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The tri-monthly newsletter of the European Society
of Clinical Pharmacy News ESCP News
ESCP News
ESCP News
ESCP News �� ��August 2014
August 2014
August 2014
August 2014 �� �� Number 164
Number 164
Number 164
Number 164 �� �� ISSN 135
ISSN 135
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ISSN 13533 33-- -- 0321
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A Few Words
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ContentsContentsContentsContents : A Few words 1 ESCP life 2 Articles & Reports 3 ESCP Conferences 7 Announcements 8
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.
On behalf of ESCP – European Society of Clinical Pharmacy- we are pleased to invite you to the 43rd Symposium on Clinical Pharmacy in Copenhagen
The main theme of the symposium is: Patient safety Patient safety Patient safety Patient safety –––– bridging the gaps. bridging the gaps. bridging the gaps. bridging the gaps.
There has been extensive work in the area of improving patient safety during the last decade. Achieve the next batch of improve-ments future work needs to address the safety problems we face today. Such as gaps between;
• Primary care and secondary care
• Health professionals
• Academia and practice
About 1/3 of the adverse events experi-enced by patients in the health care sys-tem are linked to their medication. When a
patient moves across sectors’, there is a risk of experiencing new, preventable ad-verse events. About one third of these adverse events have the potential to harm the patient.
Denmark has a strong tradition in the area of patient safety, and focus on this area has been particular extensive during the past decade.
Pharmacists and clinical pharmacy have made a difference by bridging the primary and secondary care. Both medication re-view and reconciliation have proven effec-tive in preventing harm in patients. These have been shown to be most effective when performed by pharmacists.
In order to develop and share work and ideas within patient safety a very close collaboration between practice and acade-mia is necessary. Practice must adapt and implement the findings, that can improve patient safety – and academia must sup-ply new scientific results and more impor-tantly – new theories and methods to ad-dress the comprehensive and complex work in improvement of patient safety.
Pharmacists are strong players in the field of patient safety – but we cannot and shall not work alone. The pharmacist has tradi-tionally taken on the role of controlling and correcting other healthcare professionals. The future calls for sharing and sparring instead, in order to improve the quality of cooperation between pharmacist and fellow healthcare professionals but also the quality the interaction with patients. This has been an area to which growing
attention has been paid but much more work needs to be done to perfect the skills.
We invite both pharmacist and other health care professionals to participate in the symposium and hope that you will join us in Copenhagen and contribute to the discussions on how to bridge the present gaps in clinical pharmacy in order to im-prove patient safety.
The scientific programme includes invited plenary lecturers, oral free communica-tions, industry-supported mini-symposia, workshops, and poster presentations. The symposium venue is Scandic Copen-hagen a fully modernised eco-certified combined hotel and conference centre, situated in the very centre of Copenhagen, in walking distance from the Main Station and Tivoli Gardens.
Lona Louring ChristrupLona Louring ChristrupLona Louring ChristrupLona Louring Christrup President Copenhagen
Welcome to Copenhagen 22Welcome to Copenhagen 22Welcome to Copenhagen 22Welcome to Copenhagen 22----24 October 201424 October 201424 October 201424 October 2014
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ESCP Life
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Lona Louring ChristruLona Louring ChristruLona Louring ChristruLona Louring Christrupppp,,,, born on September 25th 1954 in Aarhus, Denmark
Career outlineCareer outlineCareer outlineCareer outline Currently I am employed at Department of Drug Design and Pharmacology, University of Copenhagen as professor in Clinical Phar-macy. I obtained a masters degree in Pharmaceu-tics at The Royal Danish School of Pharmacy (now PharmaSchool, University of Copenha-gen) in 1983, and was thereafter enrolled as Ph.D. student. After having finished my Ph.D. project in biopharmaceutics in 1986, I en-tered a tenure track at PharmaSchool. During my entire career at I have profited greatly from joining other research settings. Thus, I have been on sabbaticals at The Department of Pharmaceutical Sciences at The University of Nottingham in UK in 1988, and from 1994 to 1997 intermittently at The Department of Clinical and Experimental Pharmacology, University of Adelaide in Australia. In 2000, I joined the Intensive Care Unit at Herlev University Hospital as a clinical phar-
macist, and from October 2005 to October 2006 I worked at Nycomed Pharma as con-sultant Medical Adviser.
