OBJECTIVE: There is uncertainty about how age affects the efficacy of immunotherapy due to the natural process of immunosenescence. The aim of this systematic review and meta-analysis is to assess whether age over 65 yea...OBJECTIVE: There is uncertainty about how age affects the efficacy of immunotherapy due to the natural process of immunosenescence. The aim of this systematic review and meta-analysis is to assess whether age over 65 years affects the efficacy, in terms of overall survival, of immunotherapy treatments in combination with chemotherapy or double immunotherapy, used in first-line metastatic non-small cell lung cancer without molecular alterations. METHODS: A systematic review and meta-analysis were performed. A systematic search of PubMed and Cochrane Library until April 30, 2024 was conducted to identify randomized clinical trials comparing an experimental treatment with immune checkpoint inhibitors plus chemotherapy versus a platinum-based chemotherapy doublet in patients with locally advanced or metastatic non-small cell lung cancer, without molecular mutations and with any level of programmed death ligand 1 expression. The primary endpoint was the difference in efficacy between those older and younger than 65 years, measured in terms of difference in overall survival hazard ratio. We calculated the hazard ratio for overall survival with its 95% confidence interval in both age groups and assessed heterogeneity using an interaction test. RESULTS: A total of 1,505 publications were identified, of which 7 clinical trials were included. In addition, the European public report evaluating pembrolizumab in combination with platinum and nab-paclitaxel was incorporated. In total, the analysis included 5,572 patients: 2,893 under 65 years of age and 2,679 aged 65 years or older. The pooled Hazard Ratio for overall survival for patients in the first group was 0.68 (95% CI: 0.62-0.74), and for the second 0.77 (95% CI: 0.70-0.84). The p-interaction between the pooled Hazard Ratio of both groups was 0.0551. CONCLUSIONS: Both those younger and older than 65 years benefit from immunotherapy combined with chemotherapy in the treatment of non-small cell lung cancer. Although there appears to be greater efficacy in those younger than 65 years, the influence of age is not entirely clear.
OBJECTIVE: To validate the IF-CSS frailty index according to its predictive capacity for mortality and to define the intervals compatible with frailty states. METHODS: An observational, retrospective, multicenter study o...OBJECTIVE: To validate the IF-CSS frailty index according to its predictive capacity for mortality and to define the intervals compatible with frailty states. METHODS: An observational, retrospective, multicenter study of a cohort of elderly patients from four nursing homes with a follow up between 12 and 38 months was conducted. The IF-CSS comprised 17 variables across four domains from the comprehensive geriatric assessment. Contrast of hypothesis log-rank for survival curves according to IF-CSS index was performed. The predictive model of survival time was performed using a parametric accelerated failure model. RESULTS: 535 patients with a mean age of 83.62 years (SD7.84) were included. Mortality rate during the study period was 39.8%. Survival curves by frailty intervals showed significant differences (χ = 92; p < 0.001). The comparative analysis also showed significant differences for almost all the variables included in the construct. The parametric model of accelerated failure estimated a 29% reduction in survival time for each tenth of an increase in the IF-CSS. CONCLUSIONS: The IF-CSS results in a tool with a frailty discriminative and mortality predictive capacity that allows its use in the care programs of nursing homes.
Alfonsín Lara M, Áreas Del Águila V, Contreras Macías E
… +5 more, Mancebo González A, Martínez Castro B, Pérez Menéndez-Conde C, Sanmartín Fenollera P, Morillo-Verdugo R
OBJECTIVE: To assess the level of knowledge, perception, and willingness of hospital pharmacy residents in Spain to implement the initiatives of the MAPEX project (Strategic Map for Outpatient Pharmaceutical Care) by the...OBJECTIVE: To assess the level of knowledge, perception, and willingness of hospital pharmacy residents in Spain to implement the initiatives of the MAPEX project (Strategic Map for Outpatient Pharmaceutical Care) by the Spanish Society of Hospital Pharmacy in the future, as well as to analyze the influence of outpatient pharmacy rotations on these aspects. METHODS: A four-phase study was conducted: information review and analysis, questionnaire design, survey administration, and final report development. A questionnaire was designed to assess knowledge, perception, and application of MAPEX, as well as experience in outpatient pharmacy rotations. Factorial and bivariate analyses were performed to evaluate the questionnaire structure and identify associations between variables. RESULTS: A total of 143 residents participated. Of these, 78.3% had completed an outpatient pharmacy rotation, which was significantly associated with greater knowledge (p = 0.02) and application (p = 0.01) of MAPEX. However, only 15.4% had a high level of knowledge, and 12.6% frequently applied the Capacity-Motivation-Opportunity (CMO) methodology. Although 71.3% positively valued motivational interviewing, only 28% used it frequently. Willingness to implement MAPEX was high (73.4%), reaching 100% among those with a high level of knowledge about the project (p = 0.04). Factor analysis identified six factors explaining 66.8% of the total variance. CONCLUSIONS: Hospital pharmacy residents demonstrated a positive perception and a high willingness to implement MAPEX, highlighting the need for its structured integration into specialized training. Outpatient pharmacy rotations significantly improve knowledge and application of the CMO methodology, emphasizing their importance in pharmaceutical care training.
Vélez-Díaz-Pallarés M, Parro-Martín MÁ, Martínez-Barros H
… +6 more, Montero-Llorente B, Menacho-Román M, Gómez-Lozano A, Royo RN, Carro LM, Álvarez-Díaz A
INTRODUCTION: Inhaled antibiotics are used in the treatment of various respiratory diseases, including cystic fibrosis (CF), non-CF bronchiectasis, and ventilator-associated pneumonia. While some of these drugs are marke...INTRODUCTION: Inhaled antibiotics are used in the treatment of various respiratory diseases, including cystic fibrosis (CF), non-CF bronchiectasis, and ventilator-associated pneumonia. While some of these drugs are marketed as ready-to-use formulations, others require prior manipulation, such as dilution or reconstitution procedures that are often not standardized. Furthermore, certain antibiotics are only approved for intravenous administration, making it necessary to develop specific protocols for their preparation and use via the inhaled route. Their biochemical properties may also compromise patient safety and tolerability. The aim of this study was to assess how frequently preparation methods and biochemical parameters of inhaled antibiotic solutions are described in the scientific literature. Additionally, we explored their prevalence of use in our country and evaluated their biochemical characteristics to assess tolerability. METHODS: A literature review was conducted using the MEDLINE database to identify studies describing the dilutions used for the administration of inhaled antibiotics. In addition, a nationwide survey was carried out to assess the dilutions currently used in hospital clinical practice. Biochemical analyses were performed in parallel to determine the pH, osmolality, and sodium and chloride ion concentrations of the solutions employed. Excipients present in each formulation were recorded based on information from the product's summary of characteristics. RESULTS: The literature review identified 533 full-text publications describing 737 different inhaled antibiotic mixtures. Of these, 476 were not standardized. Only 190 mixtures included precise dilution instructions, while just 31 provided data on pH and 28 on osmolality. The national survey revealed a high prevalence of inhaled antibiotic use among participating hospitals, with 22 centres (64.7%) reporting the use of intravenous formulations administered via inhalation. Laboratory analyses showed that some of the evaluated dilutions fell outside the acceptable tolerability range, particularly those involving reconstitution of dry powders or dilution of concentrated intravenous solutions. CONCLUSION: There is limited information in the scientific literature regarding preparation methods and the biochemical characteristics of inhaled antibiotic solutions. Off-label use of intravenous formulations for inhalation is widespread, and some of the dilutions used exhibit biochemical parameters outside the recommended tolerability range, which may compromise both the safety and effectiveness of treatment.
