nl escp 146 v12 - home | escp · cussed drugs most frequently used related to pregnancy associated...

We all believe in Clinical Pharmacy, don’t we? We are all convinced that clinical pharmacy is the way, maybe the only way, to solve the huge and costly medicine related problems that affect health care professionals, patients and society. We all make sure that we have sufficient education and continuing education and visit conferences. We all believe that society loses sight of what patients really need right now, and think that we can help. But are we doing it? It can be quite simple, a here and now approach where clinical pharmacists’ knowledge and skills come to use. Helping patient to become healthier by telling them how to use their medicines in a correct way. In the mean time helping prescribers to improve their practice by providing them with accurate information about medicines and their combined use. Clinical pharmacy does not have to be very fancy. It can be done on hospital wards and in hospital pharmacies, in community pharmacies, in the patient’s home, in homes for elderly, and many other places where medicines are prescribed, handled and used. Clinical pharmacy can indeed mean a world of difference! But, we as clinical pharmacists, must grab all opportunities to do and provide clinical pharmacy as they come along. It is a question of viewing the world with clinical pharmacy spectacles on the tip of our nose. And about sharing and using the vast knowledge that we store in our heads.

How can we as professionals, specialized in clinical pharmacy, contribute best to society? I think by helping to keep patient as healthy as possible and to do it in a way that is safe for all involved. Being safe means not taking unnecessary risks. Patients should not have to experience avoidable adverse drug events just because we, who know how medicines work, are not there or do not intervene when we should. I know; sometimes we hesitate because we are afraid to get into a discussion with the doctor, even though he/she is ignorant or just protective of their turf. We back off, cross our fingers and hope for the best, We leave the drug-related problems to the other professions to solve, second best option. Ok, perhaps not all of us, but too many do this. We feel we do not have the support we need, we do not trust our own knowledge, we lack the self-confidence. But within our professional society, we can share knowledge and do the necessary networking with our peers, and thus get confidence that we need. As professional clinical pharmacists we are the answer to one of society’s major problems, and we must show it! A clinical pharmacists should be wherever medicines are prescribed, dispensed or used. and where medicine information is needed. In the spring of 2010 there will be a Patient Safety conference in Uppsala, Sweden, The focus will be on pharmacy (see www.escp-patientsafe.se). Most patient safety conferences have wider scope and tend to be a bit shallow

when it comes to pharmaceutical aspects in hospital and especially community. This conference (spring workshop) will be different! If you think about it from the patient perspective, a higher level of specialization warrants a better care. As a patient, and knowing what clinical pharmacy means, I would want to have clinical pharmacists involved in all steps of my care, also in community pharmacy. I would want their care, their pharmaceutical care. The conference participants will look at patient safety issues, but also at educational aspects. And the innovative clinical pharmacy developments will be discussed during the ESCP annual symposium in Lyon in the autumn.! I look forward to meeting you at both events.

Cecilia BersteinCecilia BersteinCecilia BersteinCecilia Berstein ESCP vice-president

[email protected]

The tri-monthly newsletter of the European Society

of Clinical Pharmacy News

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 can make a difference!Clinical pharmacists can make a difference!Clinical pharmacists can make a difference!Clinical pharmacists can make a difference!

ContentsContentsContentsContents : A Few words 1 ESCP life 2 Articles & Reports 3 Announcements 8

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Email is a powerful communication me-dium, but it must be used with caution. There are a number of email practices that are undesirable, and cause confusion or an unnecessary workload. Therefore the ESCP has adapted the following guidelines.

Sending an emailSending an emailSending an emailSending an email The subject of an email should always reflect the content. If more topics are ad-dressed in one email, this also should be reflected in the subject line. Copies of an email should only be sent to people who are directly involved. An email should never be longer than 1 A4 in print. Longer messages, discussions, deliberations etc. should be in a .doc at-tachment.

Never conduct real discussions by email. Th is w i l l lead to misun der - standings as you cannot hear voices or see faces or other body-language. If you want a response to an email: insert an indication for that in the subject line. Only ask for confirmation of reading when absolutely necessary.

Responding to an emailResponding to an emailResponding to an emailResponding to an email Responses to an email should still deal with the content of the subject line. If an email on another topic should be compi-led, the subject line should be changed. When responding to a message, only that last part of the discussion should be in the email. All older remarks, responses etc. should be removed. The ‘respond to all’ facility in many email-programs, should be used with great caution. Often it is not necessary to copy a response to a mes-sage to all previous addressees. Be selec-tive in who needs to see the response in the first place.

Larger mailings and mailingLarger mailings and mailingLarger mailings and mailingLarger mailings and mailing----listslistslistslists When sending out mailings to larger groups, the emails of the addressees should be put in the Blind Carbon Copy (BCC) fields. The message addressee should be a general email address that reflects the group at large, i.e. an email to many ESCP members should be send to [email protected], and the real email addresses of the potential recipients should be put in the BCC field. If you have

an email list, always provide the address for unsubscribing from that list. Attachments should never be larger than 1 Mb, unless explicitly accepted and/or re-quired by the addressee.

AttachmentAttachmentAttachmentAttachmentssss Better safe than sorry: save important attachments immediately into the appro-priate folder on your computer or network. You can always find it back. Take care when forwarding messages: attachments will be forwarded as well. This is not always necessary For the time being, do not send the newer office files as attachments (docx, pptx etc.). Not everyone can open them, although there now are conversion programs for the older MS Office versions. Some systems do not accept files with certain extensions (MS Access files are usually not accepted by Outlook). If necessary, change the extension to ano-ther extension while informing the addressee.

Erik GerbrandsErik GerbrandsErik GerbrandsErik Gerbrands [email protected]

ESCP guidelines on Good Email Practice ESCP guidelines on Good Email Practice ESCP guidelines on Good Email Practice ESCP guidelines on Good Email Practice (GEP guidelines) (GEP guidelines) (GEP guidelines) (GEP guidelines)

Changes in the composition of the General CommitteeChanges in the composition of the General CommitteeChanges in the composition of the General CommitteeChanges in the composition of the General Committee After the change of Art.11.2: the General Committee (GC) proposed to extend the term in office for Pat Murray for 1 more year and of Johnny Beney, Marie-Caroline Husson and Maria Skouroliakou for 2 more years.

