4CPS-051 Impact of the new antiepileptic drug monitoring programme on the activity of the pharmacy and neurology departments

Background and ImportanceIn 2016 therapeutic drug monitoring programme (TDMP) began for new anticonvulsant drugs (NAD) for inpatients and outpatients at our hospital. Weekly multidisciplinary meetings were held to revise out-of-range trough drug levels (TDL) on epileptic outpatients, and to make ear...

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Veröffentlicht in:European journal of hospital pharmacy. Science and practice 2023-03, Vol.30 (Suppl 1), p.A40-A41
Hauptverfasser: Juvany Roig, R, Mas Bauza, N, Cleries Rovira, P, Falip Centellas, M, Gonzalez Caballero, Í, Ribera Puig, C, Porredon Antelo, C, Rigo Bonnin, R, Sala Padró, JX, Badia Tahull, MB
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container_end_page A41
container_issue Suppl 1
container_start_page A40
container_title European journal of hospital pharmacy. Science and practice
container_volume 30
creator Juvany Roig, R
Mas Bauza, N
Cleries Rovira, P
Falip Centellas, M
Gonzalez Caballero, Í
Ribera Puig, C
Porredon Antelo, C
Rigo Bonnin, R
Sala Padró, JX
Badia Tahull, MB
description Background and ImportanceIn 2016 therapeutic drug monitoring programme (TDMP) began for new anticonvulsant drugs (NAD) for inpatients and outpatients at our hospital. Weekly multidisciplinary meetings were held to revise out-of-range trough drug levels (TDL) on epileptic outpatients, and to make early drug adjustment interventions (EDAI) before their scheduled clinical follow-up.Aim and ObjectivesTo evaluate the impact of NAD TDMP on the activity of the Pharmacy and Neurology departments.Material and MethodsInpatientsQuantification of pharmacokinetic interventions (PI) and patients monitored between 2016-2021.OutpatientsActivity analysis between July 2017 and May 2019: TDL revision, patients monitored and number of EDAI made. TDL and EDAI percentage calculation for each drug.ResultsInpatientsAnticonvulsant drug PI were 56% of all PI (6.067 of 10.910) during the study period. PI of classic anticonvulsant drugs (CAD) decreased from 934 in 2016 to 348 in 2021 (63%). In 2021 the percentage of PI of NAD and CAD were 27% and 16% (602 and 348 out of 2.209) respectively. Levetiracetam and Lacosamide accounted for 63% (380) and 27% (163) of all monitored NAD. Regarding CAD monitoring Valproate was the most 86% (299) and Fenitoin the least 4% (15) monitored.Outpatients1.096 TDL out of 2.324 ordered were revised (47%) which belonged to 424 patients of a total of 877 monitored (48%). 273 TDL (25%) led to an EDAI, which affected 196 patients, that is 46% of revised patients and 22% of all monitored patients. Most EDAI supposed an increase or reduction of dosage, 51% and 34% (139 and 92 out of 273) respectively. Levetiracetam, Perampanel and Lacosamide were the most monitored NAD: 26% (286), 13% (145) and 10% (110) respectively, and the most EDAI-prone: 29% (79), 27% (73) and 11% (29) respectively.Conclusion and RelevanceInclusion of outpatients to TDMP allowed early drug adjustment of almost half of the revised patients.The creation of a multidisciplinary team that includes pharmacists and neurologists with a focus on active monitoring of NAD TDL might be significant to better care for epileptic outpatients.References and/or AcknowledgementsConflict of InterestNo conflict of interest
doi_str_mv 10.1136/ejhpharm-2023-eahp.86
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Weekly multidisciplinary meetings were held to revise out-of-range trough drug levels (TDL) on epileptic outpatients, and to make early drug adjustment interventions (EDAI) before their scheduled clinical follow-up.Aim and ObjectivesTo evaluate the impact of NAD TDMP on the activity of the Pharmacy and Neurology departments.Material and MethodsInpatientsQuantification of pharmacokinetic interventions (PI) and patients monitored between 2016-2021.OutpatientsActivity analysis between July 2017 and May 2019: TDL revision, patients monitored and number of EDAI made. TDL and EDAI percentage calculation for each drug.ResultsInpatientsAnticonvulsant drug PI were 56% of all PI (6.067 of 10.910) during the study period. PI of classic anticonvulsant drugs (CAD) decreased from 934 in 2016 to 348 in 2021 (63%). In 2021 the percentage of PI of NAD and CAD were 27% and 16% (602 and 348 out of 2.209) respectively. Levetiracetam and Lacosamide accounted for 63% (380) and 27% (163) of all monitored NAD. Regarding CAD monitoring Valproate was the most 86% (299) and Fenitoin the least 4% (15) monitored.Outpatients1.096 TDL out of 2.324 ordered were revised (47%) which belonged to 424 patients of a total of 877 monitored (48%). 273 TDL (25%) led to an EDAI, which affected 196 patients, that is 46% of revised patients and 22% of all monitored patients. Most EDAI supposed an increase or reduction of dosage, 51% and 34% (139 and 92 out of 273) respectively. Levetiracetam, Perampanel and Lacosamide were the most monitored NAD: 26% (286), 13% (145) and 10% (110) respectively, and the most EDAI-prone: 29% (79), 27% (73) and 11% (29) respectively.Conclusion and RelevanceInclusion of outpatients to TDMP allowed early drug adjustment of almost half of the revised patients.The creation of a multidisciplinary team that includes pharmacists and neurologists with a focus on active monitoring of NAD TDL might be significant to better care for epileptic outpatients.References and/or AcknowledgementsConflict of InterestNo conflict of interest</description><identifier>ISSN: 2047-9956</identifier><identifier>EISSN: 2047-9964</identifier><identifier>DOI: 10.1136/ejhpharm-2023-eahp.86</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Anticonvulsants ; Conflicts of interest ; Drug stores ; Pharmacy ; Section 4: Clinical pharmacy services</subject><ispartof>European journal of hospital pharmacy. Science and practice, 2023-03, Vol.30 (Suppl 1), p.A40-A41</ispartof><rights>European Association of Hospital Pharmacists 2023. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2023 European Association of Hospital Pharmacists 2023. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids></links><search><creatorcontrib>Juvany Roig, R</creatorcontrib><creatorcontrib>Mas Bauza, N</creatorcontrib><creatorcontrib>Cleries Rovira, P</creatorcontrib><creatorcontrib>Falip Centellas, M</creatorcontrib><creatorcontrib>Gonzalez Caballero, Í</creatorcontrib><creatorcontrib>Ribera Puig, C</creatorcontrib><creatorcontrib>Porredon Antelo, C</creatorcontrib><creatorcontrib>Rigo Bonnin, R</creatorcontrib><creatorcontrib>Sala Padró, JX</creatorcontrib><creatorcontrib>Badia Tahull, MB</creatorcontrib><title>4CPS-051 Impact of the new antiepileptic drug monitoring programme on the activity of the pharmacy and neurology departments</title><title>European journal of hospital pharmacy. Science and practice</title><addtitle>Eur J Hosp Pharm</addtitle><description>Background and ImportanceIn 2016 therapeutic drug monitoring programme (TDMP) began for new anticonvulsant drugs (NAD) for inpatients and outpatients at our hospital. Weekly multidisciplinary meetings were held to revise out-of-range trough drug levels (TDL) on epileptic outpatients, and to make early drug adjustment interventions (EDAI) before their scheduled clinical follow-up.Aim and ObjectivesTo evaluate the impact of NAD TDMP on the activity of the Pharmacy and Neurology departments.Material and MethodsInpatientsQuantification of pharmacokinetic interventions (PI) and patients monitored between 2016-2021.OutpatientsActivity