Highlights of Spanish Hospital Pharmacy

 

The Spanish Society of Hospital Pharmacy (SEFH) has developed a strategic plan for the year 2020 with the aim of improving hospital pharmacy practice and healthcare system services. Strategic lines are focused on improving the efficiency and safety in the use of medication.

 

 

1. Medication errors are one of the main problems to be solved by health systems and pharmacy services. There is a lot of evidence about errors rates in each step of the process of medication use. Except in the administration stage, others stages are checked for potential errors by the succeeding stage.  For these reason the administration is the critical safety point for patient.

Currently, to identify better the patient and presented medication, we use bar code and data matrix systems, conducting a first reading by scanner. However these codes do not include information about batch and expiry date, which is the goal to get traceability´ throughout the system- there, is no further stage to conduct a check. 

The TECNO Group of SEFH, leads in the implementation and development of criteria and strategies about technological advancement; it has designed a study in collaboration to AECOC (Asociación Española de Codificación Commercial) to accomplish codified GS1 health care standards. The methodology and preliminaries results of this research will be presented.

 

2. A Traceability System has been designed for chemotherapy preparation and its administration process  in order to assure that the final product contains the medication with the dose and also the diluents included and prescribed by the oncologist/haematologist, validated by the pharmacist, and should be administrated  to the right patient.
This system uses a barcode scanner to identify all the components of the final product including name, batch and expiry date, and a weigthing method, which takes into account the density of each product (gravimetric control), in order to check that the dose or quantity of the medication is the right one with a complete subsequent quality control.
In the Outpatient Setting using a barcode scanner for: nurse identification and generation of preparation of the antiemetic/adjuvant medication; identification of patient, box, treatment and pump administration, and finally proceeding to the administration of chemotherapy treatment.
We present a case of practice of traceability in the preparation and the administration of chemotherapy to assure the concordance of the medical prescription and the chemotherapy to the right patient in a teaching hospital.
 

 

3. Auto verification of the medical prescription

Verification of medical orders by pharmacist is a quality requirement in any hospital and one of the most important tasks to ensure the safety of the medical prescriptions. Informatics system and electronic medical records must, and have to, help optimize this process. A well-defined clinical decision-support system (CDSS) is needed. 

However, the criteria for auto verification of medical orders have not been stabilised yet by any health organization, and it has to be built based on the experience, pharmacology knowledge and with the approval of the Pharmacy and Therapeutic Committee. Defining the criteria of auto verification for medical orders can be a challenge that the pharmacists must to face to optimise clinical activities.

 

 

4. Developing an individualised pharmacotherapy and monitoring plan for the management of certain diseases is nowadays becoming a priority. In this sense, pharmacogenetics and pharmacogenomics knowledge is essential when aiming to improve the efficacy, safety and efficiency in the pharmacological treatment of many diseases, such as cancer and immunological disorders among others. Today, the oncopharmacogenetics pharmacist expert plays an outstanding role in selecting treatments with the best risk-benefit balance for individuals. We will present one experience developed by a hospital pharmacist expert in oncology. 

 

 

5. Evidence based pharmacotherapy.

Evaluation and Selection of new drugs in Spain has been performed at local Pharmacy and Therapeutics Committees. 

GENESIS working group (Group for Innovation Assessment, Standardisation and Research in the Selection of Drugs) emerged in 2004 as a need within the Spanish Society of Hospital Pharmacy (SEFH), establishing a collaborative system to evaluate new drugs according to a common, participatory and transparent methodology.

Consolidation and development of health services of the regions in Spain as authorities responsible for managing the budget for healthcare and medicines, has tended to unify the evaluation and selection criteria within each territory, to optimise resources for evaluation and standardise results and decisions of drug evaluation. 

Currently two new national structures have been recently established working together the Drug Prices Interministerial Committee (CIPM) and the Therapeutic Positioning Coordination Group (GCPT). The hospital pharmacist is playing an important role in this new scenario.

 

 

 

After the presentation the participant should be able: