In renal transplant recipients, induction therapy with Thymoglobulin seems to be associated with a significantly greater incidence of CMV disease, malignancy, and death compared with ATGF.
BackgroundThe expiry of patents for infliximab in Europe coincides with the arrival on the market of new biosimilars with potential savings. However, many clinicians are reluctant to consider biosimilars as a treatment option for their patients.PurposeThe aim of this study was to evaluate concerns raised about biosimilars in the medical community in our hospital in order to reference infliximab biosimilars.Material and methodsA questionnaire with different items was put online: knowledge about the regulation of biosimilars in France, the degree of confidence in biosimilars, existence of high level evidence studies on the safety of biosimilars, and the acceptance of prescription and substitution.An item was used to evaluate the prescription frequency of biosimilars: regular prescribers (more than 1 prescription/week), occasional prescribers (between 6 and 12 prescriptions/year) and potential prescribers (<6 prescriptions/year). Comparison between prescriber groups was performed using Fisher’s exact test.Results36 prescribers responded to the survey. 47% (n = 17) were potential prescribers, 30.5% (n = 11) were occasional prescribers and 22% (n = 8) were regular prescribers. 61% (n = 22) had a good knowledge of the regulation of biosimilars. The degree of confidence was high for 70% (n = 25) of prescribers. However, 53% (n = 19) emphasised the lack of high level evidence for safety. 64% (n = 23) of prescribers were willing to prescribe a biosimilar and 50% (n = 18) to authorise substitution in patients already being treated with the originator product. The refusal rate for substitution seemed to be significantly different depending on the prescribing habits (p = 0.031). 75% (n = 6) of regular prescribers refused a substitution, while the refusal rate was 18% (n = 2) among occasional prescribers and 58.8% (n = 10) among potential prescribers. There were no statistically significant differences between prescribers groups about confidence level (p = 0.118).ConclusionMajor concerns voiced about biosimilars in this survey related to their pharmaceutical quality, safety (especially immunogenicity), efficacy (particularly in extrapolated indications) and interchangeability with the originator product. However, the acceptance of biosimilars in our hospital seems to be high. This allows pharmacists to initiate a process introducing infliximab biosimilars.References and/or AcknowledgementsThanks to the medical staff.No conflict of interest.
BackgroundMedication reconciliation is done to identify and correct medications errors but needs significant resources.PurposeThe aim of this study was to create a durable medication reconciliation activity that covers patients who are at the greatest risk of medication errors throughout the medical facility.Material and methodsIn this prospective single centre study over 2 months patients who were hospitalised through the emergency room of our facility were included. The emergency department prescribers filled out a selection grid to identify priority medication reconciliations based on following clinical and therapeutic risk factors:age;number of known drugs;anticoagulant, cardiovascular, antidiabetic, anticancer drugs, eye drops and anticonvulsants; andhistory of hypertension, heart failure, diabetes, cancer, epilepsy, tobacco consumption and memory disorders.This pre-established grid was based on a bibliographic search1 and a study performed in our hospital. A pharmacist determined each patient’s score daily. If the patient was still hospitalised 48 h after recovering the grid, a score ≥10 resulted in reconciliation.Results82 patients were included. A score ≥10 was found in 23 patients (28%). 16 medication reconciliations lasting 45 min were performed (19%). 7 patients did not participate in medication reconciliation despite a score ≥10 because it was beyond the time limit. Each prescription at admission included a mean of 1.1 unintentional deviations (UID).Reconciliation in a random unit was as time consuming as in other studies (30 ± 15 min2) but time was on the high side. The number of UID/admission was similar to that in other studies2 (1.2). The main limitation of this study was insufficient collection of risk factors by emergency prescribers.ConclusionThis grid, based on risk factors, made the selection possible. This process could be optimised by using a computerised grid in the patient’s medical file. Involving other professionals in data collection is another option.References and/or AcknowledgementsGroupe de travail sur le bilan comparatif des médicaments de l’APES. Réalisation du BCM dans les ES québécois (web). Available from: Dufay E, et al. La conciliation des traitements médicamenteux (web). OMEDIT presented at: Le parcours de soins; 2013; CH Luneville. Available from: No conflict of interest.
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