ResearchResearchResearchResearch My initial field of research was focused on drug development and biopharmaceutics, over the years my research has taken me gradually into the field of clinical pharmacy, however disciplines like drug use and phar-macotherapy, dose response relationships, influence on administration route and dosage form upon pharmacokinetics, effects and side effects have always been the recurring themes and the core issue of my research. Clinically, my research projects have mainly focused on pain treatment, including opioid pharmacology and the pharmaceutical and pharmacological aspects of treating critically ill patients in ICUs. From the very start, i.e. during the early stages of my Ph.D. project, most of the research has been carried out in close collaboration with clinicians (physicians and nurses) at hospitals and clinical pharmacologists at universities as well as with medical companies, providing me with an extensive, comprehensive research network. More than half of my publications are results of clinical trials. Over the years, I have gained valuable, multi-faceted knowledge of the different methodologies, the different phases and the different roles involved in a clinical
trial, and an insight in the difference of ap-proach between academia and industry during the design of clinical studies. My publication list includes more than 125 research papers, around 20 popular science papers, 2 patent applications, and 1 Ph.D. thesis, and more than 60 abstracts in con-nection with poster and free oral presenta-tions at scientific meetings.
TeachingTeachingTeachingTeaching Over the years I have taught a broad range of subjects, such as pharmaceutical technology, drug delivery and biopharmaceutics, pharma-cotherapy, clinical pharmacy, social pharmacy and pharmacology at both pre- and post-graduate level. Teaching activities have in-cluded lectures, workshops, laboratory exer-cises, tutorials, examinations, supervisions at both M.Sc. and Ph.D. level, as well as course planning, managing, and evaluation. Further, I have been member of several Ph.D. assessment committees, both in Denmark and abroad and have functioned as external examiner at Master Thesis projects at other universities in Denmark.
ESCP activities ESCP activities ESCP activities ESCP activities I have been a member of ESCP since 2010 and have participated in a couple confer-ences arranged by ESCP. Currently I am part of the presidency and chair of the Scientific Committee for the upcoming Symposium in Copenhagen October 2014.
Dorthe Vilstrup TomseDorthe Vilstrup TomseDorthe Vilstrup TomseDorthe Vilstrup Tomsennnn, born on the 14th of May 1970 in Denmark.
Education/work activityEducation/work activityEducation/work activityEducation/work activity I earned my Master’s Degree in Pharmacy, from the University of Copenhagen in 1996. I started my career at Pharmakon. Pharmakon is a subsidiary company to the Danish Phar-macy Association and specialises in training, research and counseling within pharmacy practice in pharmacies and in the pharma-ceutical industry. Pharmakon is also a WHO Collaboration Centre for Drug Policy and Phar-macy Practice Development. In the beginning of my career my activities were split between teaching and providing pharmaceutical assis-tance in connection with WHO projects. Later I moved on to the research department and for the next 8 years I worked with research and development of new pharmaceutical services to the Danish pharmacies. During this period I worked closely with colleagues across Europe, mostly in the newly formed PCNE (Pharmaceutical Care Network Europe).
In 2006 I made a shift, and went from “behind the desk” of a researcher to “behind
the counter” as a pharmacist at a primary care pharmacy. I wanted to try out my ideas in practice and to get a feel for the patients.
Pretty fast after that I made another big shift in my career. In order to fulfill my ambitions about changing the system for the better, I got a job as a manager of Clinical Pharmaceutical Services at Hilleroed Hospital. It was my first job with responsibilities as a leader of a unit, and I considered the work with leadership, as a challenging, important and interesting part of my career. In the period from 2007 to 2010 I earned my Diploma Degree in Leader-ship at VIA University College. In 2009 I took on a new job at the Hospital Pharmacy, The Capital Regional Pharmacy and became Area Manager of Clinical Pharmaceutical Services, for the Northern part of the Capital Region. I still hold this position today.
As the area manager of the Clinical Pharma-ceutical Services in North Zealand, I am re-sponsible for ward based TOP –UP services, economic supervision/monitoring of drug usage, safety of medicines and medication processes as well as clinical pharmaceutical services at our three (two somatic and one psychiatric) hospitals. I head a team of 55 employees mainly pharmacists and phar-maconomists, of these two are unit-leaders.
Since 2010 the Hospital I work at, has been heavily involved in a National Patient Safety initiative called “Safer Hospitals Program”. I am a “sponsor” on the workstream regarding Medicines Management, where I’m leading the improvement work on medicines recon-ciliation and High Risk medications. Because
the hospital and the pharmacy are two sepa-rate organisations in the Capital Region, we manage to combine the skills of the Phar-macy with the safety needs of the patients at the hospital. The improvement work within the field of patient safety is a strong driver in my work. I am currently completing an Improvement Advisor Professional Development Program offered by The Institute for Healthcare Im-provement, Cambridge, MA, U.S. In my current position I only have limited time for research so I try to find time for this work on the side.
I find it extremely important to have both aca-demic and practice in clinical pharmacy, I hold a position as part-time lecturer at PharmaSchool, University of Copenhagen, where I supervise master students (12) and recently my first PhD student. I teach patient communication, methods in pharmaceutical care, Improvement science, medication review, pharmacoepidemiology and methods in social and clinical pharmacy. Currently my research activities are focused on “Patient safety and implementation re-search with focus on use of antibiotics”.
