|
|
- Call for emergency action to limit global temperature increases, restore
biodiversity and protect health-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Atwoli, L; H Baqui, A, Benfield, T, Bosurgi, R, Godlee, F, Hancocks, S, Horton, R, Laybourn-Langton, L, Monteiro, C. A, Norman, I, Patrick, K, Praities, N, Rikkert, M. G. O, Rubin, E. J, Sahni, P, Smith, R, Talley, N. J, Turale, S, Vazquez, D.
Pages: 387 - 389
Keywords:
Open access, ARD
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2021-003026
Issue No: Vol. 31, No. 5 (2024)
- European Association of Hospital Pharmacists (EAHP) guidance on the
pharmacy handling of in vivo gene therapy medicinal products-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Vinent Genestar, J; Auvity, S, Christiansen, N, Ekelund, H, Huys, L, McNulty, H. B. O, Pani, M, Pires, V, Pourroy, B, Stoner, N.
Pages: 390 - 402
Abstract: Gene therapy is becoming increasingly prevalent, with new gene therapy medicinal products (GTMPs) being approved for use every year. Hospital pharmacists are expected to prepare and dispense these products, but there is substantial heterogeneity in the availability of up-to-date, practical guidance at a national level in Europe. Many institutions have no or very limited experience in handling GTMPs. As such, there is a need for updated, practical guidance to aid hospital pharmacy teams in developing institutional standard operating procedures (SOPs) for the safe handling of GTMPs across the entire workflow. Here, we present the European Association of Hospital Pharmacists’ updated guidance on the handling of GTMPs, developed by a team of recognised experts from around Europe. Each aspect of the GTMP handling process is addressed, including receipt and storage, dispensing and reconstitution, transportation, administration, waste disposal, decontamination of spills and accidental exposure. A series of figures are provided to aid the development of practical workflows. This guidance document is intended as a framework to help develop institutional SOPs and should always be used in conjunction with local regulations.
Keywords:
Editor''s choice, EAHP Statement 4: Clinical Pharmacy Services
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2023-004062
Issue No: Vol. 31, No. 5 (2024)
- Development and evaluation of a blended learning training programme for
pharmacy technicians continuing education-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Flornoy-Guedon, A; Fonzo-Christe, C, Meier, E, Gazengel-Marchand, M, Francois, O, Gschwind, L, Bonnabry, P.
Pages: 403 - 408
Abstract: ObjectivesThe role of the pharmacy technician (PT) has expanded in recent years, requiring new competencies, better communications skills and high-level knowledge about drugs. The objective of this study is to develop and evaluate a blended learning programme for PTs’ continuing professional development.MethodsA blended learning programme designed to enhance knowledge, skills and attitudes was created using a six-step approach to curriculum development for medical education. The first part included three short microlearning videos to improve knowledge; the second consisted of a 1.5 hour ‘edutainment’ session for groups of 5–6 PTs to deepen their knowledge and practice skills. Impacts on knowledge, degree of certainty and self-perceived competence were evaluated before training (pre-test), after the microlearning (post-test 1) and after the edutainment session (post-test 2).ResultsThe three microlearnings were entitled ‘Communication’, ‘Cut-crush a tablet/open a capsule’ and ‘Pharmacy website’. The edutainment session used team-based learning, game-based learning, peer instruction and simulation. Twenty-six PTs of mean±SD age 36±8 years participated. Pre-test and post-test 1 evaluation scores showed significant overall improvements in mean knowledge (9.1/18 vs 12.1/18, p
Keywords:
Open access, EAHP Statement 1: Introductory Statements and Governance
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003679
Issue No: Vol. 31, No. 5 (2024)
- Anti-interleukin-17 therapies for moderate/severe psoriasis in clinical
practice: effectiveness, safety and association with clinical patient
factors-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Garcia-Martin, E; Romero-Jimenez, R, Baniandres-Rodriguez, O, Escudero-Vilaplana, V, Benedi-Gonzalez, J, de los Rios Luna, P. M, Herranz-Alonso, A, Sanjurjo-Saez, M.
