Comprehensive medication management (CMM): Application of a new pharmaceutical practice in onco-hematology.

The integration of a large number of drugs, such as antineoplastic agents and cancer-related supportive care drugs, into the management of cancer patients exposes them to an increased number of drug-related problems (DRP). Clinical pharmacists contribute to drug management by actively intervening in detected DRP. The aim of this study is to assess the impact of the applying a clinical pharmacist-driven comprehensive medication management (CMM) service to onco-hematology patients. This prospective interventional study was carried out over six-month duration, specifically from November 06, 2022 to April 5, 2023 in the oncology and hematology departments of the EHU Oran. The adherence to treatment was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS). Whereas data related to the patient's general condition and medication history was assessed using the Pharmaceutical Care Network Europe (PCNE) Classification for Drug-Related Problems V9.1. Among the 130 patients included in the study, a total of 879 DRP were identified, with a mean of 6.78 (±1.72) DRP/patient, half of which were related to efficacy (51%). Almost half of our sample (44.6%) did not adhere to their treatment. The most frequent cause of DRP, accounting for (19.9%) of the cases, was the inappropriate administration by a health professional. A total of 875 pharmaceuticals interventions (PI) were proposed, 67.2% of which were focused at the drug level. The PI acceptance rate was 94.1%. The integration of CMM services in onco-hematology played an important role in optimizing dosing regimen and treatment administration methods, as well as preventing iatropathology in the management of cancer patients.

Pharmaco-economic evaluation of kidney transplantation at the University Hospital Establishment of Oran: cost analysis and implications / Évaluation pharmaco-économique de la transplantation rénale à l'établissement hospitalier et universitaire d'Oran : analyse des coûts et implications.

Introduction: In Algeria, the number of patients treated by dialysis is estimated at 23,798 in 2019. Kidney transplantation is the best therapeutic option for patients suffering from end stage kidney Disease (ESKD). However, this procedure is costly and requires complex management. The aim of this study is to assess the costs associated with kidney transplantation at the University Hospital Establishment of Oran, Algeria (UHEO). Materials and methods: A retrospective, descriptive, monocentric study was carried out on 31 patients who underwent kidney transplantation at the UHEO. Estimated costs included drugs, consumables, imaging and laboratory tests for pre-transplant examinations, immediate post-transplant hospitalization, post-transplant follow-up and management of any complications. Results: The average cost of graft preparation was 485,438.31 Algerian Dinar (DZD). Immediate post-transplant hospitalization represented an average cost of 375,484.70 DZD. The first year post-transplantation was the most costly with an average cost of 1,305,197.40 DZD mainly attributed to treatment, hospitalization, clinical and paraclinical examinations. Conclusion: This study estimated the cost of kidney transplantation at the UHEO and revealed that the cost of the first year is the most important due to many factors. It also showed that costs tend to decrease with the age of the transplant and the clinical stability of the recipient.

Introduction: En Algérie, le nombre de patients traités par la dialyse est estimé à 23 798 en 2019. La transplantation rénale se positionne comme la meilleure option thérapeutique pour les patients atteints d'insuffisance rénale chronique terminale (IRCT). Cependant, cette procédure est coûteuse et nécessite une prise en charge complexe. Cette étude a pour objectif d'évaluer les coûts associés à la transplantation rénale à l'établissement hospitalier et universitaire d'Oran en Algérie (EHUO). Matériels et méthodes: Une étude rétrospective, descriptive et monocentrique a été menée sur 31 patients ayant subi une transplantation rénale avec un donneur vivant apparenté à l'EHUO. Les coûts estimés englobaient les médicaments, les consommables, l'imagerie et les bilans biologiques dans les examens pré-greffe du donneur et du receveur, l'hospitalisation post-greffe immédiate, le suivi post-greffe et la gestion d'éventuelles complications. Résultats: Le coût moyen de la préparation de la greffe était de 485 438,31 Dinar algérien (DZD). L'hospitalisation post-greffe immédiate a représenté un coût moyen de 375 484,70 DZD. La première année de la greffe était la plus coûteuse avec un coût moyen de 1 305 197,40 DZD principalement attribué au traitement, à l'hospitalisation et aux examens cliniques et paracliniques. Les infections urinaires, la Covid-19 et les complications chirurgicales étaient les complications les plus fréquentes. Une variabilité significative a été observée en fonction du type de complications allant de 1 785,48 à 654 214,60 DZD. Le rejet aigu du greffon a été associé au coût moyen le plus élevé. Conclusion: Cette étude a permis d'estimer le coût de la greffe rénale à l'EHUO et a révélé que le coût de la première année est le plus important en raison de plusieurs facteurs. Elle a également montré que les coûts ont tendance à diminuer au fur à mesure de l'ancienneté de la greffe et la stabilité clinique du receveur.

