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van der Schors T, Lozano-Blázquez A, Kuruc Poje D, Miljković N, Süle A, Kohl S. Digital health. Eur J Hosp Pharm 2024; 31:188-190. [PMID: 37657918 DOI: 10.1136/ejhpharm-2023-003918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
Affiliation(s)
| | - Ana Lozano-Blázquez
- Pharmacy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Darija Kuruc Poje
- Hospital Pharmacy, General Hospital Dr Tomislav Bardek, Koprivnica, Croatia
| | - Nenad Miljković
- Hospital Pharmacy, Institute of Orthopaedics Banjica, Belgrade, Serbia
| | - András Süle
- Department of Pharmacy, Peterfy Korhaz-Rendelointezet es Manninger Jeno Orszagos Traumatologiai Intezet, Budapest, Hungary
- European Association of Hospital Pharmacists, Brussels, Belgium
| | - Stephanie Kohl
- Policy & Advocacy, European Association of Hospital Pharmacists, Brussels, Belgium
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Kuruc Poje D, Fitzpatrick RW, Stevens C, Machin C, Underhill J, Horák P, Batista A, Süle A, Miljković N, Plesan C, Kohl S, Marzal Lopez G. Investigation of the hospital pharmacy profession in Europe. Eur J Hosp Pharm 2024:ejhpharm-2023-004066. [PMID: 38604616 DOI: 10.1136/ejhpharm-2023-004066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/17/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE From 1995, the European Association of Hospital Pharmacists (EAHP) has regularly investigated the progress of the hospital pharmacy profession in Europe, and identified key barriers and drivers of this. The most recent 'Investigation of the Hospital Pharmacy Profession in Europe' was conducted from November 2022 to March 2023. METHODS The online questionnaire was sent to all hospital pharmacies in EAHP member countries. The investigation was drafted using the same questions as the 2015 baseline survey. Where possible and relevant, responses were compared with the data from previous surveys that monitored the implementation of the EAHP statements. Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, UK analysed the data. RESULTS The overall number of responses was 653, with a better response rate of 19% compared with 14% in 2018 statements survey. The findings indicated that participating hospital pharmacies have similar characteristics to previous surveys. Section 1 (Introductory statements and governance), section 2 (Selection, procurement and distribution), section 3 (Production and compounding), section 5 (Patient safety and quality assurance) questions were generally answered positively, with results ranging from 52% to 90%. However, results for section 4 (Clinical pharmacy services) returned lower levels of positivity, with responses from 8 of the 15 questions being less than 60%. When asked what is preventing hospital pharmacists from achieving implementation of these activities, most answers were limited capacity, not considered to be a priority by managers, or other healthcare professionals do this. The last section focused on self-assessment and action planning, with fewer than 50% of positive responses; COVID-19 preparedness and vaccines with mixed positive and negative responses. Furthermore, implementation of the falsified medicines directive impacted the medication handling processes in 50% or more of the answers. Regarding sustainability, the majority (59%) of respondents felt a greater focus should be on sustainability from an organisational or management perspective. CONCLUSION Results offer valuable insights into the hospital pharmacy profession throughout Europe. While there have been improvements in certain areas, challenges remain, particularly in implementing clinical pharmacy services. The findings provide a foundation for further dialogue, advocacy, and strategic planning to advance the role of hospital pharmacists and enhance patient care in Europe's healthcare systems.
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Affiliation(s)
- Darija Kuruc Poje
- Hospital Pharmacy, General Hospital Dr Tomislav Bardek, Koprivnica, Europe, Croatia
- European Association of Hospital Pharmacists, Brussels, Belgium
| | - Raymond William Fitzpatrick
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Claire Stevens
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Carl Machin
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Jonathan Underhill
- Keele University, Centre for Medicines Optimisation, School of Pharmacy and Bioengineering, Staffordshire, UK
| | - Petr Horák
- Hospital Pharmacy, University Hospital Motol, Prague, Czech Republic
| | - Aida Batista
- Unidade Hospitalar do Médio Ave EPE, Santo Tirso, Porto, Portugal
| | - András Süle
- European Association of Hospital Pharmacists, Brussels, Belgium
- Department of Pharmacy, Peterfy Korhaz-Rendelointezet es Manninger Jeno Orszagos Traumatologiai Intezet, Budapest, Hungary
| | - Nenad Miljković
- European Association of Hospital Pharmacists, Brussels, Belgium
- Hospital Pharmacy, Institute of Orthopaedics Banjica, Belgrade, Serbia
| | - Claudia Plesan
- Oncology Center Drobeta Turnu Severin, Drobeta-Turnu Severin, Romania
| | - Stephanie Kohl
- European Association of Hospital Pharmacists, Brussels, Belgium
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Miljković N, Polidori P, Leonardi Vinci D, Kuruc Poje D, Makridaki D, Kohl S, Süle A. Results of EAHP's 2023 shortages survey. Eur J Hosp Pharm 2024:ejhpharm-2024-004090. [PMID: 38307707 DOI: 10.1136/ejhpharm-2024-004090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024] Open
Abstract
AIMS AND OBJECTIVE The aim of the European Association of Hospital Pharmacists (EAHP)'s 2023 shortages survey was to collect data on causes and mitigation strategies of shortages of medicines and medical devices and their impact on patient care. The survey targeted hospital pharmacists (HPs), physicians (PHYs), nurses (NRS) and other healthcare professionals (OHCPs). A separate set of questions addressed patients (PTNs). METHODS A 49-question survey was carried out by a team at EAHP, collecting information from European HPs, PTNs, NRS, PHYs and OTHCs on shortages of medicines and medical devices in their respective countries. The survey ran from 27 February to 19 May 2023. The results were analysed by EAHP. RESULTS There were 1497 HP responses to the 2023 survey. While 95% (n=1429) of HPs and 86% (n=127) of OHCPs consider medicine shortages an ongoing problem, 84% (n=48) of PHYs and 68% (n=15) of NRS also agreed. Shortages of active pharmaceutical ingredients (77%, n=1148), manufacturing (67%, n=1007) and supply chain problems (50%, n=752) are major causes of shortages according to HPs as well as NRS and OHCPs; PHYs (49%, n=18) consider pricing to be the driver. More than 60% (n=765) of HPs, 55% (n=11) of NRS, 57% (n=30) of PHYs and 46% (n=56) of OHCPs experienced shortages of medical devices in 2022. Antimicrobials were most affected, according to all respondent groups, followed by analgesics, anaesthetics, cardiovascular and paediatric medicines. HPs (59%, n=269), NRS (57%, n=4), OHCPs (56%, n=37) and PHYs (54%, n=14) consider delays in care as the main consequence of medication shortages. CONCLUSIONS Shortages of medicines and medical devices affect healthcare services and patient care. Increased transparency and access to information regarding ongoing and emerging shortages as well as better preparedness of healthcare professionals is crucial to their effective management.
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Affiliation(s)
- Nenad Miljković
- Hospital Pharmacy, Institute of Orthopaedics Banjica, Belgrade, Serbia
- European Association of Hospital Pharmacists, Brussels, Belgium
| | - Piera Polidori
- Hospital Pharmacy, The joined hospitals Villa Sofia-Cervello, Palermo, Italy
| | | | - Darija Kuruc Poje
- Hospital Pharmacy, General Hospital "Dr Tomislav Bardek", Koprivnica, Croatia
| | - Despina Makridaki
- Pharmacy Services, "Sismanoglio- Amalia Fleming", General Hospital of Attica, Athens, Greece
| | - Stephanie Kohl
- Policy and Advocacy, European Association of Hospital Pharmacists, Brussels, Belgium
| | - András Süle
- European Association of Hospital Pharmacists, Brussels, Belgium
- Hospital Pharmacy, Péterfy Hospital, Budapest, Hungary
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Kuruc Poje D, Kuharić M, Posavec Andrić A, Mađarić V, Poje JV, Payerl-Pal M, Tambić Andrašević A, Poje JM, Bačić Vrca V, Marušić S. Perspectives of primary care physicians on academic detailing for antimicrobial stewardship: feasibility and impact assessment. J Int Med Res 2024; 52:3000605231222242. [PMID: 38193298 PMCID: PMC10777789 DOI: 10.1177/03000605231222242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE To understand primary care physicians' perspectives on academic detailing from an antimicrobial stewardship team to combat antibiotic overuse for upper respiratory infections and bronchitis in the COVID-19 era, which will help prevent avoidable outpatient visits. METHODS In this prospective study, 14 female Croatian physicians completed standardized qualitative interviews using a semi-structured guide. The data were analyzed using inductive methodology based on reflexive thematic analysis. We used a theoretically informed approach based on a conceptual framework of healthcare intervention implementability focused on three domains: acceptability, fidelity, and feasibility. RESULTS We identified six key themes highlighting barriers to changing prescribing practices, with patient pressure and specialist recommendations having an impact on the effectiveness of academic detailing. Despite challenges, primary care physicians described appreciation of direct interaction with evidence-based practices and reported usefulness, effectiveness, and further need for academic detailing. CONCLUSION This study highlights the complex dynamics involved in implementing healthcare interventions and provides valuable insights for enhancing strategies directed at improving antibiotic prescribing practices. Specifically, our findings emphasize factors influencing behavior changes in physicians' antibiotic prescribing. The authors advocate for a collaborative approach involving community and hospital-based professionals to provide tailored guidance and address questions, ultimately improving prescribing practices.
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Affiliation(s)
- Darija Kuruc Poje
- Department of Hospital Pharmacy, General Hospital “Dr. Tomislav Bardek,” Koprivnica, Croatia
| | - Maja Kuharić
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, USA
| | | | - Vesna Mađarić
- Department of Pulmology and Infectology, General Hospital “Dr. Tomislav Bardek,” Koprivnica, Croatia
| | - Janeš Vlatka Poje
- Department of Clinical Microbiology, Institute of Public Health County Koprivničko-Križevačka, Koprivnica, Croatia
| | - Marina Payerl-Pal
- Department of Clinical Microbiology, Institute of Public Health County Međimurje, Čakovec, Croatia
| | - Arjana Tambić Andrašević
- Department of Clinical Microbiology, The University Hospital for Infectious Diseases, Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Juraj Mark Poje
- Department of Neurology, General Hospital “Dr. Tomislav Bardek,” Koprivnica, Croatia
| | - Vesna Bačić Vrca
- Department of Pharmacy, Clinical Hospital Dubrava, Zagreb, Croatia
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Srećko Marušić
- Department of Endocrinology, Clinical Hospital Dubrava, Zagreb, Croatia
- University of Zagreb, School of Medicine, Zagreb, Croatia
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Kuruc Poje D, Miljković N, Polidori P, Kohl S. Infectious diseases and antimicrobial resistance. Eur J Hosp Pharm 2023:ejhpharm-2023-003920. [PMID: 37657919 DOI: 10.1136/ejhpharm-2023-003920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
Affiliation(s)
- Darija Kuruc Poje
- Hospital Pharmacy, General Hospital Dr Tomislav Bardek, Koprivnica, Croatia
| | - Nenad Miljković
- Hospital Pharmacy, Institute of Orthopaedics Banjica, Belgrade, Serbia
| | - Piera Polidori
- Hospital Pharmacy Complex Operational Unit, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
| | - Stephanie Kohl
- Policy & Advocacy, European Association of Hospital Pharmacists, Brussels, Belgium
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Kuruc Poje D, Božina N, Šimičević L, Žabić I. Severe hyperglycaemia following pazopanib treatment: The role of drug-drug-gene interactions in a patient with metastatic renal cell carcinoma-A case report. J Clin Pharm Ther 2020; 45:628-631. [PMID: 32369219 DOI: 10.1111/jcpt.13160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/14/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Pazopanib is a tyrosine kinase inhibitor with hyperglycaemia as a known adverse event, but case reports of severe hyperglycaemia are exceptional. We report a case of severe hyperglycaemia following pazopanib administration in a patient with metastatic renal cell carcinoma. CASE SUMMARY Severe hyperglycaemia developed in a patient one month following initiation of pazopanib therapy. As drug-drug-gene interactions may lead to hyperglycaemia, pharmacogenetic assessment was requested. The obtained findings indicated intermediate function of both OATP1B1 and P-glycoprotein transporters, which may cause prolonged pazopanib bioavailability and increased toxicity. Pazopanib was discontinued and, following patient recovery, was reintroduced at a lower dose. WHAT IS NEW AND CONCLUSION The pharmacogenetic profiling of the patient on polypharmacy enabled better management of pazopanib therapy.
