Pub Date : 2025-11-01DOI: 10.1016/j.farma.2025.04.004
Antonio García-Quintana , Héctor Alonso Ramos , Javier Parrondo
Introduction
Heart failure is an increasingly common syndrome with a rising prevalence, which associates significant costs, mainly related to hospitalization. In fact, heart failure is the most frequent diagnosis in hospital discharges in Spain.
Objective
To analyze the economic impact of new treatments for heart failure with reduced ejection fraction such as sacubitril/valsartan in out-patient and in-patient setting.
Material and methods
The present economic evaluation study was carried out by developing a Markov model. Treatment with sacubitril/valsartan from admission or after hospital discharge was compared, with enalapril being the comparator. Total costs, years of life gained, quality-adjusted life years, and incremental cost-effectiveness ratio and incremental cost-utility ratio were analyzed. Data were obtained from the PARADIGM-HF and PIONEER-HF studies.
Results
The results of the base cases of the three comparisons made showed that sacubitril/valsartan produced benefits in years of life gained and quality-adjusted life years compared to enalapril showing incremental cost-utility ratio below €20,000/QALY and that this ratio was better in scenarios starting sacubitril/valsartan in the hospital setting once decompensation was resolved.
Conclusion
This study shows that starting sacubitril/valsartan from hospital admission for heart failure is cost-effective from the perspective of the National Health Service in Spain.
{"title":"Coste-utilidad de sacubitrilo/valsartán en insuficiencia cardiaca con fracción de eyección reducida en España","authors":"Antonio García-Quintana , Héctor Alonso Ramos , Javier Parrondo","doi":"10.1016/j.farma.2025.04.004","DOIUrl":"10.1016/j.farma.2025.04.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure is an increasingly common syndrome with a rising prevalence, which associates significant costs, mainly related to hospitalization. In fact, heart failure is the most frequent diagnosis in hospital discharges in Spain.</div></div><div><h3>Objective</h3><div>To analyze the economic impact of new treatments for heart failure with reduced ejection fraction such as sacubitril/valsartan in out-patient and in-patient setting.</div></div><div><h3>Material and methods</h3><div>The present economic evaluation study was carried out by developing a Markov model. Treatment with sacubitril/valsartan from admission or after hospital discharge was compared, with enalapril being the comparator. Total costs, years of life gained, quality-adjusted life years, and incremental cost-effectiveness ratio and incremental cost-utility ratio were analyzed. Data were obtained from the PARADIGM-HF and PIONEER-HF studies.</div></div><div><h3>Results</h3><div>The results of the base cases of the three comparisons made showed that sacubitril/valsartan produced benefits in years of life gained and quality-adjusted life years compared to enalapril showing incremental cost-utility ratio below €20,000/QALY and that this ratio was better in scenarios starting sacubitril/valsartan in the hospital setting once decompensation was resolved.</div></div><div><h3>Conclusion</h3><div>This study shows that starting sacubitril/valsartan from hospital admission for heart failure is cost-effective from the perspective of the National Health Service in Spain.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages 359-366"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128872","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 : 2025-11-01DOI: 10.1016/j.farma.2025.06.009
Josep Maria Guiu Segura
{"title":"[Translated article] BPS certification as strategy for continuing professional development in hospital pharmacy","authors":"Josep Maria Guiu Segura","doi":"10.1016/j.farma.2025.06.009","DOIUrl":"10.1016/j.farma.2025.06.009","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages T416-T417"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555225","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 : 2025-11-01DOI: 10.1016/j.farma.2025.05.002
Ana María Álvarez-Díaz , Carlos Crespo Diz , Emilio Monte Boquet , José Antonio Marcos Rodríguez , Luis Margusino Framinan , Elena Sánchez Yañez , Manuel Vélez-Díaz-Pallarés , Esther Vicente Escrig , Ramón Morillo-Verdugo
Objective
To analyse and address the barriers that Pharmacy Services encounter when adopting the capacity-motivation-opportunity (CMO) pharmaceutical care model in outpatient consultations, identifying the relevant actors in the ecosystem, as well as the motivations. Finally, to make a first approach to solutions that will help us to select those that could be developed through future initiatives.
