connecting careand outcomeconnecting careand outcome · and cecilia ahern and so-called literary...
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The tri-monthly newsletter of the European Society
of Clinical Pharmacy News ESCP News
ESCP News
ESCP News
ESCP News �� �� October 2011
October 2011
October 2011
October 2011 �� �� Number 153
Number 153
Number 153
Number 153 �� �� ISSN 135
ISSN 135
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ISSN 13533 33-- -- 0321
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Connecting Care and Outcome Connecting Care and Outcome Connecting Care and Outcome Connecting Care and Outcome
ContentsContentsContentsContents : A Few words 1 ESCP life 2 Articles & Reports 5 ESCP Conferences 7 Announcements 8
Céad mile fáilte Céad mile fáilte Céad mile fáilte Céad mile fáilte –––– « « « « A hundred thousand A hundred thousand A hundred thousand A hundred thousand welcomeswelcomeswelcomeswelcomes »»»», the traditional Irish greeting. On behalf of the Organising and Scientific Committees of ESCP and the local organi-sing committee, I want to welcome you to the 40th ESCP Symposium, to Dublin and to Ireland. The scene is set for 4 days of meeting friends and making contacts, for productive work and good fun, or, as the Irish say, Craic agus Ceoil.
Pharmacy in IrelandPharmacy in IrelandPharmacy in IrelandPharmacy in Ireland. The Irish Health System is a mixture of public and privately funded services. The organisational development of the health service has been slow and piecemeal. Only around one third of the population are entitled to receive free health care from the public services. Everyone else must pay some of the costs. In Primary Care there is some co-payment of medicines costs from public funds for two thirds of the popula-tion. This means that there is a substantial private sector in Primary Care. Community pharmacists have had to battle the frag-mented health service system in order to be able to offer services other than those directly related to medicines provision. In hospital, while the majority of patients attend a public hospital, they will use health insurance to pay for this. Hospital pharmacists provide the full range of clini-cal interventions and technical services in many, particularly larger, hospitals and they have been active in EAHP. The Irish Pharmacy Union (IPU) represents community pharmacists; the Hospital Phar-macists Association of Ireland represents
hospital pharmacists and the Pharmaceuti-cal Society of Ireland is the Pharmacy Re-gulator, and all of these organisations are supporting the ESCP symposium. There is no representative and leadership for the Profession of Pharmacy as a whole at the moment.
IrelandIrelandIrelandIreland With the Atlantic Ocean washing its nor-thern, western and southern shores Ire-land seems to look out from Europe and its connections to the USA, Canada and beyond are extensive. Yet Ireland’s popula-tion and economic centres lie on the eas-tern side and look towards Europe and its nearest neighbour the UK. Like many neighbours, they have had their fights and reconciliations and they rejoice in their distinct traditions and habits just as much as they celebrate those things they share. The Island of Ireland comprises Northern Ireland, a semi-autonomous region of the UK with its capital, Belfast, and the Repu-blic of Ireland with its capital, Dublin, the city hosting this symposium.
DublinDublinDublinDublin Although Dublin has existed for over 1,000 years, it traditionally dates its founding as a city from Viking times and it uses a Viking-derived name – Duiblinn (Black Pool) from Dyflin, presumably the place where the ships were moored. Dublin grew into the city of today mainly in the 18th century and the buildings of that period are the domi-nant historical landmarks. There’s now a Dublin App (www.visitdublin.com/app) and iWalks and podcasts to help you get around. By way of example, just one aspect of city life will be considered here; litera-ture.
Dublin was designated a City of Literature by UNESCO in 2010 and with so many writers including four Nobel Laureates the justification is clear.
Jonhathan Swift (Gulliver’s Travels) a gra-duate of Trinity College (only just, he was reprimanded for ‘neglect of study’) he became Dean of St Patrick’s Catherdral (where he is buried) and he also gave Han-
del permission to stage his Messiah (written in Dublin) in 1742. Oscar Wilde lived in Merrion Square, where his statue is now located, lived here for some time. Bram Stoker wrote a book about a vampire that lead to an entire cultural domain that is still growing. JM Synge (another Trinity graduate) and Sean O’Casey will be less familiar, but were not only important litera-ry figures but also influenced Irish Society and its institutions. George Bernard Shaw and James Joyce spent much of their lives elsewhere, but Shaw helped establish the National Gallery of Art in Merrion Square and Joyce’s Ulysses was an innovative development of the form of the novel. WB Yeats was not only a great poet but also helped found and support the national theatre where Synge’s plays were perfor-med and subsequently, playwrights like Brendan Behan and Samuel Beckett bene-fitted from the cultural environment that had been created. Today, success is often measured in pri-zes, Iris Murdoch, Roddy Doyle, John Ban-ville and Anne Enright have all won the Man Booker Prize and there are many other notable writers working today; popu-lar novelists Maeve Binchy, John Connolly, Marian Keyes, Cathy Kelly, Patricia Scanlan and Cecilia Ahern and so-called literary fiction writers, Sebastian Barry, Colum McCann, Joseph O’Connor, Hugo Hamil-ton, and Claire Kilroy. Trinity College Dublin founded by Elizabeth 1 of England (1592) is the oldest university and has the oldest School of Pharmacy in Ireland. The College’s Dining Hall is the venue for the ESCP Dinner on Thursday 20th.
On behalf of all the local organisers and the scientific com-mittee, I look for-ward to meeting you and welcoming you to Dublin and to the 40th ESCP sympo-sium.
Martin HenmanMartin HenmanMartin HenmanMartin Henman President of the Dublin conference
E u r o p e a n S o c i e t y o f C l i n i c a l P h a r m a c y The overall aim of the Society is to develop and promote the rational and appropriate use of medicines by the individual and by The overall aim of the Society is to develop and promote the rational and appropriate use of medicines by the individual and by The overall aim of the Society is to develop and promote the rational and appropriate use of medicines by the individual and by The overall aim of the Society is to develop and promote the rational and appropriate use of medicines by the individual and by society.society.society.society.
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Clinical pharmacists still have to prove themselvesClinical pharmacists still have to prove themselvesClinical pharmacists still have to prove themselvesClinical pharmacists still have to prove themselves And with this lovely season comes a new ESCP symposium. This time we are mee-ting in Dublin and it will be a positive thrill to meet new and old friends in the world of clinical pharmacy. Clinical pharmacy and with it the clinical pharmacist are facing a new and important era. We are being as-ked for in more and more countries, health care arenas and settings. Patients need the clinical pharmacist’s competence and skills and so do the health care personnel at large. Unfortunately and in spite of all the overwhelming evidence and literature in the area, clinical pharmacists still have to prove themselves in many countries. This is a shame! And the victims in this are the patients who don’t get the care and the
therapy they deserve. This is what I want and how I see the future:
1. 1. 1. 1. The clinical pharmacist is a natural and appreciated member of the health care team and works I direct contact with both patients and all other health care workers including physicians
2. 2. 2. 2. There are clinical pharmacists at the top management level of hospitals, community pharmacy chins and health insurance companies.
3. 3. 3. 3. The education to become a clinical phar-macist is well developed everywhere and acknowledged on the political level of the European union and in all European states.
4. 4. 4. 4. Continuing education is well developed
and a must for clinical pharmacists ena-bling them to demand it from their em-ployers.
5. 5. 5. 5. Clinical pharmacists are a natural part of the hospital pharmacy as well as the com-munity pharmacy work force.
6. 6. 6. 6. Clinical pharmacists are being paid in accordance with their competence and as the professionals they are.
All this cannot be achieved at once. But it is important to have goals in life and these are mine. See you in Dublin!
Cecilia BernstenCecilia BernstenCecilia BernstenCecilia Bernsten President of the ESCP
Clinical Pharmacy Clinical Pharmacy Clinical Pharmacy Clinical Pharmacy ---- Connecting Care and Outcomes Connecting Care and Outcomes Connecting Care and Outcomes Connecting Care and Outcomes Dublin, Ireland, Dublin, Ireland, Dublin, Ireland, Dublin, Ireland, 19191919----21 October 201121 October 201121 October 201121 October 2011
Focus on Scientific ProgrammesFocus on Scientific ProgrammesFocus on Scientific ProgrammesFocus on Scientific Programmes
From Tuesday 18th until Friday 21st of October there will be 24 lectures, 21 workshops, over 340 posters and oral communica-tions, one mini-symposium and one Masterclass to interest, provoke and inform you. There are already over 400 participants regis-tered which is above expectations at this stage.
Connecting care to outcomes is not easy. Pharmacists, and other health care professio-nals care for patients to the best of their abili-ty, but this does not automatically lead to optimal outcomes for the patients. Why? Because the complex interacting factors of the patient, their condition(s) and their medi-cine(s) often requires a multiplicity of clinical and humanistic approaches, used in judiciou-sly selected combinations, which are applied in a carefully timed and monitored sequence, to produce the desired outcome. Scientifical-ly, the effects of disease-independent inter-ventions such as, for example, a medication review for patients with polypharmacy are difficult to evaluate. The 40th Symposium of the European Society of Clinical Pharmacy will try to unravel some of the interactions and to clarify some of the complexities of connecting care to outcomes.
The idea that everyone is unique and that approaches to treatment must be tailored to individuals is exemplified in the Wednesday morning session when Hans Mulder will look at the pharmacogenetic basis of this unique-ness, Steven Tomlin will consider the very young and the very old and Martin Henman will discuss the care needs and the challenge of achieving good outcomes for those with Intellectual Disability. Whether patients are best cared for in hospi-tal or at home is a difficult question. Revie-wing the evidence about care and outcomes in different settings on Friday will be a series of non-pharmacists giving their view; Ed McKone who will talk about Cystic Fibrosis in hospital practice, while Paul Gregan will dis-cuss Palliative Care and Herman van Loon will describe care at the Primary-Secondary care interface in schizophrenia.
Pursuing the idea of integrated care in order to ensure the safe, effective and economical use of medicines will be Barbara (or Barb, as she prefers) Farrell from Canada and Dick
Tromp from the Netherlands. Barb, will draw upon her experience of the IMPACT study and the CHAP programme to discuss the dos and don’ts of integrated working while Dick will describe the Dutch experience of initiati-ves used to bring prescribers and pharma-cists together for therapeutic discussions.
Residential care is a priority for all countries as a growing proportion of older people live in these types of homes. Carmel Hughes will discuss two contrasting approaches to dea-ling with the problem of the appropriate use of medicines. Medication errors can readily occur when polypharmacy is the norm and David Alldred will describe their detection and prevention. In another session, Cris Ryan and Maria Augusta Soares will debate the advan-tages and disadvantages of different criteria based approaches to appropriate drug use in polypharmacy.
Technology may offer some help in takling these issues and Alession Provencani will discuss the SMART IT systems used at IS-METT while Andrew Seger will talk about decision making. James McElnay brings his extensive experience in developing and eva-luating care programmes and will describe how remote monitoring can extend the reach of Pharmaceutical Care.
In memory of Steve Hudson, Anne Leen-dertse will give a lecture on Thursday 20th.
Anne will be well known to many of you through her work on the interesting and va-luable PHARM study. There will also be two Pharmacotherapy updates from Ulrike Gilles-pie and Bart van den Bemt.
Fundamental to progress in practice is good quality research and workshops on research methods and skills form a significant group in the programme and they link to the ESCP Masterclass (held on Tuesday 18th). There will be two workshops on scientific writing one looking at abstracts and another at research papers, both facilitated by Dr Foppe van Mil on behalf of the ESCP Communication Com-mittee. Qualitative research methods, particu-larly participant and non-participant observa-tion and focus groups will be explored by Mara Guerreiro and Sarah Crowe while Syste-matic Reviews and Meta-analysis will be discussed by Katherine Lyseng-Williamson in two method-focussed workshops. Effective use of PubMed will be demonstrated by Daniela Scala, Piera Polidori and Alessio Provenzani while Statistics in the Health Sciences will be explained by Keith Evans in another workshop.
