Objective: The expression level of programmed death ligand 1 (PD-L1) is the only approved biomarker for predicting response to immunotherapy, yet its efficacy is not always consistent. Lactate dehydrogenase (LDH) has been associated with tumor aggressiveness and poorer prognosis across various cancer types and may serve as a useful biomarker for monitoring treatment response. The objective of this study is to analyze the relationship between LDH levels prior to the start of treatment with immune checkpoint inhibitors (ICIs) and clinical outcomes in patients with non-small cell lung cancer (NSCLC).
Method: A retrospective study was conducted including patients diagnosed with NSCLC who were treated with at least three cycles of immunotherapy. Data on demographics, clinical and pathological characteristics, treatment received, pre-treatment LDH levels, and clinical outcomes such as treatment response and overall survival (OS) were analyzed.
Results: A total of 181 patients diagnosed with NSCLC were included. Elevated pre-treatment LDH levels (more than 244 U/l) were associated with significantly reduced OS. The median survival was 548 days in patients with LDH less than 244 U/l, compared to 332 days in those with LDH more than 244 U/l (p = 0.037). Among men, OS was greater in the LDH less than 244 U/l group (623 days) versus 332 days in the LDH more than 244 U/l group (p = 0.043). In patients with metastatic disease, OS was higher in those with LDH less than 244 U/l (474 days) compared to 249 days in those with LDH more than 244 U/l (p = 0.023). In patients receiving both immunotherapy and chemotherapy, OS was greater in those with LDH less than 244 U/l (623 days) compared to 281 days in the LDH more than 244 U/l group (p = 0.042).
Conclusions: High levels of LDH prior to the start of treatment with ICIs are associated with lower treatment efficacy and a worse prognosis of the disease, especially in male, metastatic patients with a PD-L1 expression level less than 1%.
{"title":"Relationship between Lactate Dehydrogenase and survival in patients with non-small cell lung cancer receiving immunotherapy.","authors":"Claudia Rosique-Aznar, Alejandro Valcuende-Rosique, Dolores Rosique-Robles, Agustín Sánchez-Alcaraz","doi":"10.1016/j.farma.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.farma.2024.09.003","url":null,"abstract":"<p><strong>Objective: </strong>The expression level of programmed death ligand 1 (PD-L1) is the only approved biomarker for predicting response to immunotherapy, yet its efficacy is not always consistent. Lactate dehydrogenase (LDH) has been associated with tumor aggressiveness and poorer prognosis across various cancer types and may serve as a useful biomarker for monitoring treatment response. The objective of this study is to analyze the relationship between LDH levels prior to the start of treatment with immune checkpoint inhibitors (ICIs) and clinical outcomes in patients with non-small cell lung cancer (NSCLC).</p><p><strong>Method: </strong>A retrospective study was conducted including patients diagnosed with NSCLC who were treated with at least three cycles of immunotherapy. Data on demographics, clinical and pathological characteristics, treatment received, pre-treatment LDH levels, and clinical outcomes such as treatment response and overall survival (OS) were analyzed.</p><p><strong>Results: </strong>A total of 181 patients diagnosed with NSCLC were included. Elevated pre-treatment LDH levels (more than 244 U/l) were associated with significantly reduced OS. The median survival was 548 days in patients with LDH less than 244 U/l, compared to 332 days in those with LDH more than 244 U/l (p = 0.037). Among men, OS was greater in the LDH less than 244 U/l group (623 days) versus 332 days in the LDH more than 244 U/l group (p = 0.043). In patients with metastatic disease, OS was higher in those with LDH less than 244 U/l (474 days) compared to 249 days in those with LDH more than 244 U/l (p = 0.023). In patients receiving both immunotherapy and chemotherapy, OS was greater in those with LDH less than 244 U/l (623 days) compared to 281 days in the LDH more than 244 U/l group (p = 0.042).</p><p><strong>Conclusions: </strong>High levels of LDH prior to the start of treatment with ICIs are associated with lower treatment efficacy and a worse prognosis of the disease, especially in male, metastatic patients with a PD-L1 expression level less than 1%.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366882","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 : 2024-09-17DOI: 10.1016/j.farma.2024.08.008
Alfonso Pereira-Céspedes, Alberto Jiménez-Morales, Aurora Polo-Moyano, Elizabeth Spruce-Esparza, Magdalena Palomares-Bayo, Fernando Martínez-Martínez, Miguel Ángel Calleja-Hernández
Objective: Characterize the health-related quality of life among patients undergoing kidney replacement therapy and to explore associated factors.
