Background Antithrombotic prophylaxis in hospitalised patients with SARS-CoV-2 acute infection has increased. Currently, most of the evidence relates to patients in intensive care units; however, there is little information on patients admitted to hospital wards and there is no consensus protocol on thromboprophylaxis during admission and after discharge. Objective To assess the effectiveness of antithrombotic prophylaxis in patients admitted with COVID-19 and 30 days after discharge. Method A prospective observational study was conducted of patients admitted with COVID-19 in which the hospital thromboprophylaxis protocol was applied, classifying the patients as having a standard or high risk of thrombosis. Pharmacists performed a daily follow-up and actively intervened during admission and at discharge. The main outcome measure was the global incidence of symptomatic venous thromboembolism (VTE) related to hospitalisation. Results A total of 113 patients were included, 98.23% of whom were admitted to a hospital ward. The incidence of hospital-acquired VTE was 1.77%. In 75.22% of the subjects, thromboprophylaxis was adjusted to the protocol during admission. A total of 23 pharmaceutical interventions were conducted, with an adherence of 52.17%. At discharge, 94.28% of the patients who had no haemorrhage and ≥4 points on the Padua Prediction Score required thromboprophylaxis, aligning with the protocol. The global incidence of haemorrhagic events during the follow-up period was 0.88%. Conclusion The incidence of hospital-acquired VTE was lower than that described in the literature. Although it cannot be certain that it is directly related to the instituted protocol, the data can show that the management of prevention of VTE is being optimally performed at the hospital. Long-term studies are needed to evaluate the incidence after discharge, as well as to agree on a specific protocol in the COVID-19 population for the prevention of these events during hospitalisation and post-discharge.

BackgroundAlirocumab and evolocumab (PCSK9-Inhibitors), are new drugs incorporated into the therapeutic arsenal for the treatment of hypercholesterolaemia, having shown effectiveness and safety in the performed clinical trials.PurposeTo assess the effectiveness and safety of PCSK9-Inhibitors, to evaluate if both drugs are equally effective and to evaluate if there is any efficacy difference when using them as monotherapy agents or plus other lipid-lowering therapies (OLLT).Material and methodsObservational, retrospective and analytical study of patients in treatment with PCSK9-Inhibitors between February 2016 and August 2017. Patients’ selection, demographic and clinical parameters (sex, age, diagnosis, prescribed PCSK9-Inhibitors, OLLT, adverse events(AE)), analytical data (LDL-Cholesterol (LDL-C) and transaminases at week 0, 24 and 48) were obtained from Farmatools® and MambrinoXXI®.Effectiveness was defined as the percent change in LDL-C from baseline to week 24 or 48. Safety was assessed by analysing AE andincrease in transaminases during treatment.Effectiveness difference between groups were analysed (alirocumab vs evolocumab and PCSK9-Inhibitors vs PCSK9-Inhibitors plus OLLT) using t-test with SPSS®v23.ResultsThirty-nine patients were included: 62% male, between 34 and 78 years’ old. Diagnosis were 77% primary hypercholesterolaemia (97% heterozygous, 3% homozygous) and 23% mixed dyslipidaemia, with mean basal LDL-C of 165.13±45.37 mg/dl. Evolocumab was prescribed in 59% of patients and alirocumab 41%. Only six patients were on PCSK9-Inhibitors monotherapy (33 plus OLLT).The percentage change in LDL-C from baseline to week 24 were −41% and to week 48 were −61%.The percentage change in LDL-C from baseline to week 24 in the evolocumab group were −50% and −46% in the alirocumab group (p=0.736). The percentage change in LDL-C in the monotherapy group were −36% and −51% in the group plus OLLT (p=0.283).No EA were reported, however, 5% of patients presented elevation of transaminases at 12 weeks. There were no cases of patients requiring suspension or interruption of the treatment.ConclusionOur study has shown a reduction in LDL-C that is comparable with that shown in clinical trials, with a greater tendency for reduction in the evolocumab group and in patients with OLLT combined, probably associated with the synergistic effect of both drugs. We must continue to study whether this is related to a reduction in morbidity and mortality.No conflict of interest

