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IMPLEMENTATION OF A CLINICAL PHARMACY ACTIVITY IN RADIOPHARMACY: A TRIPARTITE CONSULTATION HOSPITAL APPROACH FOR PLUVICTO® RADIOLIGAND THERAPY IN ELDERLY PATIENTS

European Statement

Clinical Pharmacy Services

Author(s)

J. BERGÉ, S. BRILLOUET, C. LAMESA

Why was it done?

Tripartite consultation (TC) activities are well established in oncology for chemotherapy, and are progressively emerging in radiopharmacy, where there is a clear need to support elderly and polymedicated patients receiving RLT. This therapy is costly and complex, with additional radioprotection requirements, making multidisciplinary coordination essential.

What was done?

A new activity of clinical pharmacy in radiopharmacy is developed as TC for Pluvicto® radioligand therapy (RLT) in our comprehensive cancer center.
This activity was set as TC with the nuclear physician, radiopharmacist, and nuclear medicine technologist. The initiative was done on our institutional software, with dedicated templates creation and harmonized tools.

How was it done?

Three main axes guided implementation: (1) integration into institutional software with customized reporting templates; (2) reorganization and structuring of the patient pathway; (3) harmonization of practices and training, with the involvement of pharmacy residents under senior supervision. Moreover, specific supports were developed to structure patient counseling, including interview templates and patient-oriented documents (radioprotection instructions, explanatory treatment diagrams).

What has been achieved?

The initiative enabled the standardization of reporting, the improvement of patient pathway coordination, and the reinforcement of their educational support. The integration of patient counseling tools strengthened patients’ understanding of a complex therapy, sensitization to radioprotection, and adherence to their care, while improving overall coordination. It also made possible the systematic performance of medication reviews, particularly relevant for an elderly and polymedicated patient population. Since its implementation, 40 patients have already been managed within this framework by residents under systematic senior supervision. Finally, the TC allowed the institutional financial valorization of this activity.

What next?

This activity represents an interesting and transposable example of good practice. Its implementation demonstrates that such an TC structure can be extended to other RLT to improve efficiency and harmonization of both professional practices and patient management. In parallel, we are currently driving a French multicenter study (Pharma-RIV) assessing the impact of pharmaceutical consultations in the management of patients receiving RLT. A broader preliminary effort is in progress to structure the RLT care pathway at the national level, in collaboration with the French Society of Nuclear Medicine.

UPSKILLING THE PHARMACY WORKFORCE IN MEDICATION ADHERENCE SUPPORT THROUGH MULTI-SECTOR TRAINING IN NHS SUSSEX

European Statement

Education and Research

Author(s)

Dr Sian Williams, Dr Ella Graham-Rowe, Dr Sarah Chapman and Prof John Weinman

Why was it done?

Non-adherence contributes significantly to preventable harm and waste across health systems. Although pharmacy professionals are well placed to intervene, evidence suggests that current approaches are limited in effectiveness. The aim of this initiative was to provide multi-sector professionals with a shared framework and tools to support adherence, improving patient care and consistency across services.

What was done?

A training programme was developed to improve pharmacy professionals’ confidence and capability in identifying and addressing medication non-adherence. The training was delivered to qualified pharmacists, foundation pharmacists, and pharmacy technicians across NHS Sussex, with a focus on practical skills and evidence-based behavioural change strategies.

How was it done?

The training, developed in collaboration between the University of Brighton and the Centre for Adherence Research and Education at King’s College London, consisted of three components. First, participants completed an online module introducing the causes, types, and consequences of non-adherence. This was followed by a four-hour interactive face-to-face workshop, where attendees were trained in the COM-B (Capability, Opportunity, Motivation – Behaviour) model, the ‘Making Medicines Work for You’ screener, and five practical adherence support strategies based on evidence-based behaviour change techniques. A follow-up online session four weeks later allowed participants to reflect on applying the screener in practice and to share experiences. Cross-sector representation enabled peer learning and discussion of implementation in diverse settings.

What has been achieved?