The General Assembly (GA) approved of these extensions of term for the said mem-bers of the GC. Gert Laekeman (Belgium) and Erik Ger-brands (Netherlands) have come to the

en d o f th e i r terms as G C- members. The GA was informed of that new members have been elected from these two countries. Siska Desplenter will represent Belgium and Anne Leendertse will represent The Netherlands.

Gert Laekeman and Erik Gerbrands are thanked for all the work they did for ESCP during their term in Office. Erik Gerbrands is appointed by the GC to

be Director of the International Office.

Introduction of new Secretary and Trea-surer: the GA was informed of that John-ny Beney is appointed by the GC as inte-rim Secretary-Treasurer until the GC-meeting in Uppsala, 9 May 2010.

During the interim period a task force is to delineate the responsibilities and tasks of these two Offices along with the Offices of President and Vice President, and the International Office.

ESCP SIG GeriatricESCP SIG GeriatricESCP SIG GeriatricESCP SIG Geriatric Question 1: Question 1: Question 1: Question 1: Which of the following condition is not consi-dered to be a « geriatric syndrome »? a. Delirium b. Falls c. Dizziness d. Hypothyroidism e. Urinary incontinence

AnswerAnswerAnswerAnswer d. The term « geriatric syndrome » is used in the geriatric literature to capture clinical conditions that are associated to older persons. These conditions include: falls, delirium, dizzi-ness, orthostatic hypotension, urinary inconti-nence, weight loss, anorexia.

Question 2: Question 2: Question 2: Question 2: Any symptom in an elderly patient should be considered a side effect to a drug unless proven otherwise. a. True b. False

AnswerAnswerAnswerAnswer: : : : True. Elderly patients are more at risk to develop side effects to drugs. A prescrip-tion cascade can be observed. This is a process whereby the side effect of a drug is misdiagnosed as a symptom and a new drug is being prescribed.

Question 3: Question 3: Question 3: Question 3: You receive a call from Mrs. P.’s family physi-cian. He has just been at a conference, which presented a lecture on anticholinergic load. His patient is taking the following drugs: - Amlodipine 5 mg daily - Levothyroxine 0.05 mg daily - Amitriptyline 25 mg at bedtime - Oxybutynine 5 mg three times daily - Lactulose 15 ml twice daily as needed for constipation He would like to know what is the anticholi-nergic load for this patient? a. 3 b. 6 c. 9 d. 12 AnswerAnswerAnswerAnswer: : : : 2. The anticholinergic load repre-sents the cumulative effect of taking multiple medications with anticholinergic properties. Some authors have developed an anticholi-nergic drug scale. The rating is defined as follows : level 0 = no known anticholinergic properties; level 1 = potentially anticholinergic as evidenced by receptor binding studies; level 2 = anticholi-nergic adverse events sometimes noted,

usually at excessive doses; and level 3 = markedly anticholinergic. For this patient, she is taking amitryptyline and oxybutynine which are level 3 each- so 6 points for the anticholi-nergic load.

Question 4: Question 4: Question 4: Question 4: Which one of these factors does not have an influence on the anticholinergic load? a. Integrity of the blood brain barrier b. Multiple medications with anticholinergic effects c. Changes in renal function d. Diarrhea

AnswerAnswerAnswerAnswer: : : : d. All of these factors have been shown to influence the anticholinergic load. Changes in the blood-brain barrier have been reported with aging that may influence the entry of medications with anticholinergic properties. Multiple medications and chan-ges in pharmacokinetics properties in geria-tric patients can also influence the anticholi-nergic load.

Louise MalletLouise MalletLouise MalletLouise Mallet [email protected]

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WS 1: Drugs in Pregnancy and Lactation WS 1: Drugs in Pregnancy and Lactation WS 1: Drugs in Pregnancy and Lactation WS 1: Drugs in Pregnancy and Lactation Ursula von Mandach, SwitzerlandUrsula von Mandach, SwitzerlandUrsula von Mandach, SwitzerlandUrsula von Mandach, Switzerland During this workshop participants have dis-cussed drugs most frequently used related to pregnancy associated complaints. During this discussion problems around these drugs have been looked at, and the role of pharma-cogenetics of drugs in breast feeding. In smaller groups, the participants have actively drawed up and discussed a list of potential harmful drugs for the baby.

WS 2: Measuring and Improving Medication WS 2: Measuring and Improving Medication WS 2: Measuring and Improving Medication WS 2: Measuring and Improving Medication Compliance Compliance Compliance Compliance MarieMarieMarieMarie----Paul Schneider, Switzerland, Paul Schneider, Switzerland, Paul Schneider, Switzerland, Paul Schneider, Switzerland, Marcel Bouvy, Netherlands, Marcel Bouvy, Netherlands, Marcel Bouvy, Netherlands, Marcel Bouvy, Netherlands, Sarah Clifford, United KingdomSarah Clifford, United KingdomSarah Clifford, United KingdomSarah Clifford, United Kingdom The workshop has given an overview of metho-dology used to measure medication compliance including patient self-report, pharmacy dispen-sing data and electronic measurements. More-over possible causes of non adherence have been discussed. The participants have worked on cases to calculate compliance from medica-tion record and have learned how to discuss possible non-compliance with patients.

WS 3: Learning together WS 3: Learning together WS 3: Learning together WS 3: Learning together –––– Models of Inter Models of Inter Models of Inter Models of Inter----professional Education professional Education professional Education professional Education Moira Kinnear, United Kingdom, Moira Kinnear, United Kingdom, Moira Kinnear, United Kingdom, Moira Kinnear, United Kingdom, Ann Snyder, USA, Ann Snyder, USA, Ann Snyder, USA, Ann Snyder, USA, Dick Toering, NetherlandsDick Toering, NetherlandsDick Toering, NetherlandsDick Toering, Netherlands Interprofessional education (IPE) has been defined as “occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (CAIPE 2002). IPE was developing in many European countries (www.eipen.org) with and without Pharmacy integration. The aim of this workshop was to share examples from established IPE programmes and to encourage participants to consider the ac-tions they could take in their own institutions to explore opportunities for IPE. This was a workshop of the ESCP Education & Training SIG and the Education Committee.