Method: A descriptive observational study was conducted using the Kidney Disease Quality of Life Short Form questionnaire to assess health-related quality of life. The Dader Method was employed to evaluate negative outcomes associated with medications. Face-to-face interviews and clinical records were utilized to collect sociodemographic and clinical data from patients undergoing kidney replacement therapy at the Nephrology Department of Virgen de las Nieves University Hospital (Granada, Spain). We explored the association between independent variables (clinical and demographic factors) and dependent variables (Mental Component Score and Physical Component Score) using the linear regression method.
Results: Ninety-one participants were included, 47 (48.35%) were females. The mean age was 62 years, 52 patients (57.14%) were on hemodialysis, 13 patients (14.29%) on peritoneal dialysis, and 26 patients (28.57%) on other forms of kidney replacement therapy. The study revealed a mean Physical Component Score of 40.89 and a Mental Component Score of 47.19. Additionally, 98.90% of the patients experienced negative outcomes associated with medications. Influential factors include age, comorbid conditions, the number of medications, and clinical parameters such as vitamin D and calcium levels.
Conclusions: This study underscores significant findings in patients undergoing kidney replacement therapy, indicating low Mental Component Score and Physical Component Score, accompanied by negative outcomes associated with medications.
目的描述接受肾脏替代治疗的患者的健康相关生活质量，并探讨相关因素：采用肾脏疾病生活质量简表问卷评估与健康相关的生活质量，进行了一项描述性观察研究。采用达德法评估与药物治疗相关的负面结果。我们利用面对面访谈和临床记录收集了在 Virgen de las Nieves 大学医院（西班牙格拉纳达）肾脏科接受肾脏替代治疗的患者的社会人口学和临床数据。我们采用线性回归法探讨了自变量（临床和人口学因素）与因变量（心理成分得分和生理成分得分）之间的关联：91名参与者中有47名女性（48.35%）。平均年龄为 62 岁，52 名患者（57.14%）接受血液透析，13 名患者（14.29%）接受腹膜透析，26 名患者（28.57%）接受其他形式的肾脏替代治疗。研究显示，患者的平均身体成分得分为 40.89 分，精神成分得分为 47.19 分。此外，98.90% 的患者经历了与药物相关的负面结果。影响因素包括年龄、合并症、药物数量以及维生素 D 和钙水平等临床参数：本研究强调了在接受肾脏替代治疗的患者中的重要发现，表明患者的心理成分得分和身体成分得分较低，并伴有与药物相关的负面结果。
{"title":"Health-Related Quality of Life and Associated Factors in Patients Undergoing Kidney Replacement Therapies.","authors":"Alfonso Pereira-Céspedes, Alberto Jiménez-Morales, Aurora Polo-Moyano, Elizabeth Spruce-Esparza, Magdalena Palomares-Bayo, Fernando Martínez-Martínez, Miguel Ángel Calleja-Hernández","doi":"10.1016/j.farma.2024.08.008","DOIUrl":"https://doi.org/10.1016/j.farma.2024.08.008","url":null,"abstract":"<p><strong>Objective: </strong>Characterize the health-related quality of life among patients undergoing kidney replacement therapy and to explore associated factors.</p><p><strong>Method: </strong>A descriptive observational study was conducted using the Kidney Disease Quality of Life Short Form questionnaire to assess health-related quality of life. The Dader Method was employed to evaluate negative outcomes associated with medications. Face-to-face interviews and clinical records were utilized to collect sociodemographic and clinical data from patients undergoing kidney replacement therapy at the Nephrology Department of Virgen de las Nieves University Hospital (Granada, Spain). We explored the association between independent variables (clinical and demographic factors) and dependent variables (Mental Component Score and Physical Component Score) using the linear regression method.</p><p><strong>Results: </strong>Ninety-one participants were included, 47 (48.35%) were females. The mean age was 62 years, 52 patients (57.14%) were on hemodialysis, 13 patients (14.29%) on peritoneal dialysis, and 26 patients (28.57%) on other forms of kidney replacement therapy. The study revealed a mean Physical Component Score of 40.89 and a Mental Component Score of 47.19. Additionally, 98.90% of the patients experienced negative outcomes associated with medications. Influential factors include age, comorbid conditions, the number of medications, and clinical parameters such as vitamin D and calcium levels.</p><p><strong>Conclusions: </strong>This study underscores significant findings in patients undergoing kidney replacement therapy, indicating low Mental Component Score and Physical Component Score, accompanied by negative outcomes associated with medications.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298236","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 : 2024-09-16DOI: 10.1016/j.farma.2024.07.010
Alba Pau-Parra, María Núñez-Núñez, Svetlana Sadyrbaeva-Dolgova, Laura Doménech Moral, Eva Campelo Sánchez, Leonor Del Mar Periañez Parraga, Khalid Saeed Khan, Sònia Luque Pardos
Introduction: Infections caused by multidrug-resistant gram-negative bacilli (MDR-GNB) in critically ill patients present a challenge for timely and appropriate antibiotic treatment. This is particularly important in patients undergoing extracorporeal life support techniques such as renal replacement therapy and extracorporeal membrane oxygenation. These techniques can introduce additional pharmacokinetic alterations, potentially leading to suboptimal exposure to antibiotics. This study aims to outline dosing strategies and therapeutic drug monitoring protocols for new β-lactam antibiotics effective against MDR-GNB in critically ill patients undergoing extracorporeal life support techniques at a national level. Additionally, the study seeks to develop a consensus document, based on available evidence.