Pages: 409 - 415
Abstract: ObjectivesInterleukin-17 (IL-17) contributes to the pathogenesis of psoriasis. Secukinumab, ixekizumab, and brodalumab are monoclonal antibodies anti-IL-17 antibodies, approved for the treatment of moderate/severe plaque psoriasis.The aim of the study was to describe the effectiveness and safety of anti-IL-17 agents in moderate/severe plaque psoriasis in clinical practice. We also analysed anti-IL-17 therapies’ survival, dose adjustment, and clinical patients’ factors associated with their effectiveness and safety.MethodsA retrospective, longitudinal study was conducted at a tertiary hospital. We included patients with moderate/severe psoriasis treated with anti-IL-17 agents. The effectiveness was evaluated with Psoriasis Area and Severity Index (PASI) score and safety through the adverse drug reactions (ADRs) collected.Results38 patients were studied (median age=47.4 years, 71.0% male). The mean number of biological therapies that patients received was 2.6, and anti-IL-17 therapy was the first biological therapy for 36.8% of patients. The median years in treatment were 2.5 (95% CI 1.95 to 2.98) for secukinumab, 1.2 (95% CI 0.36 to 1.47) for ixekizumab, and 0.7 (IQR 0.71) for brodalumab. The median PASI score after 6 months of treatment was 0 (IQR 0) and 85.3% of patients achieved a PASI of 90 (84.0% with secukinumab, 87.5% with ixekizumab, and 100% with brodalumab). Dose adjustment was associated with the line of treatment (p=0.034 for naïve patients), age (p=0.044 for younger patients), and concomitant pathologies (p=0.015 without more diseases).24 patients suffered from ADRs, mainly infections of the upper respiratory tract, and there were no statistically significant differences between the three therapies.ConclusionsAnti-IL-17 agents constitute an effective treatment for patients with moderate/severe plaque psoriasis and for longer. Dose reductions were associated with fewer lines of treatment, younger patients and absence of concomitant pathologies. ADR were minor and similar among the anti-IL-17.
Keywords:
EAHP Statement 4: Clinical Pharmacy Services
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003594
Issue No: Vol. 31, No. 5 (2024)
- Can antibiotics affect the clinical features of patients with candidemia'
-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Durmus, M; Kalkan, S, Güzel Karahan, S, Bicakcioglu, M, Özdemir, N, Gün, Z. U, Özer, A. B.
Pages: 416 - 422
Abstract: BackgroundCandidemia is an opportunistic infection of intensive care units (ICUs) and causes morbidity and mortality. Multiple antibiotic exposure was found to be an independent risk factor for mortality and non-albicans candidemia (NAC) in candidemia patients.AimThe aim of this study was to determine the relationship between antibiotics and clinical features of patients with candidemia, and to determine the independent risk factors for hospital stay>50 days, 30-day mortality in hospital, candidemia types, and septic shock in candidemia patients.MethodsPatients were evaluated retrospectively for 5 years. A total of 148 candidemia cases were detected and included in the study. Characteristics of cases were defined and recorded. The relationship between qualitative data was determined by the 2 test. Logistic regression analysis was used to determine the independent risk factors for hospital stay>50 days, 30-day mortality in hospital, candidemia types, and septic shock in candidemia patients.ResultsThe incidence of candidemia for 5 years was 4.5%. Candida parapsilosis was the most reported species with 65% (n=97). Linezolid and central venous catheters (CVC) were found to be independent risk factors for NAC. Carbapenems and cephalosporins were found in association to lower mortality. No antibiotics or characteristics were found to be independent risk factors for mortality. Some broad spectrum antibiotics and antibiotic combinations were found in relationship with hospital stay>50 days; however, none of them were found to be independent risk factors. Metisilin resistant staphylococcus aureus (MRSA) antibiotics, meropenem+linezolid piperacillin-tazobactam+fluoroquinolones and comorbidity were found in association with septic shock, although only piperacillin-tazobactam+fluoroquinolones and comorbidity were found to be independent risk factors for septic shock.ConclusionsThis study concluded that many antibiotics were safe for candidemia patients. However, clinicians should pay attention when prescribing linezolid or piperacillin-tazobactam and flouroquinolons concomitantly or sequentially for patients with candidemia risk factors.
Keywords:
EAHP Statement 4: Clinical Pharmacy Services
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003673
Issue No: Vol. 31, No. 5 (2024)
- Game-based training to promote handwashing, handrub and gloving for
hospital pharmacy operators-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Garnier, A; Dubs, C, Haerder, C, Bonnabry, P, Bouchoud, L.
