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Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lung transplantation requires a complex therapeutic approach, exposing patients to potential iatrogenic and infectious complications. Within our institution, a Patient Education Program dedicated to lung transplant recipients has been authorized since 2013. Starting November 2020, pharmacy interns and pharmacy students have been actively involved with the implementation of follow-up educational workshops on treatments. To assess the impact of these workshops on patient knowledge, we conducted the EnPhaSE study (Entretien Pharmaceutique - Suivi et Education). This study, a single-center, non-interventional comparative before-and-after evaluation, consisted of two educational sessions held three months apart, where a knowledge assessment questionnaire was administered at the outset of each session. The results of this study demonstrate a positive impact on enhancing patient knowledge. The average knowledge score during the second session showed a significant increase (93 ± 12 versus 68 ± 26; p < 0.001). Additionally, participants expressed a high level of satisfaction with these educational workshops. This work contributes to enhancing the healthcare trajectory of lung transplant patients and underscores the beneficial impact of pharmaceutical educational workshops on improving patient understanding regarding their treatments. [ABSTRACT FROM AUTHOR]

Introduction : Entre le médecin qui établit le diagnostic et définit la stratégie thérapeutique, et l’infirmier qui administre les soins aux malades doit se trouver le pharmacien qui s’intéresse à la validation et l’optimisation de la thérapeutique médicamenteuse, à la prévention de la pathologie iatrogène et contribue ainsi à l’excellence du projet thérapeutique du patient. La présente étude évalue les besoins d’interventions pharmaceutiques des praticiens des unités de soins pédiatriques. Méthodologie : Il s’est agi d’une étude transversale à visée descriptive qui s’est déroulée durant la période de mars à mai 2021. Elle s’est déroulée dans les quatre centres hospitaliers universitaires de la ville de Ouagadougou. Les données ont été recueillies à l’aide d’un questionnaire et traités avec le logiciel sphinx V5 et Excel 2016. Résultats : Au total 408 agents de santé des centres hospitaliers universitaires de Ouagadougou ont participé à l’étude. Les enquêtés étaient majoritairement les infirmiers, suivis des médecins généralistes. Les agents de santé qui avaient une ancienneté de service de 0 à 5 ans et 6 à 10 étaient les plus représentés avec respectivement 51,70% et 42,20%. Selon les enquêtés, 32% des activités pharmaceutiques dans l’hôpital était occupé par d’autres professionnels de la santé, contre 69,9%, dans leurs services. Les participants à l’étude n’étaient pas satisfaits des activités pharmaceutiques réalisées par les autres professionnels à 68,90%. Seulement 34,10% des enquêtés avait une notion sur la pharmacie clinique. Les contextes souhaités pour les interventions pharmaceutiques étaient le staff et lors de la visite médicale respectivement à 91,20% et 90,40%. Les principales limites dans la collaboration se rapportaient à l’insuffisance de communication et à l’absence de pharmaciens dans les services de soins cliniques. Conclusion : Cette étude décrit les attentes des autres praticiens en matière d’interventions pharmaceutiques. Des actions de renforcement des effectifs et de la place des pharmaciens dans les équipes hospitalières devront être envisagées.

L'admission d'un patient âgé à l'hôpital constitue un point critique à la continuité de son traitement médicamenteux. La conciliation médicamenteuse représente un moyen efficace d'identifier et de corriger des erreurs liées à un recueil imparfait de l'historique médicamenteux du patient. La pratique de la conciliation médicamenteuse est sécurisante pour le patient notamment du fait de la détection des erreurs médicamenteuses à impact clinique significatif. La mise en œuvre de cette dernière doit être conforme aux recommandations de la Haute Autorité de Santé (HAS) et son déploiement est aujourd'hui intégré dans le contrat d'amélioration de la qualité et de l'efficience des soins (CAQES). Toutefois, bien que la conciliation médicamenteuse permette d'intercepter les erreurs médicamenteuses, des questions restent posées concernant son impact sur la durée d'hospitalisation, le taux de réadmission et/ou de décès dans les suites de la sortie du patient. Compte tenu des ressources humaines limitées pour réaliser cette activité chronophage, une priorisation des malades doit être examinée. Des études portant sur le devenir des patients et sur les enjeux médico-économiques sont nécessaires afin de pérenniser cette activité. Admission to hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. The practice of medication reconciliation is securing for the patient because of the medication errors detected with significant clinical impact. Its implementation must comply with the recommendations of the French National Authority for Health (HAS) and its deployment is now integrated into the contract for improving the quality and efficiency of care (CAQES). However, although it allows to intercept medication errors, its impact on the length of hospitalization, the rate of readmission and/or death following discharge seems limited. Given the limited human resources to carry out this time-consuming activity, patient prioritization should be considered. Studies on the fate of patients and on the medico-economic issues are also necessary in order to make this activity sustainable. [ABSTRACT FROM AUTHOR]