ESCP activitiesESCP activitiesESCP activitiesESCP activities My aim with getting involved with ESCP is to tie a knot between the different threads in my career. I have met a lot of people from my past as a researcher at Pharmakon but also a lot of new people, with whom I hope to make a network. I believe that we need each other in order to bridge the gabs we’re still facing in the field of clinical pharmacy.
Who’s who: two presidents for Who’s who: two presidents for Who’s who: two presidents for Who’s who: two presidents for the Copenhagen Symposium the Copenhagen Symposium the Copenhagen Symposium the Copenhagen Symposium
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Scientific ProgrammeScientific ProgrammeScientific ProgrammeScientific Programme
43rd ESCP Symposium on Clinical Pharmacy, 43rd ESCP Symposium on Clinical Pharmacy, 43rd ESCP Symposium on Clinical Pharmacy, 43rd ESCP Symposium on Clinical Pharmacy, Copenhagen, Denmark, 22Copenhagen, Denmark, 22Copenhagen, Denmark, 22Copenhagen, Denmark, 22----24 Oct 201424 Oct 201424 Oct 201424 Oct 2014
Patient SafetyPatient SafetyPatient SafetyPatient Safety————Bridging the GapsBridging the GapsBridging the GapsBridging the Gaps
The scientific programme includes keynote lectures, invited lectures, oral free commu-nications, scientific and industry-supported mini-symposia, workshops, and poster presentations.
Main TopicMain TopicMain TopicMain Topicssss: • Bridging the gaps between: - Primary and secondary care - Academia and practice - Healthcare professionals
• Challenges in: - Discontinuation of medicine - Optimisation of patient safety - Defining the optimal outcome measures in research and practice - Implementation of IT-technology in clinical practice
• How to: - Educate undergraduates in clinical prac-tice - Organise clinical pharmacy - Academise clinical pharmacy - Integrate clinical pharmacy in the health care system - Use PK-PD modelling as a tool in indivi-dualized drug therapy
• Challenges in the pharmacological treat-ment of: - Children and adolescents - Ethnic minorities - Patients suffering from complex chronic pain conditions
• The future role of: - Biopharmaceuticals - Life style medicine - Off label use of drug - Political barriers to optimal drug therapy All afternoon parallel sessions are schedu-led including workshops, oral free commu-nications, poster discussion fora, and invi-ted lectures.
Workshop scheduleWorkshop scheduleWorkshop scheduleWorkshop schedule WS01 : Writing Original Papers Moderator: Dr. J.W.Foppe van Mil (FESCP). Perhaps the workshop will be co-moderated by another member of the Communication Committee. WS02 : Getting abstracts accepted Moderator: Dr. J.W.Foppe van Mil (FESCP). Perhaps the workshop will be co-moderated by another member of the Communication Committee. WS03 : The Challenge of Competent Phar-macists in Individualized Pharmaceutical Care Plan Moderators: Assist.Prof.Dr. Betül Okuyan (Turkey), Assoc.Prof.Dr. Mesut Sancar (Turkey), Prof.Dr. Fikret Vehbi Izzettin (FESCP - Turkey).
WS04 : The workplace as an educational environment for clinical teaching within everyday pharmacy practice Moderators: Caroline Souter, Principal Pharmacist, Education, Research & Deve-lopment, NHS Lothian and Honorary lectu-rer University of Strathclyde and Moira Kinnear, Head of Pharmacy Education, Research & Development NHS Lothian, Honorary senior lecturer University of Strathclyde and co-ordinator of ESCP Edu-cation & Training SIG WS05 : Role of the pharmacist to assure efficacy and security of medications in Nursing homes Moderators: Georges L. Zelger (FESCP – Zwissterland), Louise Mallet (FESCP – Canada). WS06 : Medication use in pregnant and breastfeeding women - useful information sources Moderators: Charlotte Verrue (Belgium), Yolande Hanssens (FESCP - Qatar). WS07 : Sharing Care of Medicines across Primary and Secondary Care Moderators: Dr Simon Hurding (Scotland, UK), Katherine Davidson (Scotland, UK) WS08 : Tailored communication in promo-ting medication intake behaviour Moderators: Dr Annemiek Linn (Netherlands), Dr BJF (Bart) van den Bemt (Netherlands). WS09 : From Socrates to Georgetown - Ethical Problems in Pharmacy Practice Moderators: Pr Alan Greenberg (New York), Dr. Rudolf P. Dessing (FESCP - Nether-lands). WS10 : One Stop Dispensing on a Danish hospital ward - how to convince nurses to dispense medicine bedside Moderators: Morten B. Andersen (Denmark), Marie-Louise Duckert (Denmark), Helle Mcnulty (Denmark). WS11 : Mismatch between Regulatory Affairs and Clinical Practice Moderators: Pr Hanne Rolighed Christen-sen (Denmark), Pr Steffen Thirstrup (Denmark) WS12 : The clinical pharmacist as a link in the medication process Moderators: Rikke Nørgaard Hansen, An-nette Nissen Gubi, Tina Buch (Denmak). WS13 : STOPP-START Version 2 - Polyphar-macy Care of the Older Person What is the potential role of a pharmacists Moderators: Dr. Stephen Byrne (Ireland), Mr Shane Cullinan.
WS14 : Developing a patient safety focu-sed systematic review protocol Moderators: Katie MacLure (Scotland), Dr Vibhu Paudyal (Scotland).
WS15 : Student-led med review_ A debate- Pharmacy students should receive training in medication review with real patients Moderator: Mr. Richard Adams (UK).
WS16 : TDM Workshop _ Therapeutic Drug Monitoring Moderator: Khidir, Mohamed Elhassan Mohamed (United Arab Emirates)
WS17 : How to recognize homecare pa-tients who benefit most of clinical pharma-cy services Moderators: Carita Linden-Lahti (Finland), Sini Kuitunen (Finland).
WS18 : Safety monitoring of patients on psychiatric pharmacotherapy Moderator: Mirjam Simoons (Netherlands).
WS19 : Workplace learning and assess-ment in the (post)graduate education of pharmacists Moderators: Henk Buurma (Netherlands), Annemieke - F loo r - Sch reude r i ng (Netherlands).
WS20 : NNT game_ NNT NNH and TUB – and their use in developing a pharmaceuti-cal care plan for individual patients Moderators: Adrianne Faber (Netherlands), Anne J. Leendertse (Netherlands).
WS21 : Pharmacoeconomics a practical approach to assessing the literature Moderator: Katherine Lyseng-Williamson: editor of the Adis journal Drugs & Therapy Perspectives
WS22 : Challenges in discontinuation of medicine; N-of-1 trials as an individualized treatment approach Moderators: Dr. Hanna M. Seidling, Anette Lampert (Germany).
WS23 : Health Information Technology and Patient Safety Moderators: Mara Guerreiro (Portugal), Sarah P. Slight (US).
WS24 : CDSCP2 Tackling drug-drug inte-ractions clinical decision support vs clinical pharmacists Moderators: Stephane Steurbaut (Belgium), Pieter Cornu (Belgium), Drug-drug interaction and Clinical Decision Sup-port specialist.
WS25 : Supporting development of Advan-ced Clinical Pharmacy Practice to ensure Patient Safety Moderators: Lilian M. Azzopardi (Malta), Sam Salek (UK), Anthony Serracino-Inglott (Malta), Alan Lau (USA).
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ESCP SIG GeriatricESCP SIG GeriatricESCP SIG GeriatricESCP SIG Geriatric
The SIG Geriatrics presents a clinical case. If you cannot find the answer… see page 6.The SIG Geriatrics presents a clinical case. If you cannot find the answer… see page 6.The SIG Geriatrics presents a clinical case. If you cannot find the answer… see page 6.The SIG Geriatrics presents a clinical case. If you cannot find the answer… see page 6.
Clinical case: OsteoarthritisClinical case: OsteoarthritisClinical case: OsteoarthritisClinical case: Osteoarthritis A 75-year-old woman (MDRD: 65 mL/min/1.73 m2, 65 kg) presents to your pharmacy with complaints of pain and stiffness in both knees, hips, and thumbs. She also has occasional back pain. Family history reveals that her mother had similar problems. The patient has bony enlargement in her fingers. The physicians diagnosed her with osteoarthritis. She has no other co-morbidities and even walks 30 mi-nutes/day without walking aid. She
indicated that she already uses 2 x 500 mg paracetamol/day. Question 1: Which analgesic would you advise? Paracetamol, a non-steroidal anti-inflammatory drug (NSAID) or an opiate? Back to the patient Back to the patient Back to the patient Back to the patient After 6 months, she is again in your pharmacy. Previous therapy was insuf-ficient to decrease her pain. Further-more, 3 months ago she was admitted to the hospital due to an acute myo-
cardial infarction. Now, she now also uses acetylsalicylic acid (80 mg daily), simvastatin (40 mg daily), dipyrida-mole (75 mg twice daily), metoprolol (50 mg daily) and lisinopril (10 mg daily) Despite this, the physician in-tents to prescribe a NSAID.
Question 2: Which NSAID will you ad-vise?
Question 3: Which additional advice will you give with respect to the gastro-
intestinal safety?
