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The most prevalent pathology was lung cancer (19 CT, 14 of which were non-small cell lung cancer) and melanoma (four CT). Conclusion The CT are an opportunity to contain pharmaceutical costs in hospitals. Patients in CT produced a cost saving of C ¼ 3,482,662/year. The potential savings justify the need to incorporate as many clinical trials as possible, not just for cost savings but because it would mean better access for patients to these highly effective and/or breakthrough therapies.

BackgroundSince 2009, the Surgical Block Pharmacy has been involved in the management of medical devices (MD) via centralisation, the use rationalisation and the production of procedural kits (standardised MD sets including sutures, syringes and scalpels, associated with one or more surgical procedure).Since June 2016, the production of kits has been implemented with eye surgery, first cataract surgery and intravitreal injections, and, since January 2017, with all types of eye surgery.Kit composition is periodically reviewed by the pharmacist through the analysis of unused MD returned to the pharmacy.PurposeTo optimise kit contents, to improve logistics and to streamline daily delivery processes.Material and methodsWe analysed unused MD returned to the pharmacy from the ophthalmic operating room for every kit in the first 4 months of 2017.MD returned to the pharmacy were analysed via a query of the logistic software.Our focus was concentrated on the most critical kits, identified by unused MD returned ≥50%.Once the critical MD was identified, we estimated whether the quantity was to be reduced or the MD should be removed.Subsequently, the change was proposed to the operating room staff, to be accepted and approved by the head physician.At the same time, kit content was re-evaluated, if necessary with the addition of other MD.ResultsTwenty-five different types of kits were prepared for eye surgery.Fifteen kits had unused MD returned to the Pharmacy ≥50% and all were analysed.Contents of 11 kits (73%) were revised: in particular, 30 MD were removed (26% of unused MD returned and analysed) and the amount of nine MD was reduced (8%).For MD removed from kits, a storage space was provided in the operating room cabinet.We replaced two MD and added one MD.In addition, new kits will be created for specialised surgery.Conclusion?Analysis of unused MD returned is useful for identification of critical issues and for standardisation-optimisation (the most difficult requirement), significantly reducing MD amount returned to the pharmacy, which negatively affects working time.We cleared human resources’ activity that can be used to implement the Surgical Block Pharmacy activity and increase kthe production of kits.In this way operating rooms’ needs can be met, confirming the efficiency of our system.No conflict of interest

Information to nurse care services was delivered by a pharmacy intern and a public health nurse after each insertion and during changes in dressings. Medical criteria (indications, complications, catheter operating times and removal reasons) and handling criteria (evaluation sheet by installers) were listed. Results Mean age was 74±15 years (G1) and 70±17 years (G2). There were seven successful insertions and three failures due to venous access difficulties in G1; there were eight insertions in G2. Midlines were placed by anaesthetist (94% of cases) for antibiotic therapy or nutrition. Median catheter use duration was 7 (2-24) days for G1 and 15.5 (1-65) days for G2. The reasons for withdrawal were: end of treatment (28.6% G1, 37.5% G2), accidental withdrawal by the patient (28.6% G1, 12.5% G2), thrombosis (14.3% G1), clogged catheter (12.5% G2), death (12.5% G2) and worsening of health (14.3% G1). Positive opinions were expressed regarding the length of the catheter (100% G1 vs 33% G2) and ease of installation (86% G1 vs 67% G2). Comments were made for G1 ("rigid guide") and for G2 ("complexity of handling a peel-away sheath"); 80% of installers who tested both devices preferred the Smartmidline. Conclusion and relevance The various clinical situations and small number of patients made the medical criteria not relevant to make a choice. The handling criteria and practicality of the Smartmidline, as evaluated by caregivers, led to its recommendation. To secure its use, a hygiene protocol has been implemented in the hospital. To facilitate the interface between hospital and community carers, instructions for patients, doctors and pharmacists have to be reinforced.

BackgroundOncology drugs feature multiple adverse effects, however, physicians often consider toxicity acceptable and focus on the outcome, providing tools to deal with unavoidable side effects. The threshold of evaluation of adverse drug reactions (ADR) is different from other areas and many adverse effects are so predictable that are not even considered.PurposeTo record the toxicity reported in our hospital for patients receiving cancer treatment, to perform a quantitative evaluation, and to estimate the culture of pharmacovigilance in this field.Material and methodsWe analysed ADR reports included in the National Network of Pharmacovigilance in 2014, and then sorted the ADR reports by category: antineoplastic agents and immunomodulators. We identified: the type of drug, active ingredients most reported, seriousness of the symptoms experienced and their resolution.ResultsDuring the reporting period, there were 67 ADRs. 74% involved injectable drugs and more than half (61%) related to generics/biosimilars. Major toxicity was reported for: oxaliplatin (10), paclitaxel (9), filgrastim (7, 5 non-response to treatment), carboplatin (6), Afinitor and docetaxel (5). 81% were non-serious reactions. All were known and reported in drug leaflets. Most adverse reactions occurred during drug administration or the following days. Regarding outcome, 48% completely resolved (reversible toxicity in a short period), 27% improved and only 3% had a resolution with sequelae. There were no drug related deaths. 1 ADR was caused by a medication error and 1 involved an off-label use.ConclusionData collected showed ADR reporting related to injectable drugs and generics/biosimilars. ADRs were mostly not serious, did not become chronic and were known; we can therefore suspect an important phenomenon of under reporting. In onco-haematology there have been many new drugs launched on the market (many oral), and for many of them the safety profile needs to be further evaluated: pharmacovigilance is an important resource. The pharmacist has a key role in raising awareness of the problem, but also in encouraging appropriate reporting.No conflict of interest.