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Bazin C.,Angers University Hospital Center | Cassard B.,Center Hospitalier Marc Jacquet | Caudron E.,Pharmacy | Prognon P.,Pharmacy | Havard L.,Pharmacy
International Journal of Pharmaceutics | Year: 2015

Control of chemotherapies preparations are now an obligation in France, though analytical control is compulsory. Several methods are available and none of them is presumed as ideal. We wanted to compare them so as to determine which one could be the best choice. We compared non analytical (visual and video-assisted, gravimetric) and analytical (HPLC/FIA, UV/FT-IR, UV/Raman, Raman) methods thanks to our experience and a SWOT analysis. The results of the analysis show great differences between the techniques, but as expected none us them is without defects. However they can probably be used in synergy. Overall for the pharmacist willing to get involved, the implementation of the control for chemotherapies preparations must be widely anticipated, with the listing of every parameter, and remains according to us an analyst's job. © 2015 Elsevier B.V. All rights reserved.

Efficient communication is an integral part of everyday life and as such is important for the successful professional work of a pharmacist as a member of the medical personnel, foremost on the primary health care level. Nowadays, few studies of pharmaceutical practice in the field of communication in state pharmacies are focused on the communication from a pharmacist s point of view. Few studies have dealt with the analysis of the interactive process of communication and few studies have been directed at identifying essential factors necessary for measuring the communication in a pharmacy, or to the development of communication skills that both a pharmacist and a patient should develop in order to have more successful communication and improve their interpersonal relationship, providing more adequate health care services, which would lead to the re-professionalisation of pharmaceutical expertise in the healthcare system. Therefore, the aim of this paper is to identify the barriers in communication and ways to overcome them by reviewing the literature, with a particular emphasis on personal barriers of pharmacists in community pharmacies.

Mammadov F.I.,Pharmacy | Aliyev F.I.,Pharmacy
Azerbaijan Pharmaceutical and Pharmacotherapy Journal | Year: 2016

The article describes the activities of "Azerbaijan Pharmaceutical and Pharmacoterapy Journal" for 15 years, granted by "Scopus Award Azerbaijan - 2016". The first and the only scientific journal in the field of pharmacy in the country is included to the list of journals indexed by the world's leading bibliographic databases. The information on the evaluation of the parameters on the basis of which journal's activity has been estimated was given. The article also gives statistics on the materials published over the years in the journal and information about foreign authors (Russia, Ukraine, Irak, Iran Turkey, Vietnam). In the future it is planned to improve the journal activities according to the international evaluation criteria.

Whelpley R.,Bon Secours Memorial Regional Medical Center | Pierce M.,Bon Secours Memorial Regional Medical Center | Collins R.,Pharmacy | Timmerman W.,Bon Secours Memorial Regional Medical Center
Hospital Pharmacy | Year: 2011

Objective: Delayed gastrointestinal (GI) recovery (postoperative ileus) is a risk for patients undergoing bowel resection (BR) and presents clinical challenges including prolonged hospital length of stay (LOS) and increased postoperative morbidity. Alvimopan, an oral, peripherally acting mu-opioid receptor antagonist, is the first therapy approved to accelerate GI recovery after BR. Published data have described alvimopan use in open BR. In contrast, this study focused on laparoscopic BR.Methods: Historic data were retrospectively collected and alvimopan data were prospectively collected from 1 surgeon at our facility. Adults undergoing laparoscopic partial small or large BR with primary anastamosis scheduled to receive intravenous, opioid-based, patient-controlled analgesia were eligible. Pregnancy, opioid analgesic on the home medication reconciliation form, complete bowel obstruction, colostomy or ileostomy creation, and unplanned surgery were exclusion criteria. All patients were uniformly managed with a standardized accelerated postoperative care pathway to facilitate GI recovery. LOS, time to first bowel movement (BM), 30-day readmission rate, and the cost were evaluated. Data were analyzed using Pearson chi-square and independent samples t tests.Results: Thirty-nine alvimopan and 56 historic cohort patients were included. Time to first BM was reduced by 1.2 days and LOS was reduced by 1.1 days (both P < .001) in the alvimopan cohort compared with control. Overall variable cost data were reduced by $1,368 in the alvimopan cohort. Readmission rates were low and comparable.Conclusions: Laparoscopic surgery can decrease LOS compared with open BR; however, alvimopan use at our facility reduced LOS and time to BM while remaining cost-effective in this patient population. © 2011 Thomas Land Publishers, Inc.

Lafaurie M.,Infectious Diseases Intervention Unit U2i | Porcher R.,University Paris Diderot | Donay J.-L.,Microbiology | Touratier S.,Pharmacy | Molina J.-M.,University Paris Diderot
Journal of Antimicrobial Chemotherapy | Year: 2012

Objectives: High rates of methicillin-resistant Staphylococcus aureus (MRSA) and fluoroquinolone-resistant Pseudomonas aeruginosa may be related, in part, to the overuse of fluoroquinolones. The objective was to analyse and correlate long-term surveillance data on MRSA and fluoroquinolone-resistant P. aeruginosa rates and antibiotic consumption after implementation of an institution-wide programme to reduce fluoroquinolone use. Methods: An interrupted time series/quasi-experimental study of monthly fluoroquinolone use and MRSA and fluoroquinolone-resistant P. aeruginosa isolation rates was carried out in a tertiary hospital during three periods: pre-intervention (January 2000-August 2005), intervention (September 2005-March 2006), and post-intervention (March 2006-March 2010). The effect of the intervention on the consumption of fluoroquinolones and bacterial resistance was assessed using segmented regression analyses. Results: Mean monthly fluoroquinolone consumption dropped by 29.1 defined daily doses per 1000 patient-days (DDD/1000 PD) (95% CI 13.1-45.9; P = 0.0005) from a mean of 148.2 to 119.1 DDD/1000 PD during the intervention period. A sustained and significant decrease in fluoroquinolone consumption of -0.95 DDD/1000 PD/month was also observed during the post-intervention period (P = 0.0002). During the post-intervention period the rate of fluoroquinolone-resistant P. aeruginosa continuously decreased, from a mean of 42% to 26%, with a constant relative change rate of -13%/year (95% CI -19 to -5, P = 0.001). A decrease in the MRSA rate was observed during the intervention period, from a mean resistance rate of 27% to 21% (P < 0.0001). Conclusions: We showed the sustained impact of a fluoroquinolone control programme on the reduction of fluoroquinolone use with a significant decrease in fluoroquinolone-resistant P. aeruginosa and MRSA rates over 4 years. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Anderegg S.V.,Georgia Regents Medical Center | Anderegg S.V.,University of Kansas | Wilkinson S.T.,Pharmacy | Couldry R.J.,Pharmacy | And 2 more authors.
American Journal of Health-System Pharmacy | Year: 2014

Purpose: The impact of an innovative medication reconciliation and discharge education program on 30-Day readmissions and emergency department (ED) visits was evaluated.Methods: An observational pre-post analysis was conducted at an academic medical center to compare rates of hospital readmissions and return to ED visits during three-Month periods before and after implementation of a restructured pharmacy practice model including (1) medication reconciliation at transitions of care for every patient and discharge education for a high-risk subgroup, (2) new or expanded services in the preanesthesia testing clinic and ED, (3) a medication reconciliation technician team, and (4) pharmacist-topatient ratios of 1:30 on acute care floors and 1:18 on critical care units. The primary outcome was the composite of rates of readmissions and return to ED visits within 30 days of discharge.Results: A total of 3,316 patients were included in the study. Pharmacy teams completed medication reconciliation in 95.8% of cases at admission and 69.7% of cases at discharge. Discharge education was provided to 73.5% of high-risk patients (defined as those receiving anticoagulation therapy or treatment for acute myocardial infarction, chronic obstructive pulmonary disease, congestive heart failure, or pneumonia). No significant difference was observed between the preimplementation and postimplementation groups with regard to the primary outcome. In the high-risk subgroup, there was a significant reduction in the 30-Day rate of hospital readmissions, which declined from 17.8% to 12.3% (p = 0.042); cost projections indicated that this reduction in readmissions could yield annual direct cost savings of more than $780,000.Conclusion: Implementation of a teambased pharmacy practice model resulted in a significant decrease in the rate of 30-Day readmissions for high-risk patients. © 2014, American Society of Health-System Pharmacists, Inc.

Paton C.,Pharmacy | Flynn A.,Mental Health of Learning Disabilities | Shingleton-Smith A.,Center for Quality Improvement | Mcintyre S.,Center for Quality Improvement | And 3 more authors.
Journal of Intellectual Disability Research | Year: 2011

Background Antipsychotics are perceived to be over-used in the management of behavioural problems in people with an intellectual disability (ID). Published guidelines have set good practice standards for the use of these drugs for behavioural indications. We sought to identify the range of indications for which antipsychotic drugs are prescribed in people with ID and to audit clinical practice against the standards. Method Data were collected from the clinical records of individuals with ID who were under the care of mental health services in the UK, and prescribed an antipsychotic drug. Results The sample comprised 2319 patients from 39 clinical services. Twenty-seven per cent of the patients had a diagnosis of a psychotic illness (ICD-10 F20-29) and 27% an affective illness (ICD-10 F30-39). The proportion who did not have a psychiatric diagnosis ranged from 6% of those with borderline/mild ID to 21% of those with severe/profound ID. Overall, the most common indications for prescribing an antipsychotic drug were comorbid psychotic illness, anxiety and agitation, and a range of behavioural disturbances. The prevalence of use of antipsychotic drugs to manage challenging behaviour in the absence of concomitant mental illness increased with the severity of ID and accounted for almost half of prescriptions in those with severe/profound ID. Adherence to the audit standards related to documentation of clinical indications and review of efficacy was high. Side effect monitoring was less assiduous. Conclusions In clinical practice, most prescriptions for antipsychotic drugs in people with ID are consistent with the evidence base and the overall quality of prescribing practice, as measured against recognised standards, is good, although in some patients potentially remedial side effects may not be detected and treated. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

Stucki C.,University of Geneva | Sautter A.-M.,Pharmacy | Wolff A.,University of Geneva | Fleury-Souverain S.,Pharmacy Quality Control Unit | Bonnabry P.,University of Geneva
American Journal of Health-System Pharmacy | Year: 2013

Purpose. The results of a study of the accuracy of i.v. medication preparation by anesthesiologists are presented. Methods. The accuracy of syringe preparation was assessed by analyzing the contents of 500 unused syringes collected after adult and pediatric surgery procedures. The collected syringes contained various i.v. medication formulations representative of different preparation techniques: atracurium 1, 2.5, and 5 mg/mL and fentanyl 10, 20, 25, and 50 μg/mL, which required serial dilution after withdrawal of the drugs from ampuls; thiopental 5, 25, and 50 mg/ mL, prepared by diluting reconstituted powdered drug from vials; and lidocaine 10-mg/mL solution, which was withdrawn directly from the ampul into a syringe. Variances between actual and labeled drug concentrations were determined via a validated ultraviolet - visible light spectrophotometry method. Results. Overall, 29% of the evaluated syringes were found to contain drug concentrations outside the designated range of acceptability (±10% of the targeted concentration); 18% of preparations deviated from the declared dose by ±20%, 8% deviated by ±50%, and 4% deviated by ±100%. In one instance, the actual drug concentration was at variance with the labeled concentration by >100%. In 4% of cases (n = 20), discrepancies exceeded 100%, suggesting not just imprecision but errors in the preparation process, such as incorrect dilution calculations and selection of the wrong medication vial by the syringe preparer. Conclusion. Analysis of different i.v. formulations of four medications prepared in syringes by anesthesiologists revealed a high rate of discrepancies between ordered and actual drug concentrations, suggesting a need for increased institutional efforts to prevent errors during the preparation process. Copyright © 2013, American Society of Health-System Pharmacists, Inc. All rights reserved.