Daratumumab is a humanized monoclonal antibody IgG1 anti-CD38, available since august 2016. It is indicated, among other indications, for the treatment of multiple myeloma in association with lénalidomide and dexaméthasone (DRd protocol). POLLUX trial demonstrated an improvement of overall survival and progression-free survival in patients receiving DRd compared to Rd only. This study is monocentric and observationnal and retrospective and included all patients receiving DRd for multiple myeloma in a cancer centre between august 2016 and decembre 2020. 49 patients received intravenous daratumumab at 16 mg/kg; after 6 months of therapy, overall response rate is 79.6% ; after 12 months of therapy 79.1% of the patients did not progress and 78.9% of the patients are still alive. Our results are less than POLLUX study in which the 12 months overall survival is 92.1% (versus 79.1%), 12 months progression-free survival is 85.7% (versus 78.9%) and overall response rate is 92.9% (versus 79.6%). These results can be explained by a population with a poorer prognosis in our cohort. This real-life study allows a realistic vision of the benefits of a treatment by DRd over a population that was non selected. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Dans le cadre du retraitement comptable des établissements, la nouvelle unité d'œuvre (UO) des pharmacies à usage intérieur (PUI) de la base d'Angers introduit une appréciation plus exhaustive des activités pharmaceutiques et plus proche du référentiel de la Société française de pharmacie clinique que la précédente [5, 6]. Il est attendu de cette redéfinition de l'UO une meilleure analyse des organisations pharmaceutiques au sein des établissements. L'objectif de ce travail est de s'interroger sur l'intérêt de l'UO à rendre compte des évolutions organisationnelles de la pharmacie à usage intérieur (PUI) du groupe hospitalier Paul Guiraud (GHPG) en faveur du déploiement quantitatif et qualitatif des activités de pharmacie clinique. Matériel et méthode. Il s'agit d'une étude rétrospective observationnelle sur données. Les données sont issues des rapports d'activités des années 2017 [3], 2021 [4] de la PUI du GHPG, de deux études de temps travaillés conduites en interne, des données d'hospitalisation temps plein du GHPG [2] et des données de temps travaillés colligées et pondérées par l'ANAP auprès de neuf PUI d'établissements psychiatriques. Elles ont été analysées avec le logiciel SPSS (v.28.0.1). Résultats et discussion. L'étude comparative sur les temps travaillés en matière de dispensation globale (activité de référence) et de conciliations médicamenteuses (l'une des activités de pharmacie clinique) entre la PUI du GHPG d'une part et les PUI des établissements psychiatriques de l'échantillon test d'autre part, révèle une plage de valeurs dans laquelle s'inscrit la PUI du GHPG. En ce sens, quand bien même les PUI seraient distinctes par leur organisation, leurs activités, leur taille ou leurs moyens, l'étude de temps travaillé et pondéré révèle une certaine homogénéité des PUI d'établissements psychiatriques. Au cours de la période d'étude, les dispensations augmentent de 10 % lorsqu'elles sont exprimées en nombre d'actes, diminuent de 3 % en temps pondéré et leur part au sein de l'UO diminue de 4,8 % passant de 42 % à 40 %. En ce sens, l'UO rend compte de deux phénomènes inverses : l'augmentation du périmètre références produits et clients liés à l'épidémie de Covid-19 et la diminution des lits et places liés à la crise de la psychiatrie publique. Conformément au projet de service et de pôle, les activités de pharmacie clinique augmentent de 2 % lorsqu'elles sont exprimées en nombre d'actes, croissent de 26 % en temps pondéré et leur part au sein de l'UO augmente de 26 % passant de 5,8 % à 7,3 %. En ce sens, l'évolution de l'UO rend compte des modifications organisationnelles en faveur du déploiement des activités de pharmacie clinique. Perspectives. L'évolution de l'UO illustre la réorganisation mise en œuvre ces 5 cinq dernières années. Peut-elle guider un pharmacien gérant et un décideur local dans la mise en œuvre du décret d'application n° 2019-489 du 21 mai 2019 relatif aux PUI ? Et éclairera-t-elle le chemin à parcourir dans le cadre de la coopération pharmaceutique associée à une mutualisation des fonctions techniques et logistiques, une robotisation de la dispensation et un déploiement des activités de pharmacie clinique dans les établissements partenaires encore non couverts... ? As part of the French public hospital accounting restatement, the new work's unit (UO) for pharmacy is more exhaustive and closer to the Société Française de Pharmacie Clinique frame of reference than the oldest one [5, 6]. Redefinition is expected to result in a better understanding of pharmacy organisations. The objective of this work was to examine the interest of the UO in reporting on organisational changes in our pharmacy Groupe Hospitalier Paul Guiraud (GHPG) in favour of quantitative and qualitative development of clinical pharmacy activities. Material and method. This was an observational retrospective study on database. Data was recorded from 2017 [3] and 2021 [4] annual activity reports of pharmacy GHPG, two internal studies on working time, full time hospitalization data during the study period [2] and weighted time calculations by ANAP among 9 psychiatric hospital pharmacies. Data analysis was done using SPSS software (release 28.0.1). Results and discussion. The comparative study based on pharmaceutical dispensing weighted time (reference activity) and medication reconciliation weighted time (one activity of clinical pharmacy) between pharmacy GHPG and the 9 psychiatric hospital pharmacies, shows that both are in the same range. Although our organizations, activities, resources, sizes and budgets are different, weighted time of two main activities are close and reveals some homogeneity between psychiatric hospital pharmacies corpus. During the study period, pharmaceutical dispensing increased by 10% when expressed in number of acts, decreased by 3% in weighted time and their share within the UO reduced by 4.8% from 42% to 40%. In this respect, the UO reports two opposite trends: the increase of health products in the formulary and extension of customers related to the COVID-19 pandemic and the decrease in beds related to the crisis of public psychiatry. Clinical pharmacy activities increased by 2% when expressed in number of acts, increased by 26% in weighted activities and their share within the UO increased by 26% from 5.8% to 7.3%. In that respect UO evolution reflects organizational changes in favour of clinical pharmacy activities deployment. Perspectives. New UO illustrates the reorganization implemented over the last 5 years. But can it guide pharmacist manager and local decision-maker in decree n° 2019-489 05/21/2019 implementation related to hospital pharmacy? And will it shed light on the path to be taken within the framework of pharmaceutical cooperation associated with a pooling of technical and administrative functions, robotic dispensing, and deployment of clinical pharmacy activities in partner facilities that are not yet covered...? [ABSTRACT FROM AUTHOR]

