BackgroundMultiple sclerosis (MS) is a chronic demyelinating central nervous disease characterised by a broad spectrum of physical and psychosocial impairments. The MS Quality of Life-54 (MSQoL-54) questionnaire is a health-related quality of life (HRQoL) measure that yields summary scores for physical health composite score (PCS) and mental health composite score (MCS). Both PCS and MCS are expressed on a scale of 0 (poorest QoL) to 100 (best possible QoL).PurposeTo evaluate HRQoL in MS patients calculating PCS and MCS scores. To analyse if there are differences in HRQoL and Expanded Disability Status Scale (EDSS) between disease-modifying therapies (DMTs) of parenteral administration.Material and methodsA prospective study was performed from March to September 2017. MS patients were asked by a hospital pharmacist to complete the MSQoL-54 questionnaire. Clinical data were collected from electronic medical and pharmaceutical records (sex, age, MS disease course, EDSS, disease duration, DMTs). DMTs included were interferon (IFN), glatiramer acetate (GA) and natalizumab. Kruskal–Wallis multivariant analysis with SPSS 15,0 was used for statistical analysis.ResultsNinety patients completed the questionnaire (68% females). Median age was 46 years (IQR 38–55). Eighty-three patients had relapsing remitting multiple sclerosis (RRMS). Median disease duration was 10 years (IQR 5–14). Forty-nine patients were treated with IFN, 22 with GA and 19 with natalizumab. Median EDSS in IFN, GA and natalizumab patients were 1.5, 1.3 and 3 respectively (p<0.001). Median PCS in these patients were 68.3, 54.0 and 48.1 and median MCS 66.0, 63.5 and 45.1. Statistical significant differences between IFN and natalizumab were found in both PCS (p<0.02) and MCS (p<0.001) composite scores.ConclusionThe majority of patients in this study were young females with RRMS. Patients treated with GA and IFN had similar HRQoL. GA and IFN patients had better PCS and MCS scores than natalizumab patients. This could be explained due to higher EDSS values in natalizumab patients. For future research, oral DMTs could be included to investigate if there are any differences in HRQoL with parenteral DMTs.No conflict of interest

BackgroundMultiple Sclerosis (MS) is a chronic demyelinating CNS disease that negatively affects patient quality of life (QoL). The hospital pharmacist dispenses MS disease modifying therapies (DMT) at the outpatient pharmacy.PurposeTo analyse QoL in MS patients who collect firstline DMT at the outpatient pharmacy.Material and methodsA prospective study was performed from March to September 2016. QoL was assessed according to an internal questionnaire. It was designed by a pharmacist and included: demographic characteristics, employment status, home adaptations, mobility, need for support with everyday activities, vacation and leisure habits, and MS medical history during the last year. An Excel database was designed to analyse the results. All MS patients were asked to complete a questionnaire at the outpatient pharmacy when collecting DMT. Firstline DMT included: parenteral drugs (interferon beta-1A and 1B, glatiramer acetate) and oral drugs (dimethyl fumarate, teryflunomide).Results100 of 107 MS patients with the following characteristics completed the questionnaire: mean age 44.83 years (±11.08), 73% women and 91% lived with relatives. 16% were treated with firstline oral DMT. Nearly half of MS patients (45%) were occupationally active. Home adaptations were reported by 13% of patients. 55% did not require support for everyday activities and 79% could move normally. 36% of patients had changed their holiday habits and 58% their leisure activities because of MS. During the last year, 7% of MS patients had suffered a relapse and were admitted to hospital, and 51% reported daily activity disturbances because of MS (mean lost days per year 57). The average number of visits per patient to the neurologist during the last year was 2.ConclusionMost patients included in this study were young active women living with relatives. A high percentage of patients reported an acceptable QoL related to mobility, home adaptations and independence with routine activities, which could be explained by early DMT treatment according to clinical guidelines. Assessing QoL in MS patients is not common in everyday clinical practice. As part of clinical practice, it has the potential to improve communication between the patient and pharmacist, identify frequently overlooked problems and detect those patients most in need of pharmaceutical care.No conflict of interest

PIs were carried out in relation to DRP in the Third Consensus of Granada and the prescribing physician was orally informed of all of them. Results A total of 31 interventions were registered, 71% of which were males and 29% females, with an average age of 74 years (41-92). PIs were classified in this way: 15.2% drug dose adjustment; 9.2% start of medication; 8.2% pharmacokinetics monitoring; 6.2% routes of administration of drugs; 4.2% interruption of treatment; 4.2% mistakes in the transcription of physician orders; 4.2% drug interaction prevention; and 4.2% allergic reaction prevention. 93.3 per cent of PIs were accepted.The group of drugs J (systemic antiinfectious) was the most involved, with 35.5% of PIs, followed by group C (cardiovascular system) with 19.4% and group B (blood and haematopoietic organs) with 12.1%, among others. Regarding DRP, 51.7% were related to safety, 25.7% to the efficacy of the treatment and 22.6% to the indication. Conclusion The high level of acceptance of the proposed interventions and its clinical relevance demonstrates the significance of clinical pharmacists that prevent, detect and solve DRP in the prescription process before they affect the patient. According to the published literature, the presence of a clinical pharmacist in critical patient care multidisciplinary teams provides improvements in terms of safety, efficacy and cost of treatments.

