BackgroundIn recent years, the number of prescriptions for sedative drugs has increased significantly, as has their long-term use. Moreover, sedative use is frequently initiated during hospital stays.ObjectivesThis study aimed to describe new prescriptions of sedative drugs during hospital stays and evaluate their maintenance as discharge medication.MethodsThis observational prospective study took place in an internal medicine ward of a Swiss hospital over a period of 3 months in 2014. Demographic (age, sex, diagnosis, comorbidities) and medication data [long-term use of sedative drugs, new regular or pro re nata (‘as needed’) prescriptions of sedative drugs, drug-related problems] were collected. Sedative medications included: benzodiazepines, Z-drugs, antihistamines, antidepressants, neuroleptics, herbal drugs, and clomethiazole. McNemar’s test was used for comparison.ResultsOf 290 patients included, 212 (73%) were over 65 years old and 169 (58%) were women; 34% (n = 98) were using sedative drugs long term before their hospital stay, and 44% (n = 128) had a prescription for sedative drugs at discharge—a 10% increase (p < 0.05). Sedative drugs were newly prescribed to 37% (n = 108) of patients during their stay. Among these, 37% (n = 40) received a repeat prescription at discharge. Over half of the sedative drugs were prescribed within 24 h of admission. Drug-related problems were detected in 76% of new prescriptions, of which 90% were drug–drug interactions.ConclusionThis study showed that hospital stays increased the proportion of patients who were prescribed a sedative drug at discharge by 10% (absolute increase). These prescriptions may generate long-term use and expose patients to drug-related problems. Promoting alternative approaches for managing insomnia are recommended.

Objective: This study was focused on reviewing the emergency and disaster preparedness of European hospital pharmacists. Methods: An online survey based on International Pharmaceutical Federation (FIP) guidelines for natural disasters was sent to European hospital pharmacies, with the support of the European Association of Hospital Pharmacists. Additional questions were added about the characteristics of respondents, as well as preparedness and experience of manmade disasters. Descriptive statistics were used to analyze the results. Results: Hospital pharmacists in France (20%) and Spain (19%) returned most of the 306 questionnaires completed in 27 countries. Half of the respondents had analyzed their regional disaster risk, but 65% had never practiced emergency drills. Fifteen percent of respondents had experienced at least 1 major emergency or disaster event in the last 5 years. Fifty-six percent of those respondents who experienced a disaster subsequently created and promoted internal standard operating procedures (SOPs) for future emergencies, versus 23% for those who had not experienced disasters. Among pharmacists having experienced disasters, 40% organized a post-disaster debriefing to improve their future response. Conclusions: Results highlighted that most European hospital pharmacists were not fully compliant with FIP guidelines. However, respondents who had experienced disasters were more likely to create and promote SOPs for future disasters. Further worldwide analysis and benchmarking are necessary, and FIP guidelines should be more strongly promoted.

Purpose Assess whether full-scale simulation exercises improved hospital pharmacies’ disaster preparedness. Methods Swiss hospital pharmacies performed successive full-scale simulation exercises at least four months apart. An interprofessional team created two scenarios, each representing credible regional-scale disasters involving approximately fifty casualties (a major road accident and a terrorist attack). Four exercise assessors used appraisal forms to evaluate participants’ actions and responses during the simulation (rating them using five-point Likert scales). Results Four hospital pharmacies performed two full-scale simulation exercises each. Differences between exercises one and two were observed. On average, the four hospitals accomplished 69% ± 6% of the actions expected of them during exercise one. The mean rate of expected actions accomplished increased to 84% ± 7% (p < 0.005) during exercise two. Moreover, the average quality of actions improved from 3.0/5 to 3.6/5 (p = 0.01), and the time required to gather a crisis management team drastically decreased between simulations (from 23 to 5 min). The main challenges were communication (reformulation) and crisis management. Simulation exercise number one resulted in three hospital pharmacies creating disaster action plans and the fourth improving its already existing plan. Conclusion This study highlighted the value of carrying out full-scale disaster simulations for hospital pharmacies as they improved overall institutional preparedness and increased staff awareness. The number of expected actions accomplished increased significantly. In the future, large-scale studies and concept dissemination are warranted.

Résumé Du 16 mars au 18 juin 2020, en raison de la pandémie COVID-19, le Conseil fédéral suisse a déclaré une “situation extraordinaire” au sens de la Loi sur les épidémies. Ce travail évalue les rôles d’une pharmacie interhospitalière dans la lutte contre le SRAS-CoV-2 en Suisse dans le contexte du Service sanitaire coordonné. Pendant cette période, toutes les missions effectuées par cette pharmacie ont été systématiquement collectées et évaluées. Elles ont également été comparées à ses responsabilités traditionnelles. Les missions spécifiques ont été principalement gérées par la cellule de crise et les 4 secteurs de la pharmacie (Logistique pharmaceutique, Fabrication, Pharmacie clinique et Approvisionnement des maisons de retraite): (1) garantie de la continuité des ressources humaines, (2) sécurisation de l’infrastructure propre à la pharmacie (notamment en termes d’hygiène), (3) approvisionnement spécifique en médicaments (par exemple : anesthésiques, sédatifs, antiviraux, y.c. pour les essais cliniques), (4) production et approvisionnement de désinfectant pour les mains, (5) appui clinique (particulièrement dans les unités de soins critiques), (6) fabrication de médicaments individualisés, (7) gestion des pharmacies d’unité de soins, et (8) fourniture de masques hygiéniques pour les professionnels de la santé de la région. Les missions (4) et (8) ne faisaient pas partie des rôles habituels de la pharmacie et ont été réalisées avec le soutien de la protection civile suisse. Un défi particulier a été la gestion de la pénurie de divers produits et l’identification d’options thérapeutiques alternatives. En conclusion, notre pharmacie d’hôpital a été confrontée à divers défis durant la première vague de la pandémie. Certaines missions réalisées ont même dépassé les responsabilités traditionnelles. Sur la base des enseignements tirés de cette pandémie, le plan d’urgence de notre pharmacie, ainsi que la formation associée du personnel, ont été développés.

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ObjectiveThis survey aims at reviewing the actions undertaken by Switzerland’s hospital pharmacies during the first wave of COVID-19 pandemic.MethodsA questionnaire covering topics related to the management of the COVID-19 crisis was sent to 65 heads of swiss hospital pharmacy.Results59% of pharmacies reported changes in the role of their staff. 41% of pharmacies had existing standard operating procedures or pandemic plans. 51% created new drug lists for: COVID-19-specific treatments (83% of pharmacies), sedatives (81%), anaesthetics (77%) and antibiotics (73%). Drug availability in COVID-19 wards was managed by increasing existing stocks (54% of pharmacies) and creating extra storage space (51%). Two drugs generated the most concern about shortages: propofol (49% of pharmacies) and midazolam (44%). Remdesivir stocks even ran out in 26% of pharmacies. 77% of pharmacies experienced problems procuring hand sanitiser solutions and 53% manufactured these themselves. Specific new documents were drafted to respond to medical needs with regards to drug administration (29% of pharmacies), drug preparation (29%) and treatment choices (24%). 47% of pharmacies implemented internal specific hygiene measures and 28% introduced team debriefings.ConclusionsSwiss hospital pharmacies encountered many challenges related to the COVID-19 crisis and had to find solutions quickly and effectively.