Farmacia Hospitalaria[JOURNAL]
Sun
200 papers
Post-intensive care syndrome: Epidemiology, pathophysiology, and the role of the pharmacist in its management.
Doménech-Moral L, Martin-Cerezuela M, Domingo Chiva E … +10 more , Fernández Polo A, Betancor García T, Amor García MA, Aquerreta González I, Albanell Fernández M, Bastida Ferndández C, Ortiz Pérez S, Cobo Sacristán S, Becerril Moreno F, Egüés Lugea A
Farm Hosp · 2026 May · PMID 42177121 · Publisher ↗
With the progressive decline in mortality rates in intensive care units in recent decades, increasing attention has been drawn to the fact that many patients who survive their stay in the intensive care unit develop long...
With the progressive decline in mortality rates in intensive care units in recent decades, increasing attention has been drawn to the fact that many patients who survive their stay in the intensive care unit develop long-lasting physical, cognitive and psychological impairments, which can last for months or even years after their critical illness. This health problem, known as post-intensive care syndrome, can be alleviated by implementing certain practices during hospitalisation, and its treatment generally requires attention upon discharge from hospital. The stress and trauma associated with the intensive care unit experience can also affect family members in the long term, manifesting as mental health problems known as family post-intensive care syndrome. In this context, pharmacists play a key role in the prevention and treatment of post-intensive care syndrome, integrating into multidisciplinary teams in both the intensive care unit and post-intensive care unit recovery clinics. Their intervention includes comprehensive optimisation of pharmacotherapy, reconciliation, identification and prevention of adverse drug events, and health education for patients and their families.
[Translated article] Assessment of serum creatinine-based equations for estimating glomerular filtration rate in critically ill patients with or without augmented renal clearance.
Roma JR, Arranz-Pasqual N, Bastida C … +1 more , Soy D
Farm Hosp · 2026 · PMID 42173748 · Publisher ↗
BACKGROUND: Serum creatinine-based equations are commonly used to estimate glomerular filtration rate (eGFR) in critically ill patients, despite not having been specifically developed for this population. This study aime...
BACKGROUND: Serum creatinine-based equations are commonly used to estimate glomerular filtration rate (eGFR) in critically ill patients, despite not having been specifically developed for this population. This study aimed to assess and compare the performance of three widely used serum creatinine-based equations in this setting. METHODS: Observational retrospective study conducted in four intensive care units of a tertiary university hospital. The most commonly used serum creatinine-based equations, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD-4), and Cockcroft-Gault (CG) equations were compared to the creatinine clearance from 24-hour urine collection (CrCl), used as the reference method. Bland and Altman plots, bias and precision were performed to contrast CrCl values with estimated GFR. Bias and its 95% confidence interval were calculated as the mean difference between the eGFR estimated by each equation and the measured CrCl. Precision was reported as one standard deviation of the bias. RESULTS: A total of 261 patients were included. In patients with CrCl between 0-129 mL/min, no significant differences were observed between equations. However, in patients with augmented renal clearance (15.7%), with a mean CrCl of 180 mL/min, there was a statistically significant bias between the CKD-EPI equation (66.4 mL/min/1,73m) and both the CG and MDRD-4 equations (24.8 mL/min/m and 29.3 mL/min/1,73 m, respectively; p < 0.01). CONCLUSIONS: This study highlights that the most commonly used equations to estimate glomerular filtration rate in critically ill patients have remarkable limitations compared to creatinine clearance from 24-hour urine collection. In critically ill patients with CrCl between 0-129 mL/min, no significant differences were found between the CG, MDRD-4, and CKD-EPI equations. However, for patients with augmented renal clearance, the CG and MDRD-4 equations performed statistically better than the CKD-EPI equation.
[Translated article] Anticholinergic burden and its relationship with cognitive impairment in a neuropsychiatric unit.
Ruiz-Julián M, Piñol-Ripoll G
Farm Hosp · 2026 · PMID 42156261 · Publisher ↗
BACKGROUND: The use of drugs with anticholinergic activity is widespread and appears to be associated with an increased risk of cognitive impairment. We evaluated the prevalence of anticholinergic prescriptions in a neur...
BACKGROUND: The use of drugs with anticholinergic activity is widespread and appears to be associated with an increased risk of cognitive impairment. We evaluated the prevalence of anticholinergic prescriptions in a neuropsychiatric unit, the anticholinergic burden and its relationship with cognitive impairment. METHODS: A cross-sectional observational study was conducted with 135 patients. Sociodemographic data, substance use, medical and psychiatric diagnoses, presence of cognitive impairment, and Mini-Mental State Examination (MMSE) score were collected. Anticholinergic burden was assessed using the Anticholinergic Cognitive Burden Scale (ACB) and a composite index of 14 scales, considering a high anticholinergic burden ≥3 points. Descriptive analysis, the chi-squared test, Student's t-test, Pearson's correlation coefficient, and multiple lineal regression models adjusted for confounding factors were performed, with p < 0.05 for statistical significance. RESULTS: The mean number of anticholinergics per patient was 4.1 ± 1.7. According to the ACB, the mean burden was 4.8 ± 2.5. The burden was higher in patients with cognitive impairment (t = -2.38; p = 0.019). Among those exposed to high burden, 71.7% presented impairment vs. 51.7% exposed to low-moderate burden (χ = 4.13; p = 0.042; OR = 2.36). With the 14-scale composite, the mean burden was 5.9 ± 2.8. A higher prevalence of impairment was observed in high burden (70% vs 46.7%), although this was not significant (χ = 3.30; p = 0.069; OR = 2.36). The correlation between ACB burden and MMSE was negative and significant (r = -0.178; p = 0.039), whereas with the composite index, the correlation between total burden and MMSE was not significant (r = -0.092; p = 0.289). ACB burden was also associated with a lower MMSE score in the model adjusted for sex and age (B = -0.27; p = 0.047), losing significance after controlling for education and comorbidities (B = -0.24; p = 0.072). The anticholinergic burden estimated with multiple scales showed non-significant coefficients. CONCLUSION: High anticholinergic consumption and burden are observed in patients with neuropsychiatric disorders, especially those with cognitive impairment. A negative correlation was detected between scores on the ACB scale and the MMSE. The findings confirm that, despite the known negative effect of anticholinergics on cognition, their prescription remains very high in populations at high risk of cognitive impairment.