The symposium begins on the morning of Wednesday 19th but prior to that on Tues-day, apart from the ESCP Masterclass, Phar-maceutical Care Network Europe (PCNE) are running a Medication Review meeting with presenters from several European countries. As a prelude to the meeting, on Tuesday evening, Charles Normand a Health Econo-mist in Trinity College Dublin will speak about ‘Doing more with less’. Charles is an entertai-ning and provocative speaker with a wealth of international experience, such as the Euro-pean Public Health Observatory project, to bring to bear to this topical theme.
Martin HenmanMartin HenmanMartin HenmanMartin Henman President of the Dublin conference
Trinity College
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Masterclass Pharmacy Practice Research 18 October 2001Masterclass Pharmacy Practice Research 18 October 2001Masterclass Pharmacy Practice Research 18 October 2001Masterclass Pharmacy Practice Research 18 October 2001
Pharmacy practice research focuses on the assessment and evaluation of pharmacy practice, both in primary and secondary care. It includes both the evaluation of pharmacists’ current roles and the evalua-tion of new interventions, but also the pres-cribing and actual use of medicines. Phar-macy practice research includes health systems research and clinical research.
This course will focus on the principles of pharmacy practice research. Participants will learn how to define their research questions and how to choose adequate methodology to answer these research questions. The course will give examples of pharmacy practice re-search studies and will stimulate participants in group work to propose their own practice research.
This course is of interest to both early career academic researchers and practising phar-macists who would ike to initiate practice research. Participants will have priority for several research oriented workshops (qualitative studies, scientific writing, sear-ching for literature, understanding systematic reviews and understanding statistics) that are provided during the parallel ESCP conference.
9.45 - 10.30 Defining your research question.
10.50 - 12.00 Overview of pharmacy practice research methodology. Observational vs. evaluative studies.
12.00 - 13.00 Making the most of postal questionnaires (covering designing & a review of the evi-dence on improving response rate).
14.00 - 14.30 Proposals for research projects by partici-pants and selection of projects to further elaborate on in small groups.
14.30 - 16.00 5 small Working groups: Defining a research question and deciding on research methodo-logy. Preparing a five minute presentation.
16.30 -17.30 Presentations of subgroups, discussion and feedback.
Related workshops during ESCP confe-rence (choose from the following topics): Study design (qualitative methods), covering participant and non-participant observation, in-depth interviews, focus groups, etc.
We identified 5 workshops within the confe-rence format which complement the pro-gram. Amongst them: 1. Successful Scientific Writing: getting abs-tracts accepted - J.W.F. van Mil (Netherlands) 2. Successful Scientific Writing: original re-search papers - J.W.F. van Mil (Netherlands) 3. Understanding and Evaluating Systematic Reviews and Meta-Analysis - K. Lyseng-Williamson (New Zealand) & K. Evans (UK) 4. Understanding Statistics in Health Science - K. Lyseng-Williamson (UK) & K. Evans (New Zealand) 5. Pubmed for All: learning how to use Me-dline - D. Scala (Italy), P. Polidori (Italy) & A. Provenzani (Italy)
Marcel BouvyMarcel BouvyMarcel BouvyMarcel Bouvy [email protected]
ESCP Symposium, Dublin WorkshopsESCP Symposium, Dublin WorkshopsESCP Symposium, Dublin WorkshopsESCP Symposium, Dublin Workshops 1. 1. 1. 1. Successful Scientific Writing: getting abs-tracts accepted - J.W.F. van Mil (Netherlands)
2. 2. 2. 2. Successful Scientific Writing: original re-search papers - J.W.F. van Mil (Netherlands)
3. 3. 3. 3. Cross-border Healthcare and Rare Disea-ses - M. Dooms & G. Laekeman (Belgium)
4. 4. 4. 4. Bring your own cases: Prescription Cas-cade in geriatrics: How to detect and prevent - L. Mallet (Canada) & G.L. Zelger (Switzerland)
5. 5. 5. 5. Evidence-based Practice – How to apply available information to a geriatric population - Y. Hanssens (Qatar)
6. 6. 6. 6. Understanding and Evaluating Systematic Reviews and Meta-Analysis - K. Lyseng-Williamson (New Zealand) & K. Evans (UK)
7. 7. 7. 7. Understanding Statistics in Health Science - K. Evans (UK) & K. Lyseng-Willamson (New Zealand)
8. 8. 8. 8. Medication Review in Primary care. Doing it the PCNE way - N. Griese (Germany), K.E. Hersberger (Switzerland) & J.W.F. van Mil (Netherlands)
9. 9. 9. 9. Pubmed for All: learning how to use
Medline in 2 hours - D. Scala (Italy), P. Polidori (Italy) & A. Provenzani (Italy)
10. 10. 10. 10. The Effects Of Hypoalbuminemia On Optimizing Antibiotic Dosing In Critically Ill Patients - D. Soy (Spain), E. Carcelero (Spain) & D. D’Arcy (Ireland)
11. 11. 11. 11. Enteral Nutrition in Adult Hospitalized Patients. Optimizing the Outcome Using Com-puter - Assisted Individualization of Nutritional Support - M. Skouroliakou (Greece)
12. 12. 12. 12. Resistance is not futile – Developing and Implementing Successful Antimicrobial Ste-wardship Program, the Role of Clinical Phar-macy - E. Schwartzberg (Israel) & A. Green-berg (USA)
13. 13. 13. 13. Safe use of Psychotropic Drugs: How to avoid and monitor drug interactions and drug therapy problems - M. Hahn (Germany)
14 14 14 14 Patient Care Competencies – how to carry out a self assessment - A. Meštrovi (UK)
15. 15. 15. 15. Indicators of quality of pharmacy practice - Z. Bezverhini (Moldova) & O. Grintsova (Ukraine)
16. 16. 16. 16. Integrating Care with Physicians to im-prove Cardiovascular Outcomes - B. Farrell (Canada)
17. 17. 17. 17. Teaching Clinical Reasoning and Clinical Problem Solving - M. Kinnear (Scotland) & A. Snyder (USA)
18. 18. 18. 18. Care of the Elderly and inappropriate Prescribing - S. Byrne (Ireland)