INTRODUCTION: dalbavancin is approved for treating acute bacterial skin and soft tissue infections, but its off-label use for treating complex chronic infections has become increasingly common. Currently, there is no est...INTRODUCTION: dalbavancin is approved for treating acute bacterial skin and soft tissue infections, but its off-label use for treating complex chronic infections has become increasingly common. Currently, there is no established dosing regimen for such infections. Given the need for prolonged treatments, a dosing adjustment strategy based on therapeutic drug monitoring may optimize its use and allow for individualized regimens. This systematic review analyzes dalbavancin dosing in complex infections and TDM-based strategies to optimize treatment. MATERIALS AND METHODS: A search was conducted in PubMed, Embase, Scopus, and the Cochrane Library (2014-2024) using the following keywords: "dalbavancin", "pharmacokinetics", "pharmacodynamics", "therapeutic drug monitoring", and "TDM". Three independent reviewers selected and evaluated the studies. Clinical studies related to the pharmacokinetics of dalbavancin and the use of TDM in complex infections requiring prolonged regimens were included. Due to the heterogeneity among the studies, a qualitative analysis of the data was performed. RESULTS: A total of 241 articles were identified. After removing duplicates and applying the inclusion and exclusion criteria, 10 studies were included. These studies exhibited heterogeneity in design (6 retrospective and 4 prospective) and sample size, encompassing 457 patients and 1.298 samples. Most studies focused on osteoarticular infections treated with dalbavancin using an initial two-dose regimen of 1,500 mg administered one week apart, followed by dose adjustments based on plasma level monitoring. The most commonly targeted pharmacokinetic/pharmacodynamic parameters were a trough concentration above 8 μg/ml and an area under the curve/minimum inhibitory concentration ratio greater than 111.1. Therapeutic Drug Monitoring-Guided strategies were found to optimize dosing and maintain adequate plasma levels. Significant interindividual variability in plasma concentrations was observed, influenced by factors such as renal function and body surface area. DISCUSSION: The use of Therapeutic Drug Monitoring in dalbavancin dosing optimizes the treatment of complex chronic infections by adjusting dosing intervals and maintaining adequate therapeutic levels over extended periods. However, further validation and definition of specific pharmacokinetic/pharmacodynamic targets is required.
OBJECTIVE: The objective of the study was to analyse possible changes in antibiotic policy with ceftazidime-avibactam during the SARS-CoV-2 pandemic in an Intensive Care Unit (ICU) to determine patient mortality 28 days...OBJECTIVE: The objective of the study was to analyse possible changes in antibiotic policy with ceftazidime-avibactam during the SARS-CoV-2 pandemic in an Intensive Care Unit (ICU) to determine patient mortality 28 days after initiation of antimicrobial therapy and to describe the microorganisms that most frequently colonise critically ill patients. MATERIAL AND METHOD: Observational, single-centre, cohort study that included patients on treatment with ceftazidime-avibactam in ICU between March 2020 and September 2021. Demographic (age, sex), microbiological (colonisation, microorganisms isolated in blood cultures), pharmacotherapeutic (duration of treatment with ceftazidime-avibactam, antimicrobials used in synergy with ceftazidime-avibactam) and clinical (mortality, length of hospital stay and comorbidities) variables were collected. As associated comorbidities, we identified how many of the patients included in the study had diabetes mellitus (DM), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD) or obesity. RESULTS: Eighty-nine patients were included, 85.39% of whom were male. Forty-nine patients were infected with Sars-CoV-2. Median ICU stay was 46 days (RIQ = 58-27) in SARS-CoV-2 infected and 34 days (RIQ = 51-24) in non-infected patients. Patients were on ceftazidime-avibactam treatment for a median of 8 days (RIQ = 13-4), being 7 days (RIQ = 11-2) in COVID-19 positive patients and 11 days (RIQ = 14-6) in COVID-19 negative patients (p > 0.05). Empirical treatment with ceftazidime-avibactam was started empirically in 41.57% (n = 37) of the patients. The percentage of empiric initiations in SARS-CoV-2 infected patients was 43% and in non-infected patients 40%, with no statistically significant difference between empiric initiation according to SARS-CoV-2 diagnostic status (p > 0.05). A total of 43.8% (n = 39) of the patients were colonised by a multidrug-resistant (MDR) bacterium. Regarding on the microorganisms that colonised patients had, the most frequent was Klebsiella pneumoniae, present in 66.6% of patients (n = 26 patients). Overall mortality was 41.6%, with no statistically significant differences between SARS-CoV-2 infected and non-infected patients (42.9% and 40%, respectively; p > 0.05). CONCLUSION: The SARS-CoV-2 pandemic did not lead to a change in the criteria for the use of ceftazidime-avibactam in the critically ill patient.
INTRODUCTION: Heart failure is an increasingly common syndrome with a rising prevalence, which associates significant costs, mainly related to hospitalization. In fact, heart failure is the most frequent diagnosis in hos...INTRODUCTION: Heart failure is an increasingly common syndrome with a rising prevalence, which associates significant costs, mainly related to hospitalization. In fact, heart failure is the most frequent diagnosis in hospital discharges in Spain. OBJECTIVE: To analyze the economic impact of new treatments for heart failure with reduced ejection fraction such as sacubitril/valsartan in out-patient and in-patient setting. MATERIAL AND METHODS: The present economic evaluation study was carried out by developing a Markov model. Treatment with sacubitril/valsartan from admission or after hospital discharge was compared, with enalapril being the comparator. Total costs, years of life gained, quality-adjusted life years, and incremental cost-effectiveness ratio and incremental cost-utility ratio were analyzed. Data were obtained from the PARADIGM-HF and PIONEER-HF studies. RESULTS: The results of the base cases of the three comparisons made showed that sacubitril/valsartan produced benefits in years of life gained and quality-adjusted life years compared to enalapril showing incremental cost-utility ratio below €20,000/QALY and that this ratio was better in scenarios starting sacubitril/valsartan in the hospital setting once decompensation was resolved. CONCLUSION: This study shows that starting sacubitril/valsartan from hospital admission for heart failure is cost-effective from the perspective of the National Health Service in Spain.
Farré Cabrerizo N, Montero Pérez O, Miquel Zurita ME
… +8 more, Badàs Moreno M, Company Martos M, Garcia Deu G, Rodríguez Rojas J, González Laguna M, Narváez Seixa S, Fontanals Martínez S, Perayre Badia M
In recent years, there has been a considerable increase in clinical trials in the field of oncohematology, an area in which new drugs are constantly emerging. In addition to the large number of available clinical trials,...In recent years, there has been a considerable increase in clinical trials in the field of oncohematology, an area in which new drugs are constantly emerging. In addition to the large number of available clinical trials, the growing complexity of the treatments for cancer is also a relevant factor. This situation has required a notable evolution and specialization of the functions and responsibilities of pharmacy technicians within the Clinical Trials Unit of the Pharmacy Service. This article describes the role of the pharmacy technician in a Clinical Trials Unit of tan oncohematological hospital pharmacy service, with over 20 years of experience in clinical trials.
OBJECTIVE: To compare radiographic progression-free survival in metastatic prostate cancer patients treated with low-dose abiraterone versus standard-dose abiraterone acetate (Abi-SD), and to evaluate prostate-specific a...OBJECTIVE: To compare radiographic progression-free survival in metastatic prostate cancer patients treated with low-dose abiraterone versus standard-dose abiraterone acetate (Abi-SD), and to evaluate prostate-specific antigen progression-free survival. METHODS: Retrospective cohort study of patients with metastatic prostate cancer, castration-sensitive or castration-resistant, treated with low or standard-dose abiraterone. All patients were followed until radiographic or prostate-specific antigen progression. Cox proportional hazards regression was used to assess radiographic progression-free survival and prostate-specific antigen progression-free survival according to abiraterone dose (low vs. standard-dose). The model was adjusted for Charlson Comorbidity Index, castration resistance status, disease volume based on CHAARTED criteria, and presence of de novo metastases. RESULTS: A total of 144 patients with metastatic prostate cancer were included in the study, with 28.4% (n = 41) receiving low-dose abiraterone. The median age was 79 years (IQR: 75-85) in the low-dose group and 75 years (IQR: 70-81) in the standard-dose group. For radiographic progression-free survival, the crude hazard ratio for the low-dose group compared with the standard-dose group was 0.49 (95% CI: 0.23-1.07). After adjusting for clinical variables, the adjusted hazard ratio was 0.65 (95% CI: 0.29-1.45). For prostate-specific antigen progression-free survival, the crude hazard ratio was 0.48 (95% CI: 0.24-0.90), and the adjusted hazard ratio was 0.58 (95% CI: 0.29-1.14). CONCLUSION: This study provides evidence supporting the use of low-dose abiraterone in patients with metastatic prostate cancer, showing survival and progression outcomes comparable to those of the standard-dose. This approach may improve access to treatment; however, larger studies are needed to validate these findings.
OBJECTIVE: To assess pharmacobezoar formation in a case of intoxication following the massive ingestion of extended-release divalproex sodium tablets, using an in vitro model conducted in the pharmacy laboratory. METHODS...OBJECTIVE: To assess pharmacobezoar formation in a case of intoxication following the massive ingestion of extended-release divalproex sodium tablets, using an in vitro model conducted in the pharmacy laboratory. METHODS: An in vitro model was created to simulate gastric conditions and evaluate pharmacobezoar formation. Simulated gastric fluid was prepared according to the European Pharmacopeia procedure. The conglomerate's size and pH were measured at 30 min, 1 h, 2 h, 4 h, 8 h, 12 h, and 24 h intervals. Serum valproic acid concentrations were determined at all mentioned time points and then compared with the patient's serum concentrations. RESULTS: The in vitro model revealed the formation of a solid pharmacobezoar (5 cm x 6 cm) after 2 h (pH = 1.5), which remained stable for 24 h. The peak serum concentration of valproic acid occurred approximately 22 h post-ingestion, reaching 656 μg/mL. The in vitro assay indicated a similar peak concentration around 24 h after the tablets were immersed in the simulated gastric fluid. CONCLUSIONS: The experiment conducted supports the hypothesis of pharmacobezoar formation following excessive ingestion of extended-release divalproex sodium tablets. Understanding which drug formulations can potentially cause pharmacobezoars formation is crucial for toxicological management.
Otero MJ, Rodríguez Marrodan B, Prieto Santos N
… +6 more, Villalobos Pinto E, Manrique Rodríguez S, Padilla Peinado R, Fernández-Llamazares CM, Madrid Rodríguez A, representing the Spanish Association of Pediatrics, the Spanish Society of Hospital Pharmacy and Autonomous Communities
OBJECTIVE: The objectives of this consensus document were to establish a standardized list of high-risk medications for the pediatric population and to compile the recommended practices for their safe use with the aim of...OBJECTIVE: The objectives of this consensus document were to establish a standardized list of high-risk medications for the pediatric population and to compile the recommended practices for their safe use with the aim of promoting the implementation of medication error prevention programs in health care centers. METHOD: The Ministry of Health, the Spanish Institute for Safe Medication Practices, the Spanish Association of Pediatrics and the Spanish Society of Hospital Pharmacy and regional administration representatives participated in the project. The Recommendations for the Safe Use of High-Risk Medications was used as reference, and its contents adapted and expanded to address specific issues in the pediatric population based on the current evidence. RESULTS: The document provides a reference list of high-risk medicines in pediatric care. It recommends that health care centers, in addition to prioritizing interventions in relation to anticoagulants, insulins, opioids, neuromuscular blockers, IV potassium, oral methotrexate and cytostatic agents, also consider interventions for IV adrenergic agonists, aminoglycosides and vancomycin, drugs for moderate and minimal sedation, parenteral nutrition and IV paracetamol in pediatric patients. The document emphasizes the need to implement multiple safe practices at every stage of the medication use process, prioritizing those with the greatest effectiveness, and involving pediatricians, pharmacists and other healthcare professionals. It also highlights the importance of active involvement by patients and caregivers. Finally, it provides general guidelines common to all these medications, as well as specific practices for each prioritized pharmacological group or medication, which should be combined to enhance pediatric patient safety. CONCLUSION: Developing programs to increase the safety of high-risk medications in pediatric patients is essential in order to reduce medication errors in this vulnerable population. The implementation of safe practices should be accompanied by continuous monitoring and periodic updates to guarantee effectiveness and strengthen the safety culture in health care centers.
