Journal de pharmacie de Belgique最新文献

Osteoporosis is a chronic disease with an increasing prevalence due to the ageing of the population. The consequences of this disease are not negligible because of the morbidity and mortality associated with it. Osteoporotic fractures are often the cause of loss of independence in the elderly, requiring considerable resources in terms of health services. Osteoporosis can be prevented effectively, but remains underestimated. Thanks to his frequent contacts with the public, the pharmacist can play an important role by informing about the disease and raising awareness for the prevention of it.

Osteoporosis is a chronic disease with an increasing prevalence due to the ageing of the population. The consequences of this disease are not negligible because of the morbidity and mortality associated with it. Osteoporotic fractures are often the cause of loss of independence in the elderly, requiring considerable resources in terms of health services. Osteoporosis can be prevented and treated. However, it remains underestimated, underdiagnosed and undertreated. Thanks to his frequent contact with the public, the pharmacist can play an important role at multiple levels: supporting patients in treatment, by providing information on the disease, its treatment, proper use of medication, adherence and persistence, as well as raising awareness for the prevention of osteoporosis and identifying patients at risk.

Medicines and food supplements containing anthranoid herbal drug preparations were verified on identity of the herbal substance, content of total hydroxyanthracene glycosides and microbiological quality. All examined medicines complied with the fixed requirements whereas all food supplements deviated from 1 or more of the criteria. The food supplements showed a large variability in quality and content.

In a pilot project, the value of a clinical pharmacist in the oncology department is examined. There is special attention given to two clinical pharmaceutical criteria concerning use of potential inappropriate drugs in this population. First of all, the Drug Burden Index (DBI), a measurement of the individual exposure to anticholinergic and sedative drugs. Second of all, the Beers criteria, an explicit criterion of potential inappropriate use of drugs by the geriatric patient. Criteria are adapted for application in Belgian practice. It can be concluded that the clinical pharmacist can be used to support the multidisciplinary approach to cancer patients. The use of the two criteria mentioned above in the estimation of the clinical impact of drugs on functional outcome and cognition on the (oncolgeriatric patient and the correlation with hard endpoints, still need to be investigated.

Introduction: Improvement of healthcare quality and safety are two main goals for hospitals. High risk preparations of injectable drugs is one of the possible areas for improvement. In this context the production of batches of standard doses is a practical solution in response to the increased demand. Some toolkits exists to facilitate the implementation of dose banding, but, to our knowledge, no complete strategy was available until today.

Aim and purpose: To propose a rational approach to analyse the possibility of implementing standard doses and choose the most relevant drugs for dose standardization.

Method: The method is based on the analysis of literature focusing on different themes: safety, international guidelines, batch production regulation and stability studies.

Results: An approach on the strategies to develop is detailed for pharmacists willing to implement standard doses. All key stages are discussed: the needs of care units, the analysis and risk assessment, the stability studies and the practical implementation of the standard doses preparation and quality control.

Conclusion: The implementation of standard doses seems a rational and necessary evolution of hospital pharmacy in response to the increase of compounding activity and the requirements of quality preparation. A global and all-inclusive approach is needed for this purpose. All parameters have to be considered to avoid errors. A process and a decision aid are suggested to facilitate the development of standard doses.

Introduction: The identification, the management and if possible the prevention of drug related problems (DRP), are the main responsibilities of pharmacists.

Aim: The aims of the study were 1/to investigate the frequency and nature of drug related problems detected by community pharmacists, 2/to inventories the frequency and nature of the interventions by community pharmacists on prescribed medicines, and 3/to evaluate whether there is a difference between DRP detection at the moment of dispensing versus in a quiet setting (a posteriori detection).

Method: All trainees of the participating universities of Belgian were asked to contribute to a observational study. Participating pharmacists quantified DRP's and their interventions on prescribed medicines for 5 days. Registrations were made by using a web tool based on an adapted version of the classification list of PCNE. The registration took place in two phases, at the time of delivery as well as in an a posteriori verification of the prescriptions with the pharmaceutical record file of the patients.

Results: The study was conducted from November 2012 to April 2013 in 534 community-pharmacies with internship. During this period 9.869 prescriptions (15%) with at least one DRP were detected on a total of 64.962 prescriptions treated by tutor pharmacists. Since there could be more than one problem on a prescription, 15.952 DRP's were registered. 2.597 of the DRP's were detected by a posteriori verification. 75% of all problems had a technical cause and 37% were clinical in nature. Under the technical causes an incomplete prescription was the most common. The most frequently registered clinical causes were a drug interaction, an inopportune time of intake, a too high or too low dose and an unsuitable drug. Participating pharmacists solved almost 3 of the 4 detected DRP's. In more than half of the DRP's, the patient was verbally and/or written informed. In 44% of the a posteriori discovered problems, the pharmacist intervened.

Conclusion: Pharmacist detected one or more DRP's with 15% of the prescriptions. Analysis of a prescription prior to dispensing the medicines therefore appears necessary. The active intervention of the pharmacist in 83% of the problems indicates that he contributes to the optimization of drug therapy with a potential increase in the quality of life of the patient and a reduction in the cost of healthcare. The a posteriori discovered DRP's demonstrate the need for pharmacist lead meditation reviews possibly together with the physician and/or patient.

Vitalink is a digital platform to share health patient data among health care professionals in primary care. The Flemish community started the development of this platform in collaboration with representatives of professional associations primary care. Sharing medication charts online was the first Vitalink project. In December 2012 four pilot regions in Flanders (Turnhout, Limburg, Aalst and Halle) tested medication chart sharing through Vitalink. Due to difficulties with software development effective sharing started only in April 2013. The test phase was ended in October 2013. Each pilot region made an evaluation report. Conclusions were similar: the realization business cases were limited. Integration in end user software was insufficiently performant. Moreover, interpretation of downloaded medication charts was found out to differ among participating software applications. Because of these problems exchange of patient records among primary care actors was limited. Therefore research questions could not be conclusively answered. Nevertheless the Vitalink pilot project can be considered successful in some ways. Collaboration and communication among health care professionals and their associations was ameliorated. The awareness of digital data sharing in primary care is growing. Pilot projects created buy in among patients, physicians, pharmacists and nurses. Uniform lay-out guidelines were established in deliberation with all participating actors. Since November 2013 Vitalink is in production. Medication charts, summarized electronic health records and vaccination data can be uploaded to the platform and health care professionals that are registered can consult them. End user software must still be developed to make broad use of the platform feasible. Meanwhile further deliberation with software vendors and professional associations can be organized in order to achieve the implementation and integration of user friendly Vitalink modules.