19. 19. 19. 19. How to Communicate with Patients with Depression? - S. Liekens (Belgium) & V. Fou-lon (Belgium)
20. 20. 20. 20. Qualitative research - M. Guerreiro (Portugal) & S. Crowe (UK)
21. 21. 21. 21. Medication Safety ; Practical implementa-tion - C. Kirke (Ireland) & E. Relihan (Ireland)
384 abstracts in total were submitted for the Dublin conference. After the peer review process 341 were ac-cepted; these 11% of abstracts were rejected because of poor quality, it represents slightly less than the usual percentage of rejection in ESCP conferences. Of the 341 accepted abstracts, 24 authors were invited for an Oral Communication, 36 authors for a Poster Discussion, and the 341 authors were asked to present a poster (all
PDF have to put up their poster; all OC are allowed to put up their poster, but do not have to). As usual a special jury will be in place to select the best presenter and best poster for an award. During the symposium the jury will look at all the posters and will get judgements from all the moderators of the oral communi-cation and the poster discussion sessions. The awards are a free registration to the next ESCP Symposium, Barcelona 29-31 October
2012. In order to help authors to improve their abstracts, workshops about writing an abstract will be held during the Dublin confer-ence. The abstracts of all presented commu-nications and posters will be published in the International Journal of Clinical Pharmacy (IJCP, ex-PWS). They will also be available on the website of Springer: www.springerlink.com.
MarieMarieMarieMarie----Caroline HussonCaroline HussonCaroline HussonCaroline Husson [email protected]
Posters, Poster discussion fora and Oral communications & AwardsPosters, Poster discussion fora and Oral communications & AwardsPosters, Poster discussion fora and Oral communications & AwardsPosters, Poster discussion fora and Oral communications & Awards
Clinical Pharmacy Clinical Pharmacy Clinical Pharmacy Clinical Pharmacy ---- Connecting Care and Outcomes Connecting Care and Outcomes Connecting Care and Outcomes Connecting Care and Outcomes Dublin, Ireland, Dublin, Ireland, Dublin, Ireland, Dublin, Ireland, 19191919----21 October 201121 October 201121 October 201121 October 2011
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This is an 89 year-old man living alone at home. He is independent with his activities of daily living (ADL) and his instrumental activi-ties of daily living (IADL). Once a week, he has help for cleaning. He cooks, drives his car and visits his wife in a long term care every day from 14h00 to 18h00. He takes his weight every morning which is stable at 70 kg. He has no known allergies, does not smoke and drinks one glass of wine weekly. He has a pacemaker and congestive heart failure. He takes the following medications: Bisoprolol 5 mg (morning) + 2.5 mg (bedtime) Furosemide 20 mg in the morning Ramipril 5 mg twice daily
Isosorbide-5-mononitrate 60 mg (morning) Enteric coated aspirin 80 mg one tablet on Monday, Wednesday and Friday Lab values on Feb 7, 2011 were within nor-mal limit except for: K = 5.3 mmol/L (from 4.5 mmol/L in Dec 2010); Creatinine = 150 umol/L (from 120 umol/L in Dec 2010). Calculated creatinine clearance = 20 mL/mn. Upon discussion with this patient, you find out that he has been using a NoSalt® –salt subs-titute product since January 2011. This was provided by the housekeeper who comes once a week. She was using it at home; as the patient was on a low salt diet she thought it would be a good idea to use.
Furthermore, since the February 1st, the patient was using a topical gel for a muscle pain in his right leg every day. One of his daughters had given him a tube of Voltaren Emulgel® which contains diclofenac diethyla-mine gel 1.16%; this product being available without a prescription.
Clinically the patient was doing well. However, during the week of February 13th, a family member notices fatigue and shortness of breath. Upon questioning the patient, it was discovered that he had been using topical diclofenac emulgel and NoSalt substitute.
Louise MalletLouise MalletLouise MalletLouise Mallet [email protected]
ESCP SIG GeriatricESCP SIG GeriatricESCP SIG GeriatricESCP SIG Geriatric
Patients infections and the Clinical PharmacistPatients infections and the Clinical PharmacistPatients infections and the Clinical PharmacistPatients infections and the Clinical Pharmacist Int. WS, Leuven, Belgium 30 May Int. WS, Leuven, Belgium 30 May Int. WS, Leuven, Belgium 30 May Int. WS, Leuven, Belgium 30 May –––– 1st June 2012 1st June 2012 1st June 2012 1st June 2012
LaceworkLaceworkLaceworkLacework
The emerging enterhaemorragic E. coli re-minds us of our vulnerability for infections. Two years ago we had the fear of the H1N1 flu epidemic. Opportunistic infections like TBC can complicate the use of TNF alpha antago-nists. Systemic mycoses remain life threaten-ing as infected patients are usually already in a bad condition. MRSA is always looking around the edge… More than enough exam-ples for more than contemplation.
Whether in the hospital or in the community: infections come in their own right or they complicate existing conditions. We try to master them on a rational way, in accor-dance with the mission of ESCP: ... develop-ing and promoting the rational and appropri-ate use of medicines, medical products and devices by the individual and by society… However, when we have to take into account too many variables, some of them with an
emotional component, we may tend to forget about rational guidelines and rules. On the one hand over-reacting and moving away from rationality can happen from the profes-sional side. On the other hand concerns about costs and side effects may influence the opinion of patients. Anti-vaccination and anti-antibiotic feelings can hamper prevention and treat-ment. Especially in case of long-lasting treat-ments, compliance and adherence become important for a positive outcome. On top of that, resistance of micro-organisms against the medicines available keeps us vigilant.
