OBJECTIVES: To assess changes in quality of life in patients with rare disease hereditary transthyretin amyloidosis after initiating vutrisiran. Secondary objectives included evaluating effectiveness and safety. METHODS:...OBJECTIVES: To assess changes in quality of life in patients with rare disease hereditary transthyretin amyloidosis after initiating vutrisiran. Secondary objectives included evaluating effectiveness and safety. METHODS: Prospective, observational study, conducted in a real-world clinical setting between November 2023 and May 2024. Quality of life was assessed using Norfolk QOL-DN questionnaire at baseline and six months after treatment initiation. Statistical analysis was performed using SPSS Statistics®, and the Wilcoxon signed-rank test was applied to compare outcomes. RESULTS: Twenty-five patients were included. The median Norfolk QOL-DN score changed from 54 (40.5; 77.5) to 48 (32.0; 83.0) after six months (p = 0.935). NIS scores decreased from 41 (14.0; 70.0) to 22 (6.0; 66.5) (p = 0.177). Serum TTR levels were maintained or reduced to undetectable levels in all patients. NT-proBNP decreased from 464.0 (102.0; 827.0) to 345.0 pg/mL (146.0; 995.0) (p = 0.518). No treatment-related adverse events were reported. CONCLUSION: Although statistical significance was not reached, vutrisiran maintained or improved quality of life and clinical status in a real-world population that was more pretreated and had greater disease burden than the clinical trial. Combined with its favorable safety profile, subcutaneous administration, and extended dosing interval-preferred by patients-vutrisiran represents a promising therapeutic option for ATTRv amyloidosis. Long-term real-world studies are warranted to confirm these findings.
Garrido Quintero A, Cercas Lobo S, Ruiz Ramos J
… +6 more, Plaza Díaz A, González Díez A, Cañón Santos A, Villarejo Jiménez A, Pérez Méndez MC, Puig Campmany M
BACKGROUND: Gastrointestinal bleeding is a frequent cause of emergency department visits among anticoagulated patients. Antidepressants may potentiate bleeding risk by impairing platelet aggregation. The impact of concom...BACKGROUND: Gastrointestinal bleeding is a frequent cause of emergency department visits among anticoagulated patients. Antidepressants may potentiate bleeding risk by impairing platelet aggregation. The impact of concomitant antidepressant use on emergency room re-visits for gastrointestinal bleeding in anticoagulated elderly patients remains unclear. OBJECTIVE: This study aimed to assess the risk factors for Emergency Department (ED) re-visit within 90 days after an initial bleeding episode in elderly patients on oral anticoagulant (OAC) therapy. METHODS: A retrospective observational study was conducted at a hospital in Catalonia, including patients over 65 years treated with OACs who presented to the ED for gastrointestinal bleeding between 2018 and 2024. Data were obtained from electronic health records, including comorbidities, chronic medications, and discharge treatments. The primary outcome was ED revisit for bleeding within 90 days. Multivariate logistic regression was used to identify independent predictors. RESULTS: Of 143 patients included [mean age 82.4 years; 51.7% women], 26.7% were on antidepressants, 8.3% on antiplatelet agents, and 77.6% on proton pump inhibitors. Over a mean follow-up of 90 days, 23.1% patients re-visited the emergency room with bleeding. Univariate analysis identified chronic kidney disease, antidepressant therapy, and antiplatelet use as significant factors. In multivariate models, independent predictors were chronic kidney disease (OR 2.50; 95% CI 1.07-5.85; p = 0.034), antidepressant use (OR 2.56; 95% CI 1.07-6.14; p = 0.034), and concomitant antiplatelet therapy (OR 4.55; 95% CI 1.27-16.28; p = 0.020). CONCLUSIONS: In elderly patients anticoagulated, the addition of antidepressants significantly increases the risk of ED re-visit for gastrointestinal bleeding within 90 days. Chronic kidney disease and concomitant antiplatelet therapy also emerge as key risk factors.