Pages: 423 - 427
Abstract: ObjectivesAdherence to handwashing, handrub and gloving procedures is mandatory for safe, aseptic drug compounding in hospital pharmacies. This study measured participants’ satisfaction and effectiveness of a game-based training tool (Handtastic Box) developed to improve adherence.MethodsHandtastic Boxes were played by pairs of pharmacy operators (introductory video, 1 min study of guidelines, game). In module 1, players watched videos of somebody handwashing and had to find the missing step. They examined wooden models of hands under ultraviolet (UV) light, with some areas stained with fluorescein, to find the hand showing contamination. In module 2, players used a fluorescein hydroalcoholic solution and placed their hands under UV light to highlight missing areas. In module 3, players identified major errors that could compromise glove sterility and linked them to a problem explanation. Then, they applied paint to their fingertips and donned gloves—the paint had to stay inside them. Satisfaction about the training was assessed with a 10-question survey; knowledge about procedures was assessed using a before-and-after questionnaire of nine questions, a 100-point confidence score (modules 1 and 2), and the number of before-and-after errors made during donning gloves (module 3).ResultsOperators were very satisfied and felt more competent after training. Average knowledge score increased from 56.3% (SD 18.2%) to 93.7% (SD 9.5%), and confidence in answers increased from 66.4% (SD 18.7%) to 95.7% (SD 5.52%) (n=14, both modules 1 and 2). The mean error score for gloving procedure decreased from 1.7 (SD 0.8%) to 0.3 (SD 0.5%) (n=10, module 3).ConclusionHandtastic Boxes proved to be a highly effective training method for improving knowledge of handwashing, handrub and gloving.
Keywords:
Open access, EAHP Statement 1: Introductory Statements and Governance
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003648
Issue No: Vol. 31, No. 5 (2024)
- Association of polypharmacy with cognitive impairment in older trauma
patients: a cross-sectional study-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
de Godoi Rezende Costa Molino, C; Rübel, L, Mantegazza, N, Bischoff-Ferrari, H. A, Freystaetter, G.
Pages: 428 - 433
Abstract: IntroductionFew if any studies have been conducted to date on the association between polypharmacy and cognitive impairment among older trauma patients. Therefore, we investigated whether polypharmacy is associated with cognitive impairment in trauma patients aged ≥70 years.MethodsThis is a cross-sectional study of patients aged ≥70 years hospitalised due to a trauma-related injury. Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score ≤24 points. Medications were coded according to the Anatomical Therapeutic Chemical classification. Three exposures were examined: polypharmacy (≥5 medications), excessive polypharmacy (≥10 medications), and number of medications. Separate logistic regression models adjusted for age, sex, body mass index (BMI), education, smoking, independent living, frailty, multimorbidity, depression, and type of trauma were used to test the association between the three exposures and cognitive impairment.ResultsA total of 198 patients were included (mean age 80.2; 64.7% women and 35.4% men), of which 148 (74.8%) had polypharmacy and 63 (31.8%) had excessive polypharmacy. The prevalence of cognitive impairment was 34.3% overall, 37.2% in the polypharmacy group and 50.8% in the excessive polypharmacy group. More than 80% of participants were taking at least one analgesic. Overall, polypharmacy was not statistically significantly associated with cognitive impairment (odds ratio (OR) 1.20 [95% confidence interval (CI) 0.46 to 3.11]). However, patients in the excessive polypharmacy group were more than two times more likely to have cognitive impairment (OR 2.88 [95% CI 1.31 to 6.37]) even after adjustments for relevant confounders. Similarly, the number of medications was associated with greater odds of cognitive impairment (OR 1.15 [95% CI 1.04 to 1.28]) after adjustments for the same relevant confounders.ConclusionCognitive impairment is common among older trauma patients, particularly among those in the excessive polypharmacy group. Polypharmacy was not associated with cognitive impairment. Excessive polypharmacy and number of medications, on the other hand, were associated with greater odds of cognitive impairment in older trauma patients.
Keywords:
EAHP Statement 4: Clinical Pharmacy Services
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003645
Issue No: Vol. 31, No. 5 (2024)
- Population pharmacokinetics and dosing optimisation of imipenem in
critically ill patients-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Bai, J; Wen, A, Li, Z, Li, X, Duan, M.