The cost of multiple myeloma and its complications: A single-center study from Oran, Algeria.

BACKGROUND: The expenses of multiple myeloma (MM) represent a real economic and societal burden for patients and health authorities. However, very little is known about the situation in Algeria. Therefore, the aim of this study is to evaluate the costs generated by the management of MM and its complications in Algerian patients. MATERIALS AND METHODS: An observational retrospective study conducted on patients diagnosed with MM, from January 1st, 2019 to April 31st, 2023, at the Establishment Hospitalier Universitaire November 1st, Oran. A bottom-up costing methodology was used to assess the phase-specific cost and the complication burden. RESULTS: In total, 249 qualified for the study. For autologous stem cell transplantation (ASCT) eligible patients, the mean per patient cost of treating myeloma was estimated at: induction regimen ($4072); ASCT ($2899); consolidation ($1538); and maintenance ($355.76). The mean drug cost for ASCT-ineligible patients was $1421. The use of generic bortezomib and generic melphalan has led to a reduction in expenses of $1,075,181 ($5,024 per patient; 55.35%) and $10,864 ($487 per patient; 15.07%), respectively. Another cost-saving adaptation was ASCT using non-cryopreserved (NC) stem cells. The cost of managing MM complications was $177,782 per year. CONCLUSION: A number of adjustments have been implemented to the management of MM over time to improve clinical efficacy and reduce costs in Algeria. However, this may have come with a startlingly high cost of complications.

Echinops spinosissimus Turra Root Methanolic Extract: Characterization of the Bioactive Components and Relative Wound Healing, Antimicrobial and Antioxidant Properties.

Echinops spinosissimus Turra subsp. bovei (Asteraceae) is a medicinal plant in western Algeria. Traditionally, roots and inflorescences are employed as hypertensive agents and in the treatment of hemorrhoids. The current study evaluates the chemical composition, antioxidant, antimicrobial, and wound-healing properties of the root methanolic extract from E. spinosissimus subsp. bovei. The content of total phenolics, flavonoids, and tannins was determined. In addition, the phenolic profile was typified. The studied plant extract resulted in being primarily composed of Apigenin, Kaempferol, and their derivatives. The total phenolic content was equal to 95.31 ± 2.90 mg GAE/g DW, while the number of flavonoids and condensed tannins was 16.01 ± 0.16 mg CE/g DW and 8.30 ± 0.65 mg CE/g DW, respectively. The methanolic extract was found to exhibit antioxidant activity towards the DPPH radical, with an IC50 of 7.99 ± 0.28 mg/mL and a TAC of 30.30 ± 0.54 mg AAE/g DW, as well as an antibacterial effect, especially against P. aeruginosa. No significant wound-healing property was observed, even though the histopathological observations showed enhanced wound-healing quality. According to our evidence, E. spinosissimus could represent a source of phytochemicals with potential beneficial effects for human health in terms of antioxidant and antibiotic properties, although further investigations on this species are needed.

Analysis of Drug-Related Impurties by HPLC in Ciprofloxacin Hydrochloride Raw Material.

Objectives: In this study, we report the quality control results of drug-related impurity analysis of seven raw materials of ciprofloxacin hydrochloride marketed in Algeria. Materials and Methods: According to the European Pharmacopoeia (Eur. Ph.), high-performance liquid chromatography (HPLC) was used to analyze (B, C, D and E) impurities, while thin layer chromatography (TLC) used to control impurity A. Results: HPLC analysis showed that the C1, C2, C3, C4, and C6 samples have individual contents of specified impurities (B, C, D, E), unspecified and the total of all present impurities conform to norms. The C5 sample contains a very high content (0.579%) of impurity C, which is a photodegradation product and the impurities total (0.625%) exceeding limit, while C7 sample has a slightly higher content (0.118%) of unspecified impurity. The control solution of impurity A was not migrated in all developed TLC plates, so the system is not compliant, for this reason, an HPLC analysis protocol was developed. Conclusion: The results showed that impurity A content conformed in all samples except for the C6 sample, which has equal content to the limit. Therefore, we recommend revising the detecting technique of impurity A by TLC in the Eur. Ph. or replacing it with a more sensitive technique such as HPLC.