Guideline to radiopharmaceutical procedures for in vitro labeling of leukocytes.
Romero-Zayas I, de Arcocha-Torres M, Peñuelas I … +4 more , Martínez Montalbán E, Plancha Masanet MC, Fernández Sánchez AJ, Pérez Iruela JA
Farm Hosp · 2026 May · PMID 42140761 · Publisher ↗
This guide outlines the radiopharmaceutical procedure for the in vitro labelling of leukocytes. Scintigraphy using leukocytes labeled with [Tc]Tc-exametazime or [In]In-oxine is a highly valuable diagnostic tool in infect...
This guide outlines the radiopharmaceutical procedure for the in vitro labelling of leukocytes. Scintigraphy using leukocytes labeled with [Tc]Tc-exametazime or [In]In-oxine is a highly valuable diagnostic tool in infectious and inflammatory diseases due to its high sensitivity and specificity. It is based on established guidelines and consensus protocols, which incorporate the recent Spanish regulations on the extemporaneous preparation of radiopharmaceuticals, this document provides detailed and precise instructions for the safe and effective preparation and quality control of in vitro labeled leukocytes. The clinical indications for leukocyte scintigraphy are described, along with the technical requirements for both facilities and equipment. The various stages of the radiolabelling procedure are developed and substantiated, including blood sample collection, leukocyte fraction separation and isolation, incubation and subsequent radiolabelling with either [Tc]Tc-exametazime or [In]In-oxine, radiopharmaceutical conditioning for administration, and the necessary quality control procedures. The document concludes with a section describing drug interactions reported in the literature. Two annexes are included, providing example labeling protocols for both radiopharmaceuticals.
Orphan drug regulation: a global comparison of the United States Food and Drug Administration, European Medicines Agency, and Japanese pharmaceuticals and medical devices agency approaches.
Elango R, Martin R, Mutta SK
Farm Hosp · 2026 May · PMID 42135085 · Publisher ↗
OBJECTIVE: To perform a comparative review of orphan drug policies and designation criteria implemented by the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), and Japan's Pharmaceuticals and M...
OBJECTIVE: To perform a comparative review of orphan drug policies and designation criteria implemented by the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), and Japan's Pharmaceuticals and Medical Devices Agency (PMDA), assessing their influence on development, approval, and access. METHOD: A targeted review of legislation, guidance documents, and peer-reviewed analyses from each regulatory body was conducted. RESULTS: The FDA accelerates development via robust tax credits and seven-year market exclusivity, though high pricing remains challenging. The EMA emphasizes unmet medical needs and ten-year exclusivity, ensuring more homogeneous pricing despite slower approvals. Japan's PMDA utilizes specific subsidies and the Sakigake designation to counter "drug loss" and encourage innovation. Despite expedited pathways globally, significant disparities in affordability and patient access persist. CONCLUSIONS: While national incentives successfully boost orphan drug approvals, global access inequities remain unresolved. Harmonizing regulatory criteria and promoting international collaboration on evidence requirements are essential for equitable and sustainable access to rare disease therapies worldwide.
Standardisation of ready-to-use intravenous antimicrobial preparation in a paediatric hospital-at-home unit.
Merino-Pardo A, Algarra Sánchez E, Hernández-Ramos JA … +2 more , Fernández-Rubio B, Cuervas-Mons Vendrell M
Farm Hosp · 2026 May · PMID 42135084 · Publisher ↗
INTRODUCTION: Outpatient parenteral antimicrobial therapy (OPAT) in paediatric hospital-at-home (HAH) units is expanding. Standardisation of ready-to-use presentations increases safety, reduces variability, and facilitat...