Alves da Costa F, Fernandez-Llimos F, Desselle S
… +14 more, Arnet I, Babar Z, Bond C, Cordina M, Cardenas VG, El Hajj MS, Jacobsen R, Law AV, Nørgaard LS, Polidori C, Shcherbakova N, Stewart D, Tonin FS, Weidmann AE
Álvarez-Díaz AM, Crespo Diz C, Monte Boquet E
… +6 more, Marcos Rodríguez JA, Margusino Framinan L, Sánchez Yañez E, Vélez-Díaz-Pallarés M, Vicente Escrig E, Morillo-Verdugo R
OBJECTIVE: To analyse and address the barriers that Pharmacy Services encounter when adopting the capacity-motivation-opportunity (CMO) pharmaceutical care model in outpatient consultations, identifying the relevant acto...OBJECTIVE: To analyse and address the barriers that Pharmacy Services encounter when adopting the capacity-motivation-opportunity (CMO) pharmaceutical care model in outpatient consultations, identifying the relevant actors in the ecosystem, as well as the motivations. Finally, to make a first approach to solutions that will help us to select those that could be developed through future initiatives. METHOD: A structured methodology was developed in several phases. Two teams were formed: the "Core Team," consisting of hospital pharmacists with experience in pharmaceutical care and patient-centered care, and the "Guiding Team," made up of professionals from various disciplines. The first phase included an online prospecting workshop to explore the phases of model adoption. Subsequently, semi-structured interviews were conducted with key actors, such as physicians, managers, and patient associations, to identify needs and barriers. Finally, a face-to-face workshop was organized to facilitate the ideation and validation of solutions. RESULTS: Three categories of actors in the CMO model ecosystem were identified: interested agents (beneficiaries), interesting agents (influencers), and executive agents (implementers). Significant barriers were found, including variability in infrastructure, lack of commitment from managers, and the workload of pharmacists. However, there was also growing motivation among professionals and organizations to adopt the model. During the ideation workshop, ten initiatives were prioritized, including the use of digital technologies and ongoing training programs. CONCLUSIONS: The study highlights the high potential of the CMO model to improve pharmaceutical care in outpatient settings in Spain, despite the identified barriers. The proposed strategies, focused on digitalization and multidisciplinary collaboration, are essential for effective implementation. Future research is suggested to evaluate the long-term impact of these initiatives and to strengthen the involvement of patient associations and other actors in the adoption process.
Martín Cerezuela M, Becerril Moreno F, Ruiz Ramos J
… +13 more, de Lorenzo Pinto A, Domingo Chiva E, Valera Rubio M, Aquerreta González I, Bastida Fernández C, Doménech Moral L, Egüés Lugea A, Amor García MÁ, Betancor García T, Cobo Sacristán S, Albanell Fernández M, Ortiz Pérez S, Pérez de Amezaga Tomás L
OBJECTIVE: Medication reconciliation is an essential process in the care of critically ill patients, ensuring that patients' chronic medication is adapted to the patient's clinical situation and administered safely durin...OBJECTIVE: Medication reconciliation is an essential process in the care of critically ill patients, ensuring that patients' chronic medication is adapted to the patient's clinical situation and administered safely during hospitalisation. Given the profile of the patient admitted to a critical care unit (ICU), this becomes even more relevant. Reconciliation minimises possible medication errors and adverse effects, improving safety in the critically ill patient. METHODS: The project, carried out between 2021 and 2024, was led by the FarMIC (Pharmacists in Intensive Care Medicine and Critical Care) and RedFaster (Pharmaceutical Care in Emergencies) groups of the Spanish Society of Hospital Pharmacy (SEFH), and included: selection of the drugs, review of the available literature and previous conciliation guidelines in similar areas of application, preparation of the drug information with the recommendations issued by the working group, the review of the same and the development of the mobile application. RESULTS: In October 2024, the app 'Conciliation Guide for Critically Ill Patients®' was published, available free of charge for iOS and Android. It provides a drug index with detailed information on medication reintroduction schedules, routes of administration, monitoring, and drug-specific considerations. In addition, the tool includes information on withdrawal syndromes, drug-drug interactions with the usual ICU drugs and hazardous drugs information according to the NIOSH list. CONCLUSIONS: This app facilitates pharmacotherapeutic reconciliation process in the ICU, supporting healthcare professionals in making personalised decisions. Its use can optimise patient safety, reduce adverse events and improve critical patient care. Finally, this tool reinforces the role of the clinical pharmacist in the ICU, who must lead this process in all care transitions and adapt it to the clinical situation of the patient.