The initial training reached 26 pharmacy professionals who completed pre- and post-surveys on confidence and practice in identifying and supporting adherence. Analysis showed improved perceived skills and access to tools. A follow-up session revealed early successes alongside barriers, including time pressures in busy settings and challenges embedding the tool into systems that support routine practice.

What next?

This initiative provides an evidence-based model for embedding adherence support into pharmacy practice. It is transferable across integrated care systems and healthcare settings. Future plans include ongoing evaluation and extending training to other clinical teams and policy decision-makers.

EMBEDDING ADHERENCE SCREENING AND BEHAVIOUR CHANGE TRAINING INTO UNDERGRADUATE PHARMACY EDUCATION AT THE UNIVERSITY OF BRIGHTON, UK

European Statement

Education and Research

Author(s)

Ella Graham-Rowe, Sian Williams, Sarah Chapman and John Weinman

Why was it done?

Non-adherence to prescribed medicines remains a global problem, associated with poor health outcomes and increased healthcare costs. Despite pharmacists’ central role in addressing adherence, undergraduate education often lacks practical, evidence-based training. This initiative aimed to equip students early in their professional development with the skills and confidence to identify and support patients with adherence challenges.

What was done?

A structured programme on medication adherence was developed and embedded into the second year of the Master of Pharmacy (MPharm) degree at the University of Brighton. The training introduced students to an adherence screening tool, key behavioural frameworks, and practical support strategies, with opportunities to practise in simulated scenarios and while on placement.

How was it done?

Academic staff were first trained by the Centre for Adherence Research and Education (King’s College London) to deliver their structured programme. The training was then delivered to undergraduates over three two-hour face-to-face workshops. Workshop one explored types and causes of non-adherence using the COM-B (Capability, Opportunity, Motivation – Behaviour) model. Workshop two introduced five evidence-based behaviour change strategies. Workshop three allowed students to apply these skills using the ‘Making Medicines Work for You’ screener in simulated consultations. Learning materials and scenarios were co-developed with practising pharmacits to reflect authentic pharmacy practice.

What has been achieved?

All second-year students completed the training in the 2024–2025 academic year and were assessed in end of year OSCEs. Feedback highlighted notable improvements in students’ consultation and communication skills, along with greater empathetic engagement with patients. Learners described the tools and exercises as engaging and supportive, boosting their confidence in supporting patient adherence.

What next?

This initiative demonstrates that evidence-based adherence training can be effectively integrated into the undergraduate pharmacy curriculum. The approach is transferable to other institutions and may improve medicines optimisation in future clinical practice. In 2025–2026, these students will apply their learning during practice placements across multiple sectors. Further evaluation will explore impact on student performance during placements.

MUGHUB PODCASTING UPDATE AND INTEGRATED CURRICULUM SPIRAL FOR STUDENT PHARMACISTS

European Statement

Education and Research

Author(s)

Dr Sian Williams & Mr Connor Thompson-Poole

Why was it done?

Podcasting has been shown to enhance engagement and reflection among healthcare students by connecting taught content to real-world practice. The MUGHUB podcast, established by the Medicines Use Group (MUG) at the University of Brighton, was designed to increase student pharmacists’ access to current issues in medicines use and promote awareness of diverse career pathways. Following initial positive feedback, MUGHUB has now been embedded within each year of the new Master of Pharmacy (MPharm) programme to support an integrated and spiral learning curriculum focused on professional identity and experiential learning.

What was done?

The updated MUGHUB initiative aligns podcast and video content with the Clinical and Professional Skills (CAPS) modules delivered across all four years of the MPharm. Each year features a curated mix of episode formats—Meet the Team, Peer2Peer, and Bitesize Learning—to reinforce professional themes and competencies relevant to students’ stage of development. Episodes include topics such as Introduction to placements, Sustainability in pharmacy, and Transitioning to practice, featuring pharmacists, academics, and students.

How was it done?

