Rational Selection of valved holding chambers in the treatment of COPD or Asthma by means of the system of objectified judgement analysis

Valved inhalation chambers are important instruments to increase the available dose ofpressurized metered dose inhalers, in this study inhalation chambers are compared bymeans ofthe System of Objectified Judgement Analysis (SOJA) method. T'he SOJA method isa model for rational drug selection. The relevant selection criteria for inhalation chambers are defined and judged by a panel of experts and each selection criterion is given arelative weight. T'he following inhalation chambers were included: Aerochamber, Inspirachamber, Optichamber, Volumatic and Vortex. Selection criteria were: 'Transparancy,Feedback system in case of too forceful inhalation, Antistatic properties, Dose delivery,Availability of mouth masks, Easy to carry, Suitability for children and inclusion in Summaries of Product Characteristics of metered dose inhalers.Aerochamber showed by far the highest score. If performed well on all selection criteria.Vortex and Optichamber also performed well. Volumatic showed the lowest score.<br/

Rational Selection of valved holding chambers in the treatment of COPD or Asthma by means of the system of objectified judgement analysis

Valved inhalation chambers are important instruments to increase the available dose ofpressurized metered dose inhalers, in this study inhalation chambers are compared bymeans ofthe System of Objectified Judgement Analysis (SOJA) method. T'he SOJA method isa model for rational drug selection. The relevant selection criteria for inhalation chambers are defined and judged by a panel of experts and each selection criterion is given arelative weight. T'he following inhalation chambers were included: Aerochamber, Inspirachamber, Optichamber, Volumatic and Vortex. Selection criteria were: 'Transparancy,Feedback system in case of too forceful inhalation, Antistatic properties, Dose delivery,Availability of mouth masks, Easy to carry, Suitability for children and inclusion in Summaries of Product Characteristics of metered dose inhalers.Aerochamber showed by far the highest score. If performed well on all selection criteria.Vortex and Optichamber also performed well. Volumatic showed the lowest score.<br/

Practical differences between luteinizing hormone-releasing hormone agonists in prostate cancer: perspectives across the spectrum of care

Background:Androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone (LHRH) agonists is well established for the treatment of men with metastatic prostate cancer. As clear differences in efficacy, safety, or tolerability between the available LHRH agonists are lacking, the healthcare management team needs to look to practical differences between the formulations when selecting therapy for their patients. Moreover, as the economic burden of prostate cancer rises alongside earlier diagnosis and improved survival, the possibility for cost savings by using products with specific features is growing in importance.Methods:A review was conducted to summarize the information on the different LHRH agonist formulations currently available and offer insight into their relative benefits and disadvantages from the perspectives of physicians, a pharmacist, and a nurse.Results:The leuprorelin acetate and goserelin acetate solid implants have the advantage of being ready to use with no requirement for refrigeration, whereas powder and microsphere formulations have to be reconstituted and have specific storage or handling constraints. The single-step administration of solid implants, therefore, has potential to reduce labor time and associated costs. Dosing frequency is another key consideration, as administering the injection provides an opportunity for face-to-face interaction between the patient and healthcare professionals to ensure therapy is optimized and give reassurance to patients. Prostate cancer patients are reported to prefer 3- or 6-monthly dosing, which aligns with the monitoring frequency recommended in European Association of Urology guidelines and has been shown to result in reduced annual costs compared with 1-month formulations.Conclusions:A number of practical differences exist between the different LHRH agonist preparations available, which may impact on clinical practice. It is important for healthcare providers to be aware and carefully consider these differences when selecting treatments for their prostate cancer patients.Peer reviewe

Rapid acting fentanyl formulations in breakthrough pain in cancer: drug selection by means of the System of Objectified Judgement Analysis

Drug selection of rapid acting fentanyl formulations in the treatment of breakthrough pain in patients with cancer is performed by the System of Objectified Judgement Analysis method. All seven available formulations were included in the analysis. The following selection criteria were used: number of available strengths, variability in the rate of absorption, interactions, clinical efficacy, side effects, ease of administration and documentation. No direct double-blind comparative studies between two or more formulations were identified and the clinical documentation of all formulations is limited. The most distinguishing criterion was ease of use. This led to slightly higher scores for Abstral, Instanyl and PecFent than for the other formulations. The pros and cons of each formulation should be discussed with the patient, and the most suitable formulation selected for each individual patient