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The present study assessed the criteria for initiating cytoreduction and response to conventional therapies in 1446 patients with essential thrombocythemia (ET), 267 (17%) of which were CALR-mutated. In low risk patients, time from diagnosis to cytoreduction was shorter in CALR-positive than in the other genotypes (2·8, 3·2, 7·4 and 12·5 years for CALR, MPL, JAK2V617F and TN, respectively, P < 0·0001). A total of 1104 (76%) patients received cytoreductive treatment with hydroxycarbamide (HC) (n = 977), anagrelide (n = 113), or others (n = 14). The estimated cumulative rates of complete haematological response (CR) at 12 months were 40 % and 67% in CALR and JAK2V617F genotypes, respectively. Median time to CR was 192 days for JAK2V617F, 343 for TN, 433 for MPL, and 705 for CALR genotypes (P < 0·0001). Duration of CR was shorter in CALR-mutated ET than in the remaining patients (P = 0·003). In CALR-positive patients, HC and anagrelide had similar efficacy in terms of response rates and duration. CALR-mutated patients developed resistance/intolerance to HC more frequently (5%, 23%, 27% and 15% for JAK2V617F, CALR, MPL and TN, respectively; P < 0·0001). In conclusion, conventional cytoreductive agents are less effective in CALR-mutated ET, highlighting the need for new treatment modalities and redefinition of haematologic targets for patients with this genotype., (© 2020 British Society for Haematology and John Wiley & Sons Ltd.)

Objective: To report on the results obtained from the 2019 SEFH National Survey regarding the service portfolio, care activities, training  programs and research work of Spanish hospital pharmacy departments., Method: In March 2019, SEFH designed and distributed a questionnaire containing 77 questions grouped into 8 domains to its 368  affiliated hospital pharmacy departments. The questionnaire included an  additional section on the activities carried out in 2017 and 2018., Results: The overall response rate was 54.3%. Sixty-nine percent of hospitals were public and 75% were general hospitals. A total of 88.6% of hospital pharmacy departments provided pharmaceutical care to inpatients, whereas 77.5% and 65% treated outpatients and  ambulatory patients, respectively. Sterile formulations were prepared by  70.6% of pharmacy departments, while 12% measured drug levels in  bodily fluids; 76.9% of hospitals with more than 1,000 beds prepared  pharmacokinetic reports. In 2018, hospital pharmacies provided for a  mean of 929 patients a month and 2,680 a year. The amount of  formulations (sterile and non-sterile) prepared was 10,394,492, sterile  formulations accounting for 62.6%. The average amount of clinical trials  managed in hospitals with ≥ 500 and ≥ 1000 beds was of 186.2 and  421.8, respectively. The median of number of undergraduate tuition  agreements between pharmacy departments and universities was 1 (IQR:  0-2); 21.5% of pharmacy departments had no agreements with any  university. The mean number of undergraduate pharmacy students per  hospital pharmacy was 4.12 (SD: 8,26). A total of 290 pharmacists were  associate professors at some university. Fifteen percent of pharmacists  held a certification from the Board of Pharmacy Specialties, 55.3% of them in the specialty of oncology. Hospital pharmacy departments employed a  mean of 1.31(SD: 2,23) PhD holders. From those which reported the  impact factor of their publications, 60% had an impact factor of zero while  in 19.6% the impact factor was ≥ 10., Conclusions: Care of out-patients and medication compounding are increasingly the main activities performed in Spanish hospital  pharmacies, while there is still considerable room for improvement in the  area of clinical pharmacokinetics. Pharmacy departments are generally  committed to training as a key activity, while scientific output is still limited despite the increase in the number of PhD pharmacist., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Objective: To publicize the results regarding the general characteristics, human resources, materials and information systems of Spanish hospital pharmacy  departments arising from SEFH's 2019 Survey on the Situation of Spanish  Hospital Pharmacy Departments., Method: An online questionnaire was sent to the heads of the 368 hospital pharmacy departments affiliated to SEFH. The questionnaire included 77 questions grouped into 8 dimensions. The information was collected between  March and September 2019., Results: The overall response rate was 54.3%. Sixty-nine percent of hospitals  were public and the most commonly reported hospital size was 101-250 beds.  Nine percent of responding hospitals remained open round the clock and 57.5%  did not offer a continued care service. A total of 41.9% of hospitals dispensed  medications to outpatients in the  afternoon and 52.7% of hospital pharmacy departments were accredited to some quality standard. The mean number of  specialist pharmacists per pharmacy Department was 5.34 (SD: 6.22); 47% of  pharmacists spent at least half their working day in a clinical unit. Hospital  pharmacy departments had a mean of 0.3 (SD: 0.7) or 0:9 (SD: 1.4) automated storage and dispensing carousels, depending on whether they were horizontal or vertical, respectively. A total of 16.1% of beds were assisted by automated  dispensing systems, a figure that reached 33.5% in hospitals with more than  1,000 beds. Three percent of hospital pharmacy departments had a robotized  system for compounding chemotherapy medications and 24.8% had a raceability and safety system. Smart infusion pumps were used by 21.4% of hospitals.  Electronic prescriptions were implemented in 98.8% of hospitals for inpatients  and in 62% for outpatients., Conclusions: Spanish hospital pharmacy departments face a shortage of  specialist pharmacists, although incorporation of such professionals to clinical  units has doubled in the last few years. There has been an increase in the level  of automation of the logistic processes involved in medication dispensing, but  there is still significant room for improvement in the area of robotized dispensing and compounding traceability systems. This data could play an invaluable role in the design of future action plans., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

BACKGROUND AND OBJECTIVE MYELOFIBROSIS: is an infrequent chronic myeloproliferative neoplasm. We aimed to describe the clinico-biological characteristics, treatment, and evolutive course of myelofibrosis patients in Spain., Material and Methods: A total of 1,000 patients from the Spanish Registry of Myelofibrosis diagnosed with primary (n=641) or secondary (n=359) myelofibrosis were analysed., Results: Median age was 68 years. The frequency of constitutional symptoms, moderate to severe anaemia (Hb<10g/dL), and symptomatic splenomegaly was 35%, 36%, and 17%, respectively. The rate of thrombosis and haemorrhage was 1.96 and 1.6 events per 100 patient-years, respectively. The cumulative incidence of leukaemia at 10 years was 15%. The most frequent therapies for the anaemia were the erythropoiesis stimulating agents and danazol. From 2010, a progressive increase in the use of ruxolitinib was noticed. A total of 7.5% of patients were transplanted. During the observation period, 42% of patients died mainly due to the clinical deterioration caused by myelofibrosis or leukaemic transformation. The median survival of the series was 5.7 years. Four different risk categories were identified by the IPSS: median survival was not reached in the low risk group and was 8.8 years, 5.3 years, and 2.8 years in the intermediate-1, intermediate-2, and high-risk groups, respectively., Conclusions: Myelofibrosis is a disabling condition mainly affecting elderly people. Its treatment is mostly driven by symptom control. Despite its clinical heterogeneity, several prognostic models are useful to select candidates for transplantation., (Copyright © 2019 Elsevier España, S.L.U. All rights reserved.)

Background and Objective: To examine the current status of safety practices for medication-use systems in Spanish hospitals and to identify major areas of risk., Material and Method: Those hospitals that completed the "Medication use-system safety self-assessment for hospitals" between June 1 and July 15, 2007, were included in the study. The survey contained 232 items for evaluation grouped into 20 core characteristics., Results: A total of 105 hospitals from the 17 autonomous communities in Spain participated in the study. The average aggregate score for the survey of all the participating hospitals was 612.7 (39.7% of the maximum possible score) and there were no differences found with regard to number of beds, training activity or type of hospital. When core characteristics were analyzed, there were 3 criteria with the lowest values (< 25%), associated with professional training, skills, and the establishment of a system for reporting errors. Another 9 criteria, with percentages between 25% and 50%, reflected practices related to: access to information regarding patients and medications; communication of medication orders; prevention of errors due to naming, labeling, and packaging problems; standardization of medication delivery devices; restriction of medications in patient care units; and safety culture and double-checking procedures., Conclusions: Many opportunities for improvement have been identified, particularly in areas related to training, risk management, incorporating new technologies and patient participation. The information obtained may prove useful for prioritizing practices when establishing patient safety strategies, and as a baseline for successfully monitoring the effectiveness of the initiatives and programs consequently set into motion.

Objective: To make available a consistent terminology and taxonomy that permits standardization in medication error detection, analysis, classification, and recording., Methods: A working group consisting of healthcare professionals from four hospitals of varying characteristics was established to develop the terminology and the taxonomy, which was validated through a qualitative analysis of 423 medication errors registered in the participating hospitals., Results: A document with a terminology and a taxonomy for classifying medication errors is presented., Conclusions: This document will facilitate analysis of the information collected on incidents caused by medication, and will allow comparisons to be made among data gathered in different kinds of settings. In addition, it will be a useful tool for medication safety committees in hospitals in their efforts to set up internal reporting programs designed to identify shortcomings in their medication use systems and to adopt effective measures to reduce the incidence of medication errors.