INTRODUCTION: Outpatient parenteral antimicrobial therapy (OPAT) in paediatric hospital-at-home (HAH) units is expanding. Standardisation of ready-to-use presentations increases safety, reduces variability, and facilitates logistics, particularly in paediatrics, where administration volumes, maximum concentrations, and infusion times strongly condition preparation. OBJECTIVE: To standardise the antimicrobials used in a paediatric HAH unit by defining preparation, final container selection, and storage, based on the available evidence on physicochemical and microbiological stability, while considering administration criteria specific to the paediatric setting. METHODS: Antimicrobials included in the hospital's OPAT protocol were selected. Administration systems and consumables were reviewed, prioritising syringes and low-adsorption plastic materials. Maximum concentrations and infusion times recommended in paediatrics were compiled. Physicochemical stability was established through a literature review, selecting studies with comparable conditions (diluent, concentration, temperature, photoprotection, and primary container material) and assays that had evaluated active ingredient degradation; a content deviation of ≤10% was considered acceptable. Microbiological stability was estimated using the risk matrix for sterile preparations from the Good Preparation Practice Guide for Hospital Pharmacy Services, considering aseptic compounding in a cleanroom using a Class II biological safety cabinet and subsequent home storage. RESULTS: Sixteen antimicrobials were standardised (acyclovir, amikacin, ampicillin, cefazolin, cefepime, ceftazidime, ceftriaxone, cefuroxime, cidofovir, clindamycin, ganciclovir, imipenem/cilastatin, meropenem, piperacillin/tazobactam, tobramycin, and vancomycin). A fixed diluent volume and filling into syringes were prioritised; bags were used when the volume exceeded 60 mL. For each drug, diluent, material, temperature, photoprotection, and maximum in-use time were defined, integrating physicochemical stability evidence and adopting a conservative approach for microbiological use due to uncontrolled home refrigeration. CONCLUSIONS: This study supports a more uniform and safer OPAT practice in paediatric HAH units and provides an operational basis for protocol implementation and future evaluation, combining stability evidence for compounded preparations with paediatric administration requirements.
Quality of life in hospitalized patients receiving palliative care: Do current tools cover all their needs?
Martins IVO, Marques IM, da Silva FATA … +8 more , Trinca MEM, Coelho LB, Gonçalves AMRF, Figueras A, Zanetti MOB, Pereira LRL, Herdeiro MT, Varallo FR
Farm Hosp · 2026 May · PMID 42135083 · Publisher ↗
INTRODUCTION: Quality of life (QoL) is a central outcome in palliative care (PC), particularly in hospital settings, where patients often present with advanced illness, complex symptoms, and multidimensional needs. Accur...
INTRODUCTION: Quality of life (QoL) is a central outcome in palliative care (PC), particularly in hospital settings, where patients often present with advanced illness, complex symptoms, and multidimensional needs. Accurate QoL assessment is essential to support patient-centered and family-centered decision-making; however, the diversity of available instruments and limited validation beyond oncology populations pose challenges for their clinical and research use. OBJECTIVES: We aimed to identify tools measuring QoL in hospitalized PC patients, highlighting their domains and psychometric properties. METHODS: A scoping review was conducted following Joanna Briggs Institute guidelines and the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched MEDLINE (PubMed), CINAHL, EMBASE, The Cochrane Library, Scopus, Web of Science, Google Scholar, and LILACS from inception until April 11, 2025. Independent reviewers assessed eligibility, extracted data, and evaluated risk of bias. RESULTS: Of 6026 studies retrieved, after removing duplicates (n = 1680) and full-text screening (n = 17), 12 met inclusion criteria, including 5 validation, 5 observational studies and 2 clinical trials. Eight tools were identified, most originally developed for advanced-stage conditions and applied in high-income countries. Main domains included physical comfort (n = 7), psychological well-being (n = 7), and spiritual well-being (n = 7). Quality of death was assessed in one instrument. Two instruments were validated for Brazilian Portuguese, primarily for cancer patients. Frequently reported psychometric properties were face validity (n = 9), content validity (n = 6), and construct validity (n = 6). CONCLUSION: No gold-standard instrument exists for measuring QoL in PC. Selection should consider patient and family preferences, health status, prognosis, life expectancy, and intended use. Findings highlight the need for psychometrically robust instruments applicable across disease stages and conditions. Incorporation of death preparedness, quality of death, and patient- and family-centered outcomes remains limited but is important to guide individualized, safe, and equitable hospital-based PC.
Atezolizumab plus platinum-based chemotherapy and etoposide as first-line treatment for metastatic small cell lung cancer: A retrospective multicenter observational study.
Moñino Domínguez L, Amaro Álvarez L, Aguado Paredes A … +1 more , Carrión Madroñal IM
Farm Hosp · 2026 May · PMID 42128783 · Publisher ↗
INTRODUCTION: The standard first-line treatment for metastatic small-cell lung cancer (SCLC) is platinum-based chemotherapy in combination with etoposide. The aim of this study was to evaluate the real-world effectivenes...