Objectives: Pharmaceutical care for patients receiving oral anticoagulants (OACs) should be performed by trained healthcare professionals to prevent adverse effects and improve patient adherence. Before meeting patients, all pharmacy students in our department (in a one-year hospital internship program) experienced a theoretical training for several years. It was decided to add a practical component based on simulation training. The study reports the simulation program conception and the assessment of the simulation-based training for pharmacy students involved in conducting interviews with patients receiving ACOs., Methods: Organization and content of the training course were defined by two hospital pharmacists and one pharmacy resident. Skills' assessment was measured in pharmacy students in 3 steps: (1) initial assessment by individual interview, (2) group training by simulation, (3) final assessment by individual interview. Student satisfaction was also assessed at the end of the training., Results: Four scenarios and one assessment form were developed and 16 pharmacy students experienced the training. An improvement in skills after the simulations courses was observed in all parts of the process: the pre-interview (mean +15%), the interview itself (+16%) and the post-interview (+18%). All students felt more comfortable and motivated to conduct interviews and recommended that this training be continued., Conclusions: The study underlines the impact of the simulation training on students' skills and their satisfaction with the overall training program. The simulation training is now fully added to the program. Further studies should explore the skills improvement in real life during the first patient interview., (Copyright © 2024 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

The integration of a large number of drugs, such as antineoplastic agents and cancer-related supportive care drugs, into the management of cancer patients exposes them to an increased number of drug-related problems (DRP). Clinical pharmacists contribute to drug management by actively intervening in detected DRP. The aim of this study is to assess the impact of the applying a clinical pharmacist-driven comprehensive medication management (CMM) service to onco-hematology patients. This prospective interventional study was carried out over six-month duration, specifically from November 06, 2022 to April 5, 2023 in the oncology and hematology departments of the EHU Oran. The adherence to treatment was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS). Whereas data related to the patient's general condition and medication history was assessed using the Pharmaceutical Care Network Europe (PCNE) Classification for Drug-Related Problems V9.1. Among the 130 patients included in the study, a total of 879 DRP were identified, with a mean of 6.78 (±1.72) DRP/patient, half of which were related to efficacy (51%). Almost half of our sample (44.6%) did not adhere to their treatment. The most frequent cause of DRP, accounting for (19.9%) of the cases, was the inappropriate administration by a health professional. A total of 875 pharmaceuticals interventions (PI) were proposed, 67.2% of which were focused at the drug level. The PI acceptance rate was 94.1%. The integration of CMM services in onco-hematology played an important role in optimizing dosing regimen and treatment administration methods, as well as preventing iatropathology in the management of cancer patients., (Copyright © 2024 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Résumé: Les lymphocytes T à récepteur chimérique (CAR-T cells) sont une nouvelle classe de médicaments nécessitant une adaptation des hôpitaux pour pouvoir prendre en charge ces nouveaux traitements et assurer la sécurité des patients traités. Outre les impératifs de parcours de soins médicaux, un autre point primordial est la structuration du circuit intra-hospitalier de ces médicaments. L'objectif de cet article est de décrire le rôle du pharmacien hospitalier dans la mise en œuvre du circuit au sein d'un centre hospitalier universitaire, mais également dans son rôle de pharmacien clinicien. Les différentes étapes du circuit sont détaillées en rappelant le rôle du pharmacien décrit dans la réglementation, et sa place au sein de l'équipe pluri-professionnelle intervenant sur le circuit du médicament, de l'étude de faisabilité jusqu'au suivi du patient au décours de l'hospitalisation. Après trois années d'expérience au sein de notre centre hospitalier, des perspectives d'amélioration sont également présentées pour sécuriser davantage ce circuit pharmaceutique et optimiser la prise en charge des patients. Chimeric receptor T-cells (CAR-T cells) are a new class of drugs that require hospitals to adapt in order to manage these new treatments and ensure the patients' safety. In addition to the imperatives of medical care pathways, another essential point is the structuring of the intra-hospital supply chain for these drugs. The objective of this article is to describe the role of the hospital pharmacist in the implementation of the supply chain within the institution but also in his role as clinical pharmacist. The different steps of the supply chain are detailed by recalling the role of the pharmacist described in the regulation, and his/her place within the multi-professional team involved in this process, from the feasibility study to the follow-up of patients during hospitalization. After 3 years of activity in our university hospital, perspectives for improvement are also presented to further secure this pharmaceutical circuit and optimize patient care. [ABSTRACT FROM AUTHOR]