INTRODUCTION: Glioblastoma is one of the most aggressive primary brain tumors with the worst prognosis. Few therapeutic options are currently available. Vemurafenib is a kinase inhibitor that demonstrated efficacy in cli...INTRODUCTION: Glioblastoma is one of the most aggressive primary brain tumors with the worst prognosis. Few therapeutic options are currently available. Vemurafenib is a kinase inhibitor that demonstrated efficacy in clinical trials for the treatment of tumors with BRAF V600 mutation. Its experience of use in glioblastomas is very limited. We present the case of a patient diagnosed with BRAF V600 mutated glioblastoma who progressed to standard therapy. After starting treatment with vemurafenib in June 2022, the patient currently maintains a good clinical situation and the disease remains stable, with no progression observed. DISCUSSION: There is little literature supporting the efficacy of vemurafenib in BRAF 600 mutated glioblastomas. Published data suggest promising results, although survival in these patients remains low. This patient's progression-free survival is one of the longest documented to date.
Colomer Aguilar C, Negro-Vega E, Fernández de Gamarra-Martínez E
… +4 more, Martínez Castro B, Pérez Abánades M, Redondo Capafons S, Pérez Menéndez Conde C
OBJECTIVE: Collecting updated information on the organization of Hospital Pharmacy specialty rotations in different areas across Spanish hospitals, in order to create a map of residency rotations for hospital pharmacy re...OBJECTIVE: Collecting updated information on the organization of Hospital Pharmacy specialty rotations in different areas across Spanish hospitals, in order to create a map of residency rotations for hospital pharmacy residents, serving as a guideline and reference for hospital pharmacy tutors. METHOD: A cross-sectional, multicenter descriptive study on the planning of residency rotations for hospital pharmacy interns in hospitals accredited for specialized healthcare training in Spain. An online survey was designed and distributed via mailing list by the Spanish Society of Hospital Pharmacy between May and June 2024. The survey, validated and tested in a pilot sample, gathered general information about the hospital, rotations by areas of activity (year of residency, duration, complete/partial modality, shared rotations), external and elective rotations, additional training, supervision and assessment of the residents. Data were analyzed descriptively, including measures of central tendency and dispersion for quantitative variables and frequencies for categorical variables. RESULTS: The response rate was 86.8%. A basic initial rotation is present in 88.9% of hospitals, with a median duration of 6.5 weeks. Stock management, compounding, and validation and dispensing to inpatients are primarily carried out during the first year, while nutrition and oncology are concentrated in the 2nd year. Outpatient pharmaceutical care, clinical trials, medication evaluation and selection, drug information, and pharmacokinetics are conducted in the third year, whereas management/administration, primary care, and pharmaceutical care in clinical units are undertaken in the 4th year. The most common clinical rotations include Infectious Diseases (70.7%) and Hematology (67.7%). The duration of rotations varies between 1 and 9 months, with many organized as shared rotations, particularly in drug information and medication evaluation. Rotations not included in the official programme are included in 93.3% of hospitals, 91.9% of residents participate in clinical committees, and 22.2% have the opportunity to pursue a PhD. CONCLUSIONS: This study shows considerable variability in the organization of training programs across hospital pharmacy teaching units in Spain.