Key Learning Outcomes for Clinical Pharmacology and Therapeutics Education in Europe: A Modified Delphi Study.

Harmonizing clinical pharmacology and therapeutics (CPT) education in Europe is necessary to ensure that the prescribing competency of future doctors is of a uniform high standard. As there are currently no uniform requirements, our aim was to achieve consensus on key learning outcomes for undergraduate CPT education in Europe. We used a modified Delphi method consisting of three questionnaire rounds and a panel meeting. A total of 129 experts from 27 European countries were asked to rate 307 learning outcomes. In all, 92 experts (71%) completed all three questionnaire rounds, and 33 experts (26%) attended the meeting. 232 learning outcomes from the original list, 15 newly suggested and 5 rephrased outcomes were included. These 252 learning outcomes should be included in undergraduate CPT curricula to ensure that European graduates are able to prescribe safely and effectively. We provide a blueprint of a European core curriculum describing when and how the learning outcomes might be acquired

Pharmacokinetic and pharmacodynamic interaction trial after repeated oral doses of imdapril and digoxin in healthy volunteers

Aims To investigate the potential pharmacokinetic and pharmacodynamic interaction between imidapril and digoxin

Influence of pharmacist intervention on drug safety of geriatric inpatients: a prospective, controlled trial

Background: Demographic shift leads to an increasing number of geriatric patients suffering from multimorbidity and resulting polypharmacy. Polypharmacy is shown to be associated with drug-related problems (DRPs) and increased morbidity. For Germany, a hospital-based intervention may be successful optimizing of polypharmacy. The aim of this study was to reduce DRPs in geriatric inpatients by a structured pharmacist’s intervention and to measure the acceptance rate of pharmaceutical recommendations. Methods: This study followed an open, prospective, quasi-randomized, controlled design and was conducted in a geriatric department in a teaching hospital in Germany. Patients of all sexes were included, with a minimum age of 70 years, a written informed consent and a regular intake of at least five drugs daily. Primary outcome was the percentage of patients having a DRP at admission and discharge. A DRP was defined as a prescription without indication or a relevant drug–drug interaction or prescription of a potentially inappropriate medication or presence of an adverse drug reaction. Recommendations were classified and discussed face to face. Statistical analyses were performed using a full-set analysis and a matched-pairs design. Results: Within 12 months, 411 patients were recruited with median age of 82 years (intervention: n = 209; control: n = 202). Median number of drugs at admission was 10 (range 5–24), at discharge 9 (range 3–21). In the intervention group, the percentage of patients with a DRP was reduced from 86.6% to 56.0%; in the control group, from 76.7% to 76.2% (p value < 0.001). Medication appropriateness index score was reduced by 56% in the intervention group and by 0.2% in the control group (p value < 0.001). Implementation rate of the pharmaceutical recommendation was 80%. Conclusion: This prospective controlled trial showed that a pharmacist’s intervention was successful in optimizing polypharmacy in geriatric inpatients

Welche Faktoren begünstigen die Anwendung potenziell ungeeigneter Medikamente bei älteren Menschen?

Hintergrund Aktuelle Untersuchungen belegen den Zusammenhang zwischen der Verordnung potenziell inadäquater Medikamente (PIM) an Patienten ab 65 Jahren und einem erhöhten Risiko dieser Patienten für unerwünschte Ereignisse, insbesondere Krankenhausaufnahmen. Die bevölkerungsrepräsentative Stichprobe der DEGS1-Studie („Studie zur Gesundheit Erwachsener in Deutschland“ des RKI) bietet die Möglichkeit, die mit der Anwendung von PIM assoziierten Faktoren zu identifizieren. Fragestellungen Was charakterisiert ältere Menschen in Deutschland, die aktuell PIM anwenden, und gibt es Subpopulationen, bei denen eine PIM-Anwendung besonders häufig ist? Material und Methoden Im Rahmen der DEGS1-Studie wurden 175 Variablen zu gesundheitlichen und sozialen Aspekten von 1392 im eigenen Haushalt lebenden Personen im Alter von 65 bis 79 Jahren erhoben und die Medikation der letzten sieben Tage dokumentiert. PIM konnten mit Hilfe der PRISCUS-Liste identifiziert werden. Mögliche Zusammenhänge zwischen PIM-Einnahme und den erhobenen Variablen wurden in einem multivariablen Modell überprüft. Ergebnisse und Diskussion In den letzten sieben Tagen vor Befragung wurden von 13,0 % (95 %-KI: 10,7–15,6) der Befragten PIM eingenommen. Folgende Faktoren begünstigen signifikant die PIM-Einnahme: Gesamtzahl der in den letzten sieben Tagen eingenommenen Medikamente; Zahl niedergelassener Arztgruppen, die in den letzten 12 Monaten aufgesucht worden sind; Einschlafstörungen; die Krankheitsgruppen Psyche und Gelenke/Knochen. Die am häufigsten eingenommenen PIM-Wirkstoffe kommen aus der Gruppe der Antidepressiva und Anxiolytika/Sedativa. Besonders betroffen von einer erhöhten PIM-Einnahme sind ältere Frauen mit Depressionen, Einschlafstörungen und Analgetikabedarf. Sie bedürfen einer besonderen Aufmerksamkeit.Peer Reviewe

Is less more? Patients' preferences for drug information leaflets

Present package information leaflets do not fulfil the needs of many patients. The objective of this study was to investigate patients' preferences towards content and presentation of drug information leaflets using prepared medication brochures in a discrete choice experiment

Operationalisation for Portugal of the EU(7)-PIM List for identification of potentially inappropriate medicines in older adults

Em 2015 foi publicada a lista EU(7)-PIM, que identifica medicamentos potencialmente inapropriados na população idosa e resultou de um consenso de peritos de sete países europeus. Portugal não fez parte deste grupo, pelo que na sua origem não foi adaptada para a realidade portuguesa. Com este trabalho pretendemos elaborar uma lista de medicamentos potencialmente inapropriados adaptada à realidade dos medicamentos comercializados em Portugal, através da operacionalização da lista EU(7)-PIM para a realidade nacional, avaliar a adequabilidade do seu uso na prática clínica.In 2015, the EU(7)-PIM List was published, which identifies potentially inappropriate medicines in older patients and resulted from a consensus of experts from seven European countries. Portugal was not part of this group, so it was not originally adapted to the Portuguese reality. With this work, we intend to elaborate a list of potentially inappropriate medicines adapted to the reality of medicines marketed in Portugal, through the operationalization of the EU(7)-PIM List for the national reality and to evaluate the adequacy of its use for clinical practice.publishe