INTRODUCTION: The standard first-line treatment for metastatic small-cell lung cancer (SCLC) is platinum-based chemotherapy in combination with etoposide. The aim of this study was to evaluate the real-world effectiveness and safety of atezolizumab plus chemotherapy in SCLC and to explore factors associated with survival. METHODS: A retrospective, observational, multicenter study was conducted in patients diagnosed with SCLC who received first-line treatment with atezolizumab in combination with platinum-etoposide chemotherapy between November 2021 and March 2025. Treatment effectiveness was evaluated by assessing the objective response rate (ORR), treatment duration, progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox models were used to explore associations between clinical variables and survival outcomes. RESULTS: A total of 76 patients with SCLC were included. Median age was 65 years, and 17.1% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2. The median duration of the treatment was 4.43 months (Interquartile range: 0.4-6.2). The ORR was 81.67% (95% CI: 70.08-89.44%). The median PFS was 7.2 months (95% CI: 6.5-8.6), and the median OS was 9.4 months (95% CI: 7.0-13.06). Patients with ECOG ≥2, hepatic metastases, and age ≥ 65 years were associated with a poor survival prognosis. Sex and the presence of brain metastases were not significantly associated with survival. Grade ≥ 3 treatment-related adverse events were observed in 44.7% patients, with no treatment-related deaths. CONCLUSIONS: In this real-world cohort, atezolizumab plus platinum-etoposide achieved high response rates and acceptable survival with a manageable safety profile in extensive-stage SCLC. Baseline ECOG performance status, hepatic metastases, and older age were associated with worse survival, underscoring the prognostic value of clinical factors. These observational data complement, but do not validate, the results of IMpower133, as no randomized control group or formal trial emulation methods were used.
Computerized gravimetric control of parenteral analgesic admixtures: A retrospective quality improvement study.
Caíña-López S, Dávila-Pousa MC
Farm Hosp · 2026 May · PMID 42128782 · Publisher ↗
OBJECTIVE: Postoperative pain and labor pain are among the most prevalent and intense types of acute pain. Their effective management often requires the administration of parenteral analgesic mixtures combining opioids w...
OBJECTIVE: Postoperative pain and labor pain are among the most prevalent and intense types of acute pain. Their effective management often requires the administration of parenteral analgesic mixtures combining opioids with local anesthetics. Since no ready-to-use commercial formulations are available and given the complexity and risk of error in their preparation, the Spanish Guide to Good Medication Preparation Practices in Hospital Pharmacy Services recommends their centralized compounding in clean rooms within the pharmacy department. The aim of this study is to describe the implementation experience of a computerized gravimetric control system for stock-prepared analgesic formulations and to assess its reliability and usefulness. METHOD: A retrospective observational study was conducted including all analgesic units prepared in the Pharmacy Department between July 2024 and April 2025. Gravimetric control was performed using an electronic balance integrated into the Pharmasuite® software, which automatically calculated the concordance between theoretical and actual weight, generating alerts in case of deviations. Primary acceptance limits were set at ±1.5-1.7% depending on the formulation, based on previous experience and the consistency observed in earlier batches. A total of seven different formulations were analyzed. RESULTS: During the study period, 1,460 units were prepared, corresponding to 238 batches. Five out of the seven formulations achieved 100% compliance with the acceptance limit. In the remaining formulations, the proportion of non-compliant units was below 1%. The mean relative standard deviation ranged from 0.189% to 0.338%, always below 0.5%, indicating high reproducibility. The mean actual weight was very close to the theoretical weight in all formulations. Units falling outside the acceptance range were individually discarded, and no complete batch had to be rejected. CONCLUSIONS: The implementation of computerized gravimetric control in the compounding of analgesic formulations proved to be an effective and safe strategy to ensure accuracy, detect errors, and reinforce traceability. The experience described represents a quality improvement tool that may be extrapolated to other centers.
[Translated article] Generational priorities, motivations, concerns, and expectations of hospital pharmacists in Spain.
Pérez Menéndez Conde C, Martínez Castro B, Pérez Abánades M … +2 more , Fernández de Gamarra-Martínez E, Negro-Vega E
Farm Hosp · 2026 May · PMID 42106288 · Publisher ↗
OBJECTIVE: To analyze generational differences in priorities, motivations, concerns, and professional expectations among pharmacists working in Hospital Pharmacy Services in Spain, in order to generate actionable evidenc...
OBJECTIVE: To analyze generational differences in priorities, motivations, concerns, and professional expectations among pharmacists working in Hospital Pharmacy Services in Spain, in order to generate actionable evidence to guide strategies for managing intergenerational relationships and work engagement, as well as professional development and team well-being. METHOD: Cross-sectional descriptive study based on an online survey of members of the Spanish Society of Hospital Pharmacists who were practicing as pharmacists or undergoing specialty training in Hospital Pharmacy Services in Spain. The questionnaire, reviewed by an expert panel, was administered from 16 to 29 January 2024 and comprised 18 items grouped into three sections: demographic data, socio-occupational context, and professional domain. Descriptive and between-generation comparative analyses were conducted using ANOVA, Kruskal-Wallis, Fisher's exact test, and χ (p < 0.05). RESULTS: A total of 620 professionals participated (16% members). Recommendation of the hospital as a workplace was high and similar across generations; however, ratings of the Hospital Pharmacy Service and perceptions of the current status of Hospital Pharmacy differed, with higher scores among older cohorts. Work climate and work-life balance were the most valued job factors, with generational preferences differing for items such as teaching, professional recognition, and autonomy. Stress was the most frequently reported concern across all cohorts, with intergenerational differences in other work-related factors. Generational variation was also observed in key work concerns, professional motivations, perceptions of the current state of Hospital Pharmacy, and strategic priorities. Differences by generation were also observed in professional motivations and expectations, including institutional engagement and perceived future challenges in Hospital Pharmacy. CONCLUSIONS: This study shows intergenerational differences in priorities, concerns, motivations, and expectations among hospital pharmacists. Although work climate and work-life balance remain among the most selected priorities and stress is the main concern across all cohorts, generation-specific patterns across the evaluated dimensions suggest the need for management and professional development approaches tailored to multigenerational teams.
