NTCP and the global UTCP values of the organs at risk allow to compare a technique net benefit from another in each particular case, although in our theoretical study the comparison was done among the patients. It is important to stress that the calculations of the TCP and NTCP have a limited quantitative signification but they are useful and beneficial in order to decide between treatment plans when they are supported by the clinical knowledge.
Background
It is necessary to monitor the effect of erythropoietin (EPO) on haemoglobin (Hb) levels to check the efficacy and safety of the medicine. The desirable therapeutic range of Hb according to the product information is from 10 to 12 g/dl and higher or lower levels can damage health. The tolerance, clinical need and urgency required in the resolution of the anaemia varies among patients, however, Hb ≥13 g/dl is associated with cardiovascular events such as thromboembolism, requiring urgent care.
Purpose
To determine the proportion of patients with anaemia linked to chronic renal failure in predialysis treated with EPO, with a value of Hb within or outside (lower or higher than) the therapeutic range.
Materials and methods
A retrospective study was performed of 155 nephrology patients who collect erythropoietin at the outpatient unit of the hospital pharmacy; duration 1 month. All of them had anaemia associated with chronic renal failure in predialysis and were treated with subcutaneous erythropoietin for at least 4 weeks. The outpatient dispensing program compiles items dispensed per patient, with dates, age, sex, medical record number, diagnosis, amount collected, dosage, department/ward and prescribing physician The last Hb value was obtained for the computerised medical history records and the proportion of patients below and above the therapeutic range was estimated.
Results
139 patients, 61 women (43.9%) and 78 men (56.1%), between 21 and 101 years (mean 68.6). 48.9% (68) of the patients had an Hb within the therapeutic range (mean 11). 22.3% (31) had Hb less than 10 g/dl (mean 9.2 and minimum 6) while in 28.8% (40) it was greater than 12 (mean 13.2 and maximum 15.4).
Conclusions
71 patients (51%) had Hb outside the therapeutic range. It is necessary to monitor the haemoglobin levels to check the safety and efficacy of erythropoietin. It is essential to include all episodes and data in the computerised medical history.
Background
Multiple myeloma (MM) is a malignant monoclonal gammapathy that occurs mainly in patients over 65 years. Lenalidomide is indicated in combination with dexamethasone for the treatment of MM in patients who have received at least one prior treatment regimen.
All this makes it likely the patient will require Pharmaceutical Care (PC). PC consists of collaboration with other health professionals and with the patient to design a safe and effective treatment plan, as well as to identify Drug Related Problems (DRPs) and to resolve and prevent negative outcomes associated with medication (RNMs).
Purpose
To evaluate the impact of pharmaceutical intervention in patients diagnosed with MM treated with lenalidomide in a pharmacists-led haematological consultation within the Pharmacy Service.
Materials and MethodsQuasi-experimental study of 4 months duration on patients diagnosed with MM treated with lenalidomide. Clinical practise follow-up procedures used the Dader method adapted to the study situation. Data were obtained from interviews with patients, electronic medical records and Outpatient Service Pharmacy records.
Results
During this period, 29 patients were diagnosed with MM and treated with lenalidomide, 21 joined the study (4 didn’t gave consent and 2 weren’t able to visit the pharmacy), 11 women and 10 men. Average age: 70.3 years (52–89). During study a total of 17 DRPs were detected: 4 related to the indication, 1 to the effectiveness and 8 to the safety, and a total of 35 RNMs: 4 related to the need, 5 to the effectiveness and 26 to the safety. Of these 35, 45.7% could have been avoided. A total of 25 pharmaceutical interventions were made: 10 related to the amount of drug, 9 to the pharmacological strategy and 6 to patient education.
Conclusions
A variety of goals were achieved through pharmaceutical interventions: medicines reconciliation, resolution of health problems by detecting RNMs and avoidance of RNMs by detecting DRPs.
No conflict of interest.
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