OBJECTIVES: New drugs such as faricimab have been developed to treat ophthalmic neovascular diseases. While these drugs increase treatment success, they also increase costs. Repackaging drugs strikes a balance between te...OBJECTIVES: New drugs such as faricimab have been developed to treat ophthalmic neovascular diseases. While these drugs increase treatment success, they also increase costs. Repackaging drugs strikes a balance between technical requirements and treatment flexibility. The aim of this study was to evaluate the microbiological stability of repackaged faricimab under controlled conditions in order its already demonstrated chemical, biological, and microbiological stability. METHODS: This was a prospective, controlled experimental study. The contents of four vials of faricimab were repackaged into 16 silicone oil-free syringes with a low dead space volume. A bubble adaptor was used to ensure the maximum efficiency from fractioning. All samples were stored at 2-8 °C. Four of the syringes were cultivated on blood and Sabouraud agar at set time points (9 days, 16 days, 23 days, and 30 days). The endpoint of the study was positive microbiological growth in any of the samples. Negative and positive controls were cultivated alongside the test samples. RESULTS: None of the 16 samples or the negative controls exhibited microbiological growth at any stage of the culturing process. All positive controls showed microbiological growth. CONCLUSIONS: When repackaged in silicone oil-free syringes, faricimab retains microbiological stability for up to 30 days when it is prepared and stored under controlled conditions.
Mercadal-Orfila G, López Sánchez P, Padullés-Zamora N
… +10 more, Pou Alonso A, Ibarra-Barrueta O, Monte-Boquet E, Borrás Blasco J, Sanmartin-Fenollera P, Capilla Montes C, Bernabéu Martínez MA, Notario Rosa J, Escrivá Sancho ME, Herrera-Pérez S
INTRODUCTION: Psoriasis is a chronic immune-mediated disease with a substantial impact on health-related quality of life (HRQoL), particularly in moderate-to-severe cases requiring systemic treatment. The integration of...INTRODUCTION: Psoriasis is a chronic immune-mediated disease with a substantial impact on health-related quality of life (HRQoL), particularly in moderate-to-severe cases requiring systemic treatment. The integration of electronic patient-reported outcome measures (ePROMs) into telepharmacy platforms has emerged as a valuable approach for longitudinal monitoring and patient-centered care. The TELEPROMpsoriasis study aimed to evaluate the 12-month evolution of HRQoL and symptom burden in patients with moderate-to-severe psoriasis treated with biologic or small-molecule inhibitors and followed through a telepharmacy program, to assess the achievement of predefined HRQoL targets (DLQI ≤1 and PSSD-7 days <20), and to explore differences according to treatment history and sex. METHODS: A multicenter, prospective study was conducted using the NAVETA telepharmacy platform within the Spanish National Health System. Adult patients with moderate-to-severe plaque psoriasis initiating or switching biologic or immunomodulatory therapy were included. HRQoL was assessed using the Dermatology Life Quality Index (DLQI) and the Psoriasis Symptoms and Signs Diary (PSSD-7 days) at baseline and at months 1, 3, 6, and 12. Longitudinal analyses were performed using non-parametric tests, accounting for variable response rates across follow-up visits. RESULTS: A total of 210 patients were enrolled; 188 provided at least one validated ePROMs response and were eligible for longitudinal analyses. Both DLQI and PSSD-7 day scores showed significant and progressive improvement over 12 months, with a strong correlation between instruments throughout follow-up (r = 0.74 at month 12). Biologic-naïve patients achieved higher rates of clinically relevant HRQoL improvement than biologic-experienced patients, particularly at later follow-up visits. Women consistently reported higher symptom burden and lower HRQoL than men. No significant differences in HRQoL trajectories were observed across pharmacological classes. By month 12, more than half of the cohort achieved optimal HRQoL targets. Adherence to questionnaire completion was 71%, and overall satisfaction with the telepharmacy program was high (9/10). CONCLUSIONS: Telepharmacy-supported monitoring using validated ePROMs effectively captures longitudinal changes in HRQoL and symptom burden in patients with moderate-to-severe psoriasis. The achievement of predefined HRQoL targets supports their clinical relevance in real-world settings. These findings highlight the value of PROM-based, patient-centered digital follow-up and suggest that biologic-experienced patients and women may benefit from more tailored monitoring strategies.
