[Implementation of pharmaceutical consultations in oncohematology in a teaching hospital: Over one year outcomes]. / Mise en place de consultations pharmaceutiques en oncohématologie dans un centre hospitalo-universitaire : résultats à plus d'un an.

The development of Oral Cancer Therapies (OAT) raises the question of the therapeutic adherence of patients, put in difficulty by the isolation of the patient in the management of treatment and adverse reactions. Accompanying processes are developing, such as Pharmaceutical Consultations (PC), whose monitoring and education objectives are multiple. The PCs and their implementation are presented here, as well as the first results at 15months. The scope of the PCs was first defined, as well as their organization and supporting documents. A patient's medication history is carried out before the PC, then analyzed. The initial PC incorporates a discussion about patient's health habits, followed by information on the OAT, which is closed by the delivery of a follow-up diary. The follow-up PCs, distributed over the course of the first year following the initiation, allow to correct the erroneous knowledge of the patient, to support him in his difficulties and to detect any adverse effects. From May 2019 to August 2020, 81.2% of the 32 patients who initiated OAT took part in CP. A pharmacotherapeutic problem is encountered in 65.4% of them and a drug interaction with alternative or complementary medicines in 62.5% of patients which consuming. The PCs developed provide new elements compared to the recommendations and provide support for patients with toxicities that weaken their medical care throughout their care pathway.

Impact of the COVID-19 pandemic on drug-related problems and pharmacist interventions in geriatric acute care units.

OBJECTIVES: To assess and compare the pharmaceutical analysis on drug management in a geriatric acute care unit prior to and during the COVID-19 pandemic. METHODS: This was a single-centre, retrospective, and comparative cohort study. All Pharmacist Interventions (PIs) carried out in the unit between 27 January 2020 and 30 April 2020 were distinguished according to whether they were conducted prior to or during the first wave of COVID-19. The main outcome measure was the rate of PIs per patient and per prescription lines analysed. Other data collected were the drug class managed by the PI, the Drug Related Problems (DRP) identified, the nature of the advice given, and the acceptance rate by geriatricians. RESULTS: A total of 355 patients were analysed, with PIs generated for 21.7% of the patients prior to COVID-19, and for 53.4% of the patients during the first wave (p<0.001). Among the 4402 prescription lines analysed, 54 PIs were carried out for prescriptions prior to COVID-19, and 177 during the first wave (p=0.002). DRPs were mostly related to anti-infectious drugs during the pandemic (20.3%, p=0.038), and laxatives prior to the pandemic (13.0%, p=0.023). The clinical impact of the PIs was mainly moderate (43.7%). The acceptance rate was 59.3%. CONCLUSIONS: A greater amount of DRPs were detected and more therapeutic advice was proposed during the first wave of COVID-19, with a focus on drugs used for the management of COVID-19 rather than geriatric routine treatments. The needs for clinical pharmacists were strengthened during the pandemic.