To what extent can guidelines and develop-ment of new antimicrobial agents solve the problem? What can be done if the preferen-tial treatment seriously interacts with other important medicines?
‘Patients, infections and the clinical pharma-cist’ can be considered as pattern to be used for a nice lacework as you have probable already seen in Flanders. We want to weave this piece of lace in Leuven from 30 May to 1 June 2012. It takes only 15 minutes from the international airport of Brussels to the city of Leuven. We will welcome you on the campus ‘Gasthuisberg’ of the university hospital. Plenary lectures, interactive working sessions and poster presentations are planned during daytime. In the evening there is the enjoyable atmosphere of an historical city, since 1425 a home for thousands of students. Hopefully from the point of view of infections, a beer on a terrace remains safe and pleasant restau-rants guarantee an affordable price-quality balance. See you in Leuven!
Gert LaekemanGert LaekemanGert LaekemanGert Laekeman Chair of the Workshop
Current composition of the Communication Committee: F van Mil (Chairman), L Mallet (Secretary), J Beney, E Gerbrands, MC Hus-son, P Polidori, D Scala and I Millar. During this period, JB Rey stepped down as a mem-ber and I Millar was accepted as a new mem-ber. C Bernsten became the observer on behalf of the GC. The chairman of the com-mittee will step down in 2011, and be suc-ceeded by D Scala.
MeetingMeetingMeetingMeetingssss The Communication Committee met twice during the season 2010-2011. Once in Lyon in 2010, and the second time in Utrecht in March 2011. Tasks that have not been com-pleted are the evaluation of criteria for the oral communications and the poster discus-sion forum, and the reformatting and rewri-ting of the ESCP Guidelines for successful presentations. The discussion of a strategic plan of the committee depends on the availa-bility of a new strategic plan of the General Committee.
NewsletteNewsletteNewsletteNewsletterrrr The regular appearance of the newsletter was coordinated by the committee, but the real work was done by MC Husson, assisted
by C Tollier. I Millar was assisted the team, for language-editing purposes.
Abstract review process Abstract review process Abstract review process Abstract review process Normally, the chairman of the Communica-tion Committee also chairs the abstract sub-missions of the annual Symposia. However, for the Lyon Symposium, MC Husson was asked to take the lead in the procedures. The new scoring system seems to work fine, but it is difficult to find enough reviewers for the abstracts. Language remains a considerable problem. In 2010 a total of 588 abstracts were received for the Lyon Conference (of which the majority from France) and 483 abstracts were accepted, of which 30 for an oral presentation and 58 for the poster dis-cussion fora. In Utrecht (2011) the number of received abstracts was much smaller: 41.
To improve the quality of abstracts for ESCP, a workshop on ‘How to write an abstract’ was piloted by the Chairman in Geneva. In Dublin workshops will be given on How to write an article, and how to write an abstract. During the committee meeting in Lyon, the policy regarding the handling of posters was accep-ted. The categories will be revisited as well as the scoring system.
Website and its content management Website and its content management Website and its content management Website and its content management systemsystemsystemsystem The new website is now live. The chairs of the RESC and SIGs will need some support to learn how to maintain the information on their activities. The responsibility for the web-site will be transferred from Johnny Beney to Piera Polidori. The members of the commit-tee thank Johnny for his exceptional commit-ment with the task of modernising the web-site.
PWSPWSPWSPWS----IJCPIJCPIJCPIJCP On the 1st of January 2011, the name of the journal has changed to ‘The International Journal for Clinical Pharmacy’ (IJCP).
Satisfaction surveySatisfaction surveySatisfaction surveySatisfaction survey Since 2009, the chairman of the committee has produced the satisfaction surveys after the annual conferences and workshops, as a kind of ‘hobby’. This task has to be assigned properly to a person or the office in 2011. This assessment should also include the rating of speakers; the results of that rating should enter into the ESCP speakers data-base.
J.W.Foppe van MilJ.W.Foppe van MilJ.W.Foppe van MilJ.W.Foppe van Mil [email protected]
Report Communication committee 2010Report Communication committee 2010Report Communication committee 2010Report Communication committee 2010----2011201120112011
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In Germany, the subject of clinical pharma-cy was introduced into the pharmacy curri-culum in 2001, and it covers now about 5% of the total pharmacy programme workload. The first students who took exa-minations in clinical pharmacy graduated around 2005. Thus, by now, some 8,000 pharmacists with a basic clinical pharmacy education are ready to serve the health system with their specific knowledge and skills. In view of the current endeavour to improve medication safety by expanding clinical pharmacy services, this ratio of 1 clinical pharmacist per 10,000 German citizens is rather small. Opportunities for postgraduate clinical pharmacy education are therefore needed.
In order to meet this demand (that is reco-gnized also in other European countries), the curriculum for a postgraduate e-learning course was developed within an international project involving the acade-mic Institutes of Pharmacy in Hamburg, Cracov, Barcelona and Montpellier. This has served as foundation of a programme consisting so far of five units, each cove-ring a specified topic of clinical pharmacy (see table 1) within a period of four weeks each. This course is currently offered for both community and clinical pharmacists in German language by the University of Hamburg. So far, participants have come from all parts of Germany, Austria, Switzer-land, Norway and Luxemburg. An English version may start if there are a sufficient number of interested colleagues.