Method
A structured methodology was developed in several phases. Two teams were formed: the “Core Team,” consisting of hospital pharmacists with experience in pharmaceutical care and patient-centered care, and the “Guiding Team,” made up of professionals from various disciplines. The first phase included an online prospecting workshop to explore the phases of model adoption. Subsequently, semi-structured interviews were conducted with key actors, such as physicians, managers, and patient associations, to identify needs and barriers. Finally, a face-to-face workshop was organized to facilitate the ideation and validation of solutions.
Results
Three categories of actors in the CMO model ecosystem were identified: interested agents (beneficiaries), interesting agents (influencers), and executive agents (implementers). Significant barriers were found, including variability in infrastructure, lack of commitment from managers, and the workload of pharmacists. However, there was also growing motivation among professionals and organizations to adopt the model. During the ideation workshop, ten initiatives were prioritized, including the use of digital technologies and ongoing training programs.
Conclusions
The study highlights the high potential of the CMO model to improve pharmaceutical care in outpatient settings in Spain, despite the identified barriers. The proposed strategies, focused on digitalization and multidisciplinary collaboration, are essential for effective implementation. Future research is suggested to evaluate the long-term impact of these initiatives and to strengthen the involvement of patient associations and other actors in the adoption process.
{"title":"[Translated article] Qualitative study on the adoption and enhancement of the capacity-motivation-opportunity model for pharmaceutical care in outpatient pharmacy consultations in Spain","authors":"Ana María Álvarez-Díaz , Carlos Crespo Diz , Emilio Monte Boquet , José Antonio Marcos Rodríguez , Luis Margusino Framinan , Elena Sánchez Yañez , Manuel Vélez-Díaz-Pallarés , Esther Vicente Escrig , Ramón Morillo-Verdugo","doi":"10.1016/j.farma.2025.05.002","DOIUrl":"10.1016/j.farma.2025.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse and address the barriers that Pharmacy Services encounter when adopting the capacity-motivation-opportunity (CMO) pharmaceutical care model in outpatient consultations, identifying the relevant actors in the ecosystem, as well as the motivations. Finally, to make a first approach to solutions that will help us to select those that could be developed through future initiatives.</div></div><div><h3>Method</h3><div>A structured methodology was developed in several phases. Two teams were formed: the “Core Team,” consisting of hospital pharmacists with experience in pharmaceutical care and patient-centered care, and the “Guiding Team,” made up of professionals from various disciplines. The first phase included an online prospecting workshop to explore the phases of model adoption. Subsequently, semi-structured interviews were conducted with key actors, such as physicians, managers, and patient associations, to identify needs and barriers. Finally, a face-to-face workshop was organized to facilitate the ideation and validation of solutions.</div></div><div><h3>Results</h3><div>Three categories of actors in the CMO model ecosystem were identified: interested agents (beneficiaries), interesting agents (influencers), and executive agents (implementers). Significant barriers were found, including variability in infrastructure, lack of commitment from managers, and the workload of pharmacists. However, there was also growing motivation among professionals and organizations to adopt the model. During the ideation workshop, ten initiatives were prioritized, including the use of digital technologies and ongoing training programs.</div></div><div><h3>Conclusions</h3><div>The study highlights the high potential of the CMO model to improve pharmaceutical care in outpatient settings in Spain, despite the identified barriers. The proposed strategies, focused on digitalization and multidisciplinary collaboration, are essential for effective implementation. Future research is suggested to evaluate the long-term impact of these initiatives and to strengthen the involvement of patient associations and other actors in the adoption process.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages T384-T391"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718864","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 : 2025-11-01DOI: 10.1016/j.farma.2025.06.007
María Martín Cerezuela , Fernando Becerril Moreno , Jesús Ruiz Ramos , Ana de Lorenzo Pinto , Esther Domingo Chiva , Marta Valera Rubio , Irene Aquerreta González , Carla Bastida Fernández , Laura Doménech Moral , Amaia Egüés Lugea , Miguel Ángel Amor García , Tatiana Betancor García , Sara Cobo Sacristán , Marta Albanell Fernández , Sara Ortiz Pérez , Luis Pérez de Amezaga Tomás
Objective
Medication reconciliation is an essential process in the care of critically ill patients, ensuring that patients' chronic medication is adapted to the patient's clinical situation and administered safely during hospitalisation. Given the profile of the patient admitted to a critical care unit (ICU), this becomes even more relevant. Reconciliation minimises possible medication errors and adverse effects, improving safety in the critically ill patient.
