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.
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.
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.
OBJECTIVE: To describe the level of adherence to pharmacological treatment and explore, using a bivariate analysis, its unadjusted association with mental health variables (depression and stress) in patients with type 2....OBJECTIVE: To describe the level of adherence to pharmacological treatment and explore, using a bivariate analysis, its unadjusted association with mental health variables (depression and stress) in patients with type 2. METHOD: A cross-sectional study was conducted with 326 patients with T2D and beneficiaries of a multidisciplinary center of a social security institution in Morelos, Mexico. Sociodemographic, clinical, and mental health variables such as stress and depression were evaluated, in addition to adherence to pharmacological treatment in patients with T2D, using instruments with evidence of validity and reliability. Bivariate statistical analysis was used to evaluate the association between the variables of interest and pharmacological adherence. RESULTS: A statistically significant association was found between pharmacological adherence with depression (χ = 7.3, p = 0.01; OR = 0.28, p = 0.01), and with depression and stress as concomitance (OR = 0.18, p = 0.02). No statistically significant associations were found with sociodemographic factors. CONCLUSIONS: In this cross-sectional study, a bivariate association was observed between depression-and its co-occurrence with stress-and pharmacological adherence. These findings should be interpreted with caution and require confirmation through studies with adjusted analyses.
OBJECTIVE: Antimicrobial resistance, particularly in carbapenemase-producing Enterobacterales such as KPC-type, represents a critical threat to public health in Latin America, associated with high mortality rates and inc...OBJECTIVE: Antimicrobial resistance, particularly in carbapenemase-producing Enterobacterales such as KPC-type, represents a critical threat to public health in Latin America, associated with high mortality rates and increased healthcare costs. This systematic review aims to evaluate the therapeutic potential of siderophore-drug and siderophore-peptide conjugates against priority multidrug-resistant pathogens, including Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii, analyzing their efficacy, mechanisms of action, and implementation challenges. METHOD: A systematic search was conducted in PubMed, Scopus, and Web of Science databases up to August 2025, using key terms such as "siderophore conjugates", "Trojan horse antibiotics", "antimicrobial resistance", and "Gram-negative bacteria". Preclinical and clinical studies, reviews, and meta-analyses published between 2019 and 2025 were included, selecting 55 references based on relevance to the topic, currency, and methodological quality. This review corresponds to a narrative review with a systematic literature search, developed in accordance with PRISMA guidelines. RESULTS: Siderophore conjugates, via the "Trojan horse" mechanism, effectively exploit bacterial iron uptake systems to deliver antimicrobial agents in a targeted manner. They overcome key resistance mechanisms such as β-lactamase production, porin alterations, and efflux pump activity, while reducing systemic toxicity and preserving commensal microbiota. Clinical evidence (e.g., cefiderocol) and preclinical studies confirm efficacy against multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains, with significant reductions in minimum inhibitory concentrations (MICs). However, critical challenges were identified: optimization of chemical stability and intracellular drug release, complexity in synthesis and industrial scaling under Good Manufacturing Practice (GMP) standards, and regulatory and logistical barriers in resource-limited settings. CONCLUSIONS: Siderophore conjugates offer a targeted therapeutic approach against multidrug-resistant pathogens by exploiting the bacteria's own iron-uptake systems. Available evidence ranges from clinical results with cefiderocol to preclinical developments with other platforms. Their application, however, faces challenges that span chemical optimization, manufacturing, regulation, and access in clinical settings.