New Postgraduate Doctorate of Pharmacy Programme New Postgraduate Doctorate of Pharmacy Programme New Postgraduate Doctorate of Pharmacy Programme New Postgraduate Doctorate of Pharmacy Programme in Europein Europein Europein Europe
The University of Malta in collaboration with the University of Illinois in Chicago is launching a new postgraduate Doc-torate of Pharmacy programme, PharmD. The programme is offered by the Department of Pharmacy of the University of Malta, Malta in collabora-tion with the College of Pharmacy at the University of Illinois in Chicago, Illinois, USA (UIC). The course is ex-pected to start in October 2014 and is intended to attract European and In-ternational pharmacists who would like to develop their clinical pharmacy and research skills to a doctorate de-gree. The Department of Pharmacy at the University of Malta enjoys a longstand-ing history of experience in clinical pharmacy education and research and the College of Pharmacy at the Univer-sity of Illinois in Chicago ranks among the top colleges of pharmacy in the US.
This PharmD course which is being launched is unique in that it combines the development and application of advanced clinical pharmacy skills with contextual research. All study-units are delivered jointly by the University of Malta and the UIC College of Phar-macy. The course is targeted at phar-macists who would like to advance their careers by enhancing profes-sional clinical practice with a research perspective. It offers a professional doctorate in clinical pharmacy and is suitable for pharmacists working in hospitals, primary-care or community pharmacy and pharmacy administra-tion and regulatory settings. The course will empower pharmacists to assume leadership roles that will drive policies and developments in clinical practice and service that draws on scientific, evidence-based and innova-tive research. The Pharm D course is spread over three years of study, spanning a total of 6 semesters. The first year of study is mainly composed of taught units with the second and third years being based primarily on research and clini-cal experience. The programme is delivered using a blended learning model that includes lectures, distance learning and practice-based learning. Candidates who successfully complete 90 ECTS are awarded a Master in Ad-vanced Clinical Pharmacy degree if they do not wish to proceed further. The taught programme covers aspects of Pharmacotherapeutics, Drug infor-mation and statistics, Principles of pharmacoeconomics and Health sys-tems in Europe and the USA. The Clini-Clini-Clini-Clini-cal Experiencecal Experiencecal Experiencecal Experience will be provided through clinical rotations based in different pharmacy settings including
hospital, ambulatory care and commu-nity pharmacy. The ResearchResearchResearchResearch modules will lead the candidate to develop criti-cal analysis and literature evaluation within the context of translational and applied research in pharmacy. The PharmD course presents a unique opportunity for pharmacists in all ar-eas to acquire a doctorate degree reflecting present and future interna-tional developments in pharmacy edu-cation, practice and research. Further information may be obtained from Professor Lilian M. Azzopardi of the Department of Pharmacy at the University of Malta on li lian. [email protected] or Professor Alan Lau from the College of Pharmacy University of Illinois at Chicago on [email protected].
Lilian AzzopardiLilian AzzopardiLilian AzzopardiLilian Azzopardi [email protected]
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The Palermo ESCP workshop was attended by 83 participants. The total number of survey respondents, after 1 invitation and 1 reminder, was 32 (38.5% of attendees). Description of the respondents Description of the respondents Description of the respondents Description of the respondents Respondents mean age was 44.3±11.1 (range 25-63) and 18 (56.2%) were fe-male. The majority of respondents, 19 (59.4%) were hospital pharmacists, 5 (15.6%) worked in the research field, an-other 5 (15.6%) were community pharma-cists, 1 (3.1%) worked in the education field, with the remaining 2 (6.3%) working in different settings as reported in Figure 1.
Italy, Switzerland and The Netherlands are the most represented countries. Other European and non European countries joined the workshop (Figure 2).
Twenty-one (65.6%) respondents were ESCP member, and of those 13 (41.9%) were active within ESCP in a committee or working group. The largest group of survey respondents 15, (46.9%) reported that they had read about the symposium in the ESCP newsletter, 12 (37.5%) had heard about the workshop through word-of-mouth, 7 (21.9%) had seen the workshop’s an-nouncement on the Internet from the ESCP, and 2 (6.2%) had been invited by the pharmaceutical industry. The remaining respondents 7 (21.9%) heard about the workshop through different sources. AttendanceAttendanceAttendanceAttendance The workshop welcomed 10 (31.2%) first-timer attendants; for 8 (25.0%) respon-dents this was the second/third time that
they participated to ESCP workshop or Symposium, 2 (6.2%) attended 4-5 ESCP meetings and 12 (37.5%) had been to more than five ESCP events before. Almost all respondents (28, 87.5%) attended two days.
Opinion about sessions and lectures Opinion about sessions and lectures Opinion about sessions and lectures Opinion about sessions and lectures Survey participants were asked to rate and comment on several aspects of the scien-tific program as well as on organizational aspects. As far as scientific sessions are concerned, the results are reported in fig-ure 3, 4, and 5. Table 1 shows respondents attendance at workshops .
All workshops were run twice and lasted longer than usual (3 hours instead of 1.5 hours).
The overall impression of the Palermo workshop was good (16, 50.0%) to excel-lent (15, 46.9%). Only 1 (3.1%) judged the conference as not good – not. As a sugges-tion for the future one participant recom-mended not starting the plenary sessions before the scheduled time and avoiding served lunches in such a short time.