The management of multimorphic cancer pain is a major supportive care in oncology, for which many national and international recommendations have recently been updated. Any cancer patient must benefit from access to supportive care from the diagnosis, throughout the entire care pathway. Chronic renal failure, from any etiology, requires special attention and constant attention to details from interdisciplinary caregivers' teams to propose the best analgesic therapeutic strategy, combining complementary and interventional approaches to treatments. Analgesic therapies, in particular opioids and antineuropathics, require specific precautions. A therapeutic alliance integrating clinical pharmacy as a supportive care in its own right, is a major asset allowing the optimization and securing of analgesic drug treatments, conditioning both their efficacy, their tolerance and therapeutic observance, in the goal of improving the patient's quality of life., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Admissions of the elderly related to medication errors are frequent in hospital, more than half would be avoidable, but there is currently no validated method in French to identify them. The objective of this work was to validate the French version of the AT-HARM10 tool in order to use it for patients admitted in our healthcare facilities. The tool has 10 questions. A positive response to any of the first 3 questions identify admissions that are unlikely to be drug-related. A positive response to one of the following 7 questions identify possible medication-related admissions. For semantic and linguistic validation, we performed cross-validation with forward-backward translation. To clinically validate the method, we conducted a retrospective study including patients over 65 admitted to short-stay units (UHCD) and to orthopedic surgery units in two French hospitals. Two hundred and sixty-six (266) patients were included ; 166 patients admitted to UHCD (mean age 86.0±5.7 years; sex ratio 0.66; mean number of drugs prescribed 7.7±3.8) and 100 patients admitted to orthopedic units (mean age 85.2±6.1 years; sex ratio 0.43; mean number of prescribed drugs 6.4±3.6). We identified 55 % of admissions probably related to medication in UHCD and 76 % in orthopedic units (p<0.05). The most represented item was P5 in both groups (Might [side] effects of the medications the patient was taking [prescribed or not prescribed] prior to hospitalization have caused the admission [including over-treatment] ? The validated AT-HARM10 tool is now integrated into our clinical pharmacy practices and medication reviews are offered as a priority to patients admitted for iatrogenic reasons., (Copyright © 2023 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: Clinical pharmacists rely on different scientific references to ensure appropriate, safe, and cost-effective drug use. Tools based on artificial intelligence (AI) such as ChatGPT (Generative Pre-trained Transformer) could offer valuable support. The objective of this study was to assess ChatGPT's capacity to correctly respond to clinical pharmacy questions asked by healthcare professionals in our university hospital., Material and Methods: ChatGPT's capacity to respond correctly to the last 100 consecutive questions recorded in our clinical pharmacy database was assessed. Questions were copied from our FileMaker Pro database and pasted into ChatGPT March 14 version online platform. The generated answers were then copied verbatim into an Excel file. Two blinded clinical pharmacists reviewed all the questions and the answers given by the software. In case of disagreements, a third blinded pharmacist intervened to decide., Results: Documentation-related issues (n=36) and drug administration mode (n=30) were preponderantly recorded. Among 69 applicable questions, the rate of correct answers varied from 30 to 57.1% depending on questions type with a global rate of 44.9%. Regarding inappropriate answers (n=38), 20 were incorrect, 18 gave no answers and 8 were incomplete with 8 answers belonging to 2 different categories. No better answers than the pharmacists were observed., Conclusions: ChatGPT demonstrated a mitigated performance in answering clinical pharmacy questions. It should not replace human expertise as a high rate of inappropriate answers was highlighted. Future studies should focus on the optimization of ChatGPT for specific clinical pharmacy questions and explore the potential benefits and limitations of integrating this technology into clinical practice., (Copyright © 2023 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Cancer patients are not immune to the misuse of antibiotics. Clinical pharmacists could participate in reducing this phenomenon. The objective of this study was to assess the appropriateness of antibiotic and antifungal prescriptions in an oncology hospital before and after implementation of clinical pharmacy services. Methods. A retrospective study was conducted on anti-infective prescriptions in two separate periods of 6 months. Only patients from clinical departments where a clinical pharmacist was assigned were included. A multidisciplinary team assessed the appropriateness of the prescriptions according to French guidelines. The following criteria were taken into account: the indication, the association of drugs, the dosage and the duration of treatment. Results. 91 patients receiving 112 prescriptions in the first period and 97 patients receiving 122 prescriptions in the second period were included. The most frequent indication was febrile neutropenia (33.9% then 35.2%). The appropriateness of the prescriptions increased from 48.2% in the first period to 61.5% in the second period (p=0.042). The percentages of appropriate indication, proper dosage and appropriate duration increased by +4%, +13.4% and +8% respectively. Conclusion. This study found an improvement in the appropriateness of anti-infective prescriptions in an oncology setting and the clinical pharmacy may have contributed to this. [ABSTRACT FROM AUTHOR]