WS 4: Indicators for Quality and Safety of WS 4: Indicators for Quality and Safety of WS 4: Indicators for Quality and Safety of WS 4: Indicators for Quality and Safety of Pharmaceutical CarePharmaceutical CarePharmaceutical CarePharmaceutical Care Darren Ashcroft, United Kingdom, Darren Ashcroft, United Kingdom, Darren Ashcroft, United Kingdom, Darren Ashcroft, United Kingdom, Peter Noyce, United Kingdom, Peter Noyce, United Kingdom, Peter Noyce, United Kingdom, Peter Noyce, United Kingdom, Marcel Bouvy, NetherlandsMarcel Bouvy, NetherlandsMarcel Bouvy, NetherlandsMarcel Bouvy, Netherlands Indicators are measurable elements of care that give an indication of the quality or safety of the care provided to patients. Indicators can serve different purposes, such as impro-ving the transparency of care and generating signals for providers of care for areas that need improvement. The workshop has given an overview of basic concepts regarding the use and development of indicators for quality and safety of care in clinical pharmacy. Me-thodological issues in indicator development, use and interpretation have been discussed. Two indicators sets developed in the Nether-lands and the United Kingdom have been presented.

WS 5: Examining Safety Climate and Culture WS 5: Examining Safety Climate and Culture WS 5: Examining Safety Climate and Culture WS 5: Examining Safety Climate and Culture in Pharmacy Settings in Pharmacy Settings in Pharmacy Settings in Pharmacy Settings Darren Ashcroft, United Kingdom, Darren Ashcroft, United Kingdom, Darren Ashcroft, United Kingdom, Darren Ashcroft, United Kingdom, Peter Noyce, United Kingdom, Peter Noyce, United Kingdom, Peter Noyce, United Kingdom, Peter Noyce, United Kingdom, Marcel Bouvy, NetherlandsMarcel Bouvy, NetherlandsMarcel Bouvy, NetherlandsMarcel Bouvy, Netherlands International efforts to improve patient safety have increasingly recommended that health-care organizations should consider adopting safety management techniques used in other high risk industries. This workshop has provided participants with an overview on the use of safety climate tools in healthcare set-tings. Two safety culture/climate tools desi-gned specifically for use in pharmacy settings have been presented. Participants were also the opportunity to complete a self-assessment framework to characterize the prevailing safety culture within their own pharmacies.

WS 6: Substance Abuse in the Elderly: Is it a WS 6: Substance Abuse in the Elderly: Is it a WS 6: Substance Abuse in the Elderly: Is it a WS 6: Substance Abuse in the Elderly: Is it a Problem?Problem?Problem?Problem? Louise Mallet, Canada, Louise Mallet, Canada, Louise Mallet, Canada, Louise Mallet, Canada, Bertrand Guignard, SwitzerlandBertrand Guignard, SwitzerlandBertrand Guignard, SwitzerlandBertrand Guignard, Switzerland Misuse and abuse of legal and illegal drugs is becoming an important problem in the elder-ly. The overall prevalence of drug abuse in older individual is difficult to evaluate; up to 11% of older women misuse and abuse prescription drugs. Usage of benzodiazepines and alcohol is increasing in our elderly popu-lation. It is also reported that the “baby boo-mers” will be using illegal drugs such as co-caine, LSD, heroin. The goal of this workshop was to provide pharmacists with a geriatric approach to discontinue benzodiazepines and alcohol in this special population. This was a workshop of the ESCP-SIG Geriatrics.

WS 7: EvidenceWS 7: EvidenceWS 7: EvidenceWS 7: Evidence----Based Medicine: How do we Based Medicine: How do we Based Medicine: How do we Based Medicine: How do we Apply Literature Data to a Geriatric PopulationApply Literature Data to a Geriatric PopulationApply Literature Data to a Geriatric PopulationApply Literature Data to a Geriatric Population Yolande Hanssens, Qatar/Belgium, Yolande Hanssens, Qatar/Belgium, Yolande Hanssens, Qatar/Belgium, Yolande Hanssens, Qatar/Belgium, Louise Mallet, CanadaLouise Mallet, CanadaLouise Mallet, CanadaLouise Mallet, Canada This year, the leaders of SIG Geriatrics and SIG Medicine Information have joined forces to organize this workshop. Our main objecti-ves was for participants to: - Appreciate EBM related to geriatric patients; - Understand how to evaluate a research article using a systematic approach; - Complete a critical appraisal for an article on hypertension; - Apply critically appraised evidence to geria-tric patients – pro’s & con’s. About 60 attendees participated. The motiva-tion and enthusiasm of both groups have been a pleasure for us to run the workshop twice. A short introduction has provided stan-dard definitions of EBM and a summary of some studies in geriatric patients. A brief overview of risks and benefits about drug usage (under-usage and over-usage) in elder-ly patients was also given. Then the partici-pants were divided into 4 groups to critically evaluate a major study published by Beckett NS et al. in New England Journal of Medicine (NEJM) in 2008: “HYVET Study Group: Treat-

ment of hypertension in patients 80 years of age or older”. Over 25 questions were addressed and the feedback of each of the groups was discus-sed. Strengths and weaknesses of the study were listed as well as unanswered questions. Everybody have been surprised that even studies published in journals such as NEJM were not that perfect. The workshop was concluded with 2 short case studies and some “take home messa-ges”. We both enjoyed preparing this session with plenty of transatlantic email messages. We have thanked all the participants for joining us and sharing their views about drug usage in elderly patients. The slides have been posted on the ESCP website.

WS 8: Pharmacoeconomics: The Good, the WS 8: Pharmacoeconomics: The Good, the WS 8: Pharmacoeconomics: The Good, the WS 8: Pharmacoeconomics: The Good, the Bad and the Ugly Bad and the Ugly Bad and the Ugly Bad and the Ugly ---- A Practical Approach to A Practical Approach to A Practical Approach to A Practical Approach to Assessing the Literature Assessing the Literature Assessing the Literature Assessing the Literature KatherineKatherineKatherineKatherine Lyseng Lyseng Lyseng Lyseng----Williamson, New Zealand, Williamson, New Zealand, Williamson, New Zealand, Williamson, New Zealand, Keith Evans, United KingdomKeith Evans, United KingdomKeith Evans, United KingdomKeith Evans, United Kingdom The cost, and cost effectiveness, of pharma-cological and other therapies play an increa-singly important part in the selection of appro-priate care by health care providers and poli-cy makers. Pharmacoeconomic studies at-tempt to assess cost and clinical benefits of alternative healthcare interventions to pro-vide a decision-making framework; they should not be about reducing costs, but should be about maximising net benefits. The workshop has defined basic pharmaco-economic terms, the key factors necessary for a ‘good’ pharmacoeconomic analysis, and has presented a simple scoring system ba-sed on this factors. The scoring system has been used in the small group setting to ana-lyse two published pharmacoeconomic analy-ses.

WS 9: InterWS 9: InterWS 9: InterWS 9: Inter----Professional Training: The Professional Training: The Professional Training: The Professional Training: The Importance of Clinical Rounds in Clinical Importance of Clinical Rounds in Clinical Importance of Clinical Rounds in Clinical Importance of Clinical Rounds in Clinical Pharmacy EducationPharmacy EducationPharmacy EducationPharmacy Education Fikret Vehbi Izzettin, Turkey, Fikret Vehbi Izzettin, Turkey, Fikret Vehbi Izzettin, Turkey, Fikret Vehbi Izzettin, Turkey, Steve Hudson, United Kingdom, Steve Hudson, United Kingdom, Steve Hudson, United Kingdom, Steve Hudson, United Kingdom, Mesut Sancar, TurkeyMesut Sancar, TurkeyMesut Sancar, TurkeyMesut Sancar, Turkey The clinical and practice-based educa-tion has a major role in the pharmacy education. Introducing clinical rotations (rounds) to pharmacy education helps the pharmacist for a better professional life in the future. By increasing the expo-sure of pharmacist or pharmacy stu-dents to patients and medical team in their education, there will be an increa-sed understanding of patients, their diseases and drug therapy and it will enhance communication skills. The aim of this workshop has been to discuss the clinical practice based education in me-dical teams for the clinical pharmacists and its importance in the pharmacy education. It may also help to clarify the roles of the different participants in such clinical rotations. …/…

ESCP/GSASA ESCP/GSASA ESCP/GSASA ESCP/GSASA ---- 38th symposium 38th symposium 38th symposium 38th symposium on clinical Pharmacy on clinical Pharmacy on clinical Pharmacy on clinical Pharmacy

Geneva, Switzerland, 3Geneva, Switzerland, 3Geneva, Switzerland, 3Geneva, Switzerland, 3----6 November 2009 6 November 2009 6 November 2009 6 November 2009

Workshops abstracts in GenevaWorkshops abstracts in GenevaWorkshops abstracts in GenevaWorkshops abstracts in Geneva

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Workshops abstracts in Geneva Workshops abstracts in Geneva Workshops abstracts in Geneva Workshops abstracts in Geneva (continued)(continued)(continued)(continued)

WS 10: Access to Cancer Treatment in WS 10: Access to Cancer Treatment in WS 10: Access to Cancer Treatment in WS 10: Access to Cancer Treatment in Europe: Different Remedies for the Europe: Different Remedies for the Europe: Different Remedies for the Europe: Different Remedies for the Shared Issues Shared Issues Shared Issues Shared Issues Benoît Allenet, France, Benoît Allenet, France, Benoît Allenet, France, Benoît Allenet, France, Mikaël Daouphars, FranceMikaël Daouphars, FranceMikaël Daouphars, FranceMikaël Daouphars, France In recent years, rising prices and gro-wing expenditures on oncology drugs have caused significant concern among payers, healthcare providers and patients. Across Europe, health-care payers are confronted by the chal-lenges of scarce resource in the face of almost infinite demands. Despite budgetary constraints, there is tre-mendous political pressure to have new drugs licensed and made availa-ble to patients. Health-care systems have had to become more sophistica-ted to deal with this challenge. Partici-pants have discussed issues in rela-tion with these increasing costs and demands in the field of (especially) oncology from a European perspective. The formation of a network has been stimulated. This was a workshop of the ESCP-SIGs Cancer Care and Pharma-coeconomics.

WS 11: Clinical Community Pharmacy WS 11: Clinical Community Pharmacy WS 11: Clinical Community Pharmacy WS 11: Clinical Community Pharmacy and Trial Development and Trial Development and Trial Development and Trial Development Caroline Steensels, Belgium, Caroline Steensels, Belgium, Caroline Steensels, Belgium, Caroline Steensels, Belgium, Gert Laekeman, BelgiumGert Laekeman, BelgiumGert Laekeman, BelgiumGert Laekeman, Belgium Based on the real world data and ex-periences of a clinical trial imposed by the Belgian Medicines Board (the Sinu-tab trial), the participants have discu-sed the difficulties of implementing a clinical trial in community pharmacy practice. The mentioned trial was eventually achieved after five years. The unhappy events, adverse opinions and structural objections have been discussed. There has been a purpose of exchange coordinates at the end of the workshop in order to create a fo-rum for planning and conducting clini-cal trials in community pharmacies and reporting about the results during ESCP conferences.

WS 12: Successful Scientific Writing: WS 12: Successful Scientific Writing: WS 12: Successful Scientific Writing: WS 12: Successful Scientific Writing: Original Research PapersOriginal Research PapersOriginal Research PapersOriginal Research Papers Foppe van Mil, Netherlands and TBAFoppe van Mil, Netherlands and TBAFoppe van Mil, Netherlands and TBAFoppe van Mil, Netherlands and TBA The results of scientific research are only valuable for society, if they can be shared with others in an under-standable written or oral format. Wri-ting research papers that can be ac-cepted by a peer reviewed journal, can be a challenging experience. But there are a number of important aspects that authors can pay attention to, and that will facilitate acceptance. This workshop has been especially focus on scientific articles in the format for

Pharmacy World & Science but most other scientific journals have similar required formats. After an introduc-tion, the participants have studied and discussed examples of the different stages of scientific papers in smaller groups. This was a workshop of the ESCP Communication Committee.

