[Pharmaceutical care for pediatric hemato-oncology and stem cell transplantation patients. Inventory of experiences and needs]. / Soins pharmaceuriques des traitements en onco-hématologie et de greffe de cellules souches en pédiatrie Inventaire des expériences et des besoins des pharmaciens et des étudiants en Flandre.

Introduction Pharmacists can be faced with pediatric patients treated for a hemato-oncological condition or patients who underwent a hematopoietic stem cell transplantation [HSCT). This study aims to identify the roLe of the pharmacist and master in pharmacy students as well as their knowLedge of pharmaceutical care for this specific patient population. In addition, their experiences of basic education and expectations of continued education in pediatric hemato-oncology and HSCT are analyzed. Methods Pharmacists in Flanders and pharmacy students [Ghent University] were requested to complete and online survey with (1) general questions, (2) questions about knowledge by means of theoretical examples and practical cases and (3) questions about education (past and future) related to this topic. Results A total of 156 pharmacists and 67 students completed the survey. Results demonstrated that 22.0% of pharmacists and students already delivered medication to this particular patient group. A total of 98.2% [pharmacists and students] found that they had insufficient knowledge and experience to give optimal pharmaceutical advice. The pharmacist scored only 34.0% [average] in the general knowledge section, students 44.0%. Both pharmacists [68.6%] and students [79.0%] agreed that this topic should be included in the basic curriculum. The vas majority [91.0% pharmacists, 89.6% of students] were asking for courses on this theme by means of and evening session or an e-learning tool. Conclusion Although the role of pharmacists and students in this patient group can be confirmed, the results of the survey demonstrate a lack of knowledge among pharmacists and students about pediatric hemato-oncology and HSCT. There is interest in education in the basic curriculum and the vast majority of pharmacists are interested in continuing education.

[A practical program for outpatient parenteral antimicrobial therapy]. / Un modèle pratique pour l'antibiothérapie parentérale ambulatoire.

Some infections require prolonged parenteral antimicrobial therapy, which can be continued in an outpatient setting. The Ghent University Hospital has fifteen years of experience with Outpatient Parenteral Antimicrobial Therapy [OPAT) in the patient own home setting. As a quality improvement initiative, this process was critically reviewed in a multidisciplinary approach. Several challenges and barriers were identified, including regulatory obstacles for OPAT in Belgium, such as Lack of uniformity in ambulatory reimbursement of parenteral antimicrobials. There is no financial incentive for the patient with OPAT, as costs for the patient of outpatient therapy can be higher as compared with hospitalization. Other barriers include delayed approval of the certificate for reimbursement, low availability of medicines in the community pharmacies and limited knowledge of the medical devices for administration in ambulatory setting. All critical steps in the revised OPAT program are summarized in a flowchart with a checklist for all stakeholders. Firstly, a list with specific criteria to include patients in an OPAT program is provided. Secondly, the Multidisciplinary Infection Team received a formal mandate to review all eligible OPAT patients. In order to select the most appropriate catheter a decision tree was developed and standardized packages with medical devices were developed. Thirdly, patients receive oral and written information about the treatment with practical and financial implications. Fourthly, information is provided towards the general practitioners, community pharmacists and home care nurses. Standardization of the OPAT-program aims at improving quality and safety of intravenous antimicrobial therapy in the home setting.

[Stability of high-dose etoposide dilutions for use in hematopoietic stem cell transplantation conditioning regimens]. / Stabilité d'une dose élevée d'étoposide en dilution pour utilisation lors du conditionnement avant greffe de cellules souches.

High-dose etoposide is used in conditioning regimens for allogeneic stem cell transplantation. The limited stability of the drug induces barriers for its use for pharmacists, nurses and patients. When using a concentration of 10 mg/mL etoposide in physiologic saline, limitations can be overcome. This study provides stability data for etoposide in a high concentration that can be used in conditioning regimens. The solution was stable for 48h at 5°C, for 48h at 5°C followed by 8h at 25°C and for 24 h at 25°C.