Methods: The project will comprise two main phases: I) A national survey, and II) the development of a consensus document. This consensus document, undertaken according to ACCORD guidelines, will encompass: a) establishment of a multidisciplinary panel of experts, b) prospective registration of the consensus, c) evidence synthesis, d) modified Delphi rounds. The antimicrobials to be included will be: meropenem, ceftazidime/avibactam, ceftolozane/tazobactam, cefiderocol, meropenem/vaborbactam, imipenem/relebactam, and aztreonam. Extracorporeal life support techniques will include continuous renal replacement therapy, conventional intermittent hemodialysis, and extracorporeal membrane oxygenation.
Discussion: The availability of extracorporeal life support techniques has expanded significantly in recent years, alongside a rise in the prevalence of infections caused by multidrug-resistant gram-negative bacilli (MDR-GNB). There is a need to develop evidence-based tools of high quality to standardize dosing and monitoring strategies for new β-lactam antibiotics.
{"title":"National Survey and consensus document on dosing strategies for beta-lactam antibiotics against multidrug-resistant gram-negative bacilli (MDR-GNB) in critically ill patients undergoing extracorporeal life support techniques: The DOSEBL study protocol.","authors":"Alba Pau-Parra, María Núñez-Núñez, Svetlana Sadyrbaeva-Dolgova, Laura Doménech Moral, Eva Campelo Sánchez, Leonor Del Mar Periañez Parraga, Khalid Saeed Khan, Sònia Luque Pardos","doi":"10.1016/j.farma.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.farma.2024.07.010","url":null,"abstract":"<p><strong>Introduction: </strong>Infections caused by multidrug-resistant gram-negative bacilli (MDR-GNB) in critically ill patients present a challenge for timely and appropriate antibiotic treatment. This is particularly important in patients undergoing extracorporeal life support techniques such as renal replacement therapy and extracorporeal membrane oxygenation. These techniques can introduce additional pharmacokinetic alterations, potentially leading to suboptimal exposure to antibiotics. This study aims to outline dosing strategies and therapeutic drug monitoring protocols for new β-lactam antibiotics effective against MDR-GNB in critically ill patients undergoing extracorporeal life support techniques at a national level. Additionally, the study seeks to develop a consensus document, based on available evidence.</p><p><strong>Methods: </strong>The project will comprise two main phases: I) A national survey, and II) the development of a consensus document. This consensus document, undertaken according to ACCORD guidelines, will encompass: a) establishment of a multidisciplinary panel of experts, b) prospective registration of the consensus, c) evidence synthesis, d) modified Delphi rounds. The antimicrobials to be included will be: meropenem, ceftazidime/avibactam, ceftolozane/tazobactam, cefiderocol, meropenem/vaborbactam, imipenem/relebactam, and aztreonam. Extracorporeal life support techniques will include continuous renal replacement therapy, conventional intermittent hemodialysis, and extracorporeal membrane oxygenation.</p><p><strong>Discussion: </strong>The availability of extracorporeal life support techniques has expanded significantly in recent years, alongside a rise in the prevalence of infections caused by multidrug-resistant gram-negative bacilli (MDR-GNB). There is a need to develop evidence-based tools of high quality to standardize dosing and monitoring strategies for new β-lactam antibiotics.</p>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298237","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 : 2024-09-01DOI: 10.1016/j.farma.2024.02.013
Sonia Luque , Natalia Mendoza-Palomar , David Aguilera-Alonso , Beatriz Garrido , Marta Miarons , Ana Isabel Piqueras , Enrique Tévar , Eneritz Velasco-Arnaiz , Aurora Fernàndez-Polo
Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic (PK/PD) parameters is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised paediatric host.
In neonates and children, infections account for a high percentage of hospital admissions, and anti-infectives are the most used drugs. However, paediatric PK/PD studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals—usually used off-label in paediatrics—to determine the optimal drug dosage regimens are limited. It is widely known that this population presents important differences in the PK parameters (especially in drug clearance and volume of distribution) in comparison with adults that may alter antimicrobial exposure and, therefore, compromise treatment success. In addition, paediatric patients are more susceptible to potential adverse drug effects and they need closer monitoring.