Tobari H.,University of Tsukuba | Tobari H.,Osaka University | Arimoto T.,Yamagata University | Shimojo N.,University of Tsukuba | And 4 more authors.
American Journal of Hypertension | Year: 2010

Background: The aim of the trial was to evaluate the effectiveness of a program of cooperation between physician and pharmacist to reduce cardiovascular risk factors in patients with mild to moderate hypertension by promoting better blood pressure (BP) control, appropriate changes in antihypertensive medications, and beneficial changes in lifestyle.MethodsThe 132 subjects in this randomized, controlled trial were in the age range of 40-79 years. The inclusion criteria were: systolic BP (SBP) ranging from 140-179mmHg and/or diastolic BP (DBP) ranging from 90-99mmHg and treatment-naive (untreated for hypertension); or on a regimen of medication for hypertension. Of these 132 subjects, 124 (94%) were already receiving treatment with antihypertensive medications. Equal numbers of subjects were randomly assigned to one of two groups: a physician-pharmacist intervention group (n = 66) and a control group (n = 66).ResultsThe 6-month follow-up rate was 97% in both groups. At 6 months, the mean decrease in SBP/DBP, as measured at home in the morning, was 2.9/3.3mmHg in the intervention group relative to baseline (P = 0.02 and P < 0.0001 for SBP and DBP, respectively). The mean decrease in home morning SBP in the intervention group was not significantly greater than in the control group. However, the DBP decline was significantly greater in the intervention than control groups, which showed a mean decrease of 2.8mmHg (confidence interval:-5.5 to-0.1; P = 0.04). The percentage of patients in whom control of home morning BP was achieved was 53% in the intervention group and 47% in the control group (P = 0.40). A higher percentage of patients in the intervention group, relative to the control group, were able to reduce the use of antihypertensive medications (31 vs. 8%, P < 0.0001), and fewer patients in this group required additional medications or increases in dosage relative to the controls (11 vs. 28%, P = 0.03). Patients of the intervention group were more likely to show reduction in body mass index and sodium intake and to stop smoking, as compared with the control group.ConclusionsA program of cooperation between physician and pharmacist was successful in reducing cardiovascular risk factors in patients with mild to moderate hypertension by promoting better blood pressure (BP) control, appropriate changes in antihypertensive medications, and beneficial changes in lifestyle. © 2010 American Journal of Hypertension, Ltd.

Pittet Y.K.,Burns Center | Berger M.M.,Burns Center | Pluess T.-T.,Burns Center | Voirol P.,Pharmacy | And 3 more authors.
Intensive Care Medicine | Year: 2010

Objective: To test the dose response effect of infused fish oil (FO) rich in n-3 PUFAs on the inflammatory response to endotoxin (LPS) and on membrane incorporation of fatty acids in healthy subjects. Design: Prospective, sequential investigation comparing three different FO doses. Subjects: Three groups of male subjects aged 26.8 ± 3.2 years (BMI 22.5 ± 2.1). Intervention: One of three FO doses (Omegaven®10%) as a slow infusion before LPS: 0.5 g/kg 1 day before LPS, 0.2 g/kg 1 day before, or 0.2 g/kg 2 h before. Measurements and results: Temperature, hemodynamic variables, indirect calorimetry and blood samples (TNF-α, stress hormones) were collected. After LPS temperature, ACTH and TNF-α concentrations increased in the three groups: the responses were significantly blunted (p <0.0001) compared with the control group of the Pluess et al. trial. Cortisol was unchanged. Lowest plasma ACTH, TNF-α and temperature AUC values were observed after a single 0.2 g/kg dose of FO. EPA incorporation into platelet membranes was dose-dependent. Conclusions: Having previously shown that the response to LPS was reproducible, this study shows that three FO doses blunted it to various degrees. The 0.2 g/kg perfusion immediately before LPS was the most efficient in blunting the responses, suggesting LPS capture in addition to the systemic and membrane effects. © Copyright jointly hold by Springer and ESICM 2009.

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