Turvallinen lääkehoito on potilaiden ja ammattilaisten yhteistyötä

Teema : turvallinen lääkehoito

The problem with non-adherence arising from medical practices

Non peer reviewe

Incidence, preventability, and causality of adverse drug reactions at a university hospital emergency department

Purpose To investigate the characteristics of ADRs in patients admitting at the emergency room of a tertiary hospital. Methods We collected the patient records of 1600 emergency room visits of a university hospital in 2018. The patient files were studied retrospectively and all possible ADRs were identified and registered. Patient characteristics, drugs associated with ADRs, causality, severity, preventability, and the role of pharmacogenetics were assessed. Results There were 125 cases with ADRs, resulting in a 7.8% overall incidence among emergency visits. The incidence was greatest in visits among elderly patients, reaching 14% (men) to 19% (women) in the 80-89 years age group. The most common causative drugs were warfarin, acetylsalicylic acid (ASA), apixaban, and docetaxel, and the most common ADRs were bleedings and neutropenia and/or severe infections. Only two of the cases might have been prevented by pharmacogenetic testing, as advised in Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. Conclusion The same ATC classes, antithrombotics and cytostatics, were involved in ADRs causing university clinic hospitalizations as those identified previously in drug-related hospital fatalities. It seems difficult to prevent these events totally, as the treatments are vitally important and their risk-benefit-relationships have been considered thoroughly, and as pharmacogenetic testing could have been useful in only few cases.Peer reviewe

Medicines, environment and clinical pharmacology

Medical associations and other societies have announced their theses on protection of the climate and environmental aspects in medicine. The challenges with climate change and sustainability are complex, and no quick solutions are to be found. However, basic knowledge on these issues should be available to everyone, and environmental aspects of drugs are important to all healthcare professionals. We present here a study with medical students who were introduced for the first time to environmental aspects of medicines. The results confirmed the suitability and feasibility of the approach to introduce this subject to students, and we propose that the same method can be used also when explaining the issue to medical professionals. We would like to encourage particularly clinical pharmacologists, pharmacologists and pharmacists to take a more apparent position in this field and to participate in the discussions where the strategies for the choice of medicines are considered.Peer reviewe

Generation Green – A holistic approach to implementation of green principles and practices in educational programmes in pharmaceutical and medical sciences at the University of Helsinki

Solving the environmental and sustainability challenges associated with drug development, manufacturing, distribution, use, and end -of -life requires comprehensive change in the mindset of healthcare professionals on all fronts. Besides current professionals, the faculty teachers and students have a critical role in facilitating the implementation of green principles and practices in educational programs, but no change occurs unless the need and the tools are properly established and their impact understood. This article describes the evolution of green pharmacy practice in the Faculty of Pharmacy at the University of Helsinki, following a previously published framework for change management. Furthermore, the article describes the dissemination of the principles and good practices into medical education.Peer reviewe