The aim of this document, developed jointly by the Spanish Society of Hospital Pharmacy and the Spanish Society of Paediatric Infectious Diseases, is to describe the available evidence on the indications for therapeutic drug monitoring (TDM) of antibiotics and antifungals in newborn and paediatric patients, and to provide practical recommendations for TDM in routine clinical practice to optimise their dosing, efficacy and safety. Of antibiotics and antifungals in the paediatric population.
{"title":"[Translated article] Therapeutic Drug Monitoring of antibiotic and antifungical drugs in paediatric and newborn patients. Consensus Guidelines of the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Paediatric Infectious Diseases (SEIP)","authors":"Sonia Luque , Natalia Mendoza-Palomar , David Aguilera-Alonso , Beatriz Garrido , Marta Miarons , Ana Isabel Piqueras , Enrique Tévar , Eneritz Velasco-Arnaiz , Aurora Fernàndez-Polo","doi":"10.1016/j.farma.2024.02.013","DOIUrl":"10.1016/j.farma.2024.02.013","url":null,"abstract":"<div><p>Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic (PK/PD) parameters is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised paediatric host.</p><p>In neonates and children, infections account for a high percentage of hospital admissions, and anti-infectives are the most used drugs. However, paediatric PK/PD studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals—usually used off-label in paediatrics—to determine the optimal drug dosage regimens are limited. It is widely known that this population presents important differences in the PK parameters (especially in drug clearance and volume of distribution) in comparison with adults that may alter antimicrobial exposure and, therefore, compromise treatment success. In addition, paediatric patients are more susceptible to potential adverse drug effects and they need closer monitoring.</p><p>The aim of this document, developed jointly by the Spanish Society of Hospital Pharmacy and the Spanish Society of Paediatric Infectious Diseases, is to describe the available evidence on the indications for therapeutic drug monitoring (TDM) of antibiotics and antifungals in newborn and paediatric patients, and to provide practical recommendations for TDM in routine clinical practice to optimise their dosing, efficacy and safety. Of antibiotics and antifungals in the paediatric population.</p></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"48 5","pages":"Pages T234-T245"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130634324000345/pdfft?md5=b4971aef37c3c2335adba6a4bd2e2aec&pid=1-s2.0-S1130634324000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.farma.2024.02.005
Introduction
Digital health or “e-Health” is a set of applications based on Information and Communication Technologies that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-Health interventions to promote adherence to antiretroviral therapy in people living with HIV/AIDS.
Method
A review of systematic reviews (“meta-review”) was performed using the Medline-PubMed database on efficacy studies of e-Health components to promote adherence to antirretroviral therapy, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables.
Results
A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 randomized controlled therapies with different e-Health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load measurements (10 statistically significant); and 8 comparisons of CD4 + cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-Learning.
Conclusions
Evidence was found that supports that some e-Health interventions are effective in promoting adherence to antirretroviral therapy and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.
{"title":"Salud digital para promover la adherencia al tratamiento antirretroviral en pacientes con VIH/sida: metarevisión","authors":"","doi":"10.1016/j.farma.2024.02.005","DOIUrl":"10.1016/j.farma.2024.02.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Digital health or “e-Health” is a set of applications based on Information and Communication Technologies that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-Health interventions to promote adherence to antiretroviral therapy in people living with HIV/AIDS.</p></div><div><h3>Method</h3><p>A review of systematic reviews (“meta-review”) was performed using the Medline-PubMed database on efficacy studies of e-Health components to promote adherence to antirretroviral therapy, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables.</p></div><div><h3>Results</h3><p>A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 randomized controlled therapies with different e-Health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load measurements (10 statistically significant); and 8 comparisons of CD4<!--> <!-->+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-Learning.</p></div><div><h3>Conclusions</h3><p>Evidence was found that supports that some e-Health interventions are effective in promoting adherence to antirretroviral therapy and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.</p></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"48 5","pages":"Pages 252-258"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130634324000254/pdfft?md5=e4c6f639e26bb0e26bdfc649e31e32ce&pid=1-s2.0-S1130634324000254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.farma.2024.02.001
Hospital Pharmacy worldwide has proven to be a crucial element in healthcare. In Latin America, it draws inspiration from two main models: United States, which promoted clinical pharmacy and later pharmaceutical care, and Spain, which shares similar healthcare practices and the added advantage of a common language. Both models influenced the implementation of Hospital Pharmacy residencies in Argentina since the 1980s.
Hospital Pharmacy residencies in Argentina constitute a paid system of intensive postgraduate training on a full-time basis with exclusive dedication. They are carried out in 11 provinces across Argentina in services with recognized teaching experience. Currently, there are 46 locations with a total of 75 annual vacancies for applicants.
The objective of Hospital Pharmacy residencies is to train pharmaceutical professionals with the necessary competencies to ensure the care of patients through the optimization of the safe, effective, and efficient use of medications and healthcare products tailored to each patient’s individual therapy.
Hospital Pharmacy residencies have demonstrated that pharmacists acquire specialized training that can be decisive in influencing healthcare policies related to the safe use of medications and healthcare products. Therefore, actions to promote and encourage interest in this field among pharmaceutical professionals are necessary, involving scientific societies, universities, pharmaceutical associations, and the political sphere.
{"title":"Proceso para el acceso y formación del farmacéutico a la residencia en Farmacia Hospitalaria en Argentina","authors":"","doi":"10.1016/j.farma.2024.02.001","DOIUrl":"10.1016/j.farma.2024.02.001","url":null,"abstract":"<div><p>Hospital Pharmacy worldwide has proven to be a crucial element in healthcare. In Latin America, it draws inspiration from two main models: United States, which promoted clinical pharmacy and later pharmaceutical care, and Spain, which shares similar healthcare practices and the added advantage of a common language. Both models influenced the implementation of Hospital Pharmacy residencies in Argentina since the 1980s.</p><p>Hospital Pharmacy residencies in Argentina constitute a paid system of intensive postgraduate training on a full-time basis with exclusive dedication. They are carried out in 11 provinces across Argentina in services with recognized teaching experience. Currently, there are 46 locations with a total of 75 annual vacancies for applicants.</p><p>The objective of Hospital Pharmacy residencies is to train pharmaceutical professionals with the necessary competencies to ensure the care of patients through the optimization of the safe, effective, and efficient use of medications and healthcare products tailored to each patient’s individual therapy.</p><p>Hospital Pharmacy residencies have demonstrated that pharmacists acquire specialized training that can be decisive in influencing healthcare policies related to the safe use of medications and healthcare products. Therefore, actions to promote and encourage interest in this field among pharmaceutical professionals are necessary, involving scientific societies, universities, pharmaceutical associations, and the political sphere.</p></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"48 5","pages":"Pages 198-203"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130634324000217/pdfft?md5=c250230defface57817ffeef051166f0&pid=1-s2.0-S1130634324000217-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.farma.2024.06.002
The article examines the impact of artificial intelligence on scientific writing, with a particular focus on its application in hospital pharmacy. It analyzes artificial intelligence tools that enhance information retrieval, literature analysis, writing quality, and manuscript drafting.
Chatbots like Consensus, along with platforms such as Scite and SciSpace, enable precise searches in scientific databases, providing evidence-based responses and references. SciSpace facilitates the generation of comparative tables and the formulation of queries regarding studies, while ResearchRabbit maps the scientific literature to identify trends. Tools like DeepL and ProWritingAid improve writing quality by correcting grammatical, stylistic, and plagiarism errors. A.R.I.A. enhances reference management, and Jenny AI assists in overcoming writer's block. Python libraries such as LangChain enable advanced semantic searches and the creation of agents.
Despite their benefits, artificial intelligence raises ethical concerns including biases, misinformation, and plagiarism. The importance of responsible use and critical review by experts is emphasized. In hospital pharmacy, artificial intelligence can enhance efficiency and precision in research and scientific communication. Pharmacists can use these tools to stay updated, enhance the quality of their publications, optimize information management, and facilitate clinical decision-making.
In conclusion, artificial intelligence is a powerful tool for hospital pharmacy, provided it is used responsibly and ethically.