Academic and clinical staff collaborated with student partners through a university digital learning initiative to co-create content. Topics were mapped to module learning outcomes and professional standards to ensure curricular alignment. Episodes were recorded in the university’s sound and TV studio, edited using Adobe Audition, and disseminated monthly via the virtual learning environment and Spotify. Structured integration points within the CAPS modules and placement preparation sessions were established to encourage active student reflection and discussion.

What has been achieved?

Over 30 episodes have been produced with close to 2500 plays amassing over 200 hours of listening. With each episode linked to learning themes across the MPharm, students report using the series to reinforce understanding of professional roles, placement preparation, and communication skills. The initiative has enhanced digital literacy, self-directed learning, and engagement with the wider pharmacy community.

What next?

Future plans include expanding student-led content creation and integrating reflective podcast-based assignments to further embed digital and professional competencies within the MPharm curriculum.

THE CRUSHING FACTORY SAFE PHARMACOTHERAPY THROUGH ENTERAL FEEDING ACCESS – EXPERIENCES AND GOOD PRACTICES FROM THE UNIVERSITY CLINICAL CENTRE IN GDAŃSK

European Statement

Clinical Pharmacy Services

Author(s)

Ewelina Lubieniecka – Archutowska, Bogusława Szmaja, Dorota Świtkowska, Agnieszka Prusko, Magdalena Jaśkowska, Marzena Mielczarek – Kęska, Urszula Dobrzycka – Magulska, Wioletta Kaliszan

Why was it done?

Enteral nutrition therapy plays a crucial role in the management of patients who cannot meet their nutritional needs orally. Besides providing essential nutrients, enteral feeding access often serves as a route for drug administration, which requires specific knowledge about drug compatibility and pharmacotherapy safety among healthcare professionals.
The aim of this project was to improve the safety and effectiveness of pharmacotherapy administered through enteral feeding access at the University Clinical Centre in Gdańsk (UCC).

What was done?

Based on literature review and institutional experience, the main challenges identified were related to the selection of appropriate medicines and pharmaceutical forms, as well as to the preparation and administration techniques used by nursing staff. To address these issues, several measures were implemented within UCC to enhance pharmacotherapy safety in patients with artificial enteral access.

How was it done?

A procedure titled “Principles of Administering Medicinal Products to Patients Receiving Enteral Nutrition via Feeding Tube or Gastrostomy” was developed and implemented. Within the hospital information system (Clininet), a dedicated list of medicines that must not be crushed or administered via enteral routes was introduced and made visible to physicians and nurses to support safe prescribing. Clininet also allows physicians, nurses, and dietitians to request pharmacotherapeutic consultations from hospital pharmacists. Pharmacists analyze and, when necessary, modify patients’ therapy. Medicines suitable for administration through enteral access were added to the hospital formulary, enabling physicians to choose formulations appropriate for crushing or alternative routes of administration. The hospital pharmacy introduced the so-called “Crushing Factory” – a centralized service where pharmacists prepare R.PEG-labeled medicines in safe forms and doses for enteral administration. Each administration is recorded in the patient’s medical documentation.

What has been achieved?

The implemented system led to:
• fewer prescribing and administration errors
• reduced drug loss and preparation mistakes
• fewer interactions and adverse effects
• compliance with accreditation standards for medication safety
• lower treatment costs and fewer pharmacological interventions
• reduced nursing workload and improved efficiency

What next?

Expand staff education on enteral pharmacotherapy, standardize training materials, monitor outcomes, introduce patients pharmaceutical discharge summaries and implement solutions hospital -wide to improve safety and continuity of care.

IMPLEMENTING SIMULATED PHYSICAL ASSESSMENT SKILLS INTO UNDERGRADUATE PHARMACY TRAINING

European Statement

Education and Research

Author(s)

Dr Fernando Perez
Connor Thompson-Poole
Dr Konnie Basu

Why was it done?

Recent changes in UK pharmacy education standards by the General Pharmaceutical Council (GPhC) have emphasised the need for pharmacists to graduate with the confidence and competence to undertake independent prescribing roles. This requires proficiency in physical assessment and diagnostic skills, traditionally outside the scope of undergraduate pharmacy education. To address this gap, the University of Brighton has integrated a structured simulation-based physical assessment training package into the MPharm curriculum, preparing future pharmacists for enhanced clinical responsibility and interprofessional practice.