Respondents were also asked to identify what they found the most useful about the Palermo ESCP workshop (Table 2).
The organisational aspects of the confer-ence were also rated high: the accommo-dation and the conference centre were found excellent by 15 (46.9%) and 19 (59.4%) respondents, and good by 11 (34.4%) and 11 (34.4%)respectively. Only 3 (9.4%) and 2 (6.3%) rated the accommoda-tion and the venue respectively not good- not bad. As far as the food is concerned, 13 (40.6%) respondents scored it excellent and 13 (40.6%) good. Four (16.0%) rated the food not good not bad. Only 3 (9.4%) found the food not good not bad. Support by the conference staff ranged from excellent (15, 46.9%) to good (13, 40.6%), only 1 (4.0%) rated it not good not bad. The support by the ESCP desk was excellent for 14 (43.8%) and good for 15 (46.9%) respondents. The final component of the survey focused on future meetings. The majority of survey participants responded positively to attend-ing future meetings (Table 3).
Social eventsSocial eventsSocial eventsSocial events Respondents were invited to express their opinion on the social events. Twelve (48.0%) respondents scored the welcome reception excellent and 11 (44.0%) found it good. Only 2 (8.0%) found it not good not bad. At the end of the conference 10 (31.3%) found the wrap up and farewell drink excel-lent, 13 (40.6%) found it good and 4 (12.5%) not good not bad. Two found it boring.
Daniela ScalaDaniela ScalaDaniela ScalaDaniela Scala
Figure 2: Distribution of survey participants
Table 1: Workshops respondents attendance Workshop
Figure 3. 22 May session
Figure 4. 23 May session
Figure 5. Workshop sessions
Table 2: What did you find the most useful about the Palermo workshop (multiple an-swers allowed)
Table 3: Would you visit another ESCP sympo-sium or workshop in the future?
Figure 1: Distribution of respondents by job category
ESCP International WorkshopESCP International WorkshopESCP International WorkshopESCP International Workshop Palermo, Italy, 22Palermo, Italy, 22Palermo, Italy, 22Palermo, Italy, 22----23 May 201423 May 201423 May 201423 May 2014
Safe Transition of PharmacotherapySafe Transition of PharmacotherapySafe Transition of PharmacotherapySafe Transition of Pharmacotherapy
Satisfaction Survey Satisfaction Survey Satisfaction Survey Satisfaction Survey
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EMA newsEMA newsEMA newsEMA news
AceclofenacAceclofenacAceclofenacAceclofenac
Aceclofenac is structurally related to diclofenac and greatly metabolised to diclofenac. Similarly to diclofenac some recent epidemiological studies have found an increased risk of nonfatal acute myocardial infarction for aceclofenac.
The product information of aceclofenac will be updated with the following infor-mation:
Aceclofenac is now also contraindicated in patients with established: - ischaemic heart disease, - peripheral arterial disease, - cerebrovascular disease, - congestive heart failure (New York Heart Association [NYHA] classification II–IV).
Patients with these conditions should be switched to an alternative treatment at their next routine appointment
Aceclofenac treatment should only be initiated after careful consideration in patients with: - congestive heart failure (New York Heart Association [NYHA] classification I), - significant risk factors for cardiovascular events (e.g., hypertension, hyperlipidae-mia, diabetes mellitus, smoking), - history of cerebrovascular bleeding.
Cardiovascular risks of aceclofenac may increase with dose and duration of expo-sure, so the shortest duration possible and the lowest effective daily dose should be used in these patients. The patient’s need for symptomatic relief and response to therapy should be re-evaluated periodically.
HydroxyzineHydroxyzineHydroxyzineHydroxyzine
Hydroxyzine is used for the symptomatic treatment of anxiety in adults, Sympto-matic treatment of pruritus, urticaria and itching, insomnia related to allergic symp-toms and as premedication before sur-gery.
A benefit-risk assessment by the Market-ing Authorisation Holders (MAH) revealed a potentially increased risk of alterations of the electrical activity of the heart and arrhythmias. The MAH submitted a varia-tion to delete two approved indications (premedication, sleeping disorders) and decrease the highest recommended daily dose for adults from 300 mg to 100 mg in the remaining indications.
The EMA will review the available data on the benefits and risks of hydroxyzine-containing medicines in all authorised indications, and issue an opinion on the marketing authorisations of these medi-cines across the EU.
While the review is ongoing, patients should speak to their doctor or pharma-cist if they have any questions or con-cerns. IbuprofenIbuprofenIbuprofenIbuprofen
The results from a large meta-analysis of more than 600 randomised clinical trials indicate that the thrombotic risk with high-dose ibuprofen may be similar to the risk with COX-2 inhibitors. In addition, there is accumulating evidence that ibu-profen may also inhibit the antiplatelet action of low-dose aspirin for cardiovas-cular prophylaxis.