Pages: 434 - 439
Abstract: ObjectiveThe objective of this study was to explore factors that affect the clearance of imipenem in critically ill patients and to provide a dosing regimen for such patients.MethodsA prospective open-label study enrolled 51 critically ill patients with sepsis. Patients were between the ages of 18 and 96. Blood samples were collected in duplicate before (0 hour) and at 0.5, 1, 1.5, 2, 3, 4, 6, and 8 hours after imipenem administration. The plasma imipenem concentration was determined by the high-performance liquid chromatography-ultraviolet detection (HPLC-UV) method. A population pharmacokinetic (PPK) model was developed using nonlinear mixed-effects modelling methods to identify covariates. Monte Carlo simulations were performed using the final PPK model to explore the effect of different dosing regimens on the probability of target attainment (PTA).ResultsThe imipenem concentration data were best described by a two-compartment model. Creatinine clearance (CrCl, mL/min) was a covariate that affected central clearance (CLc). Patients were divided into four subgroups based on different CrCl rates. Monte Carlo simulations were performed to assess the PTA differences between empirical dosing regimens (0.5 g every 6 hours (q6h), 0.5 g every 8 hours (q8h), 0.5 g every 12 hours (q12h), 1 g every 6 hours (q6h), 1 g every 8 hours (q8h), and 1 g every 12 hours (q12h)) and to determine the target achievement rate covariate.ConclusionThis study identified covariates for CLc, and the proposed final model can be used to guide clinicians administering imipenem in this particular patient population.
Keywords:
Open access, EAHP Statement 4: Clinical Pharmacy Services
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003403
Issue No: Vol. 31, No. 5 (2024)
- Pharmacokinetic/pharmacodynamic analysis of vancomycin in patients with
Enterococcus faecium bacteraemia: a retrospective cohort study-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Tochikura, N; Matsumoto, C, Iwabuchi, S, Aso, H, Fukushima, S, Ootsuka, S, Ooba, N, Ishihara, M, Nakajima, H, Umemura, H, Nakayama, T.
Pages: 440 - 446
Abstract: ObjectivesThe trough concentration of vancomycin and the area under the concentration–time curve (AUC)/minimum inhibitory concentration (MIC) ratio are crucial in determining vancomycin efficacy against methicillin-resistant Staphylococcus aureus. However, the use of similar pharmacokinetic principles in determining antibiotic efficacy against other gram-positive cocci is lacking. We performed a pharmacokinetic/pharmacodynamic analysis (association of target trough concentration values and AUC/MIC with therapeutic outcome) of vancomycin in patients with Enterococcus faecium bacteraemia.MethodsBetween January 2014 and December 2021 we performed a retrospective cohort study of patients with E. faecium bacteraemia treated with vancomycin. Patients who received renal replacement therapy or had chronic kidney disease were excluded. Clinical failure, the primary outcome, was defined as a composite of 30-day all-cause mortality, vancomycin-susceptible infection requiring change of treatment, and/or recurrence. AUC24 was estimated using a Bayesian estimation approach based on an individual vancomycin trough concentration. The MIC for vancomycin was determined using a standardised agar dilution method. Additionally, classification was used to identify the vancomycin AUC24/MIC ratio associated with clinical failure.ResultsOf the 151 patients identified, 69 were enrolled. All MICs of vancomycin for E. faecium were ≤1.0 µg/mL. The AUC24 and AUC24/MIC ratio were not significantly different between the clinical failure group and the clinical success group (432±123 µg/mL/hour vs 488±92 µg/mL/hour; p=0.075). However, 7 of 12 patients (58.3%) in the clinical failure group and 49 of 57 patients (86.0%) in the clinical success group had a vancomycin AUC24/MIC ratio ≥389 (p=0.041). No significant association between trough concentration or AUC24 ≥600 µg/mLxhour and acute kidney injury was observed (p=0.365 and p=0.487, respectively).ConclusionThe AUC24/MIC ratio is associated with the clinical outcome of vancomycin administration in E. faecium bacteraemia. In Japan, where vancomycin-resistant enterococcal infection is rare, empirical therapy with a target AUC24 ≥389 should be recommended.
Keywords:
EAHP Statement 4: Clinical Pharmacy Services
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003672
Issue No: Vol. 31, No. 5 (2024)
- Testing of parenteral drug products for visible particles: comparison of
the Ph. Eur. method with an alternative method using polarised light-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Borgonje, P. E; Dunnewind, T, Bosma, L, Tokromo-Evegaars, M, Meulenhoff, P. C. W, Breukels, O.