What was done?

A series of simulated physical assessment sessions was introduced across all years of the MPharm programme. The training focuses on developing students’ competence and confidence in performing fundamental physical assessment techniques, including cardiovascular, respiratory, gastrointestinal, and neurological examinations, as well as accurate recording and interpretation of vital signs through a spiralled curriculum over the course of four years.
The simulation package was designed collaboratively by clinical academic staff and prescribing pharmacists, supported by colleagues from medicine and nursing to ensure cross-disciplinary alignment. Each session was structured around case-based clinical scenarios, encouraging students to follow a patient’s journey through different healthcare settings.

How was it done?

Sessions were delivered in the university’s clinical simulation suites using simulated patients, high-fidelity manikins, and digital monitoring tools. Each workshop included a short demonstration, guided practice, peer feedback, and reflection activities. Students benefit from this approach as they can individually work through real clinical scenarios, which better prepares them for future independent clinical practice.
Student learning was assessed through Objective Structured Clinical Examinations (OSCEs) and reflective portfolios. Staff feedback and student evaluations were collected to guide ongoing improvement.

What has been achieved?

Over two academic years, over 400 pharmacy students have participated in the programme. Student feedback indicates a marked increase in self-reported confidence in patient examination, clinical communication, and integration of physical findings into clinical reasoning. Staff observed improved engagement and enhanced preparedness for prescribing training. The initiative has also fostered stronger collaboration across disciplines.

What next?

Future plans include developing interprofessional simulation days with medical and nursing students, and exploring digital tools for remote clinical assessment practice. The model demonstrates a scalable and sustainable approach to embedding clinical examination competence within undergraduate pharmacy education.

EMBEDDING EXPERIENTIAL LEARNING ACROSS AN MPHARM CURRICULUM: IMPLEMENTATION, EVOLUTION, AND IMPACT TWO YEARS ON

European Statement

Education and Research

Author(s)

Connor Thompson-Poole
Sam Ingram

Why was it done?

The University of Brighton introduced an Experiential Learning Strategy in 2023 to enhance pharmacy education through progressive, practice-based learning. The strategy aimed to allow students to apply their knowledge through the Master of Pharmacy (MPharm) degree and strengthen their clinical preparedness and professional identity. This initiative is in response to the General Pharmaceutical Council’s (GPhC) Initial Education and Training of Pharmacist (IETP) standards of 2021, which emphasise real-world competence and interprofessional collaboration.

What was done?

A structured experiential framework was implemented, utilising our ‘Teach > Simulate > Do’ model combining lectures, simulated clinical experiences, and real-world placements. Each year of study now includes both simulated practice activities, such as virtual clinical experiences and prescribing simulations, and direct placements across community, hospital, primary care, and specialist sectors.
A central Pharmacy Placement Operational Advisory Group (PPOAG) was established to co-create and quality assure placement provision in partnership with providers and national teams. Placement activities were supported by structured logbooks, learning agreements, and supervisor training resources to standardise expectations and feedback.

How was it done?

Over two years, the programme has expanded to over 120 multisector placement providers, offering students a total of 60 days of placement activity across the four-year MPharm degree. This expansion has opened access to previously inaccessible learning environments for undergraduate pharmacy students, including general practice, ambulance services, mental health trusts, and prison pharmacy. Simulated learning activities have been aligned with placement learning outcomes to ensure coherence between taught and experiential learning.

What has been achieved?

Student pharmacists reported improved clinical confidence and understanding of team-based care, and many students have gained part-time employment as a result of their placement experiences. Providers noted greater consistency and preparedness of students, and improved communication channels with the university. Placement networks across the region expanded significantly, increasing placement capacity and diversity.

What next?

