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ENHANCING PROFESSIONALISM IN CLINICAL PHARMACIST SERVICE THROUGH DIGITAL COMMUNICATION

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European Statement

Clinical Pharmacy Services

Author(s)

Mia Pavelics Rehn
Trine Rune Høgh Andersen

Why was it done?

Clinical Pharmacists (CPs) in the Region Zealand Hospital Pharmacy (30 CPs) are scattered over great geographical distances on multiple hospital wards. When working with Clinical Pharmacist Services (CPS), usually just one CP is present per ward. All 30 CPs have different knowledge, seniority and specialization. To enhance the professionalism of the individual pharmacist on duty, digital communication such as chat functions are implemented for quick and easy intra-pharmacist consults.

What was done?

The ward physicians and nurses experience the combined specialty knowledge of 30 CPs from each CP when engaging CPS. This is highly relevant to maintain the position of having CPS through the hospital pharmacy instead of employing one individual CP directly on the ward, which has become more common over recent years.

How was it done?

To illuminate how the CPs from the hospital pharmacy share knowledge by using each other in their clinical operation, data was collected during three weeks of daily work. The CPs at 10 department wards registered each time they consulted a CP colleague. Furthermore, they recorded what type of communication they used (Microsoft Teams®, telephone or face-to-face) and what the inquiry was about. Written communication in Teams chat was saved for qualitative analysis.

What has been achieved?

The collected data illustrate the utilization of collective knowledge. In the three weeks 34 consults were made using primarily Microsoft teams. In 9 cases the contact was face-to-face and in 6 cases by phone. Most common was pharmacological discussion about specific cases during medication reviews (23), followed by questions about technical issues in the electronic patient record (11), general professional discussions (7) and consults about medication shortages and alternatives (8).

What next?

This initiative illustrates how using easy and available digital communication such as Teams chat functions across geographical distances will increase professionalism and harness the collective knowledge of many CPs working in collaboration for the benefit of improved CPS.

DESIGNING A 360° IMMERSIVE VIRTUAL REALITY TOOL FOR TRAINING IN INFUSION SET-UP

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European Statement

Education and Research

Author(s)

V. LE BIGOT, A. BROS, F. NATIVEL, T. ADNET, D. CABELGUENNE, F. LINDENBERG, S. GENAY, P. BESNIER, S. RODIER

Why was it done?

Creation of a training tool for infusion set-ups in a digital 360° virtual reality, utilizing a fun format based on learning from errors. It is specifically designed for novice professionals, with a focus on pharmaceuticals teams.

What was done?

Errors in infusion set-ups are common and can have serious consequences on patient care. Adhering to best practices in infusion is essential to mitigate these risks. Therefore, comprehensive training for both healthcare staff on proper techniques and procedures, is crucial to ensure safe and effective infusion management. Choosing a digital navigating environment allows a remote or a mobile use and enhances interactivity between the trainer and learners when used for in-person training.

How was it done?

A multicenter working-group of 9 pharmacists with expertise in infusion and healthcare simulation was formed, divided into three subgroups: two for content creation and one for reviewing. Firstly, the priority issues were selected, drawn on the guidelines issued by learned societies. An illustrated presentation of the most frequently encountered infusion errors was developed using an online Learning Management System platform, integrating the teaching content into a 360° virtual reality environment.

What has been achieved?

A virtual patient pathway was designed in 3 different environments: an operating room, a post-operative recovery room and a ward. Within the virtual spheres, 12 “points of interest” (POIs) were defined as a clickable elements, focusing on predefined key themes. Each POI was illustrated with photos or videos and included errors that required learners to answer up to three multiple choice questions (MCQs). In total, there were 25 MCQs. Additionally, each POI featured an explanatory debriefing slide that was presented afterwards.

What next?

This training tool will be tested under real-life conditions at a national pharmacy congress. It will be approved by a panel of experts/learned societies, then evaluated by trainers/learners, so that it can find its place in the training programs of all healthcare professionals involved with infusion set-up.

PHARMACY STUDENT PRACTICAL FORMATION TO PHARMACEUTICAL HEALTHCARE IN HOSPITAL CARE UNIT

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European Statement

Education and Research

Author(s)

Elisa Vitale, Quentin Perrier, Arnaud Tanty, Claire Chapuis, Armance Grevy, Agathe Landoas, Dorothée Lombardo, Prudence Gibert, Lénaik Doyen, Benoit Allenet, Pierrick Bedouch, Sébastien Chanoine

Why was it done?