文章探讨了人工智能对科学写作的影响，尤其关注其在医院药学中的应用。文章分析了能提高信息检索、文献分析、写作质量和稿件起草的人工智能工具。Consensus等聊天机器人以及Scite和SciSpace等平台可以在科学数据库中进行精确搜索，提供基于证据的回复和参考文献。SciSpace 可帮助生成比较表并提出有关研究的询问，而 ResearchRabbit 则可绘制科学文献地图以确定趋势。DeepL 和 ProWritingAid 等工具可以纠正语法、文体和抄袭错误，从而提高写作质量。A.R.I.A.可加强参考文献管理，而 Jenny AI 则可帮助克服写作障碍。LangChain等Python库可以进行高级语义搜索并创建代理。尽管人工智能好处多多，但它也会引发道德问题，包括偏见、错误信息和剽窃。专家们强调了负责任地使用和严格审查的重要性。在医院药房，人工智能可以提高研究和科学交流的效率和精确度。药剂师可以利用这些工具随时更新信息，提高出版物的质量，优化信息管理，促进临床决策。总之，人工智能是医院药学的强大工具，但前提是必须以负责任和合乎道德的方式使用。
{"title":"El rol de la inteligencia artificial en la publicación científica: perspectivas desde la farmacia hospitalaria","authors":"","doi":"10.1016/j.farma.2024.06.002","DOIUrl":"10.1016/j.farma.2024.06.002","url":null,"abstract":"<div><p>The article examines the impact of artificial intelligence on scientific writing, with a particular focus on its application in hospital pharmacy. It analyzes artificial intelligence tools that enhance information retrieval, literature analysis, writing quality, and manuscript drafting.</p><p>Chatbots like <em>Consensus</em>, along with platforms such as <em>Scite</em> and <em>SciSpace</em>, enable precise searches in scientific databases, providing evidence-based responses and references. <em>SciSpace</em> facilitates the generation of comparative tables and the formulation of queries regarding studies, while <em>ResearchRabbit</em> maps the scientific literature to identify trends. Tools like <em>DeepL</em> and <em>ProWritingAid</em> improve writing quality by correcting grammatical, stylistic, and plagiarism errors. A.R.I.A. enhances reference management, and <em>Jenny AI</em> assists in overcoming writer's block. <em>Python</em> libraries such as <em>LangChain</em> enable advanced semantic searches and the creation of agents.</p><p>Despite their benefits, artificial intelligence raises ethical concerns including biases, misinformation, and plagiarism. The importance of responsible use and critical review by experts is emphasized. In hospital pharmacy, artificial intelligence can enhance efficiency and precision in research and scientific communication. Pharmacists can use these tools to stay updated, enhance the quality of their publications, optimize information management, and facilitate clinical decision-making.</p><p>In conclusion, artificial intelligence is a powerful tool for hospital pharmacy, provided it is used responsibly and ethically.</p></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"48 5","pages":"Pages 246-251"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130634324000965/pdfft?md5=83e271c9fe0c13e31659e0e4661a1b82&pid=1-s2.0-S1130634324000965-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.farma.2024.01.009
Objective
To determine the degree of agreement of 2 differents stratification models for pharmaceutical care to people living with HIV.
Methods
This was a single-center observational prospective cohort study of patients with regular follow-up in pharmaceutical care consultations according to the Capacity–Motivation–Opportunity methodology, conducted between January 1 and March 31, 2023.
Patients received the pharmacotherapeutic interventions applied routinely to ambulatory care patients according to this model. As part of the usual clinical practice, the presence or absence of the variables that apply to both stratification models were collected.
The scores obtained and the corresponding stratification level were collected for each patient according to both stratification models published (ST-2017 and ST-2022).
To analyze the reliability between the measurements of 2 numerical score models of the stratification level with both tools, their degree of concordance was calculated using the intraclass correlation coefficient. Likewise, reliability was also evaluated from a qualitative perspective by means of Cohen's Kappa coefficient.
Additionally, the existence of correlation between the scores of the 2 models was assessed by calculating Pearson's correlation coefficient.
Results
Of the total of 758 patients being followed in the cohort, finally, 233 patients were enrolled. The distribution of patients for each stratification model was: ST-2017: 59.7% level-3, 25.3% level-2, and 15.0% level-1, while for ST-2022: 60.9% level-3, 26.6% level-2, and 12.4% level-1.
It was observed that the reclassification was symmetrical (P = .317). The qualitative analysis of the agreement between the models showed a good Cohen's kappa value, (K = 0.66). A value of 0.563 was found as the intraclass correlation coefficient.
Finally, the correlation analysis between the quantitative scores of the 2 models yielded a Pearson correlation coefficient of 0.86.
Conclusions
The concordance between the 2 models was good, which confirms that the multidimensional adaptation and simplification of the model were correct and that its use can be extended in routine clinical practice.