Zavaleta-Monestel E, Villalobos-Madriz A, Fallas-Mora A
… +12 more, Martínez-Vargas E, Munich-Calvo A, Teixeira V, Dalmaso-Neto S, Sánchez C, Morales-Vallespín J, Milano-Gil A, Arroyo-Monterroza D, Delgado-Pérez G, Stepanovic M, Eckel S, Ivey M
OBJECTIVE: The standardization of hospital pharmacy practice remains a challenge in Latin America due to the heterogeneity of healthcare systems. The Basel Statements, developed by the International Pharmaceutical Federa...OBJECTIVE: The standardization of hospital pharmacy practice remains a challenge in Latin America due to the heterogeneity of healthcare systems. The Basel Statements, developed by the International Pharmaceutical Federation, provide guidelines aimed at improving patient safety and medication management; however, their implementation across the region is inconsistent. To evaluate the application of the Basel Statements Self-Assessment Questionnaire in hospitals across Latin America and identify priority areas for improvement. METHOD: A multicenter study was conducted in eight hospitals from eight countries. A 33-item questionnaire based on the Basel Statements was electronically distributed to clinical and hospital pharmacists. A descriptive analysis was performed. RESULTS: Only 25% of hospitals reported effective integration of pharmacists into clinical decision-making. Fewer than one-third had adequate medication traceability systems. Additionally, only 37.5% reported having regulations for the use of dietary supplements. Lack of standardization in medication storage and administration was also observed, increasing the risk of medication errors. CONCLUSIONS: Implementation of the Basel Statements in Latin America is heterogeneous and requires targeted interventions. Strengthening pharmacists' involvement in multidisciplinary teams, improving traceability systems, and developing stronger regulations to support the safe use of medications are essential steps to enhance patient safety in the region.
BACKGROUND: The Pharmaceutical Care in Infectious Diseases Group (AFinf) is composed of a coordinating group of 11 pharmacists, 1 fellow, 1 resident pharmacist intern, 4 senior consultants and 221 associate members (July...BACKGROUND: The Pharmaceutical Care in Infectious Diseases Group (AFinf) is composed of a coordinating group of 11 pharmacists, 1 fellow, 1 resident pharmacist intern, 4 senior consultants and 221 associate members (July 2025). The aim is to understand and describe the profile of the members as a basis for defining future strategic lines to improve their participation. METHODS: An online survey was distributed to all AFinf group members, including questions about their professional activity, expectations and potential contributions to the group. RESULTS: The 41.7% of associated professionals participated in the survey. The median length of experience in the area of infectious diseases was 5 years (RIC 2-10). Antimicrobial stewardship programmes represented the main area of expertise (73.9%; 95% CI: 63.2-84.5), followed by pharmacokinetic monitoring (16.9%; 95% CI: 7.8-26.0). The priorities of the adherents were to receive training and education (52.3%; 95% CI: 40.2-64.5%) as well as the need to share doubts and experiences (27.7%; 95% CI: 16.8-38.6). Among the respondents, 50.0% (95% CI: 39.0-61.0) consider that they could contribute ideas and experiences, while 31.3% (95% CI: 21.1-41.4) research/collaborate on projects and 18.7% (95% CI: 10.2-27.3) participate in teaching and other group activities. CONCLUSION: This study has allowed us to better understand the professional profile of pharmacists who are members of the AFinf group and to analyze their concerns and possible contributions.