In France, during their 5th year of study, pharmacy students complete a six-month full-time equivalent internship in a hospital setting. At our hospital, most students spend six months in a care unit to perform pharmaceutical care and promote quality use of medicines. These missions are carried out in collaboration with all healthcare professionals, either under the direct supervision of a pharmacy resident, senior pharmacist, or independently. While tasks assigned to pharmacy students in the care unit with direct pharmaceutical supervision were well known, other students reported difficulties in understanding what was expected of them, as well as a lack of confidence when integrating an established interprofessional team.

What was done?

The aim was to create and evaluate a specific training session for all pharmacy students joining a care unit for the first time.

How was it done?

Four hospital pharmacists collaborated to define the learning objectives and select the appropriate teaching tools. A pre- and post-training self-assessment questionnaire consisting of seven questions was created to evaluate students’ self-efficacy regarding the learning objectives and their satisfaction with the training.

What has been achieved?

A four-hour training session, divided into five sequences, was created. The objectives were: 1) Highlighting the challenges of joining an interprofessional team, 2) identifying the tasks and learning opportunities for pharmacy students, 3) simulating a medication reconciliation, 4) managing pharmaceutical issues through problem-solving exercises.
Regarding the evaluation, students reported that they: a) were more enthusiastic about the idea of working in a care unit after the training course (85% vs. 74%, p=0.001); b) had a clear understanding of their mission (84% vs. 53%, p<0.001); c) felt more confident in performing a medication reconciliation (93% vs. 35%, p<0.001); d) were more aware of the pharmaceutical resources available to them (95% vs. 27%, p<0.001); e) had a better understanding of how hospital pharmacy is organized (58% vs. 19%, p<0.001). Additionally, 99% found the training useful, and 94% felt that the training methods aligned with the training objectives.

What next?

Assess the long-term impact of the training and its effectiveness in ensuring that pharmacy students perform pharmaceutical care successfully and confidently

SIDE EFFECTS OF CHEMOTHERAPY: INFORMING TO ACT BETTER

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European Statement

Clinical Pharmacy Services

Author(s)

Margot DESCHAMPS, Nejib BORGAAOUI, Jimmy ROSE, Jennifer LE GRAND, Louise NICOLAS

Why was it done?

Digestive cancers represent about 25% of new cancer cases diagnosed in France each year. The medical management of these cancers mainly relies on cytotoxic drugs. Side effects of these medications (fatigue, hair loss, nausea, or digestive issues) can affect negatively patients quality of life. These symptoms can make daily life challenging.

What was done?

As part of a patient therapeutic education program, the goal of our project was to develop an innovative educational tool to help patients better understand these side effects and find ways to manage them.

How was it done?

As part of the implementation of a multidisciplinary therapeutic education program, bringing together oncologists, pharmacists, sophrologists, osteopaths, and nutritionists, designed for patients treated for digestive cancers, the pharmacy is responsible for a workshop focused on the side effects of chemotherapy. The main molecules used to treat digestive cancers were listed, along with their most common side effects. Based on this analysis, playing cards were created, each corresponding to a specific side effect.

What has been achieved?

The developed tool is an educational and interactive board game, consisting of a board, a dice, and 56 cards. These cards are divided into 6 categories: general symptoms, neurology-psychology, heart-lungs, gastroenterology, dermatology, and real-life scenarios. The cards were designed to be understandable and accessible to all patients. The workshop takes place in two parts, with the pharmacist as the main facilitator. In the first part, patients are encouraged to share their personal experiences related to the drawn card. Then, the scenario cards are presented to help patients manage these challenges in their daily lives.

What next?

The decision was made to limit the number of participants to 6, in order to allow everyone to express themselves and exchange freely. The duration of the workshop was theoretically set at 1.5 hours but will need to be adjusted during the first workshops. It will be necessary to implement satisfaction surveys and patient follow-up on various criteria, such as emergency room visits, the number of calls after the session, and the rating of side effects.

INTERNSHIP OF RESIDENT PHARMACISTS IN NEONATOLOGY CARE UNIT AT ULSSA: A COLLABORATIVE APPROACH

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European Statement

Clinical Pharmacy Services

Author(s)

Rita Sofia Conde Lopes, Rita Manuel Neves Lopes, Ana Paula Barbeita, Teresa Cunha, Patrocínia Rocha

Why was it done?

Improving the training of PRs and supporting the neonatal medical team by addressing their needs.

What was done?