Suárez-Casillas P, Mejías-Trueba M, Gutiérrez-Urbón JM
… +6 more, Goycochea-Valdivia WA, Varela-Rubio E, Neth O, López-Ramos MG, Gil-Navarro MV, Guisado-Gil AB
OBJECTIVE: To analyze the use of antimicrobials in the pediatric and neonatal population at a national level in order to identify consumption patterns, assess treatment appropriateness, and detect potential areas for imp...OBJECTIVE: To analyze the use of antimicrobials in the pediatric and neonatal population at a national level in order to identify consumption patterns, assess treatment appropriateness, and detect potential areas for improvement in therapeutic management. METHOD: We designed a retrospective, cross-sectional, multicenter observational study that included neonatal (<1 month) and pediatric (<15 years) inpatients with at least one active prescription of systemic antibacterials or antifungals. The study consists of two phases. The first phase involves the analysis of antimicrobial consumption through quarterly data collection, expressed as pediatric and neonatal defined daily doses (DDD) per 100 patient-days. A temporal trend analysis will be performed using segmented regression and calculation of the average quarterly percent change with 95% confidence intervals, identifying change points through the Monte Carlo permutation method. The second phase focuses on evaluating prescription appropriateness based on indication, antimicrobial selection, timing of administration, dose, frequency, route of administration, treatment duration, monitoring of efficacy and adverse effects, and documentation in the medical record. The review will be conducted by a hospital pharmacist and an infectious diseases specialist, with interobserver verification in 25% of cases. A sample size of 379 patients (270 pediatric and 109 neonatal) has been estimated for this phase. Differences between variables will be analyzed using Student's t-test, Mann-Whitney U test, Chi-squared test, or Fisher's exact test as appropriate. Inter-rater agreement will be assessed using Cohen's Kappa coefficient, and factors associated with differences in appropriateness will be analyzed through binary logistic regression and generalized lineal mixed models. DISCUSSION: This study will allow the identification of antimicrobial consumption patterns and the evaluation of prescription appropriateness in pediatric and neonatal populations, providing objective and comparable information across centers. The findings will help strengthen Antimicrobial Stewardship Programs, serve as a solid basis for future research, and support the development of targeted national strategies, ultimately improving patient safety and helping to curb the progression of antimicrobial resistance.
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
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 diagnosis, 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.
Rodríguez Esquíroz A, Echeverría Gorriti A, Marín Marín M
… +6 more, Sanz Álvarez L, García González P, Gorricho Mendivil J, Úriz Otano J, Garjón Parra J, Aguinaga Ontoso I
INTRODUCTION: The presence of cirrhosis may require adjustment of medication doses or substitution with safer alternatives. Inadequate treatment can lead to medication-related problems, which in most cases are preventabl...INTRODUCTION: The presence of cirrhosis may require adjustment of medication doses or substitution with safer alternatives. Inadequate treatment can lead to medication-related problems, which in most cases are preventable. The objectives are to describe the implementation of a safety strategy involving a comprehensive medication review for patients with cirrhosis, and to evaluate the acceptance rate of the intervention. METHODS: It is a study of the implementation of a medication risk minimization strategy. It consisted of a medication review by hospital pharmacists, with clinical advice from a physician specializing in hepatology to patients in Primary Care. RESULTS: 307 patients were included, of whom 76.2% had at least one potentially inappropriate medication prescribed, with a safer alternative available in 87.2% of cases. Benzodiazepines and related drugs, proton pump inhibitors, and lipid-lowering drugs were the most frequently proposed, being benzodiazepines and related drugs the least modified by the physician. 48.1% of the 405 proposals were accepted. CONCLUSIONS: A high percentage of patients with cirrhosis were receiving inadequate treatments for their hepatic pathology, despite the availability of alternatives to minimize risks in most cases. Half of the pharmacists' recommendations were accepted and patient characteristics did not influence the acceptance rate of these proposals.