BackgroundThe use of direct-acting antivirals (DAAs) in hepatitis C virus (HCV) patients has been a controversial issue over the past years in medicine. It has changed the HCV treatment paradigm, becoming a disease that can be cured. An extensive literature has documented the efficacy of these agents in the general population with cure rates>90%.PurposeEvaluate DAAs real-life effectiveness and safety in mono-infected HCV patients.Material and methodsObservational, retrospective and analytical study, involving mono-infected HCV patients treated with DAAs since April 2016 in a teaching general hospital. Demographic variables: genotype(GT), liver fibrosis, treatment naïve or not, DDAs combination, treatment duration and sustained viral response at week 12 post-treatment (SVR-12) were obtained from the electronic health record. Data were collected in Excel®2010 and statistical intention to treat analysis (ITT) was performed with SPSS®v21.ResultsA total of 391 patients have been treated with DDAs, 330 of whom have been followed up until week 12 post-treatment. Of these 330 patients: 43.64% (144) were females, mean age 58.62 years (min 22 – max 85); 48.79% (161) GT1a, 42.12% (139) GT1b, 0.30% (1) GT1c, 0.61% (2) GT2, 4.85% (16) GT3, 3.03% (10 )GT4, 0.30% (1) GT5; 2.73% (9) F0, 6.06% (20) F1, 29.69% (98) F2, 19.70 (65) F3, 37.58% (124) F4% and 4.24% (14) undetermined fibrosis; 24.85% (82) interferon pretreated (50 no responders – NR, 32 relapses – RR); 5.76% (19) SOF+SMV, 22.73% (75) with SOF+DCV, 40% (132) SOF/LDP, 29.39% PTV/r/OBV+DSV, 2.12% (7) ELB/GZP; 9.09% (30) were treated within 8 weeks, 5.21% (169) within 12 weeks and 39.69% (131) within 24 weeks.IIT analysis determined that 96.97% (320) patients had RVS12: two exitus; four patients dropped out the medication: three with SOF+LDP and one with SOF+DCV. Two patients discontinued treatment because of adverse events – AE (headache and nausea); two virologic failures with PTV/r/OBV+DSV and other two relapsers: one with PTV/r/OBV+DSV and one with SOF+SMV. Therefore, 100% (seven) of patients with EBV/GZP achieved SVR-12, 96.90% (94) with PAR/OMB+DAS, 96.96% (128) with SOF+LDP, 97.33% (73) with SOF+DAC and 94.74% (one) with SOF+SMP.ConclusionHigh SVR-12 rates have been achieved in real-world settings with similar data to those clinical trials. Virological failures and relapsers were due to wrong genotyped assignment. Therapeutic drop-outs were caused by specific individual factors, such as social problems and acute processes that caused DDAs discontinuation, but also two cases of AE. Even so, a new generation of DDAs leads to better tolerance. These results suggest that eradication of HCV is feasible, carrying out a good screening strategy and high treatment access.No conflict of interest

BackgroundMultiple sclerosis (MS) is a chronic neurological disease that carries important personal, social and economic consequences for patients and their environment. Hospital pharmacists are responsible for effective and safe use of drugs, but also to improve Quality of Life (QoL) and therefore, it is important to evaluate QoL factors related, such as patient satisfaction and activation (or having the knowledge, skills and confidence to manage one’s health, to be related to health-related outcomes).PurposeThe aim is to measure MS patients’ satisfaction with their medication and the patient activation level.Material and methodsObservational, prospective and analytical study, carried out in two hospitals from June 2017 to September 2017. Two validated questionnaires (Treatment Satisfaction Questionnaire for Medication version 1.7 – TQSM1.7: effectiveness score 0–21 points, adverse events score 0–21 points, convenience score 0–21 points, global satisfaction 0–17 points – and Patient Activation Measure questionnaire – PAM: 0–100 points) were completed by MS patients attending the Outpatient Pharmacy Department. We collected the patients’ electronic medical record: sex, age, date of diagnosis, drug treatment, MS type (relapsing remitting MS-RRMS or secondary progressive MS-SPMS) and Expanded Disability Status Scale (EDSS). Statistical analysis was performed using SPSS®21.ResultsOne hundred and three patients (35.9% males, 64.1% females) answered the questionnaires, mean age 42.67 years (23–65 years). Treatment: 17.5% interferon-B-1a im, 16.5% interferon-B-1a sc, 4.9% peginterferon-B-1a, 9.7% interferon-B-1b, 13.6% glatiramer acetate, 8.7% dimetilfumarate, 13.6% fingolimod, 3.9% teriflunomide, 7.8% natalizumab, 3.9% fampridine. Median treatment duration was 46.94 months (3–216) and 53.4% were MS treatment-naïve. MS types 93.2% RRMS and median EDSS=2.2.TQSM1.7: average value of effectiveness was 14.3, 13.95 in adverse effects (60 patients answered, the rest did not report adverse effects), 14.26 in convenience and 13.3 in global satisfaction. PAM: 19.4% were classified in level 1, 26.2% in level 2, 41.7% in level 3% and 11.7% in level 4.ConclusionThere is a low patient activation level (45.6% are in levels 1 and 2), however global satisfaction is high (13.3). Effectiveness and convenience of treatment are well valued. As pharmacists it is necessary to identify which groups of patients are the least activated and make a special emphasis on increasing their involvement with the disease to improve health outcomes.References and/or AcknowledgementsNo conflict of interest

Background The Septic Ward treats patients with bone-, jointand prosthetic-joint infections. The treatment of these infections requires complex, long-term antibiotic therapies. Clinical pharmacy services were introduced in 2015. This included