The Pharmaceutical Residency (PR) lasts four years, during which the Resident Pharmacist (RP) must acquire skills in various areas. In the PR, one of the longest functional areas is pharmacotechnics, which includes the handling of sterile and non-sterile medicines. At the Unidade Local de Saúde de Santo António (ULSSA), which includes the Centro Materno Infantil do Norte (CMIN), this type of preparation is crucial due to the type of population it serves — pediatrics. With this in mind, the RP had the opportunity to complete a one-month internship in the neonatology unit (NU), where, in addition to familiarizing with the unit’s routine, they assisted with various needs of the service.

How was it done?

PRs attended morning routine specialist doctors during the morning routine, participating in both the night-morning and morning-afternoon shift handovers and follow-ups. The schedule was coordinated between the Pharmaceutical Services (PS) and the NU to ensure this was the most productive time for both parties. During shift changes, any issues from the previous period were discussed. When these topics involved the FS, the PR provided assistance.

What has been achieved?

During their presence NU, PR were able to intervene in several key areas, including expediting Pharmacy and Therapeutics Committee authorizations (e.g., everolimus for a neonate with rhabdomyoma), managing the logistics for obtaining non-commercialized medication in Portugal (e.g., erythromycin oral suspension for prokinetic use), supporting clinical decisions regarding the prescription of parenteral nutrition bags, updating the medical prescription system for dressing materials (e.g., maltodextrin powder dressings) and creating a spreadsheet for prescribing protein supplements.

What next?

This collaboration has fostered a stronger connection between pharmaceutical and clinical services and underscores the vital role of multidisciplinary teams in healthcare, where experts from different fields contribute with their specialized knowledge. Such collaboration not only enhances patient outcomes but also optimizes workflows by reducing service duplication, increasing productivity, and saving valuable time. In the future it is expected continue this collaboration.

DERMATOLOGICAL CARE IN PATIENTS UNDERGOING TREATMENT WITH CETUXIMAB

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European Statement

Patient Safety and Quality Assurance

Author(s)

Elena Blanco Saiz

Why was it done?

It is estimated that over 80% of patients receiving treatment with cetuximab experience acneiform eruptions and/or skin dryness and flaking. Approximately 15% of these cutaneous reactions are severe, including cases of skin necrosis.
These skin lesions may predispose patients to secondary infections, potentially leading to complications such as cellulitis, erysipelas, staphylococcal scalded skin syndrome, necrotizing fasciitis, or sepsis, which can result in death.

What was done?

A kit consisting of an alcohol-free moisturizing cream, an alcohol-free gel, and a sunscreen with a sun protection factor of 100 was provided to patients undergoing treatment with cetuximab for daily skin care.

How was it done?

When the oncology department prescribes cetuximab, the patient is informed that a kit will soon be dispensed.
The pharmacy service reviews daily the patients who will initiate treatment with cetuximab in the day treatment center. If there is a patient starting treatment, nursing staff notify us when they arrive at the center, and the pharmacy dispenses a kit while explaining its contents.
We periodically call the patient to check whether they are continuing to use it correctly, if they have noticed any changes in their skin, what changes they have observed, and whether they have needed to take antibiotics and/or topical corticosteroids.

What has been achieved?

• To date, the kit has been dispensed to 21 patients undergoing treatment with cetuximab.
• It empowers patients by actively involving them in their care.
• It prioritizes the overall well-being of the patient, as it may prevent the onset of dermatological side effects and the use of topical corticosteroids and oral antibiotics.
• The process facilitates the pharmacist’s engagement with the patient in the day treatment center and throughout the treatment, allowing for addressing concerns, answering questions, and providing information about adverse effects.
• It promotes the creation of a multidisciplinary team by involving collaboration between oncology, nursing, and pharmacy.

What next?

We present a practical approach that enhances patient safety during the oncology process.
This practice can be adopted by any center.
It is necessary to continue collecting data to obtain reliable results regarding its impact on improving patient safety.

APPLICATION OF ARTIFICIAL INTELLIGENCE FOR THE COMPARISON OF NEW DRUGS AND MEDICAL DEVICES

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European Statement

Education and Research

Author(s)