analysis between July 2017 and May 2019: TDL revision, patients monitored and number of EDAI made. TDL and EDAI percentage calculation for each drug.ResultsInpatientsAnticonvulsant drug PI were 56% of all PI (6.067 of 10.910) during the study period. PI of classic anticonvulsant drugs (CAD) decreased from 934 in 2016 to 348 in 2021 (63%). In 2021 the percentage of PI of NAD and CAD were 27% and 16% (602 and 348 out of 2.209) respectively. Levetiracetam and Lacosamide accounted for 63% (380) and 27% (163) of all monitored NAD. Regarding CAD monitoring Valproate was the most 86% (299) and Fenitoin the least 4% (15) monitored.Outpatients1.096 TDL out of 2.324 ordered were revised (47%) which belonged to 424 patients of a total of 877 monitored (48%). 273 TDL (25%) led to an EDAI, which affected 196 patients, that is 46% of revised patients and 22% of all monitored patients. Most EDAI supposed an increase or reduction of dosage, 51% and 34% (139 and 92 out of 273) respectively. Levetiracetam, Perampanel and Lacosamide were the most monitored NAD: 26% (286), 13% (145) and 10% (110) respectively, and the most EDAI-prone: 29% (79), 27% (73) and 11% (29) respectively.Conclusion and RelevanceInclusion of outpatients to TDMP allowed early drug adjustment of almost half of the revised patients.The creation of a multidisciplinary team that includes pharmacists and neurologists with a focus on active monitoring of NAD TDL might be significant to better care for epileptic outpatients.References and/or AcknowledgementsConflict of InterestNo conflict of interest</description><subject>Anticonvulsants</subject><subject>Conflicts of interest</subject><subject>Drug stores</subject><subject>Pharmacy</subject><subject>Section 4: Clinical pharmacy services</subject><issn>2047-9956</issn><issn>2047-9964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpFkMtKw0AUhgdRsGgfQRhwnTqTuWWWUrwUCgp2HyZzSaY0mZhMlG7EjS_qk5i2VlfnLP7_O4cPgCuMZhgTfmPXVVuprk5SlJLEqqqdZfwETFJERSIlp6d_O-PnYNr3vkCMkExSIifgg86fXxLE8Pfn16JulY4wOBgrCxv7DlUTvW39xrbRa2i6oYR1aHwMnW9K2Hah7FRdWxiafWVs-zcft0fE_jGltyPHjLyhC5tQbqGxrepibZvYX4Izpza9nf7OC7C6v1vNH5Pl08NifrtMCowFTwRiTFGuFNaaOSu0cFww5ZRkmApjRGGws0WBLDIZNbJQzmnJUq2kyigmF-D6gB1ffh1sH_N1GLpmvJinQiKCMEHZmMKHVFGv_wMY5TvR-VF0vhOd70TnGSc_hXF4ag</recordid><startdate>20230323</startdate><enddate>20230323</enddate><creator>Juvany Roig, R</creator><creator>Mas Bauza, N</creator><creator>Cleries Rovira, P</creator><creator>Falip Centellas, M</creator><creator>Gonzalez Caballero, Í</creator><creator>Ribera Puig, C</creator><creator>Porredon Antelo, C</creator><creator>Rigo Bonnin, R</creator><creator>Sala Padró, JX</creator><creator>Badia Tahull, MB</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>K9.</scope></search><sort><creationdate>20230323</creationdate><title>4CPS-051 Impact of the new antiepileptic drug monitoring programme on the activity of the pharmacy and neurology departments</title><author>Juvany Roig, R ; Mas Bauza, N ; Cleries Rovira, P ; Falip Centellas, M ; Gonzalez Caballero, Í ; Ribera Puig, C ; Porredon Antelo, C ; Rigo Bonnin, R ; Sala Padró, JX ; Badia Tahull, MB</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1176-7055a46aa1cc5fe7c7f675afa95147dd7bd1febb0e0d84d9baffc952ca9a8413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anticonvulsants</topic><topic>Conflicts of interest</topic><topic>Drug stores</topic><topic>Pharmacy</topic><topic>Section 4: Clinical pharmacy services</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Juvany Roig, R</creatorcontrib><creatorcontrib>Mas Bauza, N</creatorcontrib><creatorcontrib>Cleries Rovira, P</creatorcontrib><creatorcontrib>Falip Centellas, M</creatorcontrib><creatorcontrib>Gonzalez Caballero, Í</creatorcontrib><creatorcontrib>Ribera