BackgroundThe use of oral chemotherapy (OC) is an effective and safe approach in the treatment of metastatic castration resistant prostate cancer (MCRP). Abiraterone and enzalutamide offer improved patient convenience and ease of administration. However, patients are now responsible for ensuring optimal adherence to their medication.PurposeThe aim of this study was to determine adherence to abiraterone and enzalutamide in patients with MCRP.Material and methodsA retrospective longitudinal study was carried out from September 2011 to March 2016. All patients treated with OC for MCRP were included. Patients with only one drug dispensation were excluded, because adherence could not be calculated. Patients´ medical records were reviewed and the following data were collected: demographics and pharmacotherapeutics (prior chemotherapy, abiraterona or enzalutamide treatment start and end date, dosing and dispensed data). Data were obtained from electronic clinical records, oncology prescription software and outpatient dispensing records.Adherence to OC was evaluated indirectly using dispensation records to calculate ‘medication possession rate’ (MPR). MPR is defined as the sum of all days of drug supplied within a given period, divided by the total number of days in that period. Optimal adherence was defined as MPR >80%, following previous studies. The end points were: measure of adherence to enzalutamide and abiraterone; duration of treatment; and percentage of patients who achieved optimal adherence. Data analysis was carried out using SPSS 15.0.Results45 patients (mean age 74 years (57–87)) with at least two drug dispensations were selected from the pharmacy database. 30 patients (66.6%) received abiraterone, 3 patients (6.66%) received enzalutamide and 12 patients (26.66%) received both drugs sequentially.Oral chemotherapy(OC)Patients(n)MPR (%)Optimal adherence: n (%) (MPR >80%)Mean duration (months) MeanMedianAbiraterone3910710236 (92%)12 (2–32)Enzalutamide15989712 (80%)5 (1–13)ConclusionMost patients showed high rates of adherence to OC in MCRP. The long duration of treatment and absence of symptoms in these patients could prove a threat to adherence to treatment. Oncology pharmacists have a key role by following patients with OC in MCRP and reminding them of the importance of adherence. Study limitations include measuring adherence using only one method.No conflict of interest

BackgroundMost studies in HIV infected patients focus on the effectiveness of antiretroviral therapy (ART) combinations included in clinical guidelines. However, few studies have analysed combinations not listed in these guidelines.PurposeTo analyse the prevalence and effectiveness of ART combinations not included in HIV guidelines.Material and methodsA retrospective observational study was carried out between January 2014 and December 2015. All patients with ART followed for at least 1 year by the outpatient pharmacy were included. ART were classified in two groups:(1) all combinations listed in the Spanish National AIDS Plan Recommended Guidelines (GESIDA) for initial antiretroviral therapy 2014–2015; and combinations not listed in GESIDA Guidelines.To determine the effectiveness of the treatment, plasma viral load (VL) and CD4+ lymphocytes were reviewed. Two analyses according to different criteria were conducted:(1) criteria reflected in Spanish GESIDA guidelines: VL <50 copies/mL (undetectable) and CD4 repeatedly >300 cells/μL, on at least two consecutive occasions;(2) criteria reflected in the American DHHS guidelines: VL <200 copies/mL (to prevent errors by blip) and CD4 repeatedly >300 cells/μL, on at least two consecutive occasions. Data were analysed with SPSS 20.0 software.Results245 patients were analysed. 68.6% (168) were men. The median age was 48.5 years (IIC: 43.5 to 53). Patients ART combinations included in guidelinesART combinationsnot included in guidelines Total (n (%)) 224 (91.4) 21 (8.6) VL <50 copies/mL and CD4 >300 cells/μL (n (%)) 110 (49.1) 9 (42.9) OR=1.287 95% CI OR: 0.521–3.174 p=0.584 VL <200 copies/mL and CD4 >300 cells/μL (n (%)) 174 (77.7) 14 (66.7) OR=1.740 95% CI OR: 0.666–4.545 p=0.253 ConclusionThis study shows that few patients receive ART combinations not included in clinical practice guidelines. The high power of current ART could explain the similar effectiveness between the listed and non-listed therapies in the guidelines.No conflict of interest