University. Results Four overarching themes were identified in this study: 'types of shared medications' such as antibiotics, antihypertensives, cardiovascular, diabetic and cholesterol medicines; 'perceived benefits of sharing medicines' such as social support and saving time and money; 'negative experience of sharing medicines' such as personal and public health risks; 'reasons for medication sharing' such as lack of access to healthcare services or medicines, lack of medication knowledge, cost of medication, forgetfulness, medication non-adherence and altruistic reasons. Cultural influence, excessive amount of medication supply and lack of information about safe disposal were reasons that appeared to be specific to the Saudi culture. Conclusion and relevance PMS was perceived as a behaviour with positive and negative outcomes. Interventions should be established to reduce PMS behaviour.
BackgroundLyell’s syndrome is one of the most severe mucocutaneous diseases, which can be life-threatening. However, it is rare, with a child mortality rate estimated at 7.5%.PurposeWe report a case of a child who developed Lyell’s syndrome after taking carbamazepine and who was aggravated by amoxicillin, and the result of the causality assessment of the adverse drugs reaction.Material and methodsA 12-year-old boy with no significant pathological history presented 20 days after taking carbamazepine, conjunctivitis and cheilitis. On the same day, the child presented with a fever and rapidly widespread generalised erythematous lesions after taking amoxicillin, which led the doctor to prescribe aspirin. The lesions evolving in a context of alteration of the general state and a fever measured at 39°C, necessitated the hospitalisation of the child. The skin histology revealed a toxic epidermal necrosis leading to Lyell’s syndrome. The diagnosis of Lyell’s syndrome of drug origin was confirmed by the anamnestic, clinical and histological elements. After a hospital stay of 21 days and symptomatic treatment, the evolution was favourable.ResultsIn response to this acute toxidermia, we conducted a drug investigation to establish the causality assesment of the adverse drugs reaction according to French pharmacovigilance rules by the Poison Control and Pharmacovigilance Centre. After eliminating any infectious origin, the results showed that the intrinsic imputability was an I2 score for carbamazepine, an I1 score for amoxicillin and the extrinsic imputability was a B4 score for both drugs. However, the occurrence of Lyell’s syndrome is probably due to the intake of carbamazepine manifested by conjunctivitis, cheilitis and influenza-like illness at the beginning of its installation, resembling an infection leading to a prescription of amoxicillin which caused an aggravation of Lyell’s syndrome, which can be further potentiated by aspirin.ConclusionThis observation illustrates the importance of the awareness of pharmacists and doctors of the risks of drug prescription that can cause Lyell’s syndrome, particularly carbamazepine. Thus, management should be systematic with any post-drug dermatological symptoms in order to prevent and further reduce the incidence of this condition and to improve the vital prognosis.Reference and/or Acknowledgements1. Roujeau, et al. Toxic epidermal necrolysis. Journal of the American Academy of Dermatology1990;23(6):1039–1058.No conflict of interest
BackgroundThe implementation of quality indicators within the hospital pharmacy have a fundamental role in the creation of its value. It contributes significantly to the achievement of the strategic goals of the structure and allows managers to measure and manage in a better way their performance.PurposeThe aim is to explore the hospital pharmacy practice in terms of the use of quality indicators and their relation to performance.Material and methodsWe have measured the internal process performance indicators and the support process efficiency indicators over the last 3 years, by measuring the customer satisfaction rate and calculating the rate of breakage, deterioration, expiry of drugs and medical devices and the rate of reactivity of corrective actions, whose formula has been previously determined in advance. The data needed for this calculation were collected using the nonconformity reporting sheets and the pharmacy database as well as a questionnaire sent to the hospital’s clinical departments. The calculated results were compared to the analysis threshold set for each indicator.ResultsMeasuring the internal process indicators over the years 2015, 2016 and the first half of 2017 showed that the strategic objectives set for all the performance indicators have been achieved for the 3 years except breaking indicators of drugs has increased in August of 2016 by a rate of 13%, which exceeds the normal threshold: this is a breakdown of 17 products and an efficiency rate of immediate actions that has decreased slightly to 68.8% compared to the threshold (>70%) during the month of December of the same year. These non-conformities have pushed the pharmacy team to review the shortcomings and take corrective measures. And regarding the effectiveness of process indicators support, a significant improvement was observed in 2016 compared to the previous year.ConclusionWe can say that performance is positively associated with quality indicators That allow us to achieve fixed goals and objectives, and to make immediate or long-term decisions in order to improve and increase the performance of the concerned structure.Reference and/or Acknowledgements1. Meftah H, et al. Contribution of hospital pharmacy ISO certification 9001 on improving performance indicators: Experience of pharmacy of a paediatric hospital. Eur J Hosp Pharm2017.No conflict of interest
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