Résumé: Récemment, on constate un développement important des activités de soins pharmaceutiques en chirurgie. Cette étude a pour but de documenter et d'évaluer l'impact clinique des interventions pharmaceutiques (IP) du pharmacien clinicien (PC) dans un service de chirurgie digestive ainsi que de déterminer si on peut établir une concordance entre l'impact clinique (IC) évalué par les chirurgiens et les pharmaciens. Méthodes : Nous avons réalisé une étude observationnelle rétrospective monocentrique sur la période de janvier 2018 à décembre 2019. Les IP classifiées selon le modèle de la Société française de pharmacie clinique (SFPC) du PC ont été extraites du dossier patient. Ensuite, l'IC de ces IP a été évalué par un groupe de PC et un groupe de chirurgiens, selon deux échelles validées (Hatoum et Med'Rec HAS). Résultats : Le PC a consulté le dossier de 1 092 patients (39,5 % des patients). Il y avait 3 181 IP chez 731 patients. Le taux d'acceptation était de 90,8 %. Le PC intervenait le plus fréquemment pour une indication non traitée et la non-conformité aux référentiels ou la contre-indication. Les IC significatifs et très significatifs étaient le plus souvent attribués selon Hatoum. Ils représentaient 95,7 % des cotations données. Le kappa de Light avait une valeur de 0,71 démontrant un accord fort entre les chirurgiens et les pharmaciens. Ces résultats ont été consolidés par ceux obtenus en utilisant l'outil Med'Rec HAS. Conclusion : Cette étude soutient l'implémentation progressive des soins pharmaceutiques pour les patients chirurgicaux. L'IC sur le patient paraît positif, après évaluation selon une échelle standardisée et validée. Plus d'études prospectives et randomisées sont nécessaires afin d'établir un lien plus clair entre les IP et leur IC. Recently, there has been a significant development in pharmaceutical care activities in surgery wards. The objectives of this study are to document and assess the clinical impact of pharmaceutical interventions (PIs) of the clinical pharmacist (CP) in a digestive surgery department and also to determine if we can establish a concordance between the clinical impact (CI) evaluated by two groups (surgeons and pharmacists). Methods : This is a retrospective monocentric observational study conducted from January 2018 to December 2019. The PIs were extracted from patient record and are classified according to the model of the French Society of Clinical Pharmacy (SFPC). Then, the clinical impact of these PIs was evaluated by a group of CPs and a group of surgeons, according to two validated scales (Hatoum and Med'Rec HAS). Results : The CP consulted 1092 patients' files (39.5% of patients). There are 3181 PIs in 731 patients. The acceptance rate is 90.8%. The most common PP are untreated indication and non-compliance with the standards or contraindication. The clinically significant and very significant impacts were mostly retained according to Hatoum. They represent 95.7% of the ratings given. Light's kappa test has a value of 0.71 demonstrating strong agreement between surgeons and pharmacists. These data are consolidated with similar data obtained from Med'Rec HAS. Conclusion : This study supports the gradual implementation of pharmaceutic care for surgical patients. The CI on the patient appears positive. More prospective and randomized studies are needed to establish a clearer link between PIs and their CI. [ABSTRACT FROM AUTHOR]

Résumé: Objectif : évaluer l'impact des activités de pharmacie clinique sur le taux de ré-hospitalisations, non programmées, des patients âgés (75 ans ou plus) admis à la médecine d'urgence de la personne âgée (MUPA) pour chute. Méthode : étude pilote, longitudinale et comparative (groupe bénéficiant des activités de pharmacie clinique et groupe contrôle). Critères de jugement : taux de ré-hospitalisation non programmée au CHU de Limoges à 90 jours (principal), 30 jours, 72 h (secondaires) et estimation des coûts économisés associés. Résultat : 252 patients inclus. Une diminution significative du taux de ré-hospitalisations a été retrouvée à 90 jours (odds ratio = 0,45 (IC95 % 0,26–0,79) p = 0,005), 30 jours (p = 0,035) et 72 h (p = 0,041) dans le groupe intervention. Une moyenne de 37 770 euros sur les 5 mois et demi de l'étude ont été économisés (21 ré-hospitalisations évitées). Conclusion : nos résultats soulignent l'impact positif de la pharmacie clinique sur la prévention des ré-hospitalisations non programmées chez les sujets âgés chuteurs. To evaluate the effect of clinical pharmacy interventions on the unplanned rehospitalizations rates of elderly people admitted for fall to the elderly emergency medicine (EEM) unit in a teaching hospital. Design and measures: This was a longitudinal, comparative pilot study. Patients aged at least 75 who were admitted to the EEM unit for a fall and who had at least two chronic diseases and who were being treated with two or more medications were included from February 1, 2018 to June 30, 2018 and followed by 90 days. The main outcomes were the unplanned rehospitalizations rate at Limoges Teaching Hospital within the 90 days (primary outcome), 30 days and 72 hrs. The estimated cost-saving was also assessed. Results: We included 252 patients. The mean age was 88.4 ± 5.8 years and the average baseline number of medications was 8.3 ± 3.4. In total, 158 pharmaceutical interventions were performed, reflecting an acceptance rate of 94.9%. We found a significant reduction of the rate of unplanned rehospitalizations at 90-day (OR = 0.45 (0.26–0.79) p = 0.005). These results were still consistent at 30-day (p = 0.035) and 72 hours (p = 0.041). We found a cost-saving of 37,770 euros related to 21 avoided rehospitalizations. Conclusions: Our results highly emphasize the positive effects of clinical pharmacy services on the prevention of unplanned rehospitalizations of old adults admitted for fall. [ABSTRACT FROM AUTHOR]

Objective: Pharmaceutical presence in oncology allows the clinical pharmacist to integrate tripartite consultations for primary prescription of oral anticancer drugs. The aim of the study is to describe the deployment of the clinical pharmacy activity in 2 oncology departments since its implementation in 2019, to assess the financial gain of the pharmaceutical interventions through the new gradation of outpatient management published on September 10, 2020, and finally to assess their satisfaction following the deployment of this pathway., Method: A retrospective study was conducted to collect pricing data for oral therapy interviews in patients between January 2019 and December 2022. To complement this, a satisfaction survey was conducted by the oral therapy pharmaceutical team between 01/01/2022 and 12/31/2022 among patients undergoing treatment., Results: 579 patients received a targeted pharmaceutical interview as part of the oral therapy patient pathway. The average invoiced amount of a pharmaceutical consultation carried out as part of a tripartite first prescription was 355.44 euros. The 579 patients who benefited from a targeted pharmaceutical interview generated a revenue of 87,545 euros for the hospital. In terms of evaluating patient satisfaction, 163 usable responses were received out of 267 patients questioned, representing a response rate of 61%, with an overall score of 9.1/10., Conclusion: Pending the introduction of a specific remuneration for clinical pharmacy activities, the valuation of tripartite consultations is a lever for financing clinical pharmacy activities in hospitals., (Copyright © 2023 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Objectives. In France, the annual number of serious adverse drug events that occur during hospitalisation is estimated to be 395 000, and one in two is due to a medication error. These events often occur in surgery units, so we implemented a pharmaceutical team and evaluated their impact. Methods. A pharmaceutical team was included in an orthopaedic surgery unit of 84 beds in a French university hospital, on a 5 day/week service. The team exhaustively reviewed the medicines of every incoming patient. Differences between the medication reconciliation form and the hospital prescription were discussed with the prescriber, leading to a pharmaceutical intervention. An observational study was carried out a year after the implementation. We measured the proportion of patients who were processed by the pharmaceutical team, the number and the acceptance rate of the pharmaceutical interventions, the number of medication errors reported, and the staff satisfaction. Results. Over the course of a year, 91% (n=3,600) of the patients admitted to the hospital were processed by the pharmaceutical team. There were 2,870 pharmaceutical interventions, of which 96% were accepted by the prescribers, and these led to the correction of faulty prescriptions. Since the inclusion of pharmacists in the surgery unit, the number of medication errors decreased by 76.5% and they were of a less critical nature. Moreover, the medical and nursing teams were satisfied with this new level of organization which allowed them to save time. Conclusion. A pharmaceutical team that is trained and dedicated to the surgery unit is a pertinent solution for ensuring safety in patient care. [ABSTRACT FROM AUTHOR]

La prise en charge du patient parkinsonien est pluridisciplinaire. Le traitement, indiqué dès l'apparition d'une gêne fonctionnelle, repose sur sept classes médicamenteuses et une stratégie chirurgicale. Un accompagnement et une gestion de la pharmacie clinique de qualité conditionnent la maîtrise des symptômes de la maladie et des effets iatrogènes. Le pharmacien est un acteur important pour la conduite et le suivi de la thérapeutique. The management of the Parkinsonian patient is multidisciplinary. The treatment, indicated as soon as functional discomfort appears, is based on seven classes of drugs and a surgical approach. The control of the symptoms of the disease and iatrogenic effects is determined by quality support and clinical pharmacy management. The pharmacist is an important player in the management and monitoring of therapy. [ABSTRACT FROM AUTHOR]

Résumé: Objectifs. Résumer la littérature relative aux rôles du pharmacien en dermatologie-allergologie, présenter un profil succinct de ces deux secteurs et développer une offre de soins pharmaceutiques cohérente en dermatologie-allergologie au Centre hospitalier universitaire (CHU) Sainte-Justine. Méthodes. Il s'agit d'une étude descriptive constituée d'une revue de littérature des articles portant sur le rôle du pharmacien en dermatologie-allergologie, d'une description sommaire des secteurs de la dermatologie et de l'allergologie, ainsi que de la mise à jour de l'offre de soins pharmaceutiques dans ces secteurs. Résultats. Un total de 35 articles (16 en dermatologie et 19 en allergologie) ont été inclus dans la revue de littérature. La majorité de ces articles était de faible qualité et décrivait les activités pharmaceutiques sans en mesurer l'impact. Les activités pharmaceutiques principalement rapportées par la littérature étaient la réalisation de conseils aux patients (articles de dermatologie) et la documentation des interventions effectuées (articles d'allergologie). En 2017-2018, les secteurs de la dermatologie et de l'allergologie ont effectué environ 14 000 et 5 000 consultations médicales de façon respective. L'offre de soins pharmaceutiques a été mise à jour en fonction de 21 activités pharmaceutiques, permettant d'identifier la pertinence d'un pharmacien répondant en dermatologie-allergologie. Conclusion. Il existe peu de données sur les rôles et les retombées de l'activité pharmaceutique en dermatologie-allergologie. Cet article présente une démarche originale incluant une revue de littérature (35 articles), un profil succinct des secteurs et une réflexion entourant les activités pharmaceutiques d'un pharmacien répondant en dermatologie-allergologie au sein d'un centre hospitalier universitaire mère-enfant. Objectives. Summarize the literature on the pharmacist's role in dermatology-allergology, present a brief description of these two sectors and develop a pharmaceutical care offer in dermatology-allergology in a mother-child teaching hospital center. Methods. This article is a descriptive study consisting of a literature review on the pharmacist's role in dermatology-allergology, a brief description of the dermatology and allergology sectors and an optimization of the pharmaceutical care in these sectors. Results. A total of 35 articles (16 in dermatology and 19 in allergology) were included in the literature review. The majority of these articles were of poor quality and described the pharmaceutical activities without measuring their impact. The pharmaceutical activities mainly reported in the literature were the advices to patients (dermatology articles) and the documentation of the pharmaceutical interventions (allergy articles). In 2017-2018, the dermatology and allergology sectors performed approximately 14,000 and 5,000 medical consultations respectively. The pharmaceutical care offer has been updated, allowing us to identify the relevance of a responding pharmacist in dermatology-allergology. Conclusion. There is few data on the roles and outcomes of the dermatology-allergology pharmaceutical activities. This article presents an original approach including a literature review (35 articles), a brief profile of the sectors and a reflection on the pharmaceutical activities of a dermatology-allergology pharmacist in a mother-child teaching hospital center. [ABSTRACT FROM AUTHOR]

