[Interest and difficulties in setting up pharmaceutical reconciliations for patients with dressings for complex wounds]. / Intérêts et difficultés de mise en place de conciliations pharmaceutiques pour les patients porteurs de pansements pour plaies complexes.

OBJECTIVES: The management of wounds is a commonplace activity in a patient's healthcare pathway. The involvement of the pharmacist in the management of complex dressings can help strengthen the continuity of this care thanks to the pharmaceutical reconciliation. The objective of this study was to improve the quality of information transmitted between the city and the hospital regarding complex wound dressings. METHODS: This is a prospective study consisting of two groups in three services (medicine, diabetology, vascular surgery): the control group corresponded to a classic patient care and in the intervention group, the pharmacists performed dressing reconciliations. A follow-up of the patients after coming back home was realized with healthcare professionals of city involved. RESULTS: Twenty patients were included in the control group and 19 in the intervention group. Entry conciliation has improved the quality and quantity of information on wounds transmitted between the city and the hospital. Exit conciliation has increased from 60 to 100% wound and dressing output prescriptions. One hundred percent of nurses surveyed were satisfied with the patients care. CONCLUSIONS: Reconciliation would improve information transmitted between the city and the hospital and avoid a break in the continuity of complex wounds cares. However, the time dedicated and the adhesion of the care services were difficulties encountered. This study is the first highlighting the interest of medical device reconciliation and could allow reconciliation extension toward other medical devices.

[Comparative profile of the use of filter needles in Quebec and France in healthcare facility]. / Profil comparé de l'utilisation des aiguilles filtrantes au Québec et en France en établissement de santé.

OBJECTIVES: The manipulation of drugs from glass ampules can generate particles when the ampule is broken. Several authors recommend the use of filter needle to withdraw the drug content. The main objective is to establish an inventory of the use of filter needles and the perception of pharmacists in Quebec and in France. METHODS: This is a cross-sectional descriptive study. A questionnaire was sent to all health facilities in Quebec (n=30) and a selection of hospitals in France (n=100). Respondents were asked to answer a questionnaire that included policies and procedures on the use of these medical devices and the conditions of their use at the pharmacy and in healthcare services. RESULTS: In total, 27 respondents from Quebec (response rate: 90%) and 41 respondents from France (response rate: 41%) participated in our survey. In Quebec, all exploitable questionnaires except one (42/43) used five micron filter needles at the pharmacy against 28% of utilisation in healthcare services. In France, this practice is nearly ignored. CONCLUSIONS: Action should be taken to decide on the use of filter needles including studies to confirm the consequences of the presence of these particles on an animal model, discussions with regulatory authorities to clarify the situation, incentives for manufacturers to use vials.

[Particulate contamination associated with the manipulation of drugs in glass ampules: A literature review]. / Présence de particules associées à la préparation de médicaments provenant d'ampoules de verre : revue de littérature.

OBJECTIVES: The manipulation of drugs from glass ampules can generate particles when the ampule is broken. Several authors recommend the use of filter needle to withdraw the drug content. The aim of this study is to make an assessment of the presence of particles during the manipulation of glass ampules and to discuss the current practices. METHODS: Literature review based on a search strategy (Pubmed, Google Scholar) and a summary table of available data. Analysis to evaluate the efficacy of the filtration when data are available. RESULTS: Eighteen articles have been included. Most of study shows the presence of particles in glass ampules. Important discrepancies reported regarding the number of particles per ampule. Analysis of data from seven studies: decrease of 83% of the total number of particles (>10µm) identified when drugs are removed with filter needle. All studies but two confirm the efficacy of filter needles. CONCLUSIONS: Studies show the presence of particles when drugs are removed from glass ampules. They do not allow to make a conclusion on human clinical consequences associated with the presence of particles. It is necessary to evaluate in human the risks associated with particle contamination to determine the optimal use of filter needle.

[The roles and the impacts of pharmacists in the management of medical devices at the hospital: A literature review]. / Rôles et retombées des pharmaciens dans la gestion des dispositifs médicaux en établissement de santé : une revue de littérature.

OBJECTIVES: Identify the training profile and the published evidences about the roles and the impacts of hospital pharmacists in medical devices. METHODS: A literature review was conducted using Google, Google Scholar and Pubmed for 1990-2016 associated with a manual search conducted in three non-indexed pharmaceutical journals for 2000-2016. RESULTS: The analysis of training programs available did not allow us to identify a specific training profile. A total of 72 articles related to the roles and the impacts of the pharmacist were identified, 52 of which came from non-indexed journals. Those articles did not deal specifically about the roles and the impacts of pharmacist; however, articles were analyses for three spheres including the referencing of medical devices (n=36), the evaluation (n=19) and the distribution system (n=13). CONCLUSIONS: French pharmacists have many theoretical and practical training opportunities. There are a few articles describing precisely the roles and the impacts of hospital pharmacists in medical device. It appears urgent to better document this activity in professional and indexed literature.