Future work will focus on using both quantitative data, including placement capacity and completion rates, and qualitative data, such as student reflections and provider feedback, to continue to inform iterative development and quality enhancement of the programme. Continued collaboration with NHS and community partners will ensure sustainable and high-quality experiential learning for future cohorts.

OPTIMIZATION OF PATIENT RECRUITMENT IN CLINICAL TRIALS THROUGH ARTIFICIAL INTELLIGENCE INTEGRATION (TRIALGPT PROJECT)

European Statement

Education and Research

Author(s)

Laura Maldonado Yagüe, Claudia Ramos Álvarez, Ana Herranz Alonso, Fernando Bustelo Paz, Eva González-Haba Peña, María Sanjurjo Saez

Why was it done?

Patient recruitment is still nowadays one of the barriers that the clinical investigation encounters: almost 80% of the clinical trials experiment delays and around 30% close due to the difficulties to identify candidates. Currently, the recruitment process in many of the hospital sites is based on the manual review of electronic medical records (EMR), which results in higher workload and higher errors and omissions. This tool aims to reduce manual screening time by 50% and increase recruitment by 20% always ensuring regulatory compliance (ICH-GCP, RGPD and national biomedical investigation laws).

What was done?

The Pharmacy Department led the initiative to evaluate TrialGPT, an Artificial Intelligence (AI) system designed to optimize clinical trials patient recruitment, in the hospital setting. Natural Language Processing (NLP) and Large Language Model (LLM) are advanced techniques used by TrialGPT which enables the automatic detection of potential eligible patients through their Electronic Medical Records (EMR) matching their profile to the inclusion and exclusion criteria for each clinical trial.

How was it done?

The project was coordinated by a Clinical Trials Unit of a tertiary hospital with multidisciplinary collaboration between pharmacist, investigators and IT specialists. Anonymized data of 50 active clinical trials from oncology, neurology and rare diseases areas were used. Technical challenges such as data heterogeneity, algorithmic bias and staff acceptance were encountered, in order to address these, an iterative training model, multidisciplinary workshops and ethical evaluation were used.

What has been achieved?

Preliminary simulations indicate that TrialGPT is able to reduce half the necessary time for patients screening and improve recruitment efficiency without compromising data security or clinical precision. The model achieved high sensitivity and specificity identifying eligible patients, demonstrating a high potential to optimize hospital investigation flowcharts.

What next?

A validation phase will evaluate the real-world performance and scalability in multiple sites. This initiative exemplifies an innovative digitalization and automatization of a process which could be transferred as a model for European hospitals in order to improve patient access to clinical trials, thus, advanced therapies.

PHARMACOKINETIC-GUIDED HIGH-DOSE METHOTREXATE PROTOCOL: MULTIDISCIPLINARY COLLABORATION AND OUTCOMES IN REAL-WORLD PRACTICE

European Statement

Clinical Pharmacy Services

Author(s)

Anais Carrillo Burdallo
Cristina Villanueva Bueno
Maria del Pilar Montero Antón
Isabel Regalado-Artamendi
Beatriz Torroba Sanz
Jose Luis Revuelta Herrero
Eva González-Haba Peña
Daniel Gomez Costas
Yeray Rioja Díez
Antonio Prieto Romero
María Martín Bartolomé
Xandra García Gonzalez
Ana Herranz Alonso
Maria Sanjurjo Saez

Why was it done?

High-dose methotrexate (HD-MTX) carries substantial toxicity risk. Safety hinges on timely, appropriately dosed leucovorin rescue plus high-volume hydration and urinary alkalinisation. Pharmacokinetic monitoring with proactive follow-up enables early detection of delayed clearance and better-informed decisions.

What was done?

A protocol for the administration and pharmacokinetic monitoring of HD-MTX was developed and implemented in a tertiary hospital in coordination with the Haematology Department.

How was it done?