Damuzzo V (1), Rivano M (2), Cancanelli L (3), Brunoro R (4), Gasperoni L (5), Ossato A (6), Colicchio A (7), Del Bono L (8), Di Spazio L (9), Celentano Fasano CN (10), Chiumente M (11), Mengato D (12), Messori A (13)
1) UOC Farmacia, AULSS2, P.O. di Vittorio Veneto
2) Hospital Pharmacy, Azienda Ospedaliero Universitaria, Cagliari
3) UOC Farmacia, AULSS2 Marca Trevigiana, P.O. di Castelfranco
4) School of Specialisation in Hospital Pharmacy, University of Milan, Milan
5) Oncological Pharmacy, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori, Meldola;
6) School of Specialisation in Hospital Pharmacy, University of Padua, Padua
7) Hospital Pharmacy, Azienda Unica Sanitaria Locale di Bologna (AUSL), Bologna
8) Azienda Ospedaliera Universitaria Pisana, Pisa
9) Hospital Pharmacy, Santa Chiara Hospital, Trento, Azienda Provinciale per i Servizi Sanitari (APSS);
10) Hospital Pharmacy, Azienda Ulss 3 Serenissima, Mirano,
11) Italian Society of Clinical Pharmacy and Therapeutics (SIFaCT), Milan
12) Hospial Pharmacy Unit – Azienda Ospedale-Università Padova
13) HTA Unit, Tuscany Region, Florence

Why was it done?

The clinical selection of available treatments and medical devices (MDs) is often hindered by the absence of direct efficacy comparisons between emerging therapies. This AI-tool aimed to address this challenge by employing advanced analytical techniques to facilitate informed decision-making in clinical settings.

What was done?

In 2016, the Italian Society for Clinical Pharmacy and Therapeutics (SIFaCT) launched the AVVICINARE project with the goal of training young hospital pharmacists to develop innovation in research based on non-original, already published data. We recently approached the field of indirect comparisons, applying the artificial intelligence (AI) technique ‘IPDfromKM’ to extract individual patient data (IPD) from Kaplan-Meier (KM) survival curves, enabling the indirect comparison of emerging pharmacological treatments and MDs

How was it done?

Drugs and technologies with similar therapeutic roles and efficacy assessed by time-dependent endpoints (Overall Survival, Progression-Free Survival) were identified. KM curves from relevant clinical trials were digitized, and the IPDfromKM application was used to reconstruct the IPD. Data from different studies on the same treatments were pooled to enhance sample size, and standard statistical techniques (Cox regression, inter-treatment comparison) were employed, considering long-surviving patients (restricted mean survival time [RMST]). A heterogeneity analysis ensured comparability of patient cohorts.

What has been achieved?

Drugs and technologies with similar therapeutic roles and efficacy assessed by time-dependent endpoints (Overall Survival, Progression-Free Survival) were identified. KM curves from relevant clinical trials were digitized, and the IPDfromKM application was used to reconstruct the IPD. Data from different studies on the same treatments were pooled to enhance sample size, and standard statistical techniques (Cox regression, inter-treatment comparison) were employed, considering long-surviving patients (restricted mean survival time [RMST]). A heterogeneity analysis ensured comparability of patient cohorts.

What next?

Given the increasing value of indirect comparisons in both clinical and pharmacoeconomic contexts, ongoing efforts will focus on refining the analytical techniques and expanding training programs for hospital pharmacists. Future work will also explore additional therapeutic areas to broaden the impact of evidence-based medicine and enhance the role of hospital pharmacists in clinical decision-making.

HOW CAN A SOCIAL MEDIA GRAPHIC PROJECT BECOME EDUCATIONAL? AN ITALIAN EXPERIENCE

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European Statement

Education and Research

Author(s)

Lamesta Chiara
Del Pizzo Mariagiovanna
Della Costanza Chiara

Why was it done?

“SIFOgram” is an information graphic project created by the Young Area of the Italian Society of Hospital
Pharmacy (SIFO) to promote scientific divulgation not only directed to students and pharmacists but also to
a broader audience.

What was done?

We inspected the development and popularity of this educational project. SIFOgram aims to create a smart and direct interaction that impact on patient perceptions, adherence, and responsibilities of hospital pharmacists in mitigating potential risks.

How was it done?

A graphic program was used for the creation of content published on official network pages. The references
for the subjects covered include certified bibliographies for scientific topics and digital graphics for
illustrations. The tool is applied to main topics related to contemporary health professions education
curricula, which include integrated educational designs, approvals of new drugs and supplementary
applications, new target therapies, drug dosing, and events organized by our society.

What has been achieved?

Since 1st March 2023 to 30th September 2024, we gathered +91% accounts with 12.000 reactions. Most of these interactions are for uploading of stories (67,2%) and post (28, 1%) and reels (4,5%). Of this total 3% -located across the different regions of Italy-was from general community; 2% from other European countries and outside Europe, including Africa. The age group that interacted were 25-34 ( 52,5%), -35-44 years old ( 27,4%) , 45-54 years old (9%), 55-64 years old (5%), +65 years old (2,3%). Most liked contents were : antimicrobial stewardship (average 900 views), international and national guidelines (average 650 views), management oxygen (1738 views) , conferences (average 1700 views) where healthcare professionals present their practices as leaders in their respective specialties. We invited our followers, via email, to complete a qualitative questionnaire made up of close-ended questions. 6 broad themes (each containing sub-themes) were identified: Content/clarity, Design/Layout, Audience, Graphics/Images, Interaction on social platforms (live box, chat) and References. The feedback received indicated a positive agreement.