{"title":"Concordance between two models of stratification for patients living with HIV infection to providing pharmaceutical care","authors":"","doi":"10.1016/j.farma.2024.01.009","DOIUrl":"10.1016/j.farma.2024.01.009","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the degree of agreement of 2 differents stratification models for pharmaceutical care to people living with HIV.</p></div><div><h3>Methods</h3><p>This was a single-center observational prospective cohort study of patients with regular follow-up in pharmaceutical care consultations according to the Capacity–Motivation–Opportunity methodology, conducted between January 1 and March 31, 2023.</p><p>Patients received the pharmacotherapeutic interventions applied routinely to ambulatory care patients according to this model. As part of the usual clinical practice, the presence or absence of the variables that apply to both stratification models were collected.</p><p>The scores obtained and the corresponding stratification level were collected for each patient according to both stratification models published (ST-2017 and ST-2022).</p><p>To analyze the reliability between the measurements of 2 numerical score models of the stratification level with both tools, their degree of concordance was calculated using the intraclass correlation coefficient. Likewise, reliability was also evaluated from a qualitative perspective by means of Cohen's Kappa coefficient.</p><p>Additionally, the existence of correlation between the scores of the 2 models was assessed by calculating Pearson's correlation coefficient.</p></div><div><h3>Results</h3><p>Of the total of 758 patients being followed in the cohort, finally, 233 patients were enrolled. The distribution of patients for each stratification model was: ST-2017: 59.7% level-3, 25.3% level-2, and 15.0% level-1, while for ST-2022: 60.9% level-3, 26.6% level-2, and 12.4% level-1.</p><p>It was observed that the reclassification was symmetrical (<em>P</em> <!-->=<!--> <!-->.317). The qualitative analysis of the agreement between the models showed a good Cohen's kappa value, (K<!--> <!-->=<!--> <!-->0.66). A value of 0.563 was found as the intraclass correlation coefficient.</p><p>Finally, the correlation analysis between the quantitative scores of the 2 models yielded a Pearson correlation coefficient of 0.86.</p></div><div><h3>Conclusions</h3><p>The concordance between the 2 models was good, which confirms that the multidimensional adaptation and simplification of the model were correct and that its use can be extended in routine clinical practice.</p></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"48 5","pages":"Pages 212-221"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130634324000205/pdfft?md5=a9cdb429d50e32b384d2a6c4720e9f12&pid=1-s2.0-S1130634324000205-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.farma.2024.02.012
Sonia Luque , Natalia Mendoza-Palomar , David Aguilera-Alonso , Beatriz Garrido , Marta Miarons , Ana Isabel Piqueras , Enrique Tévar , Eneritz Velasco-Arnaiz , Aurora Fernàndez-Polo
Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic parameters, is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised host.
In neonates and children, infections account for a high percentage of hospital admissions and anti-infectives are the most used drugs. However, pediatric pharmacokinetic and pharmacodynamic studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals -usually used off-label in pediatrics- to determine the optimal drug dosage regimens are limited. It is widely known that this population presents important differences in the pharmacokinetic parameters (especially in drug clearance and volume of distribution) in comparison with adults that may alter antimicrobial exposure and, therefore, compromise treatment success. In addition, pediatric patients are more susceptible to potential adverse drug effects and they need closer monitoring.
The aim of this document, developed jointly between the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Pediatric Infectious Diseases (SEIP), is to describe the available evidence on the indications for therapeutic drug monitoring of antibiotics and antifungals in newborn and pediatric patients and to provide practical recommendations for therapeutic drug monitoring in routine clinical practice to optimize pharmacokinetic and pharmacodynamic parameters, efficacy and safety of antibiotics and antifungals in the pediatric population.
{"title":"Documento nacional de consenso de monitorización terapéutica de antibióticos y antifúngicos en el paciente pediátrico y neonatal de la Sociedad Española de Farmacia Hospitalaria (SEFH) y la Sociedad Española de Infectología Pediátrica (SEIP)","authors":"Sonia Luque , Natalia Mendoza-Palomar , David Aguilera-Alonso , Beatriz Garrido , Marta Miarons , Ana Isabel Piqueras , Enrique Tévar , Eneritz Velasco-Arnaiz , Aurora Fernàndez-Polo","doi":"10.1016/j.farma.2024.02.012","DOIUrl":"10.1016/j.farma.2024.02.012","url":null,"abstract":"<div><p>Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic parameters, is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised host.</p><p>In neonates and children, infections account for a high percentage of hospital admissions and anti-infectives are the most used drugs. However, pediatric pharmacokinetic and pharmacodynamic studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals -usually used off-label in pediatrics- to determine the optimal drug dosage regimens are limited. It is widely known that this population presents important differences in the pharmacokinetic parameters (especially in drug clearance and volume of distribution) in comparison with adults that may alter antimicrobial exposure and, therefore, compromise treatment success. In addition, pediatric patients are more susceptible to potential adverse drug effects and they need closer monitoring.</p><p>The aim of this document, developed jointly between the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Pediatric Infectious Diseases (SEIP), is to describe the available evidence on the indications for therapeutic drug monitoring of antibiotics and antifungals in newborn and pediatric patients and to provide practical recommendations for therapeutic drug monitoring in routine clinical practice to optimize pharmacokinetic and pharmacodynamic parameters, efficacy and safety of antibiotics and antifungals in the pediatric population.</p></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"48 5","pages":"Pages 234-245"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130634324000333/pdfft?md5=8ea0f5f593a4c2fa6685fb234359729a&pid=1-s2.0-S1130634324000333-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.farma.2024.06.004
Antonio García Molina
Introduction
The first targeted therapy in oncology, imatinib, revolutionized chronic myeloid leukemia (CML) treatment and spurred research in targeted therapies for various cancers. CML results from a chromosomal translocation, forming the BCR-ABL1 fusion gene. Asciminib has been recently approved for 3rd-line refractory or intolerant patients. Treatment-free remission (TFR) is attainable with sustained deep molecular response (DMR) and this approach could be incorporated into pharmacoeconomic models.