[Translated article] Safety of Bruton kinase inhibitors in chronic lymphocytic leukemia: Real world clinical practice.
Bello-Calvo R, González-Resina R, Rubio-Martínez A … +3 more , Larrodé-Leciñena I, Delgado-Beltrán MP, Abad-Sazatornil MR
Farm Hosp · 2026 May · PMID 42103515 · Publisher ↗
INTRODUCTION: Bruton's tyrosine kinase inhibitors (BTKi) have replaced immunochemotherapy in patients with chronic lymphocytic leukemia (CLL). The safety profile, particularly in monotherapy indications under real-world...
INTRODUCTION: Bruton's tyrosine kinase inhibitors (BTKi) have replaced immunochemotherapy in patients with chronic lymphocytic leukemia (CLL). The safety profile, particularly in monotherapy indications under real-world clinical practice conditions, is key to optimizing outcomes. OBJECTIVE: To describe the safety and tolerability of continuous/indefinite BTKi therapy in patients with CLL treated in the first line and relapse/refractory (R/R) conditions with BTKi monotherapy, within labeled indications, at a tertiary care hospital. METHODS: Observational, retrospective, single-centre study including patients with CLL treated with iBTK (2015-2024). Demographic data, previous lines of treatment, dose adjustments and suspensions, and adverse events (AEs) by system and severity were recorded. Proportions were compared using Fisher's exact test. Treatment continuation was analyzed using Kaplan-Meier curves, log-rank tests, and Cox regression. RESULTS: Eighty-three patients (50.6% male) were included, with a mean age at diagnosis of 67.2 years. Forty-eight (58%) received iBTK as first-line therapy and 35 (42%) in R/R. The most commonly used iBTK was ibrutinib (62.5% in first-line and 88.6% in R/R). Median follow-up was 20.8 months. Overall, 28.9% required dose adjustment, with no differences between the two groups (p = 0.158). Treatment discontinuation was more frequent in patients with R/R patients (74.3% vs. 39.6%; RR 1.81; 95% CI: 1.23-2.66; p = 0.002). AE were the most common reason for treatment discontinuation (15.7%). A total of 161 AEs were recorded, with infectious AE being the most frequent category. Respiratory infections were significantly more common in R/R patients (p = 0.046). Patients with prior exposure to immunochemotherapy had an increased risk of treatment discontinuation (HR = 2.15; 95% CI: 1.18-3.89; p = 0.012). CONCLUSIONS: BTKi showed a manageable safety profile, with infections as the most common toxicity and secondary malignancies occurring at rates comparable to those reported in the literature. Treatment discontinuation was less frequent in the frontline setting, underscoring the influence of clinical context and prior therapies. Despite the limitations of a retrospective, single-centre design, this study provides information applicable to daily practice and highlights the importance of close follow-up to optimize both safety and treatment continuity.
Standardized classification of pharmaceutical interventions in intensive care units.
Domingo Chiva E, Becerril Moreno F, Amor García MÁ … +10 more , Doménech Moral L, Betancor García T, Bastida Fernández C, Albanell Fernández M, Aquerreta González I, Cobo Sacristán S, Egüés Lugea A, Fernández Polo A, Ortiz Pérez S, Martín Cerezuela M
Farm Hosp · 2026 May · PMID 42091371 · Publisher ↗
A standardized classification system was developed to harmonize the documentation of pharmaceutical interventions throughout the pharmacotherapeutic process in intensive care units caring for critically ill adult patient...
A standardized classification system was developed to harmonize the documentation of pharmaceutical interventions throughout the pharmacotherapeutic process in intensive care units caring for critically ill adult patients. The Intensive Care and Critical Patient Pharmacists Group (FarMIC) created an initial proposal, which was evaluated in a first phase through one week of intervention recording. After analyzing 168 interventions, modifications were made to improve applicability. In a subsequent phase, volunteer hospital pharmacists used the adapted classification for another week, documenting an additional 562 interventions. The analysis of discrepancies and suggestions allowed the consensus of a final classification comprising 35 types of interventions related to issues in indication, effectiveness, safety, and other aspects such as pharmacist consultations, therapeutic drug monitoring, and nutritional support. This classification provides a homogeneous framework that facilitates the standardization of pharmaceutical interventions in critically ill patients and promotes data comparability across centers.
[Translated article] Gender perspective in medication-related problems resulting in emergency department attendance involving high-alert medications.
Marín de la Bárcena C, Ruiz Ramos J, Puig Campmany M … +2 more , Otero MJ, Juanes Borrego A
Farm Hosp · 2026 · PMID 42062111 · Publisher ↗
OBJECTIVES: To characterize medication-related problems resulting in emergency department attendance involving high-alert medications, paying particular attention to sex-related differences in the type of the problem and...
OBJECTIVES: To characterize medication-related problems resulting in emergency department attendance involving high-alert medications, paying particular attention to sex-related differences in the type of the problem and medication associated with it. METHODS: Retrospective observational study (2021-2022) based on the medical history at discharge, including adult patients seeking emergency department due to medication-related problems as a primary or secondary diagnosis. Patient grouping was performed according to the class of medication implicated in the event, as defined by the reference list of high-alert drugs for chronic patients (HAMC list). Sociodemographic and clinical baseline variables were collected. To explore gender differences in the type of problem and drug involved, statistical analysis included binomial tests and binary logistic regression with odds ratio estimation. RESULTS: Among the 1,611 adult patients admitted to the emergency department with adverse events associated with a medication problem, 1,028 (64%) involved a high-alert medication. Women with moderate- and high-risk comorbidity showed a significative greater incidence of medication-related problems. Gender differences were particularly notable for events associated with loop diuretics (136 women [70%] vs 57 men [30%], p = 0.000); antipsychotics (30 women [65%] vs 16 men [35%], p = 0.039); opioids (37 women [73%] vs 11 men [27%], p = 0.000] and digoxin (22 women [81%] vs 5 men [19%], p = 0.02). Women showed a trend toward higher odds of experiencing unintentional drug poisoning (OR = 2.5; 95% CI: 0.786-8.356; p = 0.119). In contrast, non-adherence to prescribed high-alert medications occurred with greater frequency in men (OR = 0.711, 95% CI: 0.473-1.070; p = 0.102). CONCLUSIONS: A considerable proportion of medication-related problems that lead to emergency room attendance involve high-risk medications, and the type of problem presented and the type of drug involved differ between sexes. Findings highlight that addressing gender differences, especially with regard to high-risk medicines, could be crucial in moving toward safer and more equitable healthcare.
[Translated article] Surface disinfectants used in healthcare environments.
Romero Crespo I, Gaspar Carreño ML, Muñoz Contreras MC
Farm Hosp · 2026 · PMID 42031627 · Publisher ↗
OBJECTIVE: To review the most relevant aspects to consider when selecting the optimal surface disinfectant for use in healthcare settings. METHOD: The review was conducted over a three-month period (January to March 2024...
OBJECTIVE: To review the most relevant aspects to consider when selecting the optimal surface disinfectant for use in healthcare settings. METHOD: The review was conducted over a three-month period (January to March 2024) based on the list of healthcare surface disinfectants authorized by the Spanish Agency of Medicines and Medical Devices and those in a transitional period, with marketing allowed until their registration in the Official Biocide Register. Biocidal agents belonging to the categories of skin antiseptics and insect repellents were excluded. A total of 100 biocidal agents were selected and evenly distributed among four researchers. The review strategy involved consulting the marketing representatives of these products via email or by reviewing their technical data sheets on their respective websites. The reviewed aspects of each disinfectant included marketed presentations, declared efficacy, composition, indication, dosage and usage instructions. RESULTS: The total number of biocidal agents included in the study was 85. A total of 29 suppliers were consulted, covering 141 marketed presentations, 25 (29.41%) of which were sterile. Regarding the efficacy reported by suppliers, 100% (85 products) showed bactericidal, 81.18% (69) fungicidal, 78.82% (67) virucidal, 50.59% (43) yeasticidal, 20% (17) mycobactericidal/tuberculocidal, and 17.65% (15) sporicidal activity. In terms of usage instructions, 40 of the 85 biocides (47.06%) were presented in a ready-to-use dosage format, and 34 (40%) allowed for cleaning and disinfection in a single step. A total of 14 biocides (16.47%) included airborne disinfection options. CONCLUSIONS: Selecting the most appropriate surface disinfectant is not straightforward given the wide range of marketed products, the number of factors to consider, and the fact that not all products meet every criterion. For this reason, the selection process must be accompanied by the implementation of optimized programs aimed at reducing the transmission of pathogens from surfaces to patients and healthcare personnel.
Real-world evidence of immune-related adverse events as predictive factor of response in non-small cell lung cancer.
Fortes-Gonzalez MS, Vazquez-Blanco S, Herrero-Poch L … +2 more , Santome-Couto L, Cercos-Lleti AC
Farm Hosp · 2026 Apr · PMID 42025527 · Publisher ↗
OBJECTIVE: The aim of the study was to assess whether immune-related adverse events (irAE) act as predictive biomarkers of response to immune checkpoint inhibitors in non-small-cell lung cancer in real-life practice. MET...
OBJECTIVE: The aim of the study was to assess whether immune-related adverse events (irAE) act as predictive biomarkers of response to immune checkpoint inhibitors in non-small-cell lung cancer in real-life practice. METHODS: Retrospective observational study in a third-level hospital. INCLUSION CRITERIA: adult patients with locally advanced or metastatic non-small-cell lung cancer treated with nivolumab, pembrolizumab or atezolizumab following platinum. PRIMARY ENDPOINT: association between ≥2 irAE and progression free survival (PFS) and overall survival (OS). Secondary endpoints: PFS, OS, overall response rate defined as the percentage of patients who achieve partial response or complete response, disease control rate and adverse events graded according to the Common Terminology Criteria for Adverse Events v5. Statistical analysis was performed using SPSS v23. RESULTS: Fifty-seven patients treated with nivolumab (n = 25) pembrolizumab (n = 11) or atezolizumab (n = 21) were included. Median age was 62 (31-83) years and 81% had stage IV. Median PFS was 7.8 months (95% CI: 4.3-11.3) and OS was 13.4 months (95% CI: 5.8-20.9). Overall response rate and disease control rate were 28.1% and 59.6% respectively. irAEs occurred in 44% of patients, most frequently arthralgia, myalgia, and transaminase elevation. Grade 3 irAEs included: 3 cases of colitis, 2 pneumonitis, 1 hepatitis, 1 cutaneous toxicity, and 1 adrenal insufficiency. Survival was significantly longer in patients with ≥2 irAEs compared to those with <2: OS 28.4 vs 11.9 months (p = 0.025) and PFS 24.5 vs 5.2 months (p = 0.013). CONCLUSIONS: Patients experiencing 2 or more irAEs showed significantly improved survival, supporting the role of irAEs as potential biomarkers of response to immunotherapy in non-small-cell lung cancer.
[Translated article] Spanish consensus on the preparation of parenteral nutrient mixtures - General aspects.
Berlana D, Gomis Muñoz P, Lago N … +5 more , Chica Marchal AM, Ubeira Iglesias M, Vázquez Polo A, Pellicer Franco C, en nombre del Grupo de Trabajo de Farmacia de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) y el Grupo de Trabajo de Nutrición Clínica de la Sociedad Española de Farmacia Hospitalaria (SEFH)
Farm Hosp · 2026 · PMID 42025526 · Publisher ↗
Parenteral nutrition is a complex therapeutic intervention, particularly in pediatric and critically ill patients, requiring strict standards of safety, stability, and compatibility during its preparation. To update and...
Parenteral nutrition is a complex therapeutic intervention, particularly in pediatric and critically ill patients, requiring strict standards of safety, stability, and compatibility during its preparation. To update and harmonize clinical practice, the Pharmacy Working Group of the Spanish Society of Clinical Nutrition and Metabolism and the Spanish Society of Hospital Pharmacy have developed a new multidisciplinary consensus. This document addresses key practical questions and provides recommendations grounded in scientific evidence and clinical experience. The consensus focuses on six key areas related to parenteral nutrition preparation: lipid emulsion stability and lipid peroxidation; calcium-phosphate precipitation risk; stability of amino acids, vitamins, and trace elements; quality control and labeling; automated compounding systems and multi-chamber bags; and drug-parenteral nutritioncompatibility. It outlines strategies to minimize physicochemical instability, including guidelines on analytical techniques, the recommended sequence of component addition, and preventive measures to avoid destabilization phenomena. This document serves as a practical guide for healthcare professionals involved in the compounding and administration of parenteral nutrition across various clinical settings. Recommendations were developed using a structured consensus methodology (adapted Delphi technique) and were unanimously endorsed by all participating experts. The result is a reference tool that supports safety, quality, and efficiency in parenteral nutrition preparation throughout Spain.
Pharmacologic and pharmacokinetic factors in blood donation: A risk-based deferral framework proposal.
Lozano R, Franco ME, Bona C
Farm Hosp · 2026 · PMID 42025525 · Publisher ↗
OBJECTIVE: The presence of residual medications in blood donors can pose a risk to transfusion recipients, especially when drugs remain in plasma at clinically relevant levels. Current deferral recommendations for medica...
OBJECTIVE: The presence of residual medications in blood donors can pose a risk to transfusion recipients, especially when drugs remain in plasma at clinically relevant levels. Current deferral recommendations for medicated donors are often generalized and lack pharmacokinetic rigor. This study aims to propose a pharmacologically and pharmacokinetically informed framework for assessing donor eligibility based on drug characteristics. METHOD: A structured literature review was conducted to evaluate key pharmacokinetic variables affecting drug persistence in blood, including half-life (t), time to maximum plasma concentration (t), maximum plasma concentration (C), and elimination pathways. Medications were stratified into five risk categories according to their pharmacological profile, systemic exposure, and clinical implications. Corresponding deferral periods were assigned to each category. The framework also considers the type of blood component being donated (e.g., plasma-rich vs. cellular products). RESULTS: Medications with long half-lives, genotoxic effects, or antiplatelet activity pose higher transfusion risks and require extended deferral periods. Conversely, drugs with minimal systemic absorption, low plasma bioavailability, or that serve as physiological replacements pose minimal risk and may not warrant deferral. The proposed model aligns deferral recommendations with drug clearance data and product-specific plasma exposure. CONCLUSIONS: A pharmacokinetic approach to donor eligibility enhances transfusion safety and supports evidence-based deferral guidelines. Pharmacists and clinicians can collaborate to assess medication risk profiles and optimize donor selection. This model can reduce unnecessary deferrals and maintain blood supply integrity while protecting recipients.
Possible severe gastrointestinal toxicity following the first cycle of mirvetuximab soravtansine in a patient with high-grade serous ovarian carcinoma.
Rodríguez-Tenreiro Rodríguez C, Caso González A, Muñoz Villasur M … +2 more , Roncero Sánchez L, Lozano Blázquez A
Farm Hosp · 2026 Apr · PMID 42025524 · Publisher ↗
Abstract loading — click title to view on PubMed.
Real world outcomes of first-line pembrolizumab in metastatic non-small-cell lung cancer.
Burgos A, Calleja T, Díaz MS … +11 more , Lizeaga G, Ibáñez C, Valencia CM, Carbajales M, Conde D, Marín JF, Garrido M, Díez R, Martínez MJ, Larrosa M, Moreno E
Farm Hosp · 2026 Apr · PMID 42014283 · Publisher ↗
OBJECTIVE: To describe the effectiveness and safety of pembrolizumab in routine clinical practice as first-line treatment for advanced/metastatic non-small cell lung cancer (NSCLC) with PD-L1 expression ≥50% and without...