WS 13: Successful Scientific Writing: WS 13: Successful Scientific Writing: WS 13: Successful Scientific Writing: WS 13: Successful Scientific Writing: Getting Abstracts AcceptedGetting Abstracts AcceptedGetting Abstracts AcceptedGetting Abstracts Accepted Foppe van Mil, Netherlands and TBAFoppe van Mil, Netherlands and TBAFoppe van Mil, Netherlands and TBAFoppe van Mil, Netherlands and TBA There are several possible formats for written information such as abstracts or scientific articles. Writing a good abstract is important because it can lead to having an oral presentation at a conference. There are also many reasons why abstracts are not accepted for a scientific conference. Apart from writing a condensed text that represents the study well, there are a num-ber of other important aspects that will facilitate acceptance. This workshop focu-sed on abstracts, such as expected by the ESCP. But it has also discussed more ge-neral and ethical considerations about submitting abstracts, such as authorships and responsibilities. This was a workshop of the ESCP Communication Committee.

WS 14: The Role of Clinical Pharma-WS 14: The Role of Clinical Pharma-WS 14: The Role of Clinical Pharma-WS 14: The Role of Clinical Pharma-cists in Counselling and Preventing cists in Counselling and Preventing cists in Counselling and Preventing cists in Counselling and Preventing Cardiovascular DiseaseCardiovascular DiseaseCardiovascular DiseaseCardiovascular Disease Daniela Scala, Italy, Daniela Scala, Italy, Daniela Scala, Italy, Daniela Scala, Italy, Piera Polidori, Italy, Piera Polidori, Italy, Piera Polidori, Italy, Piera Polidori, Italy, Alessio Provenzani, Italy, Alessio Provenzani, Italy, Alessio Provenzani, Italy, Alessio Provenzani, Italy, Barbara Andria, ItalyBarbara Andria, ItalyBarbara Andria, ItalyBarbara Andria, Italy Cardiovascular Disease (CVD) is the major cause of premature death in Europe. It is an important cause of disability and contributes to the esca-lating costs of health care. The under-lying atherosclerosis develops insidiou-sly over many years. Death from CVD often occurs suddenly and before me-dical care is available. The occurrence of CVD relates strongly to lifestyle and to modifiable physiological and bioche-mical factors. Risk factor modifications have been shown to reduce CVD mor-tality and morbidity. The purpose of this workshop was to increase the awareness of pharmacist-patient‘s relationship in order to make pharma-cist’s clinical intervention more effec-tive and efficient in the prevention of CVDs.

WS 15: Research Techniques: Inter-WS 15: Research Techniques: Inter-WS 15: Research Techniques: Inter-WS 15: Research Techniques: Inter-views and Focus Groups for Beginners views and Focus Groups for Beginners views and Focus Groups for Beginners views and Focus Groups for Beginners Mara P Guerreiro, PortugalMara P Guerreiro, PortugalMara P Guerreiro, PortugalMara P Guerreiro, Portugal In recent years there has been greater acceptance and recognition of the value of qualitative research, either alone or combined with quantitative techniques. Yet, practicing pharma-

cists undertaken small-scale research and junior researchers face someti-mes difficulties in designing and conducting studies using qualitative techniques; often they get also dis-heartened by data analysis. This workshop has focused on two techniques commonly used in pharma-cy research: focus groups and inter-views. Examples of the use of these techniques have been discussed, as well as advantages and limitations. The workshop has also provided prac-tical advice on sampling, data collec-tion and data analysis. This was a workshop of the ESCP Research Com-mittee.

WS 16: A HandsWS 16: A HandsWS 16: A HandsWS 16: A Hands----on Approach to Medi-on Approach to Medi-on Approach to Medi-on Approach to Medi-cation Reviewcation Reviewcation Reviewcation Review Nina Griese, Germany, Nina Griese, Germany, Nina Griese, Germany, Nina Griese, Germany, Kurt Hersberger, SwitzerlandKurt Hersberger, SwitzerlandKurt Hersberger, SwitzerlandKurt Hersberger, Switzerland The workshop was a mixture of a lec-ture and hands-on exercises with me-dication profiles and medication re-view. Different approaches to medica-tion review were presented, together with the circumstances under which they can be useful. Three cases have been discussed. After the workshop, participants have been able to understand the different forms of medication review, and under what circumstances they could be useful in clinical practice. This was a workshop of the Pharmaceutical Care Network Europe.

W S 1 7 : P h a r m a c o k i n e t i c /W S 1 7 : P h a r m a c o k i n e t i c /W S 1 7 : P h a r m a c o k i n e t i c /W S 1 7 : P h a r m a c o k i n e t i c /Pharmacodynamic (Pk/Pd) Indices on Pharmacodynamic (Pk/Pd) Indices on Pharmacodynamic (Pk/Pd) Indices on Pharmacodynamic (Pk/Pd) Indices on Antimicrobial Therapy. Impact and Antimicrobial Therapy. Impact and Antimicrobial Therapy. Impact and Antimicrobial Therapy. Impact and Influence on Clinical Practice Influence on Clinical Practice Influence on Clinical Practice Influence on Clinical Practice Dolores Soy, SpainDolores Soy, SpainDolores Soy, SpainDolores Soy, Spain Pharmacokinetic (PK) and pharmaco-dynamic (PD) have characterized both influence dosing regimens of antimi-crobials. PK (the overall disposition of the drug in the body) is reflected by the serum concentration profile over time. PD can be characterized by the susceptibility of the pathogen to the drug, determined by measuring the minimum inhibitory concentration (MIC), which is a potency of the drug. Participants have discussed about increasing need to identify new thera-peutic approaches which could im-prove the chance to reduce the mor-bidity and obtain successful outcomes, based on a relatively new approach integrating PK and PD features has been suggested to implement optimal antibiotic dosing regimens. This was a workshop of the ESCP-SIG Pharmaco-kinetics.

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Plenary SessionsPlenary SessionsPlenary SessionsPlenary Sessions: : : : a wealth of experiences in Clinical Pharmacya wealth of experiences in Clinical Pharmacya wealth of experiences in Clinical Pharmacya wealth of experiences in Clinical Pharmacy

Clinical pharmacy means by definition a close collaboration with other health care givers. However, understanding what are the expectations of each pro-fessional category is crucial to imple-ment a successful activity. The goal of this session was to discuss what works and what does not work in the imple-mentation of clinical pharmacy servi-

ces. After a general overview of the topic, two examples, one on stroke and the other one on kidney transplan-tation, have been presented jointly by a physician and a pharmacist.