The concern relates to high-dose ibupro-fen (2,400 mg per day). Previous reviews have confirmed that there is no sugges-tion of a similar concern at usual doses up to and including 1,200 mg per day. This review is therefore not expected to affect the way ibuprofen is used by the overwhelming majority of patients. Ibu-profen is one of the most widely used medicines and has a well-known safety profile, particularly at usual doses.
The review will also evaluate evidence on the interaction of ibuprofen with low-dose aspirin (taken to reduce the risk of heart attacks and strokes) to decide whether current advice to healthcare profession-als is sufficient. Patients should continue to use ibuprofen as per instructions in the package leaflet and as directed by their doctor or pharmacist. Patients who have any questions should contact their doctor or pharmacist.
The last EMA review of ibuprofen in 2012 concluded that the possibility of a small increased risk of blood clots with high-dose ibuprofen used for long-term treat-ment could not be excluded. The product information for ibuprofen was updated with this information. Some information is contained in the current product infor-mation for ibuprofen about its interaction with low-dose aspirin but there has been uncertainty as to whether there is any clinically relevant interaction with normal use of ibuprofen. This review will take into account all the latest data.
Gert LaekemanGert LaekemanGert LaekemanGert Laekeman [email protected]
ESCP SIG GeriatricESCP SIG GeriatricESCP SIG GeriatricESCP SIG Geriatric Answer of the clinical case (page 4).Answer of the clinical case (page 4).Answer of the clinical case (page 4).Answer of the clinical case (page 4).
Answer: Question 1Answer: Question 1Answer: Question 1Answer: Question 1 Although several clinical trials indicate that NSAIDs might be more effective in reducing pain in patients with osteoarthri-tis, adequately dosed paracetamol is still effective in a significant proportion of patients. As paracetamol has a better safety profile compared to NSAIDs, it is recommended to start with adequately dosed (2.5—3 gram/day) on a regular basis. As this patient only used 1 g/day, an increased paracetamol dose of 1 gram TID is recommended.
In case patients do not respond in 2-3
months, than a NSAID can be prescribed.
Of note, besides pharmacological inter-
vention, weight management and physi-
cal therapy are also recommended in
patients with osteoarthritis. In case of an
oligo-arthritis (1-3 joints affected) a topi-
cal NSAID cream might also be consi-
dered.
Answer: Question 2Answer: Question 2Answer: Question 2Answer: Question 2 For patients with cardiovascular disease, paracetamol and topical NSAIDs are first line treatment options. Only when an oral NSAID can’t be avoided, it can be pre-scribed in the lowest possible dose for the shortest possible period. When a NSAID is necessary, naproxen is the most cardiovascular safe NSAID. The cardiovascular profile of diclofenac on the other hand is comparable with the cardiovascular risk profile of etoricoxib and celecoxib. Answer: Question 3Answer: Question 3Answer: Question 3Answer: Question 3 Patients older than 70 years have an increased risk for severe gastro-intestinal complications like ulcerations, perfora-tions and bleedings. Therefore, for these patients using a traditional NSAID, it is always recommended to concomitantly use a proton pump inhibitor. In this case, the patient also uses acetyl-
salicylic acid, which also increases the risk of a gastro-intestinal perforation, ulceration or bleeding. Using a proton pump inhibitor decreases the risk of severe gastro-intestinal adverse events. ReferencesReferencesReferencesReferences 1. McAlindon TE, Bannuru RR, Sullivan MC, et al. OARSI guidelines for the non-surgical man-agement of knee osteoarthritis. Osteoarthritis Cartilage. 2014 ; 22222222 : 363-88.
2. Coxib and traditional NSAID Trialists' (CNT) Collaboration, Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 31 ; 382382382382 : 769-79.