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.
OBJECTIVE: Pivotal study on perioperative toripalimab in resectable non-small-cell lung cancer showed population differences by histological subtype compared with other immunotherapy regimens, raising doubts about therap...OBJECTIVE: Pivotal study on perioperative toripalimab in resectable non-small-cell lung cancer showed population differences by histological subtype compared with other immunotherapy regimens, raising doubts about therapeutic positioning. The aim of this study was to interpret the methodological analysis by subgroups according to histological subtype of perioperative toripalimab in resectable non-small-cell lung cancer. METHODS: Validated subgroup analysis applicability tool was used. This tool had two parts: preliminary questions to directly rule out analysis without relevant minimum conditions, and checklist. This checklist assessed statistical association, biological plausibility and consistency of subgroup results, and related these criteria to recommendations on applicability. RESULTS: Preliminary question regarding differences in effect between subgroups p(i) < 0.1 was answered negatively, and checklist was not applied due to direct discard. Even if the checklist had been applied, statistical association criterion would have been rated 'null' due to absence of statistically significant differences. Biological plausibility would have been rated 'probable' due to non-squamous histology being a negative prognostic factor. Consistency would have been rated 'null' for absence of heterogeneity between subgroups in similar studies. CONCLUSIONS: This methodological interpretation recommended against applying histology-based subgroup results for perioperative toripalimab in resectable non-small-cell lung cancer, avoiding ruling out the use of toripalimab in the non-squamous subgroup.
OBJECTIVE: Excipients, the inactive components of medications, are essential in pharmaceutical formulations, but their safety in the pediatric population is not always guaranteed. Children, due to their physiological and...OBJECTIVE: Excipients, the inactive components of medications, are essential in pharmaceutical formulations, but their safety in the pediatric population is not always guaranteed. Children, due to their physiological and metabolic immaturity, are more susceptible to the adverse effects of these additives. This study aimed to review the safety of the most common excipients in pediatric medicines, highlighting their risks and documented mechanisms of toxicity. METHOD: A systematic review was conducted following the guidelines for systematic reviews and meta-analyses, including studies published between 2014 and 2025. Searches were performed in PubMed, Web of Science, and ScienceDirect, along with regulations from key international and national regulatory agencies. RESULTS: Fifty-four excipients with potential toxicity in children were identified and classified into four functional groups. Notable adverse effects include hepatic, renal, and neurological toxicity, as well as hypersensitivity reactions. A significant limitation is the lack of specific data for the pediatric population. CONCLUSION: exposure to excipients in children is an underestimated clinical problem, exacerbated by the frequent use of formulations adapted from adults. The discussion addresses regulatory disparities, the critical need to develop medicines specifically designed for children, and the importance of collaborative initiatives to build pediatric safety databases. The pharmacist plays a key role in the informed selection of excipients. The findings indicate that a considerable proportion of excipients used in pediatric formulations carry documented toxicological risks, especially in younger age groups. This review underscores the urgent need for more rigorous safety evaluation, the development of age-specific formulations, and greater transparency in information for healthcare professionals.
INTRODUCTION: Since the post-antibiotic era, there has been significant difficulty in treating infectious diseases due to the increase in antimicrobial resistance, the scarcity of new antimicrobials, and the complexity o...INTRODUCTION: Since the post-antibiotic era, there has been significant difficulty in treating infectious diseases due to the increase in antimicrobial resistance, the scarcity of new antimicrobials, and the complexity of the healthcare system. The World Health Organization (WHO) recognized it as one of the main public health problems. To mitigate this issue, Antimicrobial Stewardship Programs (ASPs) have been established in hospital settings and in primary care, through multidisciplinary teams with specific objectives and measurable results. However, their implementation faces multiple challenges. Digital tools and artificial intelligence (AI) can enhance these ASPs, contributing to the discovery of new molecules, the identification of resistance patterns, and improvements in infection control and prevention. OBJECTIVE: To analyze the role of digital tools and AI in the interventions carried out by hospital-based ASP teams to improve established outcomes. MATERIAL AND METHODS: This protocol follows the PRISMA-P methodology and has been registered in PROSPERO (ID: CRD42024601221). A literature search will be conducted in PubMed, Scopus, and the Cochrane Library (2014-2024); gray literature will subsequently be reviewed in Google Scholar. Articles (clinical trials, interventional and observational) involving hospitalized adult patients requiring antimicrobial treatment will be included. The risk of bias will be assessed according to the study type, and methodological quality will be evaluated using the GRADE scale. Two independent researchers will perform study selection, quality assessment, and data extraction. Discrepancies will be resolved by consensus or through the intervention of a third researcher. DISCUSSION: Previous studies highlight the role of ASPs and digital tools in antimicrobial optimization. However, the difficulty and difference in the degree of implementation have also become apparent. The heterogeneity of interventions and indicators could be a limiting factor for conducting a meta-analysis. Despite these limitations, this systematic review will provide a better understanding of the potential use of digital tools and AI in hospital-based ASPs.
OBJECTIVE: To review and summarize the available clinical evidence on the use of milrinone in aneurysmal subarachnoid hemorrhage (aSAH), focusing on its efficacy in the prevention and treatment of cerebral vasospasm and...OBJECTIVE: To review and summarize the available clinical evidence on the use of milrinone in aneurysmal subarachnoid hemorrhage (aSAH), focusing on its efficacy in the prevention and treatment of cerebral vasospasm and delayed cerebral ischemia (DCI). METHOD: A narrative review of the literature was conducted using PubMed, EMBASE, ScienceDirect, and The Cochrane Database, without restrictions on publication date. The search included the following terms: milrinone, vasospasm, delayed cerebral ischemia, and subarachnoid hemorrhage. The last bibliographic search was performed in June 2025. Studies of any methodological design were considered, including randomized clinical trials, observational studies, case series, and case reports, provided they addressed the use of milrinone in this clinical context. RESULTS: A total of 28 studies were identified, of which 21 were included in the final analysis. Most studies were observational and heterogeneous in design. Overall, intravenous and intra-arterial milrinone administration was consistently associated with angiographic improvement of cerebral vasospasm and favorable effects on cerebral hemodynamics, as well as a reduction in the need for rescue endovascular therapies. However, evidence regarding a consistent benefit on functional outcomes and mortality remains limited. Hypotension and electrolyte disturbances were the most frequently reported adverse events, although serious cardiovascular complications were uncommon. Only one randomized clinical trial comparing milrinone with magnesium sulfate showed no superiority of milrinone in preventing vasospasm and reported a higher incidence of hypotension. CONCLUSIONS: Milrinone appears to be a potentially useful therapeutic option for the management of cerebral vasospasm and DCI after aSAH, particularly as a rescue therapy. Nevertheless, the current evidence is largely based on non-randomized studies and does not provide definitive proof of consistent functional benefit. Ongoing and recently completed randomized clinical trials may help clarify its efficacy and safety profile and define its role in clinical practice.
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.
