiple chronic condition within a patient), older patients are often prescribed multiple drugs [i.e. polypharmacy). Both older age and polypharmacy significantly increase the risk for adverse drug events. International research showed that more or less 5% of all unplanned hospital admissions is related to the use of medication. About 70% of these drug related admissions happened in patients older than 65 years. Moreover, about half of the admissions could have been avoided. These preventable hospital admissions were caused by the intake of medication without an indication, problems with medication adherence, interactions and/or insufficient monitoring. We define this as (potential Drug Related Problems [DRPI. DRPs can occur on multiple occasions during the medication management process: prescribing, dispensing, intake and monitoring. When DRPs can be detected in an early stage, significant consequences can be avoided. To accomplish this, multiple strategies are possible. One of the possibilities is performing a periodic medication screening by the community pharmacist in patient groups at risk. During such a medication screening, the pharmacotherapy is critically evaluated in a systematic and structured way. The implementation of medication screening in first-line health care is currently limited. The community pharmacist is nevertheless ideally placed to perform this task. There is an important relation of trust between him and the patient and the community pharmacist has access to a full medication history. Furthermore, as an expert in drug-related issues, he possesses all necessary knowledge to perform the pharmacotherapeutic analysis.

Objective Is to evaluate the nutritional status of preoperative patients in the visceral surgery department III of CHU Ibn Rushd of Casablanca and to correlate to postoperative length of stay. Patients and methods Prospective observational study of six months from February 2015 to late July 2015, in patients from being operated in the visceral surgery department II1. The nutritional status of 151 patients preoperatively was evaluated the correlation between the various diagnostic tests and clinical and biological parameters was investigated and postoperative length of stay was calculated. Results 151 patients predominantly female (72.84%1, reporting their consent, were selected for this study. 51.56% of patients had risk factors for undernutrition. The cholelithiasis was the most responded diagnosis (57.61%). The Nutritional Risk Index (NRII allowed to identify 13 low nutritional risk patients, 7 moderate-risk and 3 major risk. According to the Mini Nutritional Assessment (MNA two elderly people [over 70 years] were at risk of undernutrition and one person had a bad nutritional status. Nutritional risk stratification identified 19 patients with postoperative nutritional grade 3. The average length of stay was variable; it was not correlated with the nutritional status of patients against it is based on the type of surgery. Conclusion The risk of undernutrition was high; however, a single parameter is insufficient for the diagnosis of preoperative undernutrition, a combination of different parameters would be a more reliable method.

Introduction Community pharmacists have an important role in the management of drug-drug interactions (DD). One of the interactions that can lead to serious adverse drug events, more specifically Torsade de Pointes and sudden cardiac death, are DDI with risk of CT-prolongation. Many drugs from different therapeutic classes have been linked with the risk of QT-prolongation (as listed in the QT-drug lists of CredibleMeds]. Moreover, patient-specific risk factors should be taken into account. This leads to a complex risk estimation of QT-prolongation for each patient. Aim The aim of this study is to investigate the prevalence of DDI and the management of these interactions in community pharmacies, with special attention for DDI with a risk of QT-prolongation. Method This epidemiological study is based on data of an interuniversity, observational study in 534 Belgian community pharmacies with a last-year pharmacy student (November 2012 - March 2013), in which all drug-related problems (DRP) and associated interventions of the pharmacist were registered for drugs on prescription. In this study, all DRP that were registered as a DDI were selected. The evidence for these DD was verified in four information sources (DelphiCare, Medscape, Drugs.com, handbook 'Commentaren Medicatiebewaking'). Finally, an in-depth analysis was performed for DDI with risk of QT-prolongation. QT-prolonging drugs were identified with the QT-drug lists of CredibleMeds. Results In total, 64.962 prescriptions and 15.952 DRP were registered in the interuniversity study, of which 1858 DRP (11.6%) described as a DDI that was confirmed in at least one of the information sources. Of these interactions, 223 [12.0%] were linked with a risk of QT- prolongation. The majority of the concerned drugs are situated in list 1 of CredibleMeds (known risk of Torsade de Pointes). In 69 CT-prolonging DDI, two drugs of list 1 were involved. The most frequent QT-prolonging DDI was between escitalopram and quetiapine (N=11J. In 69.5% of the QT-prolonging DDI, an intervention was performed by the community pharmacist. In 47.8% of these interventions, the DDI was discussed with the patient. In 28.3% of the QT-prolonging DDI, the pharmacist contacted the physician. However, the proposed intervention was often considered unnecessary by the physician (42.9%). In only 4.5% of the interventions, the involved CT-prolonging drug was replaced by an alternative. Conclusion DDI represent an important part of the DRP in community pharmacies, including DDI with a risk of CT-prolongation (12% of the interactions). In the majority of the QT-prolonging DDI, at least one QT-prolonging drug of list 1 of CredibleMeds [known risk of Torsade de Pointes) was involved. In only 4.5% of the interventions, the involved QT-prolonging drug was replaced by an alternative.

Biologicals are omnipresent in the current therapeutic arsenal for treating several chronic and life-threatening diseases. Following expiry of patent, 'generic' versions of biological medicines are being developed, so-called biosimilars. In view of their potential to reduce the continuous economic pressure of biologicals on the healthcare system, the eagerness to introduce them at fast rate as alternative treatment options is huge. For all parties involved (patients, physicians, pharmacists and other healthcare professionals), it is of utmost importance to get acquainted with the features of biosimilars. Biosimilars differ from generic drugs as they are, as a result of a complex production process in living organisms, never 100% chemically identical to the originator drug. However, the stringent regulatory pathway for approval requires similarity to the reference biological medicine in terms of biological activity, safety and efficacy. Knowledge on immunogenicity, interchangeability and substitution is constantly evolving. As more biosimilars - possibly of the same reference biological - will entrance the market, traceability becomes key for an efficient pharmacovigilance system. Pharmacists, in their role to advice and support patients, should be adequately trained and have access to relevant information about all aspects on biosimilars.

Aim Aims are: 1] Identify causes of Drug Related Problems (DRPs), interventions performed by pharmacists and results of corticosteroid- related problems and 2] distinguish between problems related to inhaled and general corticosteroids. Methods During 5 days of their internship, 534 final year students of pharmaceutical sciences in six Belgian universities collected DRPs encountered in community pharmacies, as well as related interventions performed by pharmacists and the result of the intervention. The DRPs' electronic registration was done through an adapted tool for Belgium based on the classification of Pharmaceutical Care Network Europe [PCNE- v 6.2]. Findings The frequency of DRPs is 24,8%. 766 DRPs (4,8%) related to corticosteroids, of which 351 were inhaled corticosteroids. The most common causes of corticosteroid-related problems (53- 59%) were technical causes. The most represented category of clinical causes was the inappropriate choice of drug [33-41%]. Pharmacists' intervention was similar for inhaled and general corticosteroids. Pharmacists intervened orally with patients in 38-40% of total interventions, and in writing in 16% of interventions. Pharmacists did not react in 16% of corticosteroid-related problems. 81-83% of PLMS were resolved partially or completely. Conclusion In conclusion, DRPs detected in community pharmacies related to corticosteroid are infrequent (4,8% of DRPs) but 82% of detected problems have been resolved. Furthermore, the study shows the importance for the Belgian health system to introduce an official DRPs classification and software facilitating their documentation in community pharmacies.