Introduction to Multidisciplinary care Jon Merrills, United Kingdom

Interdisciplinary perspecti-ves on stroke treatment Anne Kinnear, United Kingdom, Gillian Mead, United Kingdom Interdisciplinary perspecti-ves on kidney transplant Anna Carollo, Italy, Ma-nuel Pascual, Switzerland

Plenary session IA: Plenary session IA: Plenary session IA: Plenary session IA: Interdisciplinary CooperationInterdisciplinary CooperationInterdisciplinary CooperationInterdisciplinary Cooperation

Chair: Pierre Voirol, SwitzerlandChair: Pierre Voirol, SwitzerlandChair: Pierre Voirol, SwitzerlandChair: Pierre Voirol, Switzerland

How the drug industry wants to become more ethical Richard Bergström, Sweden

The Scottish Medical Consortium and How it works

Angela Timoney, United Kingdom

Dealing with prescribing ethics and conflict of interest Samia Hurst, Switzerland

Drugs and Therapeutics committee (DTC) is a key place in hospitals as it define the whole drug policy for the institution. Its

decisions have therefore important clinical and economical consequences for the health care givers, hospital administration and phar-maceutical industries. The choices of DTCs have to be rational and ethical. During the session, we have discussed how DTC could deal with ethics and conflicts of interest.

Plenary session IB: Plenary session IB: Plenary session IB: Plenary session IB: Multidisciplinary Cooperation in Drugs & Therapeutics CommitteesMultidisciplinary Cooperation in Drugs & Therapeutics CommitteesMultidisciplinary Cooperation in Drugs & Therapeutics CommitteesMultidisciplinary Cooperation in Drugs & Therapeutics Committees

Chair: Pascal Bonnabry, SwitzerlandChair: Pascal Bonnabry, SwitzerlandChair: Pascal Bonnabry, SwitzerlandChair: Pascal Bonnabry, Switzerland

Efficient multidisciplinary collaborations have been developed by community pharmacists in different countries and in different ways. They however all share the same goal: increasing the quality (effectiveness, safety and efficiency) of pharmacotherapy in ambulatory care settings. During this session, three mo-

dels have been presented, one in Swit-zerland, one in Portugal and one in the Netherlands. The facilitators and barriers encountered in the implementation of each one have been discussed.

Quality Circles in Switzerland Olivier Bugnon, Switzerland

The family pharmacy in Portugal Suzete Costa, Portugal

Pharmacotherapeutic consulta-tion in the Netherlands Ruud Coolen van Brakel, Nether-lands

Plenary Session 1C: Plenary Session 1C: Plenary Session 1C: Plenary Session 1C: Multidisciplinary Cooperation in Community PharmacyMultidisciplinary Cooperation in Community PharmacyMultidisciplinary Cooperation in Community PharmacyMultidisciplinary Cooperation in Community Pharmacy Chair: Olivier Bugnon, SwitzerlandChair: Olivier Bugnon, SwitzerlandChair: Olivier Bugnon, SwitzerlandChair: Olivier Bugnon, Switzerland

Communicating risks to patients Dieter Conen, Switzerland (see the report page 6)

Communicating with patients about medication adherence

Sarah Clifford, United Kingdom

Opioids for postpartal analgesia and the breastfed neonate – How clinical pharmacists commu-nicate about pharmacogenomics Ursula von Mandach, Switzerland

Clinical pharmacy means by definition a close collaboration with other health care givers and with the patients. Com-municating with patients is crucial to

optimize their treatments. The goal of this session was to discuss how commu-nicating risks to patients, and how im-proving the medication adherence. The examples of opioids for postpartal anal-gesia and the breastfed neonate have been presented. How clinical pharma-cists could communicate about pharma-cogenomic has been discussed.

Plenary session 2A: Plenary session 2A: Plenary session 2A: Plenary session 2A: Talking to patients about pharmacoTalking to patients about pharmacoTalking to patients about pharmacoTalking to patients about pharmaco----therapytherapytherapytherapy

Chair: Marcel Bouvy, The NetherlandsChair: Marcel Bouvy, The NetherlandsChair: Marcel Bouvy, The NetherlandsChair: Marcel Bouvy, The Netherlands

Most of recently released oral anticancer drugs inhibit tyrosine kinases of growth factor receptors which pathways have been de-monstrated to be involved in disease progres-sion and/or dissemination. These so-called ‘targeted therapies’ challenge oncology phar-macists’ knowledge and practice for many reasons: - understanding their mechanism of action requires a good knowledge of cellular path-ways involved in carcinogenesis and apopto-sis, - their side-effects, though usually not life-threatening, have a high potential to impair

patient’s quality of life (e.g. extensive skin reactions). Learning how to manage these side-effects, both in hospital and community settings, is therefore paramount for oncology pharmacists, - patients may encounter adherence diffi-culties, especially if facing side-effects at home, - metabolism mainly occur through CYP450 isoenzymes, leading to many potential drug-drug interactions, particularly in elderly pa-tients. Oncology pharmacists may play a crucial role in patient education and informa-tion, by managing side-effects, by improving

patients’ adherence to treatments, and by performing medications reviews to identify potential drug – drug interactions.

Oral Targeted Therapies: Rationale and Overview of

Cellular Mechanisms Robert Terkola, Austria

Drug-drug interactions and oral targeted therapies Alain Astier, France

Adhesion issues with oral

targeted therapies Mikaël Daouphar, France

Plenary session 2B: Plenary session 2B: Plenary session 2B: Plenary session 2B: Oral Targeted Therapies: From the Cell to Patient Compliance joint ESCPOral Targeted Therapies: From the Cell to Patient Compliance joint ESCPOral Targeted Therapies: From the Cell to Patient Compliance joint ESCPOral Targeted Therapies: From the Cell to Patient Compliance joint ESCP----ESOP Plenary SessionESOP Plenary SessionESOP Plenary SessionESOP Plenary Session Chair: Mikaël Daouphars, France, Klaus Meier, GermanyChair: Mikaël Daouphars, France, Klaus Meier, GermanyChair: Mikaël Daouphars, France, Klaus Meier, GermanyChair: Mikaël Daouphars, France, Klaus Meier, Germany

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Implementing a drug information Implementing a drug information Implementing a drug information Implementing a drug information system with CPOE in a hospital system with CPOE in a hospital system with CPOE in a hospital system with CPOE in a hospital and its impact on patient care and its impact on patient care and its impact on patient care and its impact on patient care Walter Haefeli, GermanyWalter Haefeli, GermanyWalter Haefeli, GermanyWalter Haefeli, Germany

The occurrence of medi-cations errors is a major challenge in current drug therapy leading to inap-propriate drug exposure of the patients and sub-sequently avoidable adverse drug reactions and non-response.