The unique feature of this programme, besides the e-learning scenario, is the continuous supervision of the trainees – both on pharmaceutical as well as social and motivational issues. The experience from three cycles of the course shows that this is an important factor for commitment and adherence. Thus, of the 46 pharma-cists who joined this course so far, 44 completed it - in spite of an average wor-
kload of around eight hours per week. Before starting the course, there is a face-to-face meeting of all participants and the pharmaceutical and social supervisors of the programme in order to become ac-quainted with each other. There is also an introduction into virtual teamwork, desi-gned them aware of and cope with its technical and communicational aspects. In the clinical pharmacy programme itself, each unit consists of: - self-study material explaining the relevant topics in a textbook-like fashion; - two or three plenary discussions for pro-fessional interaction among the whole group of participants; - several problem-solving exercises comple-ted in small groups of mostly four partici-pants; - single-learner exercises; - a multiple choice test ensuring the lear-ning success. The discussions offer the possibility to shape, within the frame of the topics men-tioned above, the course content details and the depth of information exchanged according to the trainees’ experience, professional focus and interest. At the same time, leading these discussions on a learning platform enables a non-synchronous participation within a given frame of a couple of days. This allows each trainee to give his or her input at a time that best suits the private schedule – some go online in the morning before starting work, others at night time when the children are asleep. The general rhythm of the course is given by a thoroug-hly planned course calendar (Fig. 1). This facilitates keeping track of all course activi-ties and provides a convenient overview of the whole course structure. In order to complete the course, the partici-pants have to pass all five multiple choice tests with at least 70% and have to actively
engage in the team work and the plenary discussions. It is possible to leave out up to two team exercises and three plenary discussions in order to accommodate ‘obstacles’ like holidays, periods of illness and the like. Completion of the course is awarded with a certificate from Hamburg University, five European Credit Transfer and Accumula-tion System (ECTS) credit points and up to 92 credit points issued by the German Pharmacists Association (BAK). All runs of the programme were evaluated by the participants. The evaluation docu-mented a very high degree of satisfaction with the course, its contents and its bene-fit. For example, one of the last participants stated that he felt he was much better able to enter into clinical discussions with physi-cians. Another said she was now “thinking in a much more clinical way”. The majority of the participants felt that they had achieved the learning objectives and would recommend the course to others. The most valued aspects of the course were the practice-oriented content, the exchange and interaction with collea-gues, the continuous supervision and input by the course tutors as well as the op-portunity to fulfil intensive studies with nearly absolute flexibility in terms of time and place. For more informa-tion, please contact the author of this article.
Dorothee C. DartschDorothee C. DartschDorothee C. DartschDorothee C. Dartsch Professor of clinical pharmacy
Let’s go onlineLet’s go onlineLet’s go onlineLet’s go online Postgraduate training in clinical pharmacy in GermanyPostgraduate training in clinical pharmacy in GermanyPostgraduate training in clinical pharmacy in GermanyPostgraduate training in clinical pharmacy in Germany
Fig. 1: Course calendar. As an example, the schedule of the first unit from the last course is shown.
Table 1
Unit 1 Clinical pharma-cokinetics:
Factors affecting the pharmacokinetic behaviour of drugs, therapeutic drug monitoring, methods of optimising drug dosage, new trends in dose optimisation
Unit 2 Laboratory parame-
Clinical chemistry, haematology, coagula-tion, drugs affecting lab data
Unit 3 Drug interac-tions:
Mechanisms of drug interactions, com-patibility, interactions with medical de-vices, relevance of interactions
Unit 4 Adverse drug events:
Terminology of adverse drug events, causes, causality and prevention of ADR and medication errors, pharmacovigilance
Unit 5 Special patient popula-tions:
Physiological, functional and formal differ-ences in neonates and children, pregnant and breast-feeding women, the elderly, patients with renal or hepatic insuffi-ciency, multimorbid patients in intensive care as well as pharmacogenetically different patients compared with the ‘standard’ adult patient; consequences for optimal pharmacotherapy
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EMEA newsEMEA newsEMEA newsEMEA news
On 17th June 2011 the European Medi-cines Agency held a stakeholder forum on the implementation of the new pharma-covigilance legislation with a broad cross-section of participants including industry, patient, consumer and healthcare profes-sional representatives as well as represen-tatives from national medicines regulatory authorities and the Agency itself.
Peter Arlett, Head of the Agency’s Pharma-covigilance and Risk Management Sector, moderated the session on direct patient reporting and introduced Tony Avery of the University of Nottingham who presented the results of a research project which evaluated the pharmacovigilance impact of patient reporting to the yellow card system in the United Kingdom.
This overview was complemented with other existing national experience on direct
patient reporting in Denmark and United Kingdom as well as reporting experiences from patients and consumers.
It was agreed during the panel discussion that the value of direct patient reporting has been sufficiently demonstrated by the various research projects and pilots. It was concluded that patient reporting should be seen as a complement to the reporting made by healthcare professionals but not as a substitute.
In the context of Eudravigilance develop-ment and medicinal product identification and in accordance with Article 57(2) of Regulation (EC) No 726/2004, Sabine Brosch from the Agency’s Pharmacovigi-lance and Risk Management Sector, up-dated participants on further progress on this area. The Agency will make public a formatwill make public a formatwill make public a formatwill make public a format for
the electronic submission of information on medicinal products for human use by 2nd by 2nd by 2nd by 2nd July 2011July 2011July 2011July 2011. This format will be used from this date by the marketing authorization holders with all products notified by July 2012.
The format of the Eudravigilance Medicinal Product Report Message (EVPRM) will serve as the initial format.
The Agency will update the format by the end of 2014, taking into account the ongo-ing international harmonization and techni-cal and scientific progress.
Additionally training, information days, as well as specific tools will be made available to help stakeholders with their submis-sions.