Standardised procedures for administration were defined (hydration/alkalinisation strategies; rescue timing/dose; infusion start; sampling schedule). Adults with leukaemia/lymphoma received short (5µmol/L; long: 42h, >1µmol/L).
Pharmacist-led interventions were classified as: enhanced elimination (intravenous fluids/furosemide; bicarbonate/acetazolamide; cholestyramine), rescue optimisation (dose guided by the prediction, readjusted after the measured level, and withheld when appropriate), and monitoring (additional levels and duration).
Continuous accuracy was assessed with the individual percentage error (IPE)=[(predicted−observed)/observed]×100; we report MDIPE (median IPE; accuracy), MAIPE (median absolute IPE; precision), and the proportion within 1.5-fold. Classification against thresholds was summarised with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

What has been achieved?

In 24 administrations (13 short, 11 long), pharmacist-led interventions were implemented in every cycle: enhanced elimination 88%, rescue optimisation 54%, monitoring 71%.
Continuous accuracy: MDIPE +35% (IQR 9–80), MAIPE 38% (IQR 11–80); 54% within 1.5-fold. Threshold performance (short/long): accuracy 69/91%; sensitivity 100/100%; specificity 67/86%; PPV 20/80%; NPV 100/100%.
Protocolised monitoring improved safety by standardising decisions and reducing errors. The predictive tool achieved 100% sensitivity and NPV, supporting early rule-out of delayed clearance; positive alerts should be interpreted cautiously given moderate overprediction and false positives near thresholds, with confirmation and close follow-up.

What next?

Next steps are full rollout, recalibration and threshold tuning in larger cohorts, and extension to Oncology and Paediatrics, tracking efficiency endpoints (time to <0.05-0.2 µmol/L, length of stay).

IMPLEMENTATION OF PRIORITIZATION CRITERIA IN MEDICATION REVIEW ACTIVITY IN GERIATRIC MEDICINE: AN EIGHT-MONTH STUDY

European Statement

Clinical Pharmacy Services

Author(s)

A. GHORBEL, C. KONN, J. CATROUX, J. TISSERAND, P. ROCANIERES

Why was it done?

Polypharmacy and multimorbidity make medication safety a major challenge in geriatric medicine. Medication reconciliation and review are essential but time-consuming processes that cannot be systematically performed for all patients. Prior, we made a systematic review of the French literature which identified multiple prioritization approaches – empirical, statistical, and consensus-based – but no harmonized tool. Common criteria included advanced age, polypharmacy, psychotropic use, high-risk medications, and chronic diseases such as heart failure. Then, we aimed to translate these findings into a pragmatic, locally adapted prioritization grid to improve targeting and workflow efficiency.

What was done?

An initiative was developed in the geriatric department of a French University Hospital to introduce prioritization criteria for medication review (MR) at admission. The aim was to optimize pharmacists’ clinical activity by identifying high-risk patients most likely to benefit from a MR, given the limited available resources.

How was it done?

A prospective, observational, comparative study was conducted over 13 months (early June 2024 – end June 2025) in neuro-geriatrics and onco-geriatrics. During the 8 last months, pharmacists applied a prioritization grid daily based on clinical and pharmacological criteria (≥ 5 medications, renal impairment, psychotropics, high-risk drugs). Indicators before and after its implementation were compared using a two-sample Z-test (α = 0.05).

What has been achieved?

After implementation, 295 admission and 48 discharge MR were performed (vs 272 and 31 before prioritization). The initiative allowed the targeted inclusion of patients with a mean age of 87 ± 6 years and an average of 10 ± 4 chronic medications. The most frequent prioritization criteria identified were renal impairment, use of “never-event” drugs (methotrexate, insulin, colchicine, oral chemotherapy and anticoagulant drugs), antibiotic therapy, electrolyte disorders, and diabetes. Average MR time rose (113 vs 105 min; 89 vs 47 min), reflecting higher case complexity.

What next?

Defining common prioritization criteria could support national recommendations and enable the development of digital tools integrated into hospital information systems to automatically identify high-priority patients. In the future, it is planned to use these results to create decision rules from artificial intelligence software: it could generate dynamic prioritization models based on real-time clinical, biological, and therapeutic data, embedded into dispensing software to improve patient safety and optimize pharmaceutical care.