Among the most frequent errors are dosing errors many of which are caused by ignoring elimination organ dysfunction (often renal

failure), combination therapy (drug interac-tions, incompatibilities), or combinations of several factors modifying drug clearance.

Drug treatment is thus error-prone and its quality assurance of cumbersome because of the complexity of current therapies with often large numbers of co-administered drugs (polypharmacy) targeting different diseases (co-morbidity). Computerised physi-cian order entry (CPOE) is a prerequisite for structured drug prescription and thus an essential component for clinical decision support (CDS) in pharmacotherapy. Interlinked in such a way CPOE-CDS systems may prevent, intercept, and detect errors. However, to make them efficient and user-friendly they should fulfil a number of criteria

(e.g. error-tolerant search, integration into prescription process, continuous availability, high-quality content).

Moreover, they should be validated in daily routine to minimise over-alerting and pre-clude error generation by the technology itself. If built in such a way such systems may reduce medication errors rather efficiently and sophisticated algorithms may help reduc-ing over-alerting by roughly 50%.

Thorough analysis of CPOE-CDS implementa-tion and usage also revealed that such sys-tems are frequently consulted as mere infor-mation systems and thus need to be availa-ble also independent of drug prescription for specific patients.

Communicating risks to patientsCommunicating risks to patientsCommunicating risks to patientsCommunicating risks to patients Dieter Conen, SwitzerlandDieter Conen, SwitzerlandDieter Conen, SwitzerlandDieter Conen, Switzerland

Effective communication of diagnostic and thera-peutic risks is important to enable patients to make informed decisions The perception of accep-table risks will vary de-pending on communica-tion and information available to the patient,

the severity, consequences for quality of life and probable outcome of their medical condi-tion, the economy of their country and the choices available to them. Risk has two main components one is that of chance, the pure statistical likelihood that an event will happen (probability). The other is that of a bad out-come – danger, injury, harm, or loss together with an indication of severity. Before a deci-sion is made to use an intervention, its ben-efits and harms must be weighed, ideally by the clinician and the patient together. Clini-cians should identify how much benefits matter to their patient. Patient safety is a priority in modern health care systems. From 3% to 17% of hospital admissions result in an adverse event and almost 30% to 50% of these events are considered preventable.

Why bother communication with the pa-tients? In 2005 the European Commission published the European barometer sho-wing that 47% of Europeans likely conside-red to experience a medical error during hospital stay and 23% suffered a medical error. Although much of the communica-tion in the physician-patient interactions necessarily involves information sharing about diagnosis and therapeutic options, most physicians will recognize that these encounters also involve the patient’s search for a psychosocial healing “con-nexion” or therapeutic relationship. In indi-vidual studies effective communication skills have been correlated to such positive outcomes as adherence to therapy, under-standing of treatment risks and even to a reduced risk of medical mishaps. How to communicate with Patients?

Before providing information find out what a patient knows about his or her condition. Not all patients with the same diagnosis want the same load of details in infor-mation, therefore assess what the patient wants to know. The first step in presenting information is to describe the risks and the benefits of a procedure. To present out-comes as natural frequencies (for example “a one in five chance”) is much easier to understand than information expressed in

probabilities (for ex. “a 20% chance”). Statements should be short and explana-tions clear. It is important to be truthful, euphemisms may soften the delivery of sad information but can extremely mislea-ding and create confusion. Be prepared for a reaction und allow sufficient for a full display of emotions. Taking into account that we are still lacking reliable information on harms; far less research is done to investigate them.

A Checklist for clinicians of points which should be discussed: When an adverse effect occurs, should the dose be reduced, or the drug changed? If reduced, how much? Is reducing the dose possible and practicable with the available prepara-tions? How and over what time should the effect of the change be observed and as-sessed? Should the patient, as well as the clinician, keep the records of adverse ef-fects and their intensity and timing? The patient-physician dialogue is not finished after discussing the diagnosis, tests and treatments. For the patient, this is just the beginning; the news is sinking in. The phy-sician should anticipate a shift in the pa-tient’s sense of self, which should be han-dled as an important part of the encounter – not as an unpleasant plot twist to a phy-sician’s story line.

Focus on two lecturesFocus on two lecturesFocus on two lecturesFocus on two lectures



Plenary sessions Plenary sessions Plenary sessions Plenary sessions (continued)(continued)(continued)(continued)

The use of technological innovations and a systems approach can positively influence the provision of medical and pharmaceutical services. Electronic patient records, computerized physician order entry (CPOE) preferably linked to computerised decision support (CDS) systems, automated calculation of doses and dilutions, bar coding, automated dispensing machines, robotics and other automated processes aim at higher precision and lower

error rates, thereby pharmacists can increase their oversight of critical processes during prescription preparation, dispensing and patient care. For inpatient and ambulatory settings the questions are: Does technology improve patient safety and care? What is the impact for clinical pharmacy practice? This session has addressed different applications of inno-vative technologies and experiences from different countries.

Implementing a drug information system with CPOE in a hospital and its impact on patient care Walter Haefeli, Germany (see below)

E-prescription: beneficial for all stakeholders?

Gunnel Bridell, Sweden

A national electronic patient dossier in the Netherlands Foppe van Mil, Netherlands

Plenary session 3Plenary session 3Plenary session 3Plenary session 3: : : : Integrating technology in patient careIntegrating technology in patient careIntegrating technology in patient careIntegrating technology in patient care

Chair: Kurt Hersberger, SwitzerlandChair: Kurt Hersberger, SwitzerlandChair: Kurt Hersberger, SwitzerlandChair: Kurt Hersberger, Switzerland

Joint meeting ESCPJoint meeting ESCPJoint meeting ESCPJoint meeting ESCP----SFPCSFPCSFPCSFPC Clinical Pharmacy at the Front Line of InnovationClinical Pharmacy at the Front Line of InnovationClinical Pharmacy at the Front Line of InnovationClinical Pharmacy at the Front Line of Innovation

Lyon, France, 21Lyon, France, 21Lyon, France, 21Lyon, France, 21----23 October 201023 October 201023 October 201023 October 2010

Organising Committee (OC)Organising Committee (OC)Organising Committee (OC)Organising Committee (OC) From SFPC From ESCP G. Aulagner (President) M.C. Husson J. Calop E. Gerbrands J.L. Prugnaud F. Jorgensen

A local organising committee A local organising committee A local organising committee A local organising committee will help the OC.

Scientific Committee (SC)Scientific Committee (SC)Scientific Committee (SC)Scientific Committee (SC) From SFPC From ESCP B. Allenet C. Bernsten (SC President) O. Bourdon M. Bouvy D. Breilh V. von Gunten S. Honoré F. van Mil P. Le Corre M. Kinnear M.C. Saux

A local scientific committee A local scientific committee A local scientific committee A local scientific committee will help the SC.

Main themesMain themesMain themesMain themes

The principal themes The principal themes The principal themes The principal themes for the symposium will be: - Innovations in medicines - Innovations in medical devices - Innovations in clinical pharmacy

With a focusWith a focusWith a focusWith a focus on three fields: - Cardiology - Neurology - Oncology

Symposium PresidentSymposium PresidentSymposium PresidentSymposium President: Cecilia Bersten, Sweden ESCP Vice-President

Local Organizing CommitteeLocal Organizing CommitteeLocal Organizing CommitteeLocal Organizing Committee: Cecilia Bersten, Sweden Frank Jorgensen, Norway Erik Gerbrands, Netherlands Göran Lidgren, Sweden Matts Balgard, Sweden Annette Lindberg, Sweden

Scientific Committee:Scientific Committee:Scientific Committee:Scientific Committee: Anne Gilchrist, United Kingdom Annika Nordéen Hägg, Sweden David Magnusson, Sweden Louise Mallet, Canada Marcel Bouvy, Netherlands Piera Polidori, Italy Vincent Launay-Vacher, France Peter Persson, Sweden Annika Tengvall, Sweden Anne Leendertse, Netherlands

ESCP International WorkshopESCP International WorkshopESCP International WorkshopESCP International Workshop Patient Safety & PharmacyPatient Safety & PharmacyPatient Safety & PharmacyPatient Safety & Pharmacy Uppsala, Sweden, 10Uppsala, Sweden, 10Uppsala, Sweden, 10Uppsala, Sweden, 10----11 May 201011 May 201011 May 201011 May 2010

Scientific Program (Preliminary)Scientific Program (Preliminary)Scientific Program (Preliminary)Scientific Program (Preliminary)

10 May 201010 May 201010 May 201010 May 2010

Role of pharmacists in patient safety Interactive mini-lectures : - Achieving patient safety in hospital phar-macies - Achieving patient safety in community pharmacies - The role of the clinical pharmacists in hospital patient safety - Spinning a net between pharmacists and hospital - closing the communication gap and thereby improve the safety of patients

11 May 201011 May 201011 May 201011 May 2010

Elderly and patient safety question Interactive mini-lectures: - Safety from the perspective of the elderly and the caregivers - Communication with elderly - To ensure patient safety in severely demented patients - Can pharmacist affect the community in the way they treat medicines? - Delivrery of medicines straight from industry to patients - safety issue

Lyon (France)Lyon (France)Lyon (France)Lyon (France)

Uppsala (Sweden)Uppsala (Sweden)Uppsala (Sweden)Uppsala (Sweden)

1111stststst May 2010 May 2010 May 2010 May 2010 Registration openRegistration openRegistration openRegistration open

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15151515thththth March 2010 March 2010 March 2010 March 2010 Early bird registration Early bird registration Early bird registration Early bird registration


To learnlearnlearnlearn more more more more about the

programme and register, visitvisitvisitvisit:

www.escpweb.org or mail

[email protected]

Clinical Pharmacy for Hospital Pharmacists: European Society of Clinical Pharmacy Clinical Pharmacy for Hospital Pharmacists: European Society of Clinical Pharmacy Clinical Pharmacy for Hospital Pharmacists: European Society of Clinical Pharmacy Clinical Pharmacy for Hospital Pharmacists: European Society of Clinical Pharmacy (ESCP) Workshop on "Therapeutic Education in Cancer Care" (ESCP) Workshop on "Therapeutic Education in Cancer Care" (ESCP) Workshop on "Therapeutic Education in Cancer Care" (ESCP) Workshop on "Therapeutic Education in Cancer Care" to be held at the 15th Congress of the European Association of Hospital Pharmacists (EAHP), March 24-26, 2010, in Nice, France. The ESCP Workshop will be run twice during the congress, on Wednesday 24th in the afternoon, and in the morning of Thursday 25th.

http://www.eahp.eu/

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) Page Lay-out: Corinne Tollier (France)

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 147 is 5th March 2010.

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BelgiumBelgiumBelgiumBelgium TurkeyTurkeyTurkeyTurkey Cornu Pieter ...................... Brussels Yesilyaprak Gözde..................... Sisas

To become a member : www.escpweb.org To become a member : www.escpweb.org To become a member : www.escpweb.org To become a member : www.escpweb.org Membership in ESCP is open to clinical pharmacists, researchers and other healthcare professionals who work in any of the following environments: community, hospital, academic, industry or any other healthcare setting. Pharma-cy students are also invited to become members of ESCP.

2010 Membership fees 1 year Full Membership ......................... € 75 3 years Full Membership......................... € 185 5 years Full Membership ....................... € 290 Student Membership ...............................€ 20

2010201020102010

10101010----11 May11 May11 May11 May

Uppsala (Sweden)

ESCP International Workshop on Patient safety and Pharmacy

21212121----23 October23 October23 October23 October

Lyon (France)

ESCP/SFPC Symposium Clinical Pharmacy at the Front Line of Innovation

2011201120112011

19191919----21 October21 October21 October21 October

Dublin (Ireland)

40th ESCP Symposium on Clinical Pharmacy

24242424----26 March26 March26 March26 March

Nice (France)

ESCP Workshop on Therapeutic Education in Cancer Care at the 15th Congress of the European Association of Hospital Pharmacists (EAHP)

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