Methods
The project, carried out between 2021 and 2024, was led by the FarMIC (Pharmacists in Intensive Care Medicine and Critical Care) and RedFaster (Pharmaceutical Care in Emergencies) groups of the Spanish Society of Hospital Pharmacy (SEFH), and included: selection of the drugs, review of the available literature and previous conciliation guidelines in similar areas of application, preparation of the drug information with the recommendations issued by the working group, the review of the same and the development of the mobile application.
Results
In October 2024, the app ‘Conciliation Guide for Critically Ill Patients®’ was published, available free of charge for iOS and Android. It provides a drug index with detailed information on medication reintroduction schedules, routes of administration, monitoring, and drug-specific considerations. In addition, the tool includes information on withdrawal syndromes, drug-drug interactions with the usual ICU drugs and hazardous drugs information according to the NIOSH list.
Conclusions
This app facilitates pharmacotherapeutic reconciliation process in the ICU, supporting healthcare professionals in making personalised decisions. Its use can optimise patient safety, reduce adverse events and improve critical patient care. Finally, this tool reinforces the role of the clinical pharmacist in the ICU, who must lead this process in all care transitions and adapt it to the clinical situation of the patient.
{"title":"[Translated article] Development of the mobile application Guide to medication reconciliation in the critically ill patient","authors":"María Martín Cerezuela , Fernando Becerril Moreno , Jesús Ruiz Ramos , Ana de Lorenzo Pinto , Esther Domingo Chiva , Marta Valera Rubio , Irene Aquerreta González , Carla Bastida Fernández , Laura Doménech Moral , Amaia Egüés Lugea , Miguel Ángel Amor García , Tatiana Betancor García , Sara Cobo Sacristán , Marta Albanell Fernández , Sara Ortiz Pérez , Luis Pérez de Amezaga Tomás","doi":"10.1016/j.farma.2025.06.007","DOIUrl":"10.1016/j.farma.2025.06.007","url":null,"abstract":"<div><h3>Objective</h3><div>Medication reconciliation is an essential process in the care of critically ill patients, ensuring that patients' chronic medication is adapted to the patient's clinical situation and administered safely during hospitalisation. Given the profile of the patient admitted to a critical care unit (ICU), this becomes even more relevant. Reconciliation minimises possible medication errors and adverse effects, improving safety in the critically ill patient.</div></div><div><h3>Methods</h3><div>The project, carried out between 2021 and 2024, was led by the FarMIC (Pharmacists in Intensive Care Medicine and Critical Care) and RedFaster (Pharmaceutical Care in Emergencies) groups of the Spanish Society of Hospital Pharmacy (SEFH), and included: selection of the drugs, review of the available literature and previous conciliation guidelines in similar areas of application, preparation of the drug information with the recommendations issued by the working group, the review of the same and the development of the mobile application.</div></div><div><h3>Results</h3><div>In October 2024, the app ‘<em>Conciliation Guide for Critically Ill Patients®</em>’ was published, available free of charge for iOS and Android. It provides a drug index with detailed information on medication reintroduction schedules, routes of administration, monitoring, and drug-specific considerations. In addition, the tool includes information on withdrawal syndromes, drug-drug interactions with the usual ICU drugs and hazardous drugs information according to the NIOSH list.</div></div><div><h3>Conclusions</h3><div>This app facilitates pharmacotherapeutic reconciliation process in the ICU, supporting healthcare professionals in making personalised decisions. Its use can optimise patient safety, reduce adverse events and improve critical patient care. Finally, this tool reinforces the role of the clinical pharmacist in the ICU, who must lead this process in all care transitions and adapt it to the clinical situation of the patient.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages T367-T372"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668722","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 : 2025-11-01DOI: 10.1016/j.farma.2025.03.003
Ana María Álvarez-Díaz , Carlos Crespo Diz , Emilio Monte Boquet , José Antonio Marcos Rodríguez , Luis Margusino Framinan , Elena Sánchez Yañez , Manuel Vélez-Díaz-Pallarés , Esther Vicente Escrig , Ramón Morillo-Verdugo
Objective
To analyse and address the barriers that Pharmacy Services encounter when adopting the capacity-motivation-opportunity (CMO) pharmaceutical care model in outpatient consultations, identifying the relevant actors in the ecosystem, as well as the motivations. Finally, to make a first approach to solutions that will help us to select those that could be developed through future initiatives.
Method
A structured methodology was developed in several phases. Two teams were formed: the "Core Team," consisting of hospital pharmacists with experience in pharmaceutical care and patient-centered care, and the "Guiding Team," made up of professionals from various disciplines. The first phase included an online prospecting workshop to explore the phases of model adoption. Subsequently, semi-structured interviews were conducted with key actors, such as physicians, managers, and patient associations, to identify needs and barriers. Finally, a face-to-face workshop was organized to facilitate the ideation and validation of solutions.
Results
Three categories of actors in the CMO model ecosystem were identified: interested agents (beneficiaries), interesting agents (influencers), and executive agents (implementers). Significant barriers were found, including variability in infrastructure, lack of commitment from managers, and the workload of pharmacists. However, there was also growing motivation among professionals and organizations to adopt the model. During the ideation workshop, ten initiatives were prioritized, including the use of digital technologies and ongoing training programs.
Conclusions
The study highlights the high potential of the CMO model to improve pharmaceutical care in outpatient settings in Spain, despite the identified barriers. The proposed strategies, focused on digitalization and multidisciplinary collaboration, are essential for effective implementation. Future research is suggested to evaluate the long-term impact of these initiatives and to strengthen the involvement of patient associations and other actors in the adoption process.
{"title":"Estudio cualitativo sobre la adopción y puesta en valor del modelo capacidad-motivación-oportunidad de atención farmacéutica en las consultas externas de farmacia en España","authors":"Ana María Álvarez-Díaz , Carlos Crespo Diz , Emilio Monte Boquet , José Antonio Marcos Rodríguez , Luis Margusino Framinan , Elena Sánchez Yañez , Manuel Vélez-Díaz-Pallarés , Esther Vicente Escrig , Ramón Morillo-Verdugo","doi":"10.1016/j.farma.2025.03.003","DOIUrl":"10.1016/j.farma.2025.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse and address the barriers that Pharmacy Services encounter when adopting the capacity-motivation-opportunity (CMO) pharmaceutical care model in outpatient consultations, identifying the relevant actors in the ecosystem, as well as the motivations. Finally, to make a first approach to solutions that will help us to select those that could be developed through future initiatives.</div></div><div><h3>Method</h3><div>A structured methodology was developed in several phases. Two teams were formed: the \"Core Team,\" consisting of hospital pharmacists with experience in pharmaceutical care and patient-centered care, and the \"Guiding Team,\" made up of professionals from various disciplines. The first phase included an online prospecting workshop to explore the phases of model adoption. Subsequently, semi-structured interviews were conducted with key actors, such as physicians, managers, and patient associations, to identify needs and barriers. Finally, a face-to-face workshop was organized to facilitate the ideation and validation of solutions.</div></div><div><h3>Results</h3><div>Three categories of actors in the CMO model ecosystem were identified: interested agents (beneficiaries), interesting agents (influencers), and executive agents (implementers). Significant barriers were found, including variability in infrastructure, lack of commitment from managers, and the workload of pharmacists. However, there was also growing motivation among professionals and organizations to adopt the model. During the ideation workshop, ten initiatives were prioritized, including the use of digital technologies and ongoing training programs.</div></div><div><h3>Conclusions</h3><div>The study highlights the high potential of the CMO model to improve pharmaceutical care in outpatient settings in Spain, despite the identified barriers. The proposed strategies, focused on digitalization and multidisciplinary collaboration, are essential for effective implementation. Future research is suggested to evaluate the long-term impact of these initiatives and to strengthen the involvement of patient associations and other actors in the adoption process.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages 384-391"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774491","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 : 2025-11-01DOI: 10.1016/j.farma.2025.04.003
Lucía Blasco , Inés Bleriot , Patricia Fernández-Grela , José Ramón Paño-Pardo , Jesús Oteo-Iglesias , María Tomás
The need for new antimicrobial treatments that work alternatively or synergistically with antibiotics to address the problem of the emergence and transmission of antimicrobial resistance has increased interest in the use of minority therapies such as phage therapy. For safe and widespread application of this therapy, it is necessary to establish the pharmacokinetic and pharmacodynamic parameters for its use in humans. This systematic review analyzes the criteria necessary to establish the PK/PD of this therapy, as well as its current application, based on a review of 66 clinical cases that catch diverse infections and phage administration routes.