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Affiliation(s)
| | - Nada Božina
- Division of Pharmacogenomics and Therapy Individualization, Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Livija Šimičević
- Division of Pharmacogenomics and Therapy Individualization, Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Igor Žabić
- General Hospital 'dr. Tomislav Bardek', Koprivnica, Croatia
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Kuruc Poje D, Mađarić V, Janeš Poje V, Kifer D, Howard P, Marušić S. Antimicrobial stewardship effectiveness on rationalizing the use of last line of antibiotics in a short period with limited human resources: a single centre cohort study. BMC Res Notes 2019; 12:531. [PMID: 31429801 PMCID: PMC6702748 DOI: 10.1186/s13104-019-4572-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 08/13/2019] [Indexed: 12/04/2022] Open
Abstract
Objective Antibiotics reserve (ARs) are given as a last line of treatment when other antibiotics are no longer effective. Rising threat of antimicrobial resistance makes growing use of ARs a real problem to patient safety. A single centre interventional cohort study was conducted in order to measure impact on clinical outcomes of A-team programme with limited human resources in a short period. A-team programme started on 01. September 2017. Results In 3 months preintervention and 3 months intervention period, from 3038 and 3156 hospitalized adult patients, 249 (59% of them were male, median age = 69 years) and 96 (51% of them were male, median age = 70 years) received parenteral ARs. Total duration of hospitalization of patients on AR was reduced from 28 to 17 days of hospitalization on 100 patient-days (OR = 1.92; 95% CI 1.83–2.01; p < 0.001) with no statistical significant difference in rehospitalisation due to infection of patients that were treated with ARs within 2 months after discharge. Despite short period of time and limited human resources, A-team restrictive interventions rationalised parenteral AR use and led to positive impact on clinical outcomes. These results could help our and other A-teams in similar situation in continuing with the programme to bring more evidence.
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Affiliation(s)
- Darija Kuruc Poje
- Hospital Pharmacy Ward, General Hospital "Dr. Tomislav Bardek", Željka Selingera 1, 48 000, Koprivnica, Croatia.
| | - Vesna Mađarić
- Pulmology and Infectology Ward, General Hospital "Dr. Tomislav Bardek", Željka Selingera 1, 48 000, Koprivnica, Croatia
| | - Vlatka Janeš Poje
- Clinical Microbiology Ward, Department of Public Health Koprivnica County, Željka Selingera 1, 48 000, Koprivnica, Croatia
| | - Domagoj Kifer
- Department of Biophysics, Faculty of Pharmacy and Biochemistry, University of Zagreb, A Kovačića 1, 10 000, Zagreb, Croatia
| | - Philip Howard
- Leeds Institute of Diagnostics and Therapeutics, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Srećko Marušić
- Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Dubrava, Avenija Gojka Šuška 6, 10 000, Zagreb, Croatia
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