FMEA was useful for detecting medication errors in the PN preparation process and enabling corrective measures to be taken. A checklist was developed to reduce errors in the most critical aspects of the process.

IntroductionOne of the most common complications of parenteral nutrition (PN) is liver dysfunction (LD). Therapeutic approaches for LD include, among others, administering cyclic parenteral nutrition (cPN), allowing some hours for metabolic rest. The purpose of this study was to evaluate the effectiveness of cPN in treating PN-associated LD.Materials and methodsA retrospective observational study was carried out at the Costa del Sol Hospital in Spain between 2013 and 2014. The study involved inpatients ≥18 years old prescribed with cPN due to the development of PN-associated LD. The hepatic biochemical parameters measured at baseline and after completion of cPN included aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP) and total bilirubin (TB). Quantitative values (age, biochemical parameters) were compared using matched Student’s t-test; the mean change in qualitative variables (sex, indication of PN, hepatic comorbidities, presence of insulin in cPN, infection during cPN, management of LD prior to cPN administrarion) was estimated using Mann-Whitney U test, and bivariate correlation between quantitative variables was determined by Spearman’s coefficient of correlation.ResultsThirty-seven patients met inclusion criteria. All hepatic function parameters except ALP improved after the administration of cPN, with statistically significant differences (p < 0.05) in AST GGT and TB.ConclusioncPN improves PN-associated LD by restoring abnormal AST, GGT, and BT levels to normal, and reducing ALT levels close to normal. The results obtained suggest that the administration of cPN is effective in reverting PN-associated LD.

BackgroundThe main objective of antiretroviral therapy (ART) is to maintain undetectable viral load (VL) and preserve immune function. But nowadays reduction in morbidity and improvements in patient quality of life appear to be as important therapy goals, encouraging clinicians to change ART although VL and immune function are controlled.PurposeThe aim of our study was to assess the reasons for ART switches in patients with effective previous treatment (undetectable VL) and to analyse if these switches had been done according to the GESIDA (Grupo de Estudio del SIDA, AIDS Study Group) 2015 guidelines.Material and methodsAn observational retrospective study was carried out from June 2014 to January 2015. All patients with ART during this period were included, and patients who underwent treatment switching were analysed. Previous and actual treatments, pre-switch VL, and reasons for the switch were recorder in a database. Pregnant patients and those with detectable VL were excluded from the final analysis in relation to its adaptation to the GESIDA 2015 guideline recommendations.Results781 patients were included. 120 treatments were switched (15.4): 103 patients had undetectable VL, 13 patients had detectable VL and 4 patients were pregnant. The reasons for switching in patients with undetectable VL are shown in table 1.Abstract CP-150 Table 1Reasons for switching in patients with undetectable VL (n = 103)Side effects (56%):· Gastrointestinal disorders 26% · Impaired renal function 24%· Metabolic disorders 21% · Neurologic disorders 21% · Skin reactions 5%· Osteopenia 3%Simplification (23%):· Minor number of tablets 56%· Improve adherence 44%Relevant interactions 8%New comorbidities appearance 3%Changes in patients’ lifestyle 2%Improve immune response 2%Unknown reason 6%Analysing our clinicians reasons for switching according to the GESIDA recommendations (excluding unknown reasons), we found that 32% of switches had no defined level of evidence; 17% had a level of evidence BII; 2% BI; 10% AIII; 20% AII; and 19% AI.ConclusionThe main reason for ART switching in patients with undetectable VL was side effects. Nearly one-third of all switches did not correspond to any level of evidence, according to the GESIDA 2015 guidelines. Among the switches that followed the recommendation, 71% had a level of evidence of A.No conflict of interest.

Background The number of patients infected by HIV and hepatitis has increased over the years. Some of them have swallowing difficulties that require the placement of nasogastric or gastrostomy tubes. These chronic treatments need high compliance rates to avoid antiviral drug resistance and, eventually, treatment failure. Purpose To review the existing antiviral drugs literature and develop administration recommendations for patients with swallowing problems. Materials and Methods Formulations and recommendations were obtained directly from the manufacturers, or by a PubMed search and a search on the Micromedex database, when information was not available. A guide published by SENPE with physicochemical and formulation properties of drugs was also checked. ResultsTable 1 shows the results. Extensive administration recommendations were found during literature searches but are not included in the present abstract. There was no information about the administration of adefovir, maraviroc or saquinavir through gastrostomy or nasogastric tube. Conclusions Treatment compliance is key to ensuring the success of chronic antiviral treatments and it is important to consider special situations, such as swallowing problems. This guide for nasogastric or enteral administration helps clinicians to choose the most appropriate treatment. Further research is needed to determine specific bioavailability data. Abstact DGI-024 Table 1Antiviral Drug Formulations and Administration Drug Solution available (mg/ml solution) Can be crushed/sprinkled abacavir 20 Yes didanosine 2 g/ml solution powder Use tablets, not capsules emtricitabine 10 Discouraged lamivudine 10, 5 Yes stavudine 1 Yes tenofovir Yes zidovudine 50 Discouraged efavirenz 30* Use capsules etravirine Yes nevirapine 10 Discouraged atazanavir 50 mg/1.5 g solution powder * Discouraged darunavir Yes fosamprenavir 50 indinavir Discouraged lopinavir/ritonavir 80/20 Discouraged nelfinavir Yes ritonavir 80 Discouraged tipranavir 100 raltegravir Yes abacavir/lamivudine ** abacavir/lamivudine/zidovudine ** zidovudine/lamivudine ** Yes tenofovir/emtricitabine Yes tenofovir/emtricitabine/efavirenz Discouraged boceprevir Discouraged telaprevir Discouraged ribavirin 40 Discouraged entecavir 0.05* telbivudine 20* Discouraged *Not in Spain **Individual drugs available in solution No conflict of interest.

BackgroundHospital Pharmacist integration in a medical team improve inpatient care and safety.PurposeWe want to study the impact of this physical integration over the General Surgery service staff.Material and methodsDuring two months a pharmacist worked full-time in the General Surgery Area. To assess pharmacist’s impact over the surgical team, we developed a questionnaire (table 1) qualifying from 1 (less favourable) to 5 (most favourable). The questionnaire was filled out anonymously by the Surgery staff two weeks prior integration (PRE) and after two weeks (POST). The average score was obtained and PRE-POST groups were compared.Results28 questionnaires were collected: 5 nurses’ aides, 9 nurses, 14 surgeons. The results are shown in Table 1.Abstract OHP-021 Table 1ItemPREPOSTp1. Asses the role of Hospital Pharmacist reviewing medical prescriptions3.74.6 <0.012. Asses how you believe that this revision increases patient’s security4.44.8 <0.053. How do you value the time the pharmacist employs reviewing prescriptions?3.74.7 <0.014. In Off-Label drugs use. Do you believe pharmacist opinion is important?4.04.6 <0.055. Asses the importance of making home treatment reconciliation at income4.74.80.376. Asses the importance of pharmacists carrying out reconciliation process4.34.70.097. Asses the usefulness of clinical pharmacokinetics4.64.40.718. Asses the role of pharmacist prescribing, monitoring and resolving problems related to parenteral nutrition4.54.60.869. Asses the impact of pharmacist’s presence in the final quality of treatments4.14.60.1110. Asses globally pharmacist’s role in your service4.34.8 <0.05ConclusionWhile the prior pharmacist’s assessments were high, the visibility and its presence resulted in a significant improvement in the perception of the pharmacist figure, both globally and in specific aspects such as patient safety, the importance of treatments’ review and work-time employed perception.References and/or acknowledgementsnoneNo conflict of interest.