[Definition and evaluation of a multidisciplinary patient's pharmacotherapy management method: The pharmaceutical care plan]. / Définition et évaluation d'une méthodologie interprofessionnelle d'optimisation de la pharmacothérapie des patients : le Plan de Médication Partagé.

The implementation of pharmaceutical monitoring as defined by the Council of Europe in its Resolution of March 2020 requires defining for each patient, objectives and a treatment plan, to share, monitor and update them in a manner coordinated, interprofessional and in partnership with the patient. It recognizes the central place of the pharmacist by encompassing all of its clinical pharmacy activities and emphasizes the need for interprofessional collaboration (Hepler CD, Strand LM. Opportunities and Responsibilities in Pharmaceutical Care. American Journal of Hospital Pharmacy. Mars 1990; 47(3): 533-543). This work first presents the pharmaceutical care plan as a multiprofessional methodology that meets the objectives of pharmaceutical monitoring, then in a second step its evaluation through two regional projects. The pharmaceutical care plan unites, around the patient, all the actors involved in their pharmacotherapy, throughout their care path. It makes it possible to control the iatrogenic drug risk and includes the patient's drug management with regard to curative, preventive and palliative objectives and in a global strategy for the care and promotion of patient health. This methodology is integrated into coordinated exercise strategies and care pathway approaches. Several levers will help support its deployment, such as inter-professional education and digital health tools.

[Quality management of the experimental health products circuit in hospital pharmacies: National inventory and proposed standardised tools]. / Management de la qualité du circuit des produits de santé expérimentaux dans les pharmacies hospitalières : enquête nationale et développement d'outils standardisés.

OBJECTIVES: Carry out a national inventory of the current situation regarding the quality management of the investigational health products circuit, to develop adapted standardised tools. METHODS: A survey of 76 questions, developed by a regional working group, was conducted among clinical research pharmacists in French facilities. Tools were developed to meet the identified needs and validated by participating pharmacists, using the Delphi method. The consensus was defined by achieving a score above 80% on relevance, clarity and evaluability. RESULTS: Among 94 pharmacists participating in the survey, 88 were interested in standardised tools. The score for the implementation of a quality approach depended on the type of health facility (P<0.0005) and increased with the number of active trials (P<0.0005). All nine proposed tools were useful for over two thirds of pharmacists, but the self-assessment and audit grids have been prioritised. Indeed, only 26% of pharmacies carried out a prior risk assessment and 14% carried out internal audits. The review of both grids led to a consensus on 89% and 97% of the criteria respectively. The validated grids include 62 and 72 criteria respectively. DISCUSSION: The quality approach of the investigational health products circuit is heterogeneous in the participating centres, with a strong need for standardised tools. The two grids are relevant tools developed by and for professionals. CONCLUSION: The tools developed will enable to optimise the quality approach by identifying the non-conformities of the investigational health products circuit.

[Retrocession, a profitable but risky activity]. / La rétrocession, une activité rentable mais à risques.

The retrocession (out-patient dispensing of hospital-reserved drugs)is a pharmaceutical critical activity requiring a care security with a territorial approach. In this drug supply chain, the pharmacist is the last step before the drug administration and the economic profitability is questionable. In this context, a risk mapping and an economic evaluation seem necessary. METHODS: The risk analysis was conducted with the adverse events collected. The economic study was realised with the point of view of the hospital and with the microcosting method. RESULTS: Six never events were observed with the risk analysis. The economic study showed that the retrocession was profitable in usual situations with a net margin from 7 to 14€. But, when an exceptional situation occurred as a troubleshooting or the creation of a public deal, the added costs became so important (76 and 85€) that the retrocession was an unbeneficial activity. CONCLUSION: The retrocession is an activity with a health, legal and economic high risk. In order to improve the healthcare quality and safety, the retrocession must be considered as a coordinated process. It means that the different health professionals must communicate with each other and that the connection between the ambulatory and the hospital care must be efficient.