Search

Background: Androgen deprivation therapy (ADT) is a non-curative but essential treatment of prostate cancer with severe side effects. Therefore, both over- and underuse should be avoided. We investigated adherence to guidelines for ADT following radical prostatectomy through Swedish population-based data. Material and methods: We used the database Uppsala/Örebro PSA cohort (UPSAC) to study men with localised or locally advanced prostate cancer at diagnosis (clinical stage T1–T3, N0–NX, M0–MX, and prostate-specific antigen (PSA) <50 ng/ml) who underwent radical prostatectomy 1997–2012. 114 men were treated with ADT and selected as cases; 1140 men with no ADT at the index date were selected as controls within 4-year strata of year of radical prostatectomy. All men with a biochemical recurrence and a PSA doubling time <12 months and/or a Gleason score of 8–10 were considered to have an indication for ADT according to the European Association of Urology (EAU) guidelines. Results: No indication for ADT was found in 37% of the cases. Among these, 88% had clinical stage T1–2 at diagnosis, 57% had a biopsy Gleason score 2–6, 98% had an expected remaining lifetime over 10 years, 12% received castration, and 88% received antiandrogen monotherapy. 2% of controls were found to have an indication for ADT, and 96% of these had an expected remaining lifetime over 10 years. Conclusion: Our results indicate that overtreatment with ADT after radical prostatectomy is common, whereas undertreatment is unusual. Interventions to improve adherence to guidelines are needed to avoid unnecessary side-effects and long treatment durations with ADT. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the potential of ward-based pharmacists' intervention in reducing the morbidity in patients aging 80 years and above. It utilizes randomized controlled study in 400 patients that was conducted in University Hospital of Uppsala in Uppsala, Sweden. The services that were provided by clinical pharmacists include a comprehensive medication list on admission that would ensure that the ward receives the correct medication list. It also performed drug review to inform the patients on the drug selection, dosages and monitoring needs. Information on medications and monitoring after discharge are also provided. It suggests that additional pharmacists to health care teams will greatly improve the morbidity among patients.