Gert LaekemanGert LaekemanGert LaekemanGert Laekeman [email protected]
2222ndndndnd stakeholder forum on the implementation stakeholder forum on the implementation stakeholder forum on the implementation stakeholder forum on the implementation of the new pharmacovigilance legislationof the new pharmacovigilance legislationof the new pharmacovigilance legislationof the new pharmacovigilance legislation
Concept paper on the need for revision of the guideline on Concept paper on the need for revision of the guideline on Concept paper on the need for revision of the guideline on Concept paper on the need for revision of the guideline on Clinical Investigation of Medicinal Products for Prophylaxis Clinical Investigation of Medicinal Products for Prophylaxis Clinical Investigation of Medicinal Products for Prophylaxis Clinical Investigation of Medicinal Products for Prophylaxis
of High Intraof High Intraof High Intraof High Intra---- and Post and Post and Post and Post----operative Venous Thrombooperative Venous Thrombooperative Venous Thrombooperative Venous Thrombo----embolic Risk embolic Risk embolic Risk embolic Risk
A key element in the benefit risk as-sessment of drugs used for prophylaxis of venous thrombo-embolism (VTE) is balancing their antithrombotic effect versus the risk of bleeding.
Arterial thrombo-embolic events (ATE) such as stroke and acute coronary syndromes, are important adverse events following orthopaedic surgery [Lanes 2011]. Secondary combined efficacy and safety endpoints may help to assess the net clinical benefit of new thrombo-prophylactic regimes.
The Cardiovascular Working Party/CHMP recommends revising the Guide-line on Clinical Investigation of Medici-nal Products for Prophylaxis of Intra- and Postoperative Venous Thrombo-embolic Risk.
The revised guideline will include clari-fications to the current definition of major bleeding and assessment, as well as detailed methods for measur-ing blood loss associated with a major bleed and timing for collection of data. The revised guideline is also intended to include a definition of clinically rele-
vant minor bleeding and other secon-dary safety outcomes, functional out-comes and secondary combined effi-cacy and safety endpoints.
Gert LaekemanGert LaekemanGert LaekemanGert Laekeman [email protected]
ReferenceReferenceReferenceReference Lanes S, Fraeman K, Meyers A, Ives JW, Huang HY. Incidence rates for thromboem-bolic, bleeding and hepatic outcomes in patients undergoing hip or knee replace-ment surgery. J Thromb Haemost 2011 ; 9999(2) : 325-32.
Electrolytes and creatinine were ordered Electrolytes and creatinine were ordered Electrolytes and creatinine were ordered Electrolytes and creatinine were ordered for February 23, 2011.for February 23, 2011.for February 23, 2011.for February 23, 2011.
What is the difference between ADL What is the difference between ADL What is the difference between ADL What is the difference between ADL and IADL?and IADL?and IADL?and IADL? Activities of daily living consist of self-care tasks which include: bathing, dress-ing, walking, eating, toilet use, grooming, transferring from bed or chair.
Instrumental activities of daily living in-clude: housework, meal preparation, taking medications, management of money, food or clothes shopping, use of the telephone and traveling via car or public transport.
Should this patient use NoSalt®Should this patient use NoSalt®Should this patient use NoSalt®Should this patient use NoSalt® ---- salt salt salt salt substitute?substitute?substitute?substitute? NoSalt® product contains 650 mg of potassium per ¼ teaspoon (1.3g). This patient is also on ramipril an angiotensin-
converting enzyme inhibitor which can cause hyperkalemia. Also he has a de-crease in his renal function with a calcu-lated creatinine clearance at 20 ml/min. This patient is a risk of hyperkalemia and should not use a salt substitute as part of a low-salt diet.
Is diclofenac emulgel contraindicated in Is diclofenac emulgel contraindicated in Is diclofenac emulgel contraindicated in Is diclofenac emulgel contraindicated in this patient?this patient?this patient?this patient? The use of diclofenac, a non steroidal anti-inflammatory agent, in a patient with congestive heart failure may be associ-ated with an increased risk of fluid accu-mulation and oedema.
Patients with impaired renal function, those taking a diuretic and ACEI and the elderly are at greater risk of renal toxicity. This patient has a decrease in his renal function and had hyperkalemia. He was showing signs and symptoms of conges-
tive heart failure which were well con-trolled before he started to use this topi-cal gel. Diclofenac emulgel is contraindicated in this patient; even though it is used topi-cally, it can systemically be absorbed especially in older patients.
What happened to this patient?What happened to this patient?What happened to this patient?What happened to this patient? Diclofenac emulgel was removed from the patient and paracetamol 500 mg three times a day suggested. A follow-up electrolytes and creatinine were ordered by his physician on February 23, 2011. Results to follow in next newsletter. Clini-cally the patient returned to his baseline.
Upon questioning and looking around, I discovered the NoSalt® product and the Voltaren Emulgel® topical product. The moral to this story: never take for granted that everything is ok.
ESCP SIG GeriatricESCP SIG GeriatricESCP SIG GeriatricESCP SIG Geriatric Answer of the clinical case (Answer of the clinical case (Answer of the clinical case (Answer of the clinical case (page 4).page 4).page 4).page 4).