OBJECTIVES: To evaluate the effectiveness and cost-effectiveness of immune checkpoint inhibitors in patients with non-small cell lung cancer (NSCLC) in real-world clinical practice. METHODS: A retrospective, single-cente...OBJECTIVES: To evaluate the effectiveness and cost-effectiveness of immune checkpoint inhibitors in patients with non-small cell lung cancer (NSCLC) in real-world clinical practice. METHODS: A retrospective, single-center observational study including NSCLC patients treated with atezolizumab, durvalumab, nivolumab, and pembrolizumab between 2015 and 2023. Demographic, clinical, and treatment data, as well as adverse events, were recorded. Statistical analysis was performed using the R Core Team (2024) software. RESULTS: In stage IV, pembrolizumab demonstrated the longest median overall survival (OS) at 15.49 months, compared to nivolumab (10.26 months) and atezolizumab (9.24 months). In stage III, pembrolizumab reached an OS median of 34.64 months, nivolumab 17.03 months, and atezolizumab 10.62 months. Durvalumab reached an OS median of 30.18 months. In stage IV, the Incremental Cost-Effectiveness Ratio (ICER) of pembrolizumab versus atezolizumab was €517.92 per month of life gained, and the ICER of pembrolizumab versus nivolumab was €512.66 per month of life gained. In stage III with palliative intent, the ICER of pembrolizumab versus atezolizumab was €135.76 per month of life gained, and the ICER of pembrolizumab versus nivolumab was €152.26 per month of life gained. CONCLUSIONS: Although real-world survival outcomes are lower than those reported in pivotal clinical trials, immunotherapy is established as an efficient strategy for the National Health System. All analyzed drugs were cost-effective in the hospital setting studied, falling below the efficiency thresholds proposed by the WHO for Spain (<€65,180/year). The sustainability of these high-budget-impact treatments depends on precise patient selection based on biomarkers and the implementation of dosage optimization strategies. There is a need for local economic evaluations to guide clinical and management decision-making.
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.
OBJECTIVE: To evaluate the impact of therapy optimization on medication-related safety in patients with liver cirrhosis. METHOD: Systematic review of clinical trials and before-and-after studies with time series analysis...OBJECTIVE: To evaluate the impact of therapy optimization on medication-related safety in patients with liver cirrhosis. METHOD: Systematic review of clinical trials and before-and-after studies with time series analysis in CENTRAL, MEDLINE, and INAHTA databases. The certainty of the evidence was assessed using the GRADE approach, and the risk of bias was evaluated with the ROBUST-RCT tool. RESULTS: Six articles were identified, all corresponding to a single randomized controlled trial (116 patients) that evaluated the effectiveness of a pharmacist-led intervention (medication reconciliation and individualized health education) compared to usual care. Although no significant differences were found in all-cause mortality or the crude relative risk of hospitalization, the adjusted incidence rate analysis revealed that the intervention significantly reduced unplanned hospitalizations by 48%. Furthermore, within the intervention group, each unit increase in the rate of high-risk medication-related problems was associated with more than three-fold higher odds of mortality, independently of disease severity. CONCLUSIONS: There is a current scarcity of high-quality studies in this field. Nevertheless, the available evidence suggests that pharmaceutical follow-up is an effective strategy to reduce preventable hospitalizations in outpatients with decompensated cirrhosis. Pharmacological safety is vital for survival, justifying the integration of the pharmacist into the clinical team.
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.
Amor García MÁ, Aquerreta González I, Bastida Fernández C
… +10 more, Egüés Lugea A, Cobo Sacristán S, Becerril Moreno F, Martín-Cerezuela M, Domingo Chiva E, Betancor García T, Albanell Fernández M, Doménech-Moral L, Ortiz Pérez S, Fernández Polo A
The design and implementation of antimicrobial stewardship programs for patients admitted to intensive care units must consider the specific characteristics of this population, including infection severity, organ dysfunc...The design and implementation of antimicrobial stewardship programs for patients admitted to intensive care units must consider the specific characteristics of this population, including infection severity, organ dysfunction, and pharmacokinetic/pharmacodynamic alterations. The creation of a multidisciplinary team and the establishment of clear, targeted objectives are essential to improve treatment appropriateness, reduce the emergence of antimicrobial resistance, and ensure the sustainability of healthcare system. Pharmaceutical care contributes to the optimisation of antimicrobial use through antimicrobial therapy review, dose individualisation based on pharmacokinetic/pharmacodynamic parameters, and treatment monitoring, while also facilitating the development of systems for monitoring clinical outcomes, microbiology, and antimicrobial consumption.
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.