[Development of a targeted educational activity in addictology: From design to use in specialized structures in the Normandy region]

OBJECTIVE

Risk and damage reduction is a public health issue and allows to consider addiction as a chronic pathology in which patients have the opportunity to become actors of their own care, a philosophy shared with Therapeutic Education. In this context, our objective is to develop a tool adapted to the populations of patients/users in specialized structures, meeting the criteria of a Targeted Educational Activity, to allow them a better understanding and management of their addiction to opiates on a daily basis.

METHOD

In a multi-professional setting, involving pharmacists, doctors and nurses, an exploratory phase was conducted in order to identify the theme, the target population and the tool format. Then, the tool was built and validated with the ambition of responding pedagogically to the problems encountered daily by patients/users.

RESULTS

The pedagogical tool, called "Le QUIZZ à moindre risque", contains 51 questions categorized in 2 structured parts on the reduction of risks related to opiate consumption and substitution drugs. Focused on the problems of patients/users, it helps them achieve greater autonomy in their health and a better quality of life, with and despite the illness. The proposed format makes it a tool that can be freely consulted by patients/users according to their practices and needs; it can also be used in group workshops conducted with the caregivers.

CONCLUSION

The tool developed aims to (i) enable opiate users to acquire skills to improve the management of their consumption and the risks involved and (ii) strengthen communication between patients/users and caregivers by offering them the opportunity to be actors of their care. The tool is currently being tested and evaluated in many cities in Normandy and its optimization will allow for an improvement in care that meets the challenges and needs.

Global longitudinal assessment of treatment outcomes in recurrent/metastatic nasopharyngeal carcinoma: GLANCE-NPC study

Aim: Given a lack of standard of care treatment for recurrent/metastatic nasopharyngeal carcinoma (R/M NPC), we assessed treatment patterns and overall survival in the real-world setting. Materials & methods: A retrospective chart review was conducted in patients who initiated first-line systemic therapy in Taiwan and South Korea between January 2012 and June 2013 with follow-up through December 2015. Results: Among 154 R/M NPC patients, all patients in Taiwan (n = 104) had distant metastases, whereas in South Korea (n = 50) 42% had distant metastases. Patients with distant metastases generally received systemic therapy only (71%) for whom median overall survival was 23 months (95% CI: 18-32). Conclusion: Prognosis in R/M NPC with distant metastases remains poor, underscoring the need for more efficacious treatments.

Global treatment patterns and outcomes among patients with recurrent and/or metastatic head and neck squamous cell carcinoma: Results of the GLANCE H&N study

OBJECTIVES

Given a lack of universally-accepted standard-of-care treatment for patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC), study objectives were to assess treatment utilization and survival outcomes for R/M HNSCC in the real-world setting.

MATERIALS AND METHODS

A multi-site retrospective chart review was conducted in Europe (Germany, United Kingdom, Italy, Spain), Asia Pacific (Australia, South Korea, Taiwan), and Latin/North America (Brazil and Canada) to identify patients who initiated first-line systemic therapy for R/M HNSCC between January 2011 and December 2013. Patients were followed through December 2015 to collect clinical characteristics, treatment and survival data.

RESULTS

Among 733 R/M HNSCC patients across 71 sites, median age was 60 years (inter-quartile range 54-67), 84% male, and 70% Eastern Cooperative Oncology Group performance status 0-1; 32% had oral cavity and 30% oropharyngeal cancers. The most common first-line regimen across all countries consisted of platinum-based combinations (73%), including platinum + 5-fluorouracil (5-FU) (26%), cetuximab + platinum ± 5-FU (22%), or taxane + platinum ± 5-FU (16%). However, use of different platinum-based combinations varied substantially; administration of cetuximab + platinum ± 5-FU was frequent in Italy (81%), Germany (46%) and Spain (38%), whereas use in other countries was limited. Median follow-up was 22.6 months (95% confidence interval [CI]: 21.5-24.6 months). Median real-world overall survival was only 8.0 months (95% CI: 7.0-8.0), with one-year survival reaching only 30.9% (95% CI: 27.5-34.3).

CONCLUSION

Systemic therapies used in clinical practice for patients with R/M HNSCC vary substantially across countries. Prognosis remains poor in this patient population, highlighting the need for newer, more efficacious treatments.

[Misuse of tianeptine: five cases of abuse]

Five cases of excessive consumption of tianeptine suggest possible drug-abuse of this substance. This side effect is unknown in animals and humans. According to DSM IV, CIM 10 criteria and the French public health code, these five patients had pathological profiles of psychoactive drug abusers. Tianeptine dosage was always used higher than recommended and the drug was taken in association with other psychotropes. Withdrawal was difficult and induced anxiety and other disorders which led to relapse in most of the patients.