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BackgroundPatients undergoing liver transplantation require pharmacological treatment indefinitely and some patients have complications related to this treatment (diabetes, high cholesterol, high blood pressure, impaired renal function, osteoporosis).PurposeTo evaluate and analyse the quantitative difference in the number of drugs after liver transplantation.Material and methodsA longitudinal observational study with prospective data collection and usual clinical practice of the series of cases undergoing liver transplantation over a 2 year period (2016–2017). The data collected were: sex, age, cause of transplantation, number of drugs before and after transplantation.The data have been extracted from the electronic medical record through the Selene®program and we used descriptive statistic using the SPSS®V23 program.ResultsDuring this study period, 71 patients underwent liver transplantation in our hospital, of which 67.6% were men, the mean age was 53±11 years. The main causes of liver transplantation were: 34.2% alcoholic liver cirrhosis, 22.9% hepatic cirrhosis associated with the hepatitis C virus and 10% hepatic biliary cirrhosis. The mean number of medications taken by these patients was 4.92±3, while the mean in the hospital discharge was 11.71±2.Thirty-three patients (48. 5%) had to stop all treatment prior to transplantation, one patient had already been transplanted and 50% kept only one or two drugs (omeprazole, calcium-vitamin D supplement, levothyroxine, tenofovir, acetylsalicylic acid as antiaggregant).After undergoing transplantation, 16.7% of patients had high blood pressure and 50% had diabetes mellitus that required insulin administration.All patients were discharged from the hospital with hospital diagnosis medicines with an average of 2.65±0, 54 medicines and 36.4% with hospital-use medicines. 4. 3% of the patients not got over the transplantation.ConclusionThe increase in the number of drugs after liver transplantation is significant, moreover the administration and dispensing conditions of some of the drugs have a greater complexity, especially immunosuppressants and insulin, so these patients should receive pharmaceutical care.References and/or AcknowledgementsThanks to my service for your unconditional support.No conflict of interest

BackgroundSecukinumab is a monoclonal antibody designed to recognise and attach to a messenger molecule in the immune system called interleukin 17A, whereas ustekinumab is also a monoclonal antibody which attaches to two cytokines called interleukin 12 and interleukin 23. All these cytokines are involved in the inflammation and other immune system processes that cause psoriasis. By blocking their activity, secukinumab and ustekinumab reduce the activity of the immune system and the symptoms of the disease.PurposeTo estimate the cost-comparison of secukinumab and ustekinumab following inadequate response to biologic drugs in patients with moderate to severe plaque psoriasis.Material and methodsCost evaluation of psoriasis patients treated with secukinumab and ustekinumab following inadequate response to sdalimumab or etanercept in a third-tier hospital for 2 years (2015 to 2017).The increase or decrease of costs were analysed when moving from one biological therapy to another.We also studied how many naive patients started with secukinumab or ustekinumab as their first line of treatment.ResultsA total of 43 and 58 patients were treated with adalimumab and etanercept respectively: nine patients had inadequate response to adalimumab and 16 patients to etanercept.Thirteen patients were treated with Secukinumab: seven patients had inadequate response to etanercept, one patient to adalimumab and three patients to ustekinumab. Only two patients treated with secukinumab were naive.The change from etanercept to secukinumab, adalimumab to secukinumab and ustekinumab to secukinumab caused a cost increase of €11,357/year, €2,232/year and €6,762/year respectively.Thirty patients were treated with ustekinumab: nine patients had inadequate response to etanercept, eight patients to adalimumab and one patient to secukinumab. Twenty-two patients treated with ustekinumab were naive.The change from etanercept to ustekinumab, adalimumab to ustekinumab and secukinumab to ustekinumab had a cost reduction of €5,683 €/year, €178€/year and €2,254/year respectively.Al these changes of biological therapies have increased the hospital budget by about €12,236/year.ConclusionUstekinumab provides the best cost for psoriasis in this study.Furthermore, its administration is more comfortable for patients because ustekinumab is given every 12 weeks while secukinumab is given in two injections every 4 weeks.Ustekinumab could also represent a treatment opportunity for patients’ non-adherence.References and/or AcknowledgementsData sheet Ustekinumab, Secukinumab.PUBMED.Guññía de manejo Psoriasis.No conflict of interest

BackgroundVancomycin is a drug with a narrow therapeutic range, in which accurate data on weight or renal function are indispensable for correct practice.PurposeTo analyse the minimum set of data necessary for a correct follow-up of patients on vancomycin treatment and to assess whether therapeutic drug monitoring (TDM) by the pharmacy service improves the quality of the data recorded in the electronic medical record (EMR).Material and methodsA retrospective clinical practice study of the case series treated with vancomycin and subsequently TDM or not during the period from 1 January 2016 to 31 December 2016.Following data was collected: TDM (yes/no), age, weight, creatinine at baseline and at the end, and Protein C Reactive (PCR) at the beginning and at the end. The data have been extracted from the EMR through the Selene®program and we used descriptive statistic using the SPSS®V23 program.ResultsOf the 264 patients treated with vancomycin, in 35% of them weight was not completed in EMR. 1.5% of the patients of the TDM group had not recorded the weight in EMR compared to 45% of patients of the non-TDM group (p<0.0001).Before the start of treatment with vancomycin, 5% of the patients had no creatinine data. None of them belonged to the TDM group versus 6.5% that belonged to the non-TDM group (p=0.0328).Thirteen per cent did not reflect the value of PCR at the start: 6.1% of the TDM group versus 15.6% of the non-TDM group (p=0.0315).At the end of treatment, 29.9% had not completed the PCR value (13.79% of the TDM group versus 55.90% of the non-TDM group) and 18.2% did not request the creatinine value: none of them belonged to the TDM group and 32% to the non-TDM group.ConclusionTDM by the pharmacist improves the quality of the data recorded in the EMR. Its implication in the follow-up of the patients ensures that the necessary data for the correct dosage and monitoring of the toxicity and effectiveness of the treatments are completed.References and/or AcknowledgementsThanks to my service for your unconditional supportNo conflict of interest