[Pharmaceutical analysis and validation of hospital prescriptions, a 5-year study]. / Validation pharmaceutique des prescriptions hospitalières. Intervention et analyse sur cinq ans.

BACKGROUND: Analysis and validation of hospital prescriptions by the pharmacy department, although mandatory since 1991, appears relatively uncommon. Little is known of the nature and frequency of the actions taken by clinical pharmacists during this process. OBJECTIVE: To describe the nature and frequency of pharmaceutical interventions in a large university hospital. METHODS: We reviewed interventions during the pharmaceutical analysis of prescriptions in a surgical ward, a general medical ward and a short-stay hospital unit over a 5-year period. RESULTS: Pharmacists took some type of action in 1438 of the 13,760 prescriptions analyzed (10.4%). Drug interactions accounted for 30.9% of the interventions; 20.2% concerned dose adaptation in cases of renal insufficiency; 13.8% proposed a change from injectable to oral drugs; and 4.1% concerned the physicochemical incompatibility of the simultaneous administration of two drugs through the same infusion line. Drug interactions most frequently involved oral fluoroquinolones and anticoagulants. Dose adaptation was suggested most often for amoxicillin, buflomedil, ofloxacin and allopurinol, while the pharmacists most often proposed changing mixtures of multivitamins, omeprazole, imidazole derivatives and fluoroquinolones from parenteral to oral administration. Physicochemical incompatibility was most frequently associated with furosemide or nicardipine and with antibiotics. CONCLUSION: The analysis of prescriptions by a pharmacist is useful for medical teams: it helps to modify common attitudes towards prescribing drugs and contributes to their appropriate use and to the prevention of adverse events.

[Clinical trials and outpatient dispensation: the pharmaceutical counseling place]. / Dispensation ambulatoire du médicament pour essai clinique: place du conseil pharmaceutique.

Drug dispensations in clinical trials essentially concern outpatients (90%), and several mistakes and bad uses have been noted. The aim of this work is to set up a pharmaceutical counselling for outpatients in clinical trials. The bibliographic research on this subject did not learn us about similar experiences, but several references helped us to select the support of information: personal meeting between patient and pharmacist to introduce a written leaflet. Pharmaceutical information mentioned in the leaflet has to be validated and has to respect the clinical trials regulations. In the same way, information does not interfere with the inclusion-exclusion criteria or with the physician's observations. Then, information has been deliberately limited to the practical aspects of medications. Anonymous questionnaires have been delivered to the thirty first patients concerned to value their satisfaction with our services. The need of a clear and practical pharmaceutical counselling in clinical trials has been clearly established. Such a pharmaceutical counselling in clinical trials is one component of the overall drug-use process and potentially increases drug compliance. This pharmaceutical counselling on drug management has been well accepted by patients and has been supported by physicians and clinical trial sponsors.