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Valenciennes, France

Karapinar-Carkit F.,Utrecht Institute for Pharmaceutical science | Karapinar-Carkit F.,University Utrecht | Borgsteede S.D.,Community Pharmacy | Zoer J.,Hospital Pharmacist | And 3 more authors.
Annals of Pharmacotherapy | Year: 2012

BACKGROUND: Medication reconciliation aims to correct discrepancies in medication use between health care settings and to check the quality of pharmacotherapy to improve effectiveness and safety. In addition, medication reconciliation might also reduce costs. OBJECTIVE: To evaluate the effect of medication reconciliation on medication costs after hospital discharge in relation to hospital pharmacy labor costs. METHODS: A prospective observational study was performed. Patients discharged from the pulmonology department were included. A pharmacy team assessed medication errors prevented by medication reconciliation. Interventions were classified into 3 categories: correcting hospital formulary-induced medication changes (eg, reinstating less costly generic drugs used before admission), optimizing pharmacotherapy (eg, discontinuing unnecessary laxative), and eliminating discrepancies (eg, restarting omitted preadmission medication). Because eliminating discrepancies does not represent real costs to society (before hospitalization, the patient was also using the medication), these medication costs were not included in the cost calculation. Medication costs at 1 month and 6 months after hospital discharge and the associated labor costs were assessed using descriptive statistics and scenario analyses. For the 6-month extrapolation, only medication intended for chronic use was included. RESULTS: Two hundred sixty-two patients were included. Correcting hospital formulary changes saved?1 €63/patient (exchange rate: EUR 1 = USD 1.3443) in medication costs at 1 month after discharge and?9 €79 at 6 months. Optimizing pharmacotherapy saved?20 euro;13/patient in medication costs at 1 month and? €86.86 at 6 months. The associated labor costs for performing medication reconciliation were? €41.04/patient. Medication cost savings from correcting hospital formularyinduced changes and optimizing of pharmacotherapy?(€96.65/patient) outweighed the labor costs at 6 months extrapolation by? €55.62/patient (sensitivity analysis?€ 37.25-71.10). CONCLUSIONS: Preventing medication errors through medication reconciliation results in higher benefits than the costs related to the net time investment. Source

Levi Setti P.E.,Humanitas Fertility Center | Alviggi C.,University of Naples Federico II | Colombo G.L.,University of Pavia | Pisanelli C.,Hospital Pharmacist | And 4 more authors.
Journal of Endocrinological Investigation | Year: 2015

Background: Gonadotropins are protein hormones which are central to the complex endocrine system that regulates normal growth, sexual development, and reproductive function. There is still a lively debate on which type of gonadotropin medication should be used, either human menopausal gonadotropin or recombinant follicle-stimulating hormone. The objective of the study was to perform a systematic review of the recent literature to compare recombinant follicle-stimulating hormone to human menopausal gonadotropin with the aim to assess any differences in terms of efficacy and to provide a cost evaluation based on findings of this systematic review. Methods: The review was conducted selecting prospective, randomized, controlled trials comparing the two gonadotropin medications from a literature search of several databases. The outcome measure used to evaluate efficacy was the number of oocytes retrieved per cycle. In addition, a cost evaluation was performed based on retrieved efficacy data. Results: The number of oocytes retrieved appeared to be higher for human menopausal gonadotropin in only 2 studies while 10 out of 13 studies showed a higher mean number of oocytes retrieved per cycle for recombinant follicle-stimulating hormone. The results of the cost evaluation provided a similar cost per oocyte for both hormones. Conclusions: Recombinant follicle-stimulating hormone treatment resulted in a higher oocytes yield per cycle than human menopausal gonadotropin at similar cost per oocyte. © 2014 The Author(s). Source

Lopez Tricas J.M.,Hospital Pharmacist
Atencion Farmaceutica | Year: 2014

Evaluation of carfilzomib, an inhibitor of the proteasomic cellular system, the main system of degradation of proteins in the cells. The deciphering of the protea-some structure and mechanism of action signified a scientific breakthrough worthy of the Nobel Prize award in chemistry for its discoverers, Aaron Ciechanover, Avram Hershiko, and Irwin Rose, in 2004. Carfilzomib represents an improvement in relation to bortezomib in several aspects: specificity of action, irreversible inhibition of the proteasome system (according to initial studies) reduced incidence of peripheral neuropathy; and mainly clinical efficacy in patients who are either refractory, or have relapsed after treatment with bortezomib. Carfilzomib is indicated in mono-therapy regimen, or included in more complex treatment protocols. Carfilzomib seems to be a breakthrough for the treatment of the most complex multiple myeloma stages. Source

Cousein E.,University of Lille Nord de France | Mareville J.,Hospital Pharmacist | Lerooy A.,Geriatric Short Stay Unit | Caillau A.,Geriatric Short Stay Unit | And 10 more authors.
Journal of Evaluation in Clinical Practice | Year: 2014

Rationale, aims and objectives: To assess the impact of an automated drug distribution system on medication errors (MEs). Methods: Before-after observational study in a 40-bed short stay geriatric unit within a 1800 bed general hospital in Valenciennes, France. Researchers attended nurse medication administration rounds and compared administered to prescribed drugs, before and after the drug distribution system changed from a ward stock system (WSS) to a unit dose dispensing system (UDDS), integrating a unit dose dispensing robot and automated medication dispensing cabinet (AMDC). Results: A total of 615 opportunities of errors (OEs) were observed among 148 patients treated during the WSS period, and 783 OEs were observed among 166 patients treated during the UDDS period. ME [medication administration error (MAE)] rates were calculated and compared between the two periods. Secondary measures included type of errors, seriousness of errors and risk reduction for the patients. The implementation of an automated drug dispensing system resulted in a 53% reduction in MAEs. All error types were reduced in the UDDS period compared with the WSS period (P < 0.001).Wrong dose and wrong drug errors were reduced by 79.1% (2.4% versus 0.5%, P = 0.005) and 93.7% (1.9% versus 0.01%, P = 0.009), respectively. Conclusion: An automated UDDS combining a unit dose dispensing robot and AMDCs could reduce discrepancies between ordered and administered drugs, thus improving medication safety among the elderly. © 2014 John Wiley & Sons, Ltd. Source

Simons-Sanders K.,Hospital Pharmacist | Crul M.,Hospital Pharmacist
European Journal of Oncology Pharmacy | Year: 2013

A national clinical rule for proper handling of methotrexate was developed and implemented in The Netherlands in 2010 following a number of fatal incidents. The aim was to increase patient safety by preventing dispensing errors. Interventions implemented and results obtained in two hospitals are discussed. © 2013 Pharma Publishing and Media Europe. All rights reserved. Source

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