What next?

Through this infographic project, we can gain a deeper successful use of social media in healthcare for public health awareness and improvement communication in the present and in the future.

OPTIMISING CUSTOM PACKS: A STEP TOWARDS A SUSTAINABLE HOSPITAL?

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European Statement

Selection, Procurement and Distribution

Author(s)

A. KANDEL (1), L. CABRIT (1), C. HUMARAUT (1), A. MASSRI (2), C. TAILHADES (1), S. ARRAKI ZAVA (1), V. GRENOUILLEAU (1)
(1) Pharmacy Department, Medical Devices Unit, Pau Hospital Center, France
(2) Intensive care unit, Pau Hospital Center, France

Why was it done?

Medical devices (MDs) and drugs account for 55% of the carbon footprint of a hospital’s French healthcare system, making this sector a key focus for the ecological transition. The MD sector alone is responsible for 32% of our hospital’s CO2 emissions, underlining the need to rethink our practices in order to reduce our environmental impact.

What was done?

Elimination of waste produced unnecessarily by optimising customised packs (CP) containing the MD required for treatment.

How was it done?

After a multidisciplinary team (pharmacists, intensive care units, anaesthetists, nurses) was put together, packs containing unused medical devices (UMD) were identified in 2 pilot departments: anaesthesia and intensive care. The packs were weighed with and without the UMD. The savings in terms of waste weight and carbon footprint were calculated according to the type of waste: general waste or biohazardous waste. In conjunction with the medical teams and suppliers, the re-evaluation of the MD required and the withdrawal of UMDs led to the updating of CP in the pilot departments.

What has been achieved?

The packs identified include: the suture pack (SP), the central venous line pack (CVL) and the epidural pack (EP). Over one year, the weight of waste avoided was: 64 kg for the SP, 87 kg for the CVL pack, 55 kg for the EP. After modifying these packs, annual CO2 emissions were reduced by 55% for the SP, 14% for the CVL pack and 8% for the EP, with a total annual saving of €5,423. The annual weight of waste was reduced by 206 kg, a saving of 92 kg of CO2: the equivalent of 86 Paris-London train journeys.

What next?

The re-evaluation of CP can generate a significant ecological impact. This initiative is intended to be rolled out on an institutional scale, with the active collaboration of the sustainable development department, and as part of future calls for tender. These adjustments save time for care staff, significantly reduce the carbon footprint, and contribute to the ecological transition. It is essential to strike a balance between economic and environmental imperatives, given the financial constraints facing public hospitals.

AN INTERPROFESSIONAL TRAINING WARD AND ITS BENEFIT FOR PHARMACY STUDENTS

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European Statement

Education and Research

Author(s)

Dückelmann Christina C., Landwehr Frauke

Why was it done?

According to the World Health Organization, interprofessional education and collaborative practice are leading to improved health outcomes. Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes.

What was done?

A cohort of two medical and two pharmacy students as well as four nursing trainees were selected to take over ward mangement and patient care for up to four real patients in a real hospital setting during a five weeks´ period. They were supervised by experienced professionals who “sit on their hands and look out of the window” only interfering when patients are endangered or situations are getting risky for patients.

How was it done?

To find out what the benefit was for pharmacy students, all six of them that where included in this year´s interprofessional wards on a cardiology and a neurology department, were interviewed using guided, problem-centred interviews. Their experiences were qualitatively explored and evaluated with regard to structure, supervsion, feedback and interprofessionality of this training.

What has been achieved?

Pharmacy students reported that the current structure, supervision and feedback enabled them to learn clinical pharmacy in a very profound way. On the other hand, it made other health care professionals aware of how they could benefit from clinical pharmacists and what the role of clinical pharmacists really is. The experience of being responsible for patients together with medical students and nursing trainees in this interprofessional setting was extremely helpful for their learning success and made them realize which influence on patients´ outcome working together in a team like that could have.

What next?

The Interprofessional Training Ward will be continued and rolled out on further departments of the hospital. In 2025, the surgery department will be part of the project. There, clinical pharmacists are badly needed. This qualitative research revealed the potential for further optimization of this programme in order to meet the learning objectives and expectations of the students even better. This will be aimed for in the next interprofessional training wards.