Patients, Infections and the Clinical PharmacisPatients, Infections and the Clinical PharmacisPatients, Infections and the Clinical PharmacisPatients, Infections and the Clinical Pharmacistttt Leuven, Belgium, 30 May Leuven, Belgium, 30 May Leuven, Belgium, 30 May Leuven, Belgium, 30 May ---- 1st June 2012 1st June 2012 1st June 2012 1st June 2012
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1st April 20121st April 20121st April 20121st April 2012 Registration openRegistration openRegistration openRegistration open
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ESCP Conferences
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41414141thththth ESCP Symposium on Clinical Pharmacy ESCP Symposium on Clinical Pharmacy ESCP Symposium on Clinical Pharmacy ESCP Symposium on Clinical Pharmacy
Personalised and Safe TherapyPersonalised and Safe TherapyPersonalised and Safe TherapyPersonalised and Safe Therapy Barcelona, Spain, 29Barcelona, Spain, 29Barcelona, Spain, 29Barcelona, Spain, 29----31 October, 201231 October, 201231 October, 201231 October, 2012
Scientific CommitteeScientific CommitteeScientific CommitteeScientific Committee Marcel Bouvy (Netherlands) Siska Desplenter (Belgium) Hannes Henlud (Finland) Antonio Idoate (Spain) Anne Leendertse (Netherlands) Eduardo L. Mariño Hernandez (Spain) Pilar Modamio (Spain), Chair Piera Polidori (Italy) Jaume Puig-Junoy (Spain) Maria Skouroliakou (Greece)
Organizing CommitteeOrganizing CommitteeOrganizing CommitteeOrganizing Committee Mercè Barau (Spain) Cecilia Bernsten (Sweden) Borja G. de Bikuña, Spain) Cecilia Fernández (Spain), Chair Erik Gerbrands (Netherlands) José Ibáñez (Spain) Gert Laekeman (Belgium) Anne Leendertse (Netherlands) Eduardo L. Mariño Hernandez (Spain) Mireia Massot (Spain) Cristina Roure (Spain) Inmaculada Torre (Spain)
Organising CommitteeOrganising CommitteeOrganising CommitteeOrganising Committee Siska Desplenter, Belgium Erik Gerbrands, Netherlands Gert Laekeman, Belgium Hugo Robays, Belgium Jenny Vijverman, Belgium Ludo Willems, Belgium
Scientific CommitteeScientific CommitteeScientific CommitteeScientific Committee Siska Desplenter, Belgium Veerle Foulon, Belgium Gert Laekeman, Belgium Piera Polidor, Italy Daniela Scala, Italy Steven Simoens, Belgium Franky Buyle, Belgium Isabel Spriet, Belgium Vera von Gunten, Switzerland
President of the symposium:President of the symposium:President of the symposium:President of the symposium: Prof. Eduardo Luis Mariňo Hernandez (Spain)
Plenary lecturesPlenary lecturesPlenary lecturesPlenary lectures - Opportunistic infections in patients at risk - Therapeutic drug monitoring as a tool in anti-infectious therapy - Resistance in Gram negative infections - Pharmacoeconomic aspects related to vaccinations and infections - Invasive fungal infections in hematologi-cal and pediatric patients) - Vaccination and anti-vaccination - Osteomyelitis as a clinical community pharmacy topic - Cystic fibrosis as a clinical community pharmacy topic - Perspectives in antimicrobial treatment - Infections pharmacists: concept and reality
Interactive sessionsInteractive sessionsInteractive sessionsInteractive sessions - Treatment decisions for resistance of gram negative bacteria - Use of hospital databases on antibiotic prescribing and consumption - Compliance / adherence in long-lasting therapies - Role of the pharmacists in treatment infec-tious diseases - Role of the pharmacists in prevention of infectious diseases - Urinary infections in the community and the hospital - Interactions with antimicrobial agents - Infections in pediatric oncological patients - Breakpoints of resistance - Infections and travelling
ESCP International ESCP International ESCP International ESCP International WorkshopWorkshopWorkshopWorkshop
For Your DiaryFor Your DiaryFor Your DiaryFor Your Diary
ESSSSCP European Society of Clinical PharmacyEuropean Society of Clinical PharmacyEuropean Society of Clinical PharmacyEuropean Society of Clinical Pharmacy
ESCP News ESCP News ESCP News ESCP News is published by ESCP
Editor: Marie Caroline Husson (France)Editor: Marie Caroline Husson (France)Editor: Marie Caroline Husson (France)Editor: Marie Caroline Husson (France) Page Lay-out: Corinne Tollier (France) Language editing: Ian Millar (UK)
The contents of this publication are compiled in good faith. The publisher accepts no responsibility for omissions or errors.
ESCP International OfficeESCP International OfficeESCP International OfficeESCP International Office It Krúswâld Pharmacy - Voorstraat 13 NL-9285 NM Buitenpost - The Netherlands Tel: +31 645 915 831 - Fax : +31 511 543 660 E-mail: [email protected] www.escpweb.org Deadline for the submission of material: for issue number 154 is 15th December 2011.
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Announcements
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2011201120112011
19191919----21 October21 October21 October21 October
Dublin (Ireland)
40th ESCP Symposium on Clinical Pharmacy « Connecting Care and Outcomes »
2012201220122012
30 May30 May30 May30 May----1 June1 June1 June1 June
Leuven (Belgium) International Workshop « Patients, Infections and the Clinical Pharmacist »
29292929----31 October31 October31 October31 October
Barcelona (Spain)
41th ESCP Symposium on Clinical Pharmacy « Personalised and Safe Therapy »
New MembersNew MembersNew MembersNew Members Czech RepublicCzech RepublicCzech RepublicCzech Republic Lucie Hromadkova.......Hradec Králové Ondrej Machotka..........Hradec Králové Hendrychová Tereza ....Hradec Králové
DenmarkDenmarkDenmarkDenmark Lona Christrup...............Copenhagen Hanne Herborg..............Copenhagen
FranceFranceFranceFrance Anne Boyer.....................Clermont Ferrand Charléric Bornet............Marseille Nathalie Cauvin.............Collobrieres Christine Fernandez.....Paris Damien Lannoy.............Lille J-Sébastien Martinez ...Nîmes Mélanie Noll-Burgin......Strasbourg Sonia Prot-Labarthe.....Paris Matthieu Roustit ...........Grenoble D. Schlecht-Bauer.........Tours Xavier Schneider...........Truchtersheim
Julie Serzec....................Paris Nicolas Simon...............Nancy
GermanyGermanyGermanyGermany Silvia Grote.....................München Susanne Schorr............Berlin
HungaryHungaryHungaryHungary Kovacs Ordog Tünde ...Budapest
IndiaIndiaIndiaIndia Prashant Mathur ..........Jaipur
IrelandIrelandIrelandIreland Sharon Byrne ................Naas Ronan Donelan.............Dublin John Fallon.....................Boyle Martin Henman ............Dublin Niamh McMahon .........Dublin Muriel Pate ....................Dublin Noel Stenson.................Achill
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