Ensuring patients are informed and knowledgeable about their health and disease management has been identified as a key aspect of effective health care. Patient education has been incorporated in treatment guidelines for childhood asthma. The effectiveness of patient education should be evaluated. However, the best tool to evaluate educational interventions on children's knowledge and management of their asthma is unknown and guidelines do not recommend any standard knowledge evaluation tool. The objective was to identify and analyze the asthma knowledge evaluation tools available for children and their caregivers participating in asthma education programs. Methods : The study consisted of two parts: (i) observation of patient education sessions and review of international asthma guidelines to identify essential topics for education and (ii) a literature review to identify existing knowledge evaluation tools and assess how they addressed the essential topics. Results : Six essential topics (physiology of the respiratory system, physiopathology of asthma, trigger factors, asthma treatments, asthma exacerbation management and self-management education) and sixteen knowledge evaluation tools were identified. None of the tools evaluated all the essential topics. Understanding of the respiratory system was the topic most frequently lacking. Eight validated questionnaires were found. However, they did not address all the essential topics nor were designed for children under 9 years old. Conclusions : This study highlighted some gaps in the evaluation methods for asthma education and identified the essential elements of a pediatric asthma knowledge evaluation tool. New knowledge evaluation tools assessing the six essential topics identified and appropriate for children of various ages are needed. [ABSTRACT FROM AUTHOR]