Aims
To establish a cost-effectiveness model comparing asciminib to approved third-generation tyrosine kinase inhibitors (TKIs) (bosutinib and ponatinib) with a focus on achieving TFR. Additionally, the budgetary impact of incorporating asciminib as a therapeutic alternative is assessed.
Methods
This model is based on a Markov chain with seven states. The condition for achieving TFR is to remain for 5 years in DMR state. Efficacy of the model was measured in QALYs, and the costs included in the base case analysis are based in Spain. A probabilistic (PSA) and deterministic analysis (DSA) were carried out to assess the variability of the model. There were achieved two independent models comparing asciminib vs. bosutinib and asciminib vs. ponatinib.
Results
Asciminib, when compared with ponatinib, is a cost-saving alternative, as efficacy is similar between alternatives, and asciminib has a lower cost of 30,275 €. Asciminib showed 4.33 more QALYs and a higher cost (203,591 €) than bosutinib, resulting in an ICER of €47,010.49 per QALY. PSA shows that the parameters with higher influence in the variability of the model were the probability of transitioning to BP and probabilities of achieving MMR and DMR. A one-way analysis reports that the drug cost has a higher influence on both models, and the discount rate significantly affects the asciminib vs. bosutinib model.
Conclusion
Asciminib broadens therapeutic choices for patient’s refractory or intolerant to two prior lines of treatment in a cost-effective manner. The costs of drugs significantly impact the overall cost of the disease, emphasizing the importance of the selected discount rates for each drug. Given the relatively low incidence of CML, the introduction of asciminib has a limited budgetary impact, warranting individualized decisions based on patient`s clinical characteristics.
{"title":"[Artículo traducido] Asciminib para el tratamiento de la leucemia mieloide crónica en tercera línea: análisis coste-efectividad basado en el enfoque de remisión libre de tratamiento","authors":"Antonio García Molina","doi":"10.1016/j.farma.2024.06.004","DOIUrl":"10.1016/j.farma.2024.06.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The first targeted therapy in oncology, imatinib, revolutionized chronic myeloid leukemia (CML) treatment and spurred research in targeted therapies for various cancers. CML results from a chromosomal translocation, forming the BCR-ABL1 fusion gene. Asciminib has been recently approved for 3rd-line refractory or intolerant patients. Treatment-free remission (TFR) is attainable with sustained deep molecular response (DMR) and this approach could be incorporated into pharmacoeconomic models.</p></div><div><h3>Aims</h3><p>To establish a cost-effectiveness model comparing asciminib to approved third-generation tyrosine kinase inhibitors (TKIs) (bosutinib and ponatinib) with a focus on achieving TFR. Additionally, the budgetary impact of incorporating asciminib as a therapeutic alternative is assessed.</p></div><div><h3>Methods</h3><p>This model is based on a Markov chain with seven states. The condition for achieving TFR is to remain for 5 years in DMR state. Efficacy of the model was measured in QALYs, and the costs included in the base case analysis are based in Spain. A probabilistic (PSA) and deterministic analysis (DSA) were carried out to assess the variability of the model. There were achieved two independent models comparing asciminib vs. bosutinib and asciminib vs. ponatinib.</p></div><div><h3>Results</h3><p>Asciminib, when compared with ponatinib, is a cost-saving alternative, as efficacy is similar between alternatives, and asciminib has a lower cost of 30,275 €. Asciminib showed 4.33 more QALYs and a higher cost (203,591 €) than bosutinib, resulting in an ICER of €47,010.49 per QALY. PSA shows that the parameters with higher influence in the variability of the model were the probability of transitioning to BP and probabilities of achieving MMR and DMR. A one-way analysis reports that the drug cost has a higher influence on both models, and the discount rate significantly affects the asciminib vs. bosutinib model.</p></div><div><h3>Conclusion</h3><p>Asciminib broadens therapeutic choices for patient’s refractory or intolerant to two prior lines of treatment in a cost-effective manner. The costs of drugs significantly impact the overall cost of the disease, emphasizing the importance of the selected discount rates for each drug. Given the relatively low incidence of CML, the introduction of asciminib has a limited budgetary impact, warranting individualized decisions based on patient`s clinical characteristics.</p></div>","PeriodicalId":45860,"journal":{"name":"FARMACIA HOSPITALARIA","volume":"48 5","pages":"Pages T222-T229"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130634324001004/pdfft?md5=92f0167a0735bdabdbdfc32e203c6884&pid=1-s2.0-S1130634324001004-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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