Introduction Drug shortages have been a growing global problem in recent years. Some of them are of vital necessity and importance for the patient, such as those used to treat pathologies in clinical hematology and oncology departments. The objectives of this study are to determine the impact of anti-cancer drugs shortages on both: treatment and patient in the hematology and oncology departments, to describe the actions that have been put in place to manage the shortages and to survey patients about their perspectives and experiences. Materials and methods It was a prospective, observational study, it took place in the oncology and hematology departments. It was carried out with the help of an operating sheet, which contained two parts: patient and treatment data. This sheet was filled out after the interview with the patient and on the basis of the medical file. Results Of the 101 patients interviewed, 67.3% were impacted by the shortage of drugs. The treated pathology that was most impacted by the rupture was Non-Hodgkin lymphoma (55.8%), vincristine was the drug most responsible for the shortages (34%). Most patients (51.4%) went to a non-local pharmacy to buy the medicine that was in short supply in the hospital. Delayed care was the main impact of the drug shortage (42.6%). As a result of these shortages, the majority of patients (45.6%) were frustrated and anxious about the situation. Conclusion Drug shortages have a profound impact on patient safety, clinical outcomes, quality of treatment, hospital management and other important factors. In-depth collaboration between different health actors and timely communication strategies are essential elements of an effective drug shortage management plan.

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BackgroundVitamin K antagonist (VKA) is thought to be the largest anticoagulant prescribed; its iatrogenic effect constitutes a real public health problem.PurposeThe objective of this study was to evaluate the level of knowledge of patients about VKA treatment.Material and methodsDuring September and October, a standardised questionnaire was submitted to external patients consulting in the department of cardiology and receiving VKA. Criteria for inclusion were as follows: patients >18 years, receiving VKA and who agreed to participate in the study. The items on the questionnaire allowed identification of the main areas of therapeutic education: knowledge (knowledge of treatment by the patient, treatment modalities), know-being (healthy living, communication with health professionals) and know-how (management processing). All patients gave their informed consent. Data analysis was performed using the SPSS 13.0 software.Results30 patients were included in the study, 48% men and 51% women. Mean age was 55 years and 31% were illiterate. The name of the VKA treatment was known in 96% and 100% of patients who knew their dosage. 68% knew the indication for VKA treatment. 89% declared having received information about their treatment, 65% by their doctor and 34% by their pharmacist. In case of oversight of the drug, 31% of patients did not take it the same day, 83% of patients were not informed on the target value of INR. Symptoms of overdose were unknown in 21% of cases. 68% did not know risks of underdosing. Treatments contraindicated were not know in 82% of cases whereas only 17% of patients did not know forbidden foods with VKA.ConclusionPatient knowledge about their VKA treatment was insufficient to ensure the effectiveness and safety of the treatment. It would be interesting to establish a therapeutic educational programme for patients.No conflict of interest

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Introduction. La douleur est un motif de consultation très fréquent, chaque syndrome algique justifie des modalités particulières de prise en charge thérapeutique, selon son origine, ses caractéristiques et le terrain. L’objectif de l’étude est d’évaluer la prise en charge de la douleur à l’hôpital afin de déceler d’éventuelles déficiences. Matériel et méthodes. Un questionnaire a été destiné aux médecins de tous les services de l’hôpital. Les principaux thèmes étaient : le statut du médecin prescripteur, les méthodes et le temps consacré pour l’évaluation de la douleur, les antalgiques prescrits ainsi que les voies d’administration, la douleur chez l’enfant et enfin l’objectif de la prise en charge de la douleur. Résultats. On a reçu 100 réponses, avec 22% généralistes, 40% résidents et 17% des professeurs, dont 37% ont reçu une formation sur la douleur. 62% ont un protocole de prise en charge de la douleur dans leurs services. 81% prescrivent un antalgique dès l’expression de la douleur par les patients. La moyenne du temps, pour évaluer la douleur a été de 5,82 minutes avec un écart type de 4,92. 52% utilisent la méthode EVA, 4% l’EN, 66% évaluent la douleur selon les plaintes des patients, 35% selon les réactions des patients, 23% selon les mouvements des patients, 20% selon l’expression faciale des patients. 98% prescrivent le paracétamol en première intention, 45% de la morphine, 72% des AINS, 30% du tramadol et 24% utilisent en plus de ces analgésiques, d’autres molécules tel que le néfopam, la codéine. Les obstacles rencontrés lors de la prise en charge de la douleur sont 27% d’ordre économique, 24% dû à la non adhésion des patients, 36% la non disponibilité de certains antalgiques. 89% estiment que le niveau de prise en charge de la douleur dans le service est excellent, contre 56% avec un niveau moyen et 8% un niveau insuffisant. 83% affirment que la prise en charge de la douleur est obligatoire et 82% faisant partie d’une assurance qualité des soins. Conclusion. La prise en charge de la douleur est pluridisciplinaire, les professionnels de santé doivent avoir une formation sur la nécessité de prise en charge de la douleur qui entre dans le cadre de l’assurance qualité des soins et devient obligatoire pour la prise en charge du patient.

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