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Background : Feared by the patients, chemotherapy induced nausea and vomiting (CINV) jeopardize their health and quality of life. The combination of anti-5HT3, anti-NK1 and dexamethasone is recommended by current guidelines for the prevention of CINV. Rolapitant, a novel anti-NK1 is marketed since 2017 in France. Objectives : To present and place rolapitant into the pharmacists' clinical practice. Results : Three randomized phase-III studies evidenced the efficacy and good tolerance of rolapitant, a new highly selective anti-NK1 active especially in delayed NVCI, thanks to its prolonged half-live (7 days) after a single 180 mg oral administration. Rolapitant has no effect on CYP3A4 cytochrome, which limits the risk of drug-drug interaction. Dispensed in retail pharmacies, rolapitant is to be administered within 2 hours before chemotherapy. Conclusion : With an easy administration (single dose) and a prolonged half-life, rolapitant improves compliance in the prevention of CINV; the pharmacist should be involved in patient education. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of interventions of a clinical pharmacist in a unit of orthopedic surgery specialized in bone and joint infections., Methods: Daily, in routine, a clinical pharmacist analyzed medication prescribed to inpatients via a computerized physician order entry (CPOE) (Phedra software). His attention was particularly focused on the impact of antibiotics on other medications. For this study, all of the pharmacist interventions (PI) have been retrospectively collected, then anonymized, and assessed over a two-month period., Results: Thirty-eight patients were hospitalized during the study period, with a mean age of 63 years old. Forty-five interventions were identified which represents a mean of 1.18 pharmaceutical interventions per patient. Most of them concerned lack of follow-up (24%) and drug-drug interactions (22%) and widely non-anti-infectious medication (35 interventions) with levothyroxine (10 interventions) as the most involved non-anti-infectious molecule. Among antibiotics, with respectively 9 and 8 interventions, rifampicin and fluoroquinolones (6 interventions for moxifloxacin) were the most concerned notably for drug-drug interactions with usual treatment., Conclusion: In this observational retrospective study, 1.18 pharmacist interventions (PI) per patient were observed. Most of them are lack of follow-up and drug-drug interactions especially with usual treatment of patients. Moxifloxacin and rifampicin were the most antibiotics involved. Patients' characteristics (older, polypharmacy), long-term hospitalization and surgery are known to be predictive factors of medication errors and this study highlights the importance of the presence of clinical pharmacist in orthopedic surgery wards., (Copyright © 2023 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: Medication reconciliation is a key point of the v2020 certification. The main objective of this study was to evaluate this activity over one year, including the first epidemic wave at COVID-19. The secondary objectives were to identify the obstacles and levers and to evaluate doctor satisfaction., Methods: This was a retrospective study of drug reconciliations performed on admission during 12 months of the emergence of COVID-19. Patients aged 65 years and older from orthopedic and visceral surgery, acute hospitalization and conventional medicine units were included. Unintentional discrepancies were analyzed. The obstacles and levers were identified by means of a focus group. Doctors' satisfaction was collected using online quiz., Results: A total of 760 patients were conciliated, of which 27% (n=208) by hospital pharmacy technicians. A decrease in activity was observed during the first epidemic wave. An unintentional discrepancy was found in 77% of patients, and only 48% were corrected by the prescriber. These results were impacted by the pandemic. The pharmaceutical team was mobilized in the logistical management of the crisis, but it was able to adapt in order to perpetuate the activity. Doctors are satisfied with the process., Conclusions: Medication reconciliation on admission is essential for the prevention of iatrogeny, particularly with the impact of the COVID-19 pandemic in healthcare institutions., (Copyright © 2023 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Objectives: In the context of the SARS-CoV-2 pandemic, hospital pharmacists supported the implementation of recommendations and ensured the safety of patient medication management. The aim of this study is to establish the interest of the involvement of the hospital pharmacist in this context by describing and comparing the activities carried out with patients with COVID-19 and those without., Methods: During the study period, data on clinical pharmacy activities with hospitalized patients were collected and analyzed: pharmaceutical analysis of prescriptions, participation in multi-professional consultation meetings (RCP) dedicated to COVID-19, and monitoring of adverse events., Results: The activities concerned 1483 patients, including 444 with COVID-19, resulting in 575 pharmaceutical interventions (PI). The main problems identified were overdoses, untreated indications, and drug-drug interactions (DDI). AMIs were significantly more common in patients with COVID-19, with 73.3% involving disease-specific therapies. Eleven PIs had a life-threatening impact, 189 a major impact. During the PCRs, 36 PIs were performed for 59% of the patients presented. A pharmacovigilance report was performed for a quarter of patients treated with hydroxychloroquine and 33% of patients treated with lopinavir/ritonavir., Conclusions: This study demonstrates the value of involving hospital pharmacists in the drug management of patients with COVID-19, particularly with the evolution of available therapies and the implementation of vaccination, in order to reduce the spread of SARS-COV2 and limit the appearance of resistance., (Copyright © 2023 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Admission to hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. The practice of medication reconciliation is securing for the patient because of the medication errors detected with significant clinical impact. Its implementation must comply with the recommendations of the French National Authority for Health (HAS) and its deployment is now integrated into the contract for improving the quality and efficiency of care (CAQES). However, although it allows to intercept medication errors, its impact on the length of hospitalization, the rate of readmission and/or death following discharge seems limited. Given the limited human resources to carry out this time-consuming activity, patient prioritization should be considered. Studies on the fate of patients and on the medico-economic issues are also necessary in order to make this activity sustainable., (Copyright © 2023 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

Objectives: Regarding the implementation of medication reconciliation in France, distinct issues have been raised. To promote this activity and to meet the healthcare professionals needs, a regional resource centre specialized in medication reconciliation was created. Methods: The resource centre is supported by the medicine, medical devices and therapeutic innovation observatory. It is held by experts in the field of medication reconciliation and clinical pharmacy, working in different health facilities, both private and public, with various healthcare activities. Missions are carried out: giving information, raising awareness of healthcare professionals, pooling of resources and work experiences in the region, and assessment of the activity of medication reconciliation. Results: Since its creation in January 2016, several tools have been provided to healthcare professionals: a slideshow to inform about medication errors, an educational program and two flowcharts to describe and explain how to achieve medication reconciliation, and indicators which assess the impact of the activity. These tools have been developed by the resource centre members, based on existing work and its adaptation. They are available online. Conclusion: The regional resource centre allows for the sharing of good practices and helping tools in the development of medication reconciliation. It provides a practical feedback of local experiences and it keeps evolving in order to assist professionals in the development of medication reconciliation in their own facility. Evolutions are expected this year through the opening of the education program and the expansion of the initial work group to primary care professionals. [ABSTRACT FROM AUTHOR]

NCT+ Saint-Gatien clinic developed a clinical pharmacy process, including a medication reviews, ending with a discharge document called Therapeutic Summary, cosigned by the cardiologist and the clinical pharmacist. It explains the therapeutic changes made or to be made to the patient's treatments in the short or long term. Advanced age and polypharmacy are important characteristics of the studied population (an average of 73.6 years old and 6.5 drugs). Our process permit the interception of several errors. It takes account of the latest regulatory constraints, it is reproducible in other healthcare facilities, but it still has to prove its efficiency. A full-time clinical pharmacist is required since June 2017 to carry out these activities in cardiology 3, nearly 4 800 stays per year. The extra cost can be calculated at 8-27 € per stay. The challenge of the subsequent medico-economic study will be to demonstrate that the benefit for the patient is greater than this additional cost. [ABSTRACT FROM AUTHOR]