{"title":"Estudios farmacocinéticos y farmacodinámicos de la fagoterapia","authors":"Lucía Blasco , Inés Bleriot , Patricia Fernández-Grela , José Ramón Paño-Pardo , Jesús Oteo-Iglesias , María Tomás","doi":"10.1016/j.farma.2025.04.003","DOIUrl":"10.1016/j.farma.2025.04.003","url":null,"abstract":"<div><div>The need for new antimicrobial treatments that work alternatively or synergistically with antibiotics to address the problem of the emergence and transmission of antimicrobial resistance has increased interest in the use of minority therapies such as phage therapy. For safe and widespread application of this therapy, it is necessary to establish the pharmacokinetic and pharmacodynamic parameters for its use in humans. This systematic review analyzes the criteria necessary to establish the PK/PD of this therapy, as well as its current application, based on a review of 66 clinical cases that catch diverse infections and phage administration routes.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages 407-412"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062648","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 : 2025-11-01DOI: 10.1016/j.farma.2025.08.003
Laura Moñino-Dominguez , Alicia Aguado-Paredes , Jaime Cordero-Ramos
Introduction
dalbavancin is approved for treating acute bacterial skin and soft tissue infections, but its off-label use for treating complex chronic infections has become increasingly common. Currently, there is no established dosing regimen for such infections. Given the need for prolonged treatments, a dosing adjustment strategy based on therapeutic drug monitoring may optimize its use and allow for individualized regimens. This systematic review analyzes dalbavancin dosing in complex infections and TDM-based strategies to optimize treatment.
Materials and methods
A search was conducted in PubMed, Embase, Scopus, and the Cochrane Library (2014–2024) using the following keywords: “dalbavancin”, “pharmacokinetics”, “pharmacodynamics”, “therapeutic drug monitoring”, and “TDM”. Three independent reviewers selected and evaluated the studies. Clinical studies related to the pharmacokinetics of dalbavancin and the use of TDM in complex infections requiring prolonged regimens were included. Due to the heterogeneity among the studies, a qualitative analysis of the data was performed.
Results
A total of 241 articles were identified. After removing duplicates and applying the inclusion and exclusion criteria, 10 studies were included. These studies exhibited heterogeneity in design (6 retrospective and 4 prospective) and sample size, encompassing 457 patients and 1.298 samples. Most studies focused on osteoarticular infections treated with dalbavancin using an initial two-dose regimen of 1,500 mg administered one week apart, followed by dose adjustments based on plasma level monitoring. The most commonly targeted pharmacokinetic/pharmacodynamic parameters were a trough concentration above 8 μg/ml and an area under the curve/minimum inhibitory concentration ratio greater than 111.1. Therapeutic Drug Monitoring-Guided strategies were found to optimize dosing and maintain adequate plasma levels. Significant interindividual variability in plasma concentrations was observed, influenced by factors such as renal function and body surface area.
Discussion
The use of Therapeutic Drug Monitoring in dalbavancin dosing optimizes the treatment of complex chronic infections by adjusting dosing intervals and maintaining adequate therapeutic levels over extended periods. However, further validation and definition of specific pharmacokinetic/pharmacodynamic targets is required.
