Nederlands Platform voor Farmaceutisch Onderzoek

Het Nederlands Platform voor Farmaceutisch Onderzoek (NPFO) presenteert onderzoek in de farmaceutische wetenschappen. De nadruk ligt op klinische toepassing zoals medicatieveiligheid, patiëntenzorg, formulering, analyse, farmacologie en casuïstiek.

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19 jul 2019

Farmacogenetisch paspoort voor relevante genetische variatie met betrekking tot geneesmiddelgebruik

  • Rubriek:
    Referaat
  • Identificatie:
    2019;4:e1687
  • Auteur(s):
    Martina Teichert

Farmacogenetisch paspoort voor relevante genetische variatie met betrekking tot geneesmiddelgebruik

09 jul 2019

Telefonische medicatieverificatie voor het signaleren van discrepanties na eerdere preoperatieve screening

  • Rubriek:
    Oorspronkelijk artikel
  • Identificatie:
    2019;4:a1706
  • Auteur(s):
    M.G.M. Heijnen a*, L.L.G. Šebek b en C.F.M. Heetman-Meijer c

Telefonische medicatieverificatie voor het signaleren van discrepanties na eerdere preoperatieve screening

Additional medication reconciliation by telephone to indicate discrepancies after preoperative screening

BACKGROUND

Medication reconciliation (MR) as part of the preoperative screening (POS) is widely used for identifying current medication use and potential medication related problems in patients who are scheduled for surgery. Since the POS is carried out up to three months before hospitalisation, discrepancies in the medication use may be introduced after the POS. Therefore, an additional medication reconciliation was introduced for patients who had visited the POS more than seven days ago. Patients were interviewed by telephone two to three days before hospitalisation.

OBJECTIVE

To study whether an additional medication reconciliation by telephone two to three days before hospitalisation is effective in identifying recent discrepancies in the medication use. Secondary objectives were to define the relevance of each discrepancy and to investigate the time needed for the additional MR by phone.

DESIGN and METHODS

In this retrospective, observational study, we included all patients who were interviewed by phone in January 2018. Any mutation in medication profile following the interview was defined as a discrepancy. Both the type and the relevance of each discrepancy were recorded. The relevance of each discrepancy was independently scored by two separate pharmacists. Also, the time investment of 73 additional MRs by phone in June 2018 was assessed.

RESULTS

A total of 142 patients were included. In 39% of the patients at least one discrepancy was found during MR by phone. 101 discrepancies were found, of which 49 were moderately to very relevant. An MR by phone took approximately 8.1 minutes per patient.

CONCLUSION

An additional medication reconciliation by phone two to three days before hospitalisation is effective in identifying discrepancies and leads to a more accurate medication overview.

03 jul 2019

Het effect van een zorgprotocol op het percentage patiënten met supratherapeutische clozapinespiegels tijdens ziekenhuisopname

  • Rubriek:
    Korte bijdrage
  • Identificatie:
    2019;4:a1704
  • Auteur(s):
    M.I. Koole a*, E.E. Roelofsen b, E. Baptist c, R. van der Meer d, E.B. Wilms e en L.E. Visser f

Het effect van een zorgprotocol op het percentage patiënten met supratherapeutische clozapinespiegels tijdens ziekenhuisopname

The effect of a therapeutic guideline on the percentage of patiënts with supratherapeutic clozapine blood levels during hospital admission

BACKGROUND

Hospitalized patients on clozapine are at risk for dysregulation of their clozapine blood concentration due to smoking cessation, (pre-existing) infections and the use of drugs which influence the metabolism of clozapine. In July 2017 a therapeutic guideline was implemented in the Haga Teaching Hospital and Haaglanden Medical Centre to monitor patients during hospital admission to prevent clozapine toxicity.

OBJECTIVE

Primary objective was to study the effect of the guideline by comparing the percentage of hospitalized patients with one or more serum clozapine levels > 0,80 mg/L and/or > 50% increase of their serum clozapine level during admission, before and after implementation of the guideline.

DESIGN

We conducted a non-interventional retrospective study.

METHODS

In a period of ten months before and after the implementation of the guideline, data from all hospitalized patients 18 years using clozapine for schizophrenia were collected from electronic patient files.

RESULTS

In 90% of all patients an intervention was necessary according to the guideline. There was no significant difference between the percentage of patients with supratherapeutic clozapine levels before and after the implementation of the guideline (P = 0,695). The involvement of the hospital pharmacist improved significantly after implementation of the therapeutic guideline (number of interventions; P < 0,001). The hospital pharmacist recommended the involvement/consultation of the psychiatrist in 39% of the admissions after implementation of the guideline.

CONCLUSION

The therapeutic guideline did not reduce the number of patients with supratherapeutic clozapine levels. However, the involvement of the hospital pharmacist resulted in earlier involvement of the psychiatrist. According to the guideline an intervention was necessary in most patients (90%). All patients with supratherapeutic clozapine levels (n = 28) had an infection and/or an elevated CRP which suggests early dose reductions are required.

27 jun 2019

Eerste instrument voor opsporen patiënten met hoog risico op medicatiefouten na ontslag intensive care

  • Rubriek:
    Referaat
  • Identificatie:
    2019;4:e1686
  • Auteur(s):
    Martina Teichert

Eerste instrument voor opsporen patiënten met hoog risico op medicatiefouten na ontslag intensive care

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