OBJECTIVE: To describe the effectiveness and safety of pembrolizumab in routine clinical practice as first-line treatment for advanced/metastatic non-small cell lung cancer (NSCLC) with PD-L1 expression ≥50% and without EGFR or ALK alterations. METHODS: Retrospective, multicenter observational study including patients diagnosed with advanced/metastatic NSCLC treated with pembrolizumab monotherapy as first-line therapy between January 2016 and July 2020. Clinical, treatment-related, and safety variables were collected. The primary effectiveness endpoints were overall survival (OS) and progression-free survival (PFS), estimated using the Kaplan-Meier method. RESULTS: A total of 1005 patients from 42 Spanish hospitals were included, with a median age of 67 years (interquartile range [IQR]: 14); 256 were women. The predominant histology was non-squamous (725 patients). Median follow-up was 17.9 months (IQR: 24.1), and the median number of treatment cycles received was 8 (IQR: 21). Median PFS and OS were 8.7 months (95% confidence interval [CI]: 7.2-10.1) and 18.0 months (95% CI: 16.2-21.3), respectively. In the bivariate analysis, factors significantly associated with shorter OS included: age ≥ 75 years, body mass index (BMI) <25 kg/m, never smoking, performance status (PS-ECOG) ≥2, squamous histology, baseline liver or brain metastases, ≥2 metastatic sites at diagnóstico, Lung Immune Prognostic Index (LIPI) 1-2, and prior exposure to proton pump inhibitors (PPIs), corticosteroids, and antibiotics (within the previous 10 days). Overall, 61.7% of patients experienced some degree of toxicity (G1-5), and 15.3% had G ≥ 3 toxicities. Treatment discontinuation due to toxicity occurred in 115 patients (12.7%). Patients who developed toxicity had a median OS of 28.3 months (95% CI: 23.9-34.5), compared to 6.5 months (95% CI: 5.1-9.2) in those without toxicity (p < 0.0001). CONCLUSIONS: In advanced/metastatic NSCLC with PD-L1 ≥ 50% and no EGFR/ALK alterations, first-line pembrolizumab demonstrates outcomes consistent with the pivotal trial and with published real-world evidence. The findings confirm that PS-ECOG ≥2 and prior PPI exposure are predictors of shorter OS, and that the development of toxicity during treatment is significantly associated with longer survival.
Adequacy of three-compartment parenteral nutrition bags to current European guidelines for adults: a simulation study.
de Antonio-Cuscó M, Albalat-Torres A, Mateu-de Antonio J
Farm Hosp · 2026 · PMID 42000278 · Publisher ↗
INTRODUCTION: The use of three-compartment parenteral nutrition bags (3CPNBs) has widely expanded due to their potential time- and cost-saving advantages compared to hospital-compounded parenteral nutrition bags (HCPNBs)...
INTRODUCTION: The use of three-compartment parenteral nutrition bags (3CPNBs) has widely expanded due to their potential time- and cost-saving advantages compared to hospital-compounded parenteral nutrition bags (HCPNBs). However, there is limited evidence of commercial 3CPNBs to adequately meet current nutritional guidelines. OBJECTIVES: This study assessed the nutritional adequacy of all commercial 3CPNBs available in Spain, according to current European guidelines, across four clinical scenarios for adult patients. METHODS: A simulation-based study was performed to evaluate the protein and caloric content of 3CPNBs commercially available in Spain. Four clinical scenarios were defined: early and late phases of intensive care (I1 and I2), surgical (Q), and medical (M) inpatients. Two sub-analyses were conducted: a 3CPNB-centered assessment of each formulation's theoretical adequacy for each scenario, and a patient-centered analysis involving 1,000 simulated adult patients per scenario (total: 4,000 simulations). Patients' weight was computer generated reflecting the published Spanish adult-population values (tested by the Anderson-Darling test and one-sample t-test). Nutritional requirements were calculated using ESPEN guidelines, and adequacy was defined as meeting protein and caloric targets within ±5% range. RESULTS: A total of 50 commercial 3CPNBs were identified, but 15 bags (30.0%) were excluded based on predefined criteria. Then, 35 were included in the study. While 51.4% formulations met adequacy criteria across all scenarios, 34.3% were suitable for only one, and 8.6% were unsuitable for any scenario. More than half (57.1%) failed to cover even 10% of patients in any scenario. ICU scenarios, I1 and I2, showed the lowest coverage, with only around 30% of patients with an appropriate 3CPNBs. Many weight strata showed less than 50% coverage depending on the scenario. In the 64-81,99 kg strata, around the population mean, 45.9% lacked an appropriate 3CPNBs across all scenarios. CONCLUSIONS: Substantial variability existed in the adequacy of commercial 3CPNBs to ESPEN guidelines. Many formulations failed to meet the criteria or were not usable across all scenarios. Many patients with body weight around population mean had no adequate 3CPNBs. These findings supported the need for critical evaluation of 3CPNBs and still place HCPNBs as a flexible alternative, especially in complex and critically ill populations.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe