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Oral syringes are the preferred method for delivering paediatric enteral drugs; however, little is known about factors affecting accuracy, particularly at volumes5 mL. We investigated volumetric accuracy for enteral syringes, using commercially available liquid drug formulations with various physicochemical properties at clinically relevant volumes.In vitro experiment.Ten drugs were tested using two syringe brands (Baxa, Medicina) across a range of formulation volumes (0.05-5 mL) and syringe sizes (1-5 mL). Syringe weights (empty and filled) were converted into volume, using known formulation densities. Ten replications were performed for each drug/syringe/volume combination.Delivered volume accuracy was expressed as a percentage of intended volume, with the desired range being within ±10%.Baxa demonstrated a slight positive bias (excess average volumes delivered) at the smallest volumes for each syringe size, while Medicina had poorer precision (greater variability, analysis of variance-interactions all p0.005). From these results, we identified the limit for volume accuracy for each syringe size and brand. Of note, the 1 mL syringe for both brands was inaccurate for delivering volumes ≤0.1 mL. The physicochemical properties of pH (range 2.82-7.45), surface tension (30.2-86.7 mN/m) and viscosity (2-299 mPaS) did not influence error in a discernible pattern.Dosing was inaccurate when small volumes were used across all syringe sizes and brands. These reflect volumes used in clinical practice. Administration error could potentially be reduced by (1) clinicians using syringes appropriate to dosing volumes and (2) manufacturers revising formulation concentrations for drugs.

Background Community-acquired pneumonia (CAP) is a frequent cause of morbidity, mortality and hospital admission worldwide. An adequate choice of empirical antibiotic treatment and appropriate severity assessment of the disease are key aspects in the management of CAP. Objective To audit the adherence to standards of care, such as empirical prescribing of antibiotics, and evaluate the current multidisciplinary approach to the management of CAP. Method Records of patients with CAP were identified and examined for CURB65 score documentation, discussion notes with microbiology and prescribed antibiotic treatments. Results Out of the 62 patients identified, 32 had a CURB65 score documented in their medical notes and 59 had documented chest X-ray findings. 85.5% of cases were compliant with antibiotic prescribing guidelines. Conclusion The multidisciplinary approach has considerably improved compliance with most of the standards, especially adherence to empirical antibiotic guidelines, and ultimately the standard of care for patients with CAP.

Pharmacists play a crucial role in the evaluation of the effectiveness of healthcare systems, as they are the only professionals who can measure mean health outcomes against the cost of medication use.1 Today, hospital pharmacists act as expert advisors in decision-making on the most cost-effective alternatives for medicines agencies or, locally, in hospital pharmacy commissions. Hospital pharmacists have also evaluated their own service. From the creation of pharmacy services until the last decade, various cost-effectiveness analyses have been conducted of pharmacy services.2–4 These analyses have aimed primarily to use economic impact as one of the main arguments in favour of the creation of pharmacy services within hospitals. It can be concluded that, in general, the pharmacy model has been demonstrated to be also profitable, and it is implemented all over the world. However, the evaluation of cost-effectiveness of hospital pharmacy services is based on interventions that included a full economic analysis but only performed in single centres or in isolated interventions in few kinds of drugs. But that profitability does not necessarily …

Objective The aim of this study was to quantify the level of knowledge of patients treated with fertility drugs before and after information was provided by a hospital pharmacist, the acceptability of this counselling, and patient treatment adherence. Materials and methods Infertile couples undergoing assisted reproduction techniques lasting 12 months were followed up through review of the patient9s medical notes, a personal patient interview and a structured questionnaire. Consecutive couples were enrolled. Clinical patient data were collected from the patient9s medical notes and patient medication knowledge was assessed by personal interview before and after pharmacy counselling. Acceptability by patients was evaluated using a questionnaire and adherence to treatment using hospital dispensing information. Results 61 patients were included and 22 (36.06%) completed the acceptability questionnaire. The global satisfaction rate was 92.4% (4.62 points out of 5). There was 100% patient adherence to treatment. The percentage of medication knowledge was 60.9% before pharmacist counselling and 90% (increase of 29.2%) after counselling. Conclusions This study provides reassurance of the high adherence to treatment of these patients. Patients are receptive to counselling and satisfied with pharmaceutical care. Information received and ease of staff contact were rated highest and pharmacy opening hours were rated lowest. The difference in knowledge before and after pharmaceutical counselling implies such care is beneficial.

Objectives The aim of the present work was to establish a specialised pharmaceutical care programme for patients with multiple sclerosis in order to analyse its effects on patient satisfaction, the detection of drug-related problems, and the identification and resolution of negative outcomes associated with medication. Methods This was a prospective, longitudinal study with a pre/post-exposure design regarding the pharmaceutical care programme implemented: in bimonthly visits the pharmacist identified, detected and resolved drug-related problems and negative outcomes, and also provided information about the treatment. All patients with multiple sclerosis treated with immunomodulatory drugs from 1 June to 31 December 2011 were included in the study. A Likert scale questionnaire was used before and 6 months after the implementation to assess its impact on perceived patient satisfaction. Results In all, 32 patients (20 women and 12 men), with an age of 39.7±8.3 years were included. A total of 26 were receiving treatment with interferon β and 6 with glatiramer acetate. All items assessing the pharmacist9s skills and interest in the patient along with those assessing the information received by the patient showed significant improvement (p Conclusions The implementation of a specialised pharmaceutical care programme led to a significant improvement in perceived patient satisfaction. It has also allowed for better detection of drug-related problems and identification and resolution of negative outcomes associated with medication.