Pages: 447 - 449
Abstract: ObjectivesParenteral drug products should be essentially free from visible particulate contamination. To ensure this, every batch produced must be subject to a 100% visual inspection. Monograph 2.9.20 of the European Pharmacopoeia (Ph. Eur.) describes a method for visual inspection of parenteral drug units in front of a black and white panel using a white light source. Nevertheless, several Dutch compounding pharmacies rely on an alternative method for visual inspection by means of polarised light. The objective of this study was to compare the performance of both methods.MethodsTrained technicians in three different hospitals inspected a predetermined set of samples using both methods for visual inspection of parenteral drugs.ResultsThe results of this study show that the alternative method for visual inspection yields a higher recovery than the Ph. Eur. method, while no significant difference in false positive results was found.ConclusionsBased on these findings, it can be concluded that the alternative method for visual inspection by means of polarised light can very well replace the Ph. Eur. method in pharmacy practice, provided that local validation of the alternative method is performed.
Keywords:
EAHP Statement 3: Production and Compounding
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003633
Issue No: Vol. 31, No. 5 (2024)
- Analytical and clinical validation of an LC-MS/MS method for
carbamazepine, lamotrigine and levetiracetam in dried blood spots-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Besten-Bertholee, D. d; Wegner, I, Touw, D. J, ter Horst, P. G. J.
Pages: 450 - 454
Abstract: ObjectivesTherapeutic drug monitoring is performed routinely in patients on anti-epileptic drugs (AEDs) for optimisation and individualisation of therapy. The dried blood spot (DBS) sampling technique is a suitable, more patient-friendly alternative for conventional venous sampling methods. However, before DBS can be used in routine care, data are needed to establish the correlation between standard plasma concentrations obtained from venous puncture and concentrations measured through DBS obtained by finger prick. This study aims to investigate the correlation between carbamazepine, lamotrigine and levetiracetam drug concentrations in venous blood and DBS samples in the same patients at the same time.MethodsClinical validation was conducted by direct comparison of paired DBS and venous plasma samples. Method agreement was evaluated using Passing–Bablok regression analysis and Bland–Altman plots to provide insight into the relationship between the two analytically validated methods. For Bland–Altman analysis the acceptance limit required by both FDA and EMA guidelines is at least two-thirds (67%) of the paired samples within 80–120% of the mean of both methods.ResultsPaired samples from 79 patients were studied. For all three AEDs, plasma and DBS concentrations correlated highly (r=0.90 for carbamazepine, r=0.93 for lamotrigine and r=0.93 for levetiracetam), indicating a linear relationship. For carbamazepine and lamotrigine, no proportional or constant bias was revealed. For levetiracetam, concentrations were higher in plasma samples than in DBS (slope 1.21), implying a conversion factor is needed. The acceptance limit was met for carbamazepine and levetiracetam with a value of 72% and 81%, respectively. For lamotrigine, this acceptance limit was not met with a value of 60%.ConclusionsThe method was successfully validated and will be used for therapeutic drug monitoring in patients using carbamazepine, lamotrigine and/or levetiracetam.
Keywords:
EAHP Statement 4: Clinical Pharmacy Services
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003589
Issue No: Vol. 31, No. 5 (2024)
- A new approach to drug intravenous compatibility research: the case of
obstetric parenteral drugs-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Leeuwerik, A. F; van Merendonk, L. N, de Boer, M. A, Wilhelm, A. J, Kolkman, A, Bet, P. M.
Pages: 455 - 460
Abstract: ObjectivesThe product information and literature does not provide confirmation of compatibility for co-administration of all commonly used drug pairs in obstetrics. However, there is a need for co-administration of these drugs over one lumen for this group of patients. Therefore, this study focuses on Y-site compatibility. Since different conditions between clinical and laboratory settings can lead to discrepancies in results, a novel approach for drug intravenous compatibility testing was designed to reflect clinical conditions. The aim was to study the compatibility of nine commonly used drug pairs in obstetrics and to evaluate the clinical value of the designed method.MethodsThe clinical situation was reflected by using different temperature ranges (20°C and 37°C), actual Y-site flow ratios, clinically relevant drug pairs and an observation time of 120 min. The clinically relevant drugs pairs include atosiban, nicardipine, amoxicillin/clavulanic acid, oxytocin, remifentanil, labetalol and magnesium sulpfate. Drug pairs were visually assessed according to the European Pharmacopoeia (Ph. Eur.) and pH was measured. When incompatibility of a drug pair seemed likely based on literature review or observed abnormalities during visual assessment, subvisual analysis was performed using a particle counter. Y-site compatibility applied for drug pairs when no visual changes occurred or when no additional particles were formed during the observation time.ResultsEight of the nine combinations showed no visual changes or noticeable changes in pH during the observation time. The amoxicillin/clavulanic-acid-oxytocin combination showed a colour change at 37°C at the actual Y-site flow ratio. However, subvisual particle counting showed no formation of additional particles.ConclusionsY-site compatibility was established for all tested drug pairs. The new clinical approach for analysing Y-site compatibility provides a high certainty of outcomes for clinical practice. In this way, clinical complications and use of several additional intravenous catheters can be avoided.