OBJECTIVE: To evaluate treatment persistence and dosing interval extension with faricimab in neovascular age-related macular degeneration (nAMD) in real-world practice. METHODS: Retrospective observational study conducte...OBJECTIVE: To evaluate treatment persistence and dosing interval extension with faricimab in neovascular age-related macular degeneration (nAMD) in real-world practice. METHODS: Retrospective observational study conducted in a tertiary hospital (March 2024-March 2025). Patients receiving faricimab (treatment-naïve or pre-treated with anti-VEGF therapy), with ≥1 post-loading dose, were included. Dosing intervals were analyzed at baseline, 6 and 12 months, Adherence was assessed with the medication possession ratio (MPR), with >80% considered adherent. Persistence was defined as the time from treatment initiation to discontinuation or end of follow-up. Persistence was estimated using Kaplan-Meier survival analysis. RESULTS: We included 129 patients (148 eyes), mean age 74.5 ± 8.85 years; 55% were female. A total of 39 patients (30.2%) were treatment-naïve and 90 (69.8%) were pretreated. At 12 months, 48.8% of naïve and 55.5% of pretreated patients achieved 8-12 weeks intervals. Mean persistence was 12.2 months (SD 0.2; 95% CI: 11.8-12.6). The median was not reached by the end of the study. Persistence rate was 93% at 6 and 12 months. Only one patient discontinued due to inefficacy. No serious adverse events or endophthalmitis occurred. CONCLUSIONS: Faricimab showed excellent persistence and extended dosing intervals in real-world practice. This is the first study specifically evaluating faricimab real-world persistence in nAMD.
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 (SEFH) 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% of SEFH 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.
Sangrador Rasero AM, Gomis Pastor M, Ibañez García S
… +7 more, Sanabrias Fernández de Sevilla R, Solé Fabre N, Pablos Bravo S, Estaún Martínez C, Plasencia García I, García González X, Clemente Bautista S
The participation of hospital pharmacists in multidisciplinary solid organ transplant teams is essential in the care of transplant patients. The objective of this document is to encourage clinical pharmacists in Spain to...The participation of hospital pharmacists in multidisciplinary solid organ transplant teams is essential in the care of transplant patients. The objective of this document is to encourage clinical pharmacists in Spain to become established as members of the multidisciplinary transplant team, in order to add value to the comprehensive care process of solid organ transplant patients. A detailed analysis of the literature was conducted, along with the identification of international best practices, and insights were gathered from pharmacists, physicians from various specialties, and patient associations. The final document was approved by consensus by a group of hospital pharmacist experts in solid organ transplantation. This document defines the activities in which hospital pharmacists, through their coordinated integration into the multidisciplinary transplant team, could participate and add value to the comprehensive care of patients with solid organ transplant.
Aznar de la Riera MB, Valencia Soto CM, García-Avello Fernández-Cueto A
… +7 more, Villacañas Palomares MV, Muñoz Unceta N, Fernández Martínez V, Barbadillo Villanueva S, Rioja Carrera M, Valero Dominguez M, Martínez Callejo V
OBJECTIVE: The objective is to describe the real-world effectiveness and safety of atezolizumab in combination with carboplatin and etoposide as first-line treatment for patients with extensive-stage small-cell lung canc...OBJECTIVE: The objective is to describe the real-world effectiveness and safety of atezolizumab in combination with carboplatin and etoposide as first-line treatment for patients with extensive-stage small-cell lung cancer. METHODS: We conducted a retrospective observational study of 48 patients with extensive-stage small-cell lung cancer treated with atezolizumab, carboplatin, and etoposide between March 2022 and May 2024 at a tertiary care center. The primary endpoints were progression-free survival and overall survival, analyzed using the Kaplan-Meier method. Safety outcomes and clinical predictors of survival were also assessed using software SPSS v26. RESULTS: After a median follow-up of 7.6 months (range: 1.5-28.4), median progression-free survival was 5.8 months and median overall survival was 7.1 months. Baseline ECOG performance status (ECOG 1 and 2) and the presence of brain metastases were associated with reduced overall survival. Patients who received ≤2 cycles of maintenance atezolizumab showed inferior survival outcomes. Grade 3-4 treatment-related adverse events occurred in 60.4% (n = 29) of patients, with hematologic toxicity being the most frequent. CONCLUSIONS: In this real-world cohort, atezolizumab in combination with carboplatin and etoposide demonstrated feasibility and a manageable safety profile in first-line treatment of extensive-stage small-cell lung cancer. Longer follow-up and larger sample sizes are warranted to confirm these findings and further define prognostic markers in clinical practice.
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
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.