Journal de pharmacie de Belgique最新文献

Introduction Pharmacist receive a lot of publicity for OTC products. Often one or more literature references are mentioned to support the advertising claims. Objective In this study we examine: [1) whether the advertising claim is consistent with what is stated in the literature references mentioned on the leaflet and [2] whether these literature references are trustworthy. Method Through 60 randomly selected community pharmacies, pharmacist-directed advertisements for OTC products I= medicines, medical devices, dietary supplements and parapharmacy) with at least one bibliographic reference, were collected. The literature references listed in these leaflets were assessed in terms of content [= is the claim consistent with the information in the reference) and technically [= evaluation of the quality of the references]. Results The 85 collected OTC advertisements made 214 claims that referred to 243 references. Of these, 128 references did not support the promotional claim. The remaining 84 references did support the corresponding claim. From 31 references no full text was obtained. Of the 84 supporting references 44 were of dubious quality. The remaining 40 references were found to be reliable. Conclusion This study shows that the literature references in advertising leaflets for OTC-products are not a reliable source of information on the advertised product. Pharmacists should deal critically with this information and should be encouraged to consult reliable scientific sources.

Polypharmacy is a common phenomenon among elderly patients. A simultaneous intake of a large number of drugs can possibly lead to drug-related problems due to an increased risk of drug interactions, medication errors, contra-indications, but also a lack of patient compliance. Elderly patients are particularlyvulnerable because of physiological and pathological aging. Therefore we need to be particularly attentive to their medication, especially in case of polypharmacy. A systematic review of the medication for elderly patients should regularly be performed to prevent the occurrence of potentially drug-related problems. In view of his central role in the dispensing of medicines, the pharmacist can carry out this medication review in consultation with the treating physician.

Some infections require prolonged parenteral antimicrobial therapy, which can be continued in an outpatient setting. The Ghent University Hospital has fifteen years of experience with Outpatient Parenteral Antimicrobial Therapy [OPAT) in the patient own home setting. As a quality improvement initiative, this process was critically reviewed in a multidisciplinary approach. Several challenges and barriers were identified, including regulatory obstacles for OPAT in Belgium, such as Lack of uniformity in ambulatory reimbursement of parenteral antimicrobials. There is no financial incentive for the patient with OPAT, as costs for the patient of outpatient therapy can be higher as compared with hospitalization. Other barriers include delayed approval of the certificate for reimbursement, low availability of medicines in the community pharmacies and limited knowledge of the medical devices for administration in ambulatory setting. All critical steps in the revised OPAT program are summarized in a flowchart with a checklist for all stakeholders. Firstly, a list with specific criteria to include patients in an OPAT program is provided. Secondly, the Multidisciplinary Infection Team received a formal mandate to review all eligible OPAT patients. In order to select the most appropriate catheter a decision tree was developed and standardized packages with medical devices were developed. Thirdly, patients receive oral and written information about the treatment with practical and financial implications. Fourthly, information is provided towards the general practitioners, community pharmacists and home care nurses. Standardization of the OPAT-program aims at improving quality and safety of intravenous antimicrobial therapy in the home setting.

Obstipation is a common complaint in pharmacies and one of the treatment strategies is the delivery of enteric coated bisacodyL tablets. This article reviews the different aspects that are important for pharmacists to guarantee patient safety: whether medical treatment is required or not, which advice should be given on how to use the drug, and to conclude what is the analytical quality of the commercial products on the Belgian market.

Background Medication safety and adherence are important aspects of quality of life, especially for frail elderly in our society. However, many elderly living at home may experience difficulties when taking their medication, and are therefore at risk for medication- related problems. The current living lab was implemented within the framework of the Flanders Care Living Labs and set the objective to develop a care pathway to improve medication safety and adherence for elderly living at home. Automated Individual Medication Preparation [IMP] was provided by a community-pharmacist in order to support frail elderly in taking their medication more correctly and thereby improving adherence. Methods In a before and after study, each patient was supported for 13 weeks through a multidisciplinary care pathway. Key in this pathway was the shared medication schedule (between GP and pharmacist) as the starting point for IMP and medication counselling. The increased medication support based on IMP was evaluated in frail elderly (age a 65 years, complex medication scheme a 5 medicines and a 3 intakes / day) before and after the study, by measuring adherence and satisfaction with counselling and repackaging the medication in sachets. Results The preliminary results of the current study showed that the self-reported adherence rate in frail elderly was significantly higher (p <0.05) after implementation of the pharmacists' intervention with automated IMP. At the end of the study every patient indicated that the repackaging of the medication by dose was helpful in order to take their medication correctly. Conclusion Increased medication counselling with IMP by the community-pharmacist may be a useful aid and supporting tool for frail elderly living at home with a complex medication scheme.

Introduction The administration of intravenous medications in hospital is a common practice. Although it may seem almost insignificant, this practice remains no less an act which involves risks, due to many factors identified. It is therefore important to gather, clarify and communicate the updated information on the modalities of the administration of these injections in order to facilitate and secure the work of the teams of care with a view of an optimal and standardized administration of intravenous medications. Method The tables of standardization of injectable drugs have been made on several occasions in the past and distributed in the care units. The latest version of these documents was reviewed and updated in the light of the recent editions of several sources. The data concerning each individual injectable medicine have individual as well been systematically updates. The updated data have been integrated into the electronic prescription of medicines, a standardized dilution is now proposed by default to the prescriber. For some drugs, special modalities of administration have been planned to meet the specific needs of patients hospitalized in the Intensive Care Unit (ICU). Results The methods for dilution of injections in classical hospitalization have been integrated in the electronic prescribing software (238 "packages" in total. The specific dilutions used in the ICU (48 in total, have been validated but may not be used in the conventional care units. Conclusion All of the information relating to the methods of preparation and administration have been gathered and clarified in order to facilitate and secure the work of the teams of care and thus enable optimal administration of intravenous medications. The information is accessible on paper file and via the internal computer network, the PC of intensive care units and the software Computerized prescription.

Objectives Assessing the impact of professional practices on a patient's course is an interesting way to optimize health care pathway. The aim of our study is to update and evaluate the compliance to the recommendations of the Societe de Pathologie Infectieuse de Langue Francaise with regards to professional practices and the route of patients admitted to the emergency department of a French military hospital for high urinary tract infection. Patients and methods A retrospective study was carried out on patients admitted to the emergency department and treated for high urinary tract infection from January 1st, 2015 to April 30th, 2015. Clinical and administrative data, medical exams, and antibiotic prescriptions were extracted from computerized patient medical files and from emergency medical files. Results Out of 91 medical cares, 57% were compliant with the recommendations. For 60% of the patients, blood cultures were not argued and in 70% of cases, imaging wasn't justified. Antibiotic prescriptions were not compliant in 31% of cases, mostly due to long prescription durations. Two third of patients received outpatient care. All hospitalizations were argued. Conclusions Drawing up a caring protocol, regularly raising awareness to the good use of antibiotics, as well as reinforcing a cross disciplinary approach will allow optimizing health care pathways for patients coming to the emergency department with high urinary tract infection.

For several reasons the community pharmacist plays an important role in smoking cessation. In order to know how he is fulfilling this role, a survey was conducted among Belgian community pharmacists on smoking cessation communication in their pharmacy. The pharmacists and the pharmacy personnel were invited to answer an online questionnaire. In community pharmacy the patient is quite often asked if he smokes, however there still remain some obstacles to talk with the patient about smoking behaviour. The major obstacles are lack of time and the fear of a conflict with the patient. The results of the survey reveal that pharmacists and their assistants have a good knowledge of smoking cessation, but there is still some room to improve. In order to improve the smoking cessation support by pharmacists and their assistants, some efforts are necessary to overcome the obstacles. It would also be useful to organise more courses of tabacology at the faculties of pharmacy of the universities and in the continuing education programs for pharmacists.

Herpes labialis, more commonly known as cold sores or fever blisters, is the most common clinical manifestation of infection with Herpes simplex virus type 1. It is a highly contagious and widespread infection. Generally benign, cold sores may however disturb those who suffer from them, because of the symptoms they cause or their unsightly and frequent appearance. The pharmacist is often consulted to relieve cold sore recurrences. As for any request for advice, the pharmacist will assess if he can help the patient himself or if medical advice is more appropriate. Besides a possible symptomatic treatment, the pharmacist will also advise the patient to prevent recurrence and the contamination of other people.