Puig, C</creatorcontrib><creatorcontrib>Porredon Antelo, C</creatorcontrib><creatorcontrib>Rigo Bonnin, R</creatorcontrib><creatorcontrib>Sala Padró, JX</creatorcontrib><creatorcontrib>Badia Tahull, MB</creatorcontrib><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><jtitle>European journal of hospital pharmacy. Science and practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Juvany Roig, R</au><au>Mas Bauza, N</au><au>Cleries Rovira, P</au><au>Falip Centellas, M</au><au>Gonzalez Caballero, Í</au><au>Ribera Puig, C</au><au>Porredon Antelo, C</au><au>Rigo Bonnin, R</au><au>Sala Padró, JX</au><au>Badia Tahull, MB</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>4CPS-051 Impact of the new antiepileptic drug monitoring programme on the activity of the pharmacy and neurology departments</atitle><jtitle>European journal of hospital pharmacy. Science and practice</jtitle><stitle>Eur J Hosp Pharm</stitle><date>2023-03-23</date><risdate>2023</risdate><volume>30</volume><issue>Suppl 1</issue><spage>A40</spage><epage>A41</epage><pages>A40-A41</pages><issn>2047-9956</issn><eissn>2047-9964</eissn><abstract>Background and ImportanceIn 2016 therapeutic drug monitoring programme (TDMP) began for new anticonvulsant drugs (NAD) for inpatients and outpatients at our hospital. Weekly multidisciplinary meetings were held to revise out-of-range trough drug levels (TDL) on epileptic outpatients, and to make early drug adjustment interventions (EDAI) before their scheduled clinical follow-up.Aim and ObjectivesTo evaluate the impact of NAD TDMP on the activity of the Pharmacy and Neurology departments.Material and MethodsInpatientsQuantification of pharmacokinetic interventions (PI) and patients monitored between 2016-2021.OutpatientsActivity analysis between July 2017 and May 2019: TDL revision, patients monitored and number of EDAI made. TDL and EDAI percentage calculation for each drug.ResultsInpatientsAnticonvulsant drug PI were 56% of all PI (6.067 of 10.910) during the study period. PI of classic anticonvulsant drugs (CAD) decreased from 934 in 2016 to 348 in 2021 (63%). In 2021 the percentage of PI of NAD and CAD were 27% and 16% (602 and 348 out of 2.209) respectively. Levetiracetam and Lacosamide accounted for 63% (380) and 27% (163) of all monitored NAD. Regarding CAD monitoring Valproate was the most 86% (299) and Fenitoin the least 4% (15) monitored.Outpatients1.096 TDL out of 2.324 ordered were revised (47%) which belonged to 424 patients of a total of 877 monitored (48%). 273 TDL (25%) led to an EDAI, which affected 196 patients, that is 46% of revised patients and 22% of all monitored patients. Most EDAI supposed an increase or reduction of dosage, 51% and 34% (139 and 92 out of 273) respectively. Levetiracetam, Perampanel and Lacosamide were the most monitored NAD: 26% (286), 13% (145) and 10% (110) respectively, and the most EDAI-prone: 29% (79), 27% (73) and 11% (29) respectively.Conclusion and RelevanceInclusion of outpatients to TDMP allowed early drug adjustment of almost half of the revised patients.The creation of a multidisciplinary team that includes pharmacists and neurologists with a focus on active monitoring of NAD TDL might be significant to better care for epileptic outpatients.References and/or AcknowledgementsConflict of InterestNo conflict of interest</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><doi>10.1136/ejhpharm-2023-eahp.86</doi><oa>free_for_read</oa></addata></record>
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subjects Anticonvulsants
Conflicts of interest
Drug stores
Pharmacy
Section 4: Clinical pharmacy services
title 4CPS-051 Impact of the new antiepileptic drug monitoring programme on the activity of the pharmacy and neurology departments
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