BackgroundVTE is a public health problem; the prevention of VTE is a strategy to improve patient safety. In Portugal 53 percent of HMPs are at risk of VTE and preventive measures are in place for only 59 percent of them.PurposeTo assess the risk of VTE in HMPs based on risk factors (RF), to analyse the prescription of LMWH, to determine the number of patients (a) with prescriptions without RF/contraindicated (CI), (b) without prescriptions with RF, (c) with an unadjusted dose, (d) with prescriptions and RF (e) without prescriptions or RF/CI. To evaluate the need to develop a VTE Risk Assessment Model (RAM).Material and methodsHMPs in three services were studied over 2 months. Patients with anticoagulants at therapeutic doses were excluded. Medical records were consulted to find RF. Patients were classified according to the Cohen RAM and according to the prescription of LMWH. Physicians were consulted. Pharmaceutical intervention and medical justification were recorded.ResultsOf all patients (141), 67.4% were classed as having RF for VTE; 56.7% had received prophylaxis with LMWH. Patients were classified in (a) 9.2%, (b) 19.9%, (c) 2.1%, (d) 45.4% and (e) 23.4%. Pharmaceutical interventions were made in 31.2% of prescriptions, prescriptions were changed in only 3.6%. Age factor >75 years (44.7%), active cancer requiring treatment (23.4%) and acute infection (18.4%) were the three most common RF.ConclusionOf patients who are not treated prophylactically (30%), a large number is due to the lack of consensus in relation to VTE prophylaxis in cancer patients, sick patients with dementia and patients in palliative care.As clinicians do not follow a RAM for VTE, the need to develop a consensual model has been identified.ReferencesShojania KG, Duncan BW, McDonald KM, et al. Making health care safer: a critical analysis of patient safety practicesReis A, Rocha N, et al. Guidelines for the prevention, diagnosis and treatment of venous thromboembolism in the medical patientNo conflict of interest.
BackgroundThe monoclonal antibodies (mAb) market has grown significantly in the past years. Worldwide sales will be nearly $125 billion by 2020. Cetuximab (Cet), trastuzumab (Tra), bevacizumab (Bev) and panitumumab (Pan) were the most used at our hospital. This represents 35% of the oncology department’s total expenditure.PurposeTo calculate mAb doses on the day of treatment, and to analyse differences between PD and CD, and the economic impact when PD >CDMaterial and methodsPatients’ weights with prescription of these mAb at the hospital were monitored over 4 months. Prescribed dose (PD)=dose prescribed by oncologist at the beginning of treatment. Calculated dose (CD)=weight based dose calculated by the pharmacist, according to the summary of product characteristics. CD was the dose actually administered to the patient (after authorisation by the head of the department). PD and CD were recorded and their differences were analysed. Using the drug’s average price (mg/€) cost savings where calculated when PD >CD (economic Impact=cost of PD – cost of CD).ResultsmAb doses were calculated for 77 patients(n=367). PD=CD in 24% of total treatments. PD and CD were the same in 64% of treatments using Cet, 20% using Pan, 18% using Bev and 9% using Tra. Treatments with PD
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