Bart van den BemtBart van den BemtBart van den BemtBart van den Bemt
[email protected] Louise MalletLouise MalletLouise MalletLouise Mallet
Actions inspired by the PRACActions inspired by the PRACActions inspired by the PRACActions inspired by the PRAC (Pharmacovigilance Risk Assessment Committee)(Pharmacovigilance Risk Assessment Committee)(Pharmacovigilance Risk Assessment Committee)(Pharmacovigilance Risk Assessment Committee)
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ESCP News �� �� August 2014
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August 2014 �� �� Number 164
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Number 164 �� �� ISSN 135
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43rd ESCP Symposium on Clinical Pharmacy, 43rd ESCP Symposium on Clinical Pharmacy, 43rd ESCP Symposium on Clinical Pharmacy, 43rd ESCP Symposium on Clinical Pharmacy, Copenhagen, Denmark, 22Copenhagen, Denmark, 22Copenhagen, Denmark, 22Copenhagen, Denmark, 22----24 Oct 201424 Oct 201424 Oct 201424 Oct 2014
Patient SafetyPatient SafetyPatient SafetyPatient Safety————Bridging the GapsBridging the GapsBridging the GapsBridging the Gaps
ESCPESCPESCPESCP----SFPC International Workshop, SFPC International Workshop, SFPC International Workshop, SFPC International Workshop, Nice, France, June 2015Nice, France, June 2015Nice, France, June 2015Nice, France, June 2015
Acquisition of Pharmaceutical Skills: Acquisition of Pharmaceutical Skills: Acquisition of Pharmaceutical Skills: Acquisition of Pharmaceutical Skills: Simulation, Serious Games, Simulation, Serious Games, Simulation, Serious Games, Simulation, Serious Games, Innovative ApproachesInnovative ApproachesInnovative ApproachesInnovative Approaches
President of the WorkshopPresident of the WorkshopPresident of the WorkshopPresident of the Workshop
Olivier Bourdon (FR)
Organising CommitteeOrganising CommitteeOrganising CommitteeOrganising Committee Rémy Collomp (chair) (FR) Jean Paul Fournier (FR) Julien Duquesne (FR) Valérie Chedru (FR) Olivier Bourdon (FR) Erik Gerbrands (NL) Edwin van Aalten (NL)
Scientific CommitteScientific CommitteScientific CommitteScientific Committe Bertrand Decaudin (FR) Brigitte Bonan (FR) Pierrick Bedouch (FR) Pascal Bonnabry (CH) Jean Claude Granry (FR) Vera Jordan-von Gunten (CH) Mara Pereira Guerreiro (PT) Moira Kinnear (SC) Marie-Caroline Husson (FR) Daniela Scala (IT)
Local Organising CommitteeLocal Organising CommitteeLocal Organising CommitteeLocal Organising Committee Dorthe Vilstrup Thomsen Head of clinical pharmacy, Capital Region Hospital Pharmacy Lotte Stig Nørgaard Associate professor in Social Pharmacy PhD, Department of Pharmacy, University of Copenhagen Søren Ilsø Moreno Pharmacist, PhD, Danish National Board of Health and Medicines and president of the Danish Pharmaceutical Society
Scientific CommitteeScientific CommitteeScientific CommitteeScientific Committee Lona Christrup Professor in Clinical Pharmacy PhD, De-partment of Drug Design and Pharmaco-logy, University of Copenhagen Kim Brøsen Professor in Clinical Pharmacology DMs, Department of Clinical Pharmacology, University of Southern Denmark and Odense University Hospital
Let cOPENhagen welcome you!Let cOPENhagen welcome you!Let cOPENhagen welcome you!Let cOPENhagen welcome you!
Experience our pulsating metropolitan capital where fashion and tradition go hand in hand with a safe, efficient, yet exciting environment offering modern meeting facilities, luxury hotels and a plethora of things to see and do. With a population of 1.7 million, Copenhagen is the largest city in Scandinavia.
Though smaller than many other Northern European cities, the Danish capital has pro-ven itself more than able to organise success-ful large-scale events in innovative and ap-pealing settings. In fact, Copenhagen is ranked as one of the world’s most popular convention cities, due to its easy accessibility, high levels of efficiency and low crime rate, among other factors. The city is located at the heart of a major kno-wledge centre and, in recent years, its range of hotels and meetings venues has grown exponentially. But that's not all. This is a city which effortles-sly combines old and new, preserving its 1,000-year history yet always looking to the future. We are equally skilled at combining business with pleasure - did you know, for example, that the world's best restaurant is in Copenhagen? But we'll return to that in a moment...
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ESSSSCP European Society of Clinical PharmacyEuropean Society of Clinical PharmacyEuropean Society of Clinical PharmacyEuropean Society of Clinical Pharmacy
ESCP News ESCP News ESCP News ESCP News is published by ESCP
Editor: Marie Caroline Husson (France)Editor: Marie Caroline Husson (France)Editor: Marie Caroline Husson (France)Editor: Marie Caroline Husson (France) Page Lay-out: Corinne Tollier (France) Language editing: Ian Millar (UK)
The contents of this publication are compiled in good faith. The publisher accepts no responsibility for omissions or errors.
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Deadline for the submission of material: for issue number 165 is 30 september 2014.
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ESCP News �� �� August 2014
August 2014
August 2014
August 2014 �� �� Number 164
Number 164
Number 164
Number 164 �� �� ISSN 135
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Announcements
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2014201420142014
22222222----24 October24 October24 October24 October Copenhagen (Denmark)
43rd ESCP Symposium on Clinical Pharmacy « Patient Safety - Bridging the Gaps »
2015201520152015
JuneJuneJuneJune Nice (France)
ESCP-SFPC Workshop « Acquisition of Pharmaceutical Skills: Simulation, Serious Games, Innovative Approaches »
28282828----30 October30 October30 October30 October Lisboa (Portugal)
44th ESCP Symposium on Clinical Pharmacy
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