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003577
Issue No: Vol. 31, No. 5 (2024)
- A new function in the Stabilis database: physical compatibility and
incompatibility of injectable drugs to secure Y-site administration-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Beiler, B; Vigneron, J, D'Huart, E, Demore, B.
Pages: 461 - 467
Abstract: ObjectivesIn intensive care units, the mixing of injectable drugs via Y-site administration is often necessary. However, some mixtures can lead to physical incompatibility or chemical instability. To assist healthcare professionals, several databases such as Stabilis compile compatibility and stability data. The objectives of this study were to update the online database Stabilis by adding physical compatibility data to the website and to characterise the incompatibility data already present in the database by specifying the phenomenon at the origin of the incompatibility and its time of occurrence.MethodsBibliographic sources referenced in Stabilis were evaluated using several criteria. After the evaluation, studies were rejected or the data they contain were added to the database. Data entries contained the following information: name of the two injectable drugs involved in the mixture and their concentration if available, the dilution solvent and the phenomenon at the origin of the incompatibility and its time of occurrence for incompatibility data. Three functions of the website were modified, including the ‘Y-site compatibility table’ function, which allows creation of customised compatibility tables.ResultsA total of 1184 bibliographic sources were evaluated, 77.3% (n=915) of which were scientific articles, 20.5% (n=243) were Summaries of Product Characteristics and 2.2% (n=26) were communications in a pharmaceutical congress. After evaluation, 28.9% (n=342) of the sources were rejected. From the 71.1% (n=842) sources selected, 8073 (70.2%) compatibility data entries and 3433 incompatibility data entries (29.8%) were made. With the addition of these data, the database contained compatibility and incompatibility data for 431 injectable drugs.ConclusionsSince the update, the ‘Y-site compatibility table’ function has seen its traffic increased by about 66% (~1500 tables per month compared with ~2500 tables per month). Stabilis is now more complete to offer significant help to healthcare professionals with their problems of drug stability and compatibility.
Keywords:
EAHP Statement 3: Production and Compounding
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003637
Issue No: Vol. 31, No. 5 (2024)
- Automation of parenteral nutrition: impact on process and cost analysis
-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Perrier, Q; Hosni, A, Leenhardt, J, Desruet, M.-D, Durand, M, Bedouch, P.
Pages: 468 - 473
Abstract: ObjectivesOn the basis of its safety and accuracy, automation is recommended for parenteral nutrition (PN). The aim of this study was to highlight the changes in practices related to the automation of PN and to perform a cost study comparing manual vs automated production costs.MethodsWe conducted a micro-costing study using 1 year of manual production data for adult, neonatal and paediatric PN bagsat a hospital. We used the data to estimate the costs of automating the production process for adult, neonatal and paediatric bags.ResultsMajor modification to the PN production process resulted in: rationalisation of raw materials, computerisation and optimisation of human needs. Switching from a manual to an automated process reduced the cost of neonatal/paediatric custom bags (130.73 vs 124.58) and semi-custom bags (172.08 vs 166.86); but increased the cost of adult bags (93.06 vs 127.92).ConclusionsThe changes resulting from the automation and revision of the production process globally increased annual expenditures by approximately 9.7%. However, automation minimised the risk of misproduction, bag contamination, and led to a more secure production process that reduced risks incurred by the teams. In view of the gain in patient and staff safety (linked to the use of an automated compounding device) the moderate economic impact (
Keywords:
EAHP Statement 3: Production and Compounding
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003602
Issue No: Vol. 31, No. 5 (2024)
- Recommended doses of endovenous vancomycin are insufficient to achieve
therapeutic concentrations in paediatric patients-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Aguilo Lafarga, I; Perez Moreno, M, Herranz Bayo, E, Merchante Andreu, M, Huarte Lacunza, R.
