[Evaluation of drug therapy knowledge in liver transplant patients after pharmacy counseling]. / Evaluation de l'apport d'une consultation de pharmacie sur les connaissances des patients transplantés hépatiques.

The analysis of the literature demonstrated that pharmacy counselling influenced patient outcome after transplantation. This was the reason we established pharmacy consultation in 1999. The aim of this study was to determine patient knowledge before and after pharmacy counselling. Twenty-nine patients were questioned about the identification, role and dosage of prescribed drugs. The mean duration of pharmacy counselling was 54 minutes. Before pharmacy consultation, the knowledge score was 53.7%. Afterwards, the mean score value reached 75% and seven patients had a score of 100%. The anti-rejection therapy was understood by 93% of patients. However, the associated drugs were poorly known: less than 15% of patients initially knew about the purpose of the antimicrobial agent, compared with 50-60% after counselling. During counselling, two women were identified as regularly using St John's Wort and were informed that this herbal medicine can endanger the success of organ transplantation. Five patients or family members called the pharmacist to obtain additional information. Among these, two medication errors, both with corticosteroid drugs, were reported by family members of patients of foreign origin who had difficulty in understanding and speaking French. Pharmacy counselling improved patient knowledge about therapy after transplantation.

[Evaluation of platinum contamination of a hazardous drug preparation area in a hospital pharmacy]. / Evaluation de la contamination par le platine d'une unité centralisée de préparation des médicaments cytotoxiques.

In our hospital, in accordance with recommendations for personnel protection, hazardous drugs are prepared in a class II biological safety cabinet (BSC) located in a specific area of the pharmacy. The aim of this study was to validate the efficiency of this unit in personnel protection by measuring levels of platinum in the working environment (platinum being the most common antineoplastic agent used in this hospital). Two series of surface sampling were conducted, preparation guidelines were changed for parts after first results have been completed. Performance of the sampling method is about 35%. Platinum was measured by atomic absorption spectrophotometry technique. The analytical detection limit was 10 mug/L of platinum and was sufficient to detect less than one micro-drop of cisplatinum solution (1 mg/mL). Platinum was found inside the BSC at the end of the working day: 2 to 998 pg/cm2 or 2 to 20 ppm of the total cisplatinum handled. All samples outside the BSC showed little (less than the detection limit) or no contamination. Gloves were often contaminated, either by contaminated commercial drug vials or through handling errors. Working guidelines changes did not lead to the absence contamination on surfaces. Gloves should therefore be changed frequently (every 15 min), personnel training should be regularly re-evaluated, BSC and rooms should be thoroughly cleaned every day. In this way, a centralized unit provides total protection from exposure to hazardous drugs.