dalbavancin被批准用于治疗急性细菌性皮肤和软组织感染，但其标签外用于治疗复杂的慢性感染已变得越来越普遍。目前，尚无针对此类感染的既定给药方案。鉴于需要长期治疗，基于治疗药物监测的剂量调整策略可以优化其使用并允许个体化方案。本系统综述分析了达尔巴文星在复杂感染中的剂量和基于tdm的优化治疗策略。材料与方法：检索PubMed、Embase、Scopus、Cochrane Library(2014-2024)，检索关键词：dalbavancin、pharmacodynamics、therapeutic drug monitoring、TDM。三位独立审稿人选择并评估了这些研究。包括与达巴文星的药代动力学和TDM在需要长期治疗的复杂感染中的应用相关的临床研究。由于研究的异质性，我们对数据进行了定性分析。结果：共鉴定出241篇文献。在剔除重复项并应用纳入和排除标准后，纳入了10项研究。这些研究在设计（6项回顾性研究和4项前瞻性研究）和样本量上呈现异质性，共纳入457例患者和1.298份样本。大多数研究集中在用达尔巴文星治疗骨关节感染上，最初的两剂方案为1500 mg，间隔一周给药，随后根据血浆水平监测调整剂量。最常见的目标药代动力学/药效学参数为谷浓度大于8 μg/ml，曲线下面积/最小抑制浓度比大于111.1。发现治疗药物监测指导策略可优化剂量并维持适当的血浆水平。观察到血浆浓度的显著个体差异，受肾功能和体表面积等因素的影响。讨论：治疗药物监测在达巴文星剂量中的应用通过调整给药间隔和在较长时间内保持适当的治疗水平，优化了复杂慢性感染的治疗。然而，需要进一步验证和定义特定的药代动力学/药效学靶点。
{"title":"[Translated article] Therapeutic drug monitoring of dalbavancin: A systematic review of strategies and clinical applications in the treatment of complex infections","authors":"Laura Moñino-Dominguez , Alicia Aguado-Paredes , Jaime Cordero-Ramos","doi":"10.1016/j.farma.2025.08.003","DOIUrl":"10.1016/j.farma.2025.08.003","url":null,"abstract":"<div><h3>Introduction</h3><div>dalbavancin is approved for treating acute bacterial skin and soft tissue infections, but its off-label use for treating complex chronic infections has become increasingly common. Currently, there is no established dosing regimen for such infections. Given the need for prolonged treatments, a dosing adjustment strategy based on therapeutic drug monitoring may optimize its use and allow for individualized regimens. This systematic review analyzes dalbavancin dosing in complex infections and TDM-based strategies to optimize treatment.</div></div><div><h3>Materials and methods</h3><div>A search was conducted in PubMed, Embase, Scopus, and the Cochrane Library (2014–2024) using the following keywords: “dalbavancin”, “pharmacokinetics”, “pharmacodynamics”, “therapeutic drug monitoring”, and “TDM”. Three independent reviewers selected and evaluated the studies. Clinical studies related to the pharmacokinetics of dalbavancin and the use of TDM in complex infections requiring prolonged regimens were included. Due to the heterogeneity among the studies, a qualitative analysis of the data was performed.</div></div><div><h3>Results</h3><div>A total of 241 articles were identified. After removing duplicates and applying the inclusion and exclusion criteria, 10 studies were included. These studies exhibited heterogeneity in design (6 retrospective and 4 prospective) and sample size, encompassing 457 patients and 1.298 samples. Most studies focused on osteoarticular infections treated with dalbavancin using an initial two-dose regimen of 1,500 mg administered one week apart, followed by dose adjustments based on plasma level monitoring. The most commonly targeted pharmacokinetic/pharmacodynamic parameters were a trough concentration above 8 μg/ml and an area under the curve/minimum inhibitory concentration ratio greater than 111.1. Therapeutic Drug Monitoring-Guided strategies were found to optimize dosing and maintain adequate plasma levels. Significant interindividual variability in plasma concentrations was observed, influenced by factors such as renal function and body surface area.</div></div><div><h3>Discussion</h3><div>The use of Therapeutic Drug Monitoring in dalbavancin dosing optimizes the treatment of complex chronic infections by adjusting dosing intervals and maintaining adequate therapeutic levels over extended periods. However, further validation and definition of specific pharmacokinetic/pharmacodynamic targets is required.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages T396-T406"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139049","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 : 2025-11-01DOI: 10.1016/j.farma.2025.09.001
Elizabeth Hess Ford , Christina Michalek
The role of a Medication Safety Officer has emerged as a critical element in hospital pharmacy, addressing the persistent issue of medication errors. These errors, which can cause significant patient harm, have been documented for decades, prompting the establishment of formal roles dedicated to medication safety. Organizations such as the Institute for Safe Medication Practices (ISMP), the American Society of Health System Pharmacists (ASHP) as well as the United Kingdom's Medicines and Healthcare products Regulatory Agency (MHRA) and National Health Service (NHS) have been instrumental in supporting the Medication Safety Officer role.