Pages: 474 - 479
Abstract: ObjectivesVancomycin therapeutic drug monitoring is challenging, especially in the paediatric population where evidence is scarce. The main objective of this study was to analyse the achievement of therapeutic concentrations of vancomycin in paediatric patients and to evaluate the current monitoring method (trough levels), doses used, and the time required to achieve target concentrations.MethodsPaediatric patients on treatment and monitored with vancomycin from November 2019 to December 2021 were included. Those with only one determination of serum vancomycin concentration were excluded. Demographic variables, analytical and microbiological parameters and toxicity data were collected. Pharmacokinetic parameters were assessed at baseline and during treatment.Results225 patients (40.9% female; 108 neonates, 49 infants and 68 children or adolescents) were included in the study. The main indications for vancomycin treatment were sepsis (33.9%) and fever of unknown origin (29.3%). Microbiological cultures were positive in 71.1%, mostly with Gram-positive bacteria (60.4%). Therapeutic levels of vancomycin were reached in only 20.1% of the participants in the first determination. After pharmacokinetic monitoring, 81.7% of patients reached therapeutic concentrations, requiring a 23% increase in the initial dose, a 2-day lag time and 1–2 dosage adjustments until the therapeutic concentration was reached. Of the total patients, 13 developed nephrotoxicity, nine neutropenia and one patient developed red man syndrome.ConclusionsIn our sample of paediatric patients, the recommended doses of vancomycin were insufficient to achieve therapeutic concentrations. Revision of the recommendations and/or a change in the method of pharmacokinetic monitoring is crucial to optimise treatment in this population.
Keywords:
EAHP Statement 5: Patient Safety and Quality Assurance
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2023-003694
Issue No: Vol. 31, No. 5 (2024)
- Optimisation of the quality of care for patients with severe asthma:
ASfarMA project-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Munoz-Garcia, M; Martinez-Barros, H, Sanchez-Cuellar, S, Morales-Tirado, A, De-Andres-Martin, A, De-Los-Santos-Granados, G, Antolin-Amerigo, D, Blitz-Castro, E, Fernandez-Martin, P, Santamaria-Gadea, A, De-La-Hoz-Caballer, B, Alvarez-Diaz, A. M, Gonzalez-De-Olano, D.
Pages: 480 - 482
Abstract: Severe asthma has an important impact on patients and healthcare resources. Recently, the new specific treatments have defined a new scenario in which person-focused care and specialist multidisciplinary teams are necessary. Our Severe Asthma Unit (SAU) started the ASfarMA project along with an external human-centered design company to understand patients’ vision of their illness, treatment, and healthcare experience, and to define the ideal SAU by performing a core group session, in-depth semistructured interviews and co-creation workshop. Herein, a series of tips classified as either ‘transformative solutions’ or ‘quick wins’, according to a value versus effort matrix are presented. Successful implementation of the proposed solutions will be valuable for patients and healthcare professionals, optimising patient care and resources. These findings can also be helpful to other SAUs or other humanisation projects involving complex, chronic and multidisciplinary pathologies.
Keywords:
EAHP Statement 5: Patient Safety and Quality Assurance
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2022-003611
Issue No: Vol. 31, No. 5 (2024)
- Improving the quality of publications in and advancing the paradigms of
clinical and social pharmacy practice research: the Granada Statements-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Fernandez-Llimos, F; Desselle, S, Stewart, D, Garcia-Cardenas, V, Babar, Z.-U.-D, Bond, C, Dago, A, Jacobsen, R, Norgaard, L. S, Polidori, C, Sanchez-Polo, M, Santos-Ramos, B, Shcherbakova, N. G, Tonin, F. S.
Pages: 483 - 488
Abstract: Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as ‘the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on healthcare systems, medicine use, and patient care’. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other healthcare areas (ie, medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors’ selection of the most appropriate pharmacy practice journal to submit their work.
Keywords:
Open access
PubDate: 2024-08-22T02:17:43-07:00
DOI: 10.1136/ejhpharm-2023-003748
Issue No: Vol. 31, No. 5 (2024)
|
Hybrid journal (It can contain Open Access articles)
