Plasticizers added to polyvinylchloride used in medical devices can be released into patients’ biological fluids. The substitution of di‐(2‐ethylhexyl)phthalate (DEHP) by alternative plasticizers is essential but their safety must be demonstrated. DEHP, di‐(2‐ethylhexyl)terephthalate (DEHT) and their metabolites were investigated using level 2 Organization for Economic Co‐operation and Development bioassays to screen for in vitro hormonal changes. Differences between the DEHP and DEHT metabolites were observed. Albeit weak, the hormonal activities of DEHT‐derived metabolites, e.g., 5‐OH metabolite of mono‐(ethylhexyl)terephthalate (5‐OH‐MEHT), were detected and the results of docking experiments performed on estrogen receptor alpha and androgen receptor agreed with the biological results. A co‐stimulation of human estrogen receptor alpha and human androgen receptor was also observed. With regard to steroidogenesis, a 16‐fold increase in estrogen synthesis was measured with 5‐OH‐MEHT. Therefore, even if DEHT remains an interesting alternative to DEHP because of its low migration from medical devices, it seems important to verify that multi‐exposed patients in neonatal intensive care units do not have urinary levels of oxidized metabolites, in particular 5‐OH‐MEHT, suggesting a potential endocrine‐disrupting effect.

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Background The community pharmacist is a key player in medication reviews of older outpatients. However, it is not always clear which individuals require a medication review. The objective of the present study was to identify high-priority older patients for intervention by a community pharmacist. Methods As part of their final-year placement in a community pharmacy, pharmacy students conducted 10 interviews each with older adults (aged 65 or over) taking at least five medications daily. The student interviewer also offered to examine the patient’s home medicine cabinet. An interview guide was developed by an expert group to assess the difficulties in managing and taking medications encountered by older patients. Results The 141 students interviewed a total of 1370 patients (mean age: 81.5; mean number of medications taken daily: 9.3). Of the 1370 interviews, 743 (54.2%) were performed in the patient’s home, and thus also included an examination of the home medicine cabinet. Adverse events were reported by 566 (42.0%) patients. A total of 378 patients (27.6%) reported difficulties in preparing, administering and/or swallowing medications. The inspections of medicine cabinets identified a variety of shortcomings: poorly located cabinets (in 15.0% of inspections), medication storage problems (21.7%), expired medications (40.7%), potentially inappropriate medications (15.0%), several different generic versions of the same drug (19.9%), and redundant medications (20.4%). Conclusions In a community pharmacy setting, high-priority older patients for intervention by a community pharmacist can be identified by asking simple questions about difficulties in managing, administering, taking or storing medications.

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