Medication errors can result in severe consequences, including patient harm and death. Landmark publications like the Institute of Medicine's “To Err is Human” and “Crossing the Quality Chasm” have highlighted the prevalence and impact of these errors, advocating for system improvements and the necessity of dedicated safety roles.
Medication Safety Officers lead strategies and processes related to medication safety, develop strategic plans, and implement error prevention strategies. They analyze medication error reports, collaborate with healthcare staff, and optimize medication safety technologies. Medication Safety Officers play a key role in fostering a culture of safety within organizations, influencing practices to minimize harm and support second victim programs.
Studies have shown that employing a Medication Safety Officer can significantly improve hospital safety scores, demonstrating the effectiveness of this role in enhancing patient safety. The daily responsibilities of a Medication Safety Officer include reviewing medication errors, assessing harm, attending meetings, and collaborating with healthcare practitioners.
Overall, the role of a Medication Safety Officer is essential in identifying and mitigating medication risks, making hospitals safer, and ensuring the delivery of high-quality patient care.
{"title":"[Artículo traducido] Responsables de seguridad de medicamentos: un pilar de la seguridad del paciente en la farmacia hospitalaria","authors":"Elizabeth Hess Ford , Christina Michalek","doi":"10.1016/j.farma.2025.09.001","DOIUrl":"10.1016/j.farma.2025.09.001","url":null,"abstract":"<div><div>The role of a Medication Safety Officer has emerged as a critical element in hospital pharmacy, addressing the persistent issue of medication errors. These errors, which can cause significant patient harm, have been documented for decades, prompting the establishment of formal roles dedicated to medication safety. Organizations such as the Institute for Safe Medication Practices (ISMP), the American Society of Health System Pharmacists (ASHP) as well as the United Kingdom's Medicines and Healthcare products Regulatory Agency (MHRA) and National Health Service (NHS) have been instrumental in supporting the Medication Safety Officer role.</div><div>Medication errors can result in severe consequences, including patient harm and death. Landmark publications like the Institute of Medicine's “To Err is Human” and “Crossing the Quality Chasm” have highlighted the prevalence and impact of these errors, advocating for system improvements and the necessity of dedicated safety roles.</div><div>Medication Safety Officers lead strategies and processes related to medication safety, develop strategic plans, and implement error prevention strategies. They analyze medication error reports, collaborate with healthcare staff, and optimize medication safety technologies. Medication Safety Officers play a key role in fostering a culture of safety within organizations, influencing practices to minimize harm and support second victim programs.</div><div>Studies have shown that employing a Medication Safety Officer can significantly improve hospital safety scores, demonstrating the effectiveness of this role in enhancing patient safety. The daily responsibilities of a Medication Safety Officer include reviewing medication errors, assessing harm, attending meetings, and collaborating with healthcare practitioners.</div><div>Overall, the role of a Medication Safety Officer is essential in identifying and mitigating medication risks, making hospitals safer, and ensuring the delivery of high-quality patient care.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages T392-T395"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179284","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 : 2025-11-01DOI: 10.1016/j.farma.2025.03.020
Laura Torralba-Fernández , Marta García-Palomo , Miguel López de Abechuco-Ruiz , Natalia Ramos-Sánchez , Clara Jiménez-Méndez , Rocío Prieto-Galindo , María Carmen Lorenzo-Lozano , Pablo Aguado-Barroso
Objective
To standardize the drug dilutions administered intravenously in a Pediatric Intensive Care Unit and to characterize these dilutions based on their pH, osmolarity, and vesicant nature. This aims to guide the selection of the most appropriate vascular access device, minimizing associated complications, and preserving the patient's venous capital.
Methods
Through a consensus between Pharmacy and Pediatric Services, the most frequently administered intravenous drugs in the Pediatric Intensive Care Unit were selected. Two different dilutions were established for each drug, followed by the determination of their respective osmolarity and pH values. The vesicant nature of each drug was assessed according to the classification proposed by Clark et al. Additionally, vascular access device selection was guided by the algorithm proposed by Manrique et al., which considers the drug’s properties, the duration of intravenous therapy, and the patient's venous capital status.
Results
A total of 60 dilutions corresponding to 30 drugs from the following therapeutic groups were analyzed: antimicrobials (56%), antiepileptics (13%), sedatives (7%), diuretics (7%), anti-inflammatory and analgesics (7%), and others (10%). Twenty-five percent of the dilutions exhibited at least one high-risk factor for phlebitis (osmolarity > 600 mOsm/L or pH < 4 or > 9), while 35% were classified as intermediate risk (osmolarity 450–600 mOsm/L or pH 4–5 or > 7.5–9). Only 10% of the analyzed drugs were classified as vesicants (acyclovir, phenytoin, and vancomycin). Seventeen dilutions of nine different drugs were identified that should not be administered through a peripheral venous catheter, even in short-term treatments. Of these, 15 had a high risk of causing phlebitis, while 2 had an intermediate risk.
Conclusions
The physicochemical properties (osmolarity and pH) and vesicant nature of drugs are key factors contributing to the development of phlebitis in critically ill pediatric patients. Standardizing and characterizing drug dilutions will facilitate the selection of the most appropriate vascular access device, improving the safety and effectiveness of intravenous therapy.
{"title":"Estandarización y caracterización de las diluciones administradas por vía intravenosa en el paciente crítico pediátrico","authors":"Laura Torralba-Fernández , Marta García-Palomo , Miguel López de Abechuco-Ruiz , Natalia Ramos-Sánchez , Clara Jiménez-Méndez , Rocío Prieto-Galindo , María Carmen Lorenzo-Lozano , Pablo Aguado-Barroso","doi":"10.1016/j.farma.2025.03.020","DOIUrl":"10.1016/j.farma.2025.03.020","url":null,"abstract":"<div><h3>Objective</h3><div>To standardize the drug dilutions administered intravenously in a Pediatric Intensive Care Unit and to characterize these dilutions based on their pH, osmolarity, and vesicant nature. This aims to guide the selection of the most appropriate vascular access device, minimizing associated complications, and preserving the patient's venous capital.</div></div><div><h3>Methods</h3><div>Through a consensus between Pharmacy and Pediatric Services, the most frequently administered intravenous drugs in the Pediatric Intensive Care Unit were selected. Two different dilutions were established for each drug, followed by the determination of their respective osmolarity and pH values. The vesicant nature of each drug was assessed according to the classification proposed by Clark et al. Additionally, vascular access device selection was guided by the algorithm proposed by Manrique et al., which considers the drug’s properties, the duration of intravenous therapy, and the patient's venous capital status.</div></div><div><h3>Results</h3><div>A total of 60 dilutions corresponding to 30 drugs from the following therapeutic groups were analyzed: antimicrobials (56%), antiepileptics (13%), sedatives (7%), diuretics (7%), anti-inflammatory and analgesics (7%), and others (10%). Twenty-five percent of the dilutions exhibited at least one high-risk factor for phlebitis (osmolarity ><!--> <!-->600 mOsm/L or pH < 4 or > 9), while 35% were classified as intermediate risk (osmolarity 450–600 mOsm/L or pH 4–5 or > 7.5–9). Only 10% of the analyzed drugs were classified as vesicants (acyclovir, phenytoin, and vancomycin). Seventeen dilutions of nine different drugs were identified that should not be administered through a peripheral venous catheter, even in short-term treatments. Of these, 15 had a high risk of causing phlebitis, while 2 had an intermediate risk.</div></div><div><h3>Conclusions</h3><div>The physicochemical properties (osmolarity and pH) and vesicant nature of drugs are key factors contributing to the development of phlebitis in critically ill pediatric patients. Standardizing and characterizing drug dilutions will facilitate the selection of the most appropriate vascular access device, improving the safety and effectiveness of intravenous therapy.</div></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages 373-379"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128859","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 : 2025-11-01DOI: 10.1016/j.farma.2025.01.006
Yeray Reyes-de-la-Mata, Gala Cano-Martínez, Francisco Javier Salmerón-Navas, Carmen María Domínguez-Santana, Silvia Fenix-Caballero
{"title":"Caplacizumab en debut agudo refractario a tratamiento estándar de púrpura trombocitopénica trombótica","authors":"Yeray Reyes-de-la-Mata, Gala Cano-Martínez, Francisco Javier Salmerón-Navas, Carmen María Domínguez-Santana, Silvia Fenix-Caballero","doi":"10.1016/j.farma.2025.01.006","DOIUrl":"10.1016/j.farma.2025.01.006","url":null,"abstract":"","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"49 6","pages":"Pages 413-415"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062632","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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