Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick's bites were suspected of ...generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence.
A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates.
Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P = 0.016). Sex (P = 0.53), premedication (P = 0.91), primary cancer location (P = 0.46) and chemotherapy regimen type (P = 0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P = 0.0015).
This study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs.
Palliative care (PC) is integrated into standard oncology care. However, its clinical impact at the end of life remains unclear in pancreatic adenocarcinoma (PA). We aimed to describe the end-of-life ...care pathway and to assess whether PC referral influences survival after chemotherapy discontinuation (CD) among advanced PA patients.
This retrospective single-centre observational study was conducted among deceased patients with advanced PA who had received chemotherapy between January 1, 2016, and December 31, 2021. Baseline characteristics, the timing of PC referral and events after CD were collected. The primary outcome was time from CD to death.
Among the 148 included patients, 53.4% (n = 79) received PC, mostly late after the CD (n = 133, 89.9%), 16.9% (n = 25) received chemotherapy in the last 14 days of life and 75.6% died at the hospital. None received PC in the 8 weeks following the diagnosis. PC referral significantly increased PC department admissions (p < 0.001) and decreased medical unit admissions (p < 0.001). The median survival after the CD was 35 days (IQR: 19–64.5). PC referral was associated with increased survival after CD (HR: 0.65 0.47–0.90, p = 0.010, Cox) and after adjusting (HR: 0.65 0.42–0.99, p = 0.045, Cox).
The study suggests that PC may be associated with longer survival after CD in advanced PA patients. However, PC is underused, and patients are referred late in their care pathway.
The evolution of community pharmacist education is guided by successive reforms. They aim to reduce the gap between academic education and community pharmacy practice but the perception regarding ...these reforms is poorly documented. The present study describes the cross-perceptions between community pharmacists, pharmacy students and academics teachers regarding the gap between academic education and community pharmacy practice, and, therefore, the essential knowledges and skills for the community pharmacy practice.
This study was conducted between April 2017 and April 2018 using an electronic survey for community pharmacists, academic teachers and pharmacy students. The results were discussed regarding previous studies with the aim to detect improvement points and vigilance related points.
This study shows that the pharmacy education program remains to be improved: 77% of respondents believe that there is a significant gap between the initial education program and the community pharmacy practice.
This cross-perception helps to better identify the several ways to improve the points of vigilance and the associated-barriers. All the propositions by the three groups of respondents prior ask for a better definition of the needed skills for community pharmacy practice before determine the most important knowledges and pedagogic methods to reach these. All these propositions seem consistent with reducing the gap between pharmacy education and community pharmacy practice but they also raise several questions about unicity of the pharmacy graduation in France.
Capecitabine and adermatoglyphia: trouble in border Mazza, C.; Slimano, F.; Visseaux, L. ...
Journal of the European Academy of Dermatology and Venereology,
June 2017, 2017-Jun, 2017-06-00, Letnik:
31, Številka:
6
Journal Article
Polypharmacy of elderly oncology patients and fragmented medication management are well‐known risk factors for drug–drug interactions (DDIs). These interactions can occur among antineoplastic, ...ongoing chronic treatment(s) and chemotherapy‐associated treatments, like antiemetics. Clinically relevant interactions based on enzyme‐ or transporter‐inhibition phenomena of active drugs can increase the frequency of their DDIs. We describe a strongly suspected elderly cancer patient's DDI between aprepitant and opium powder in the context of an irinotecan‐based regimen manifested by nightmares and visual hallucinations. We discuss this DDI's hypothetical pharmacological mechanisms and management.
Since 2013 French community pharmacist are involved in pharmaceutical care program (PCP) for patients treated with vitamin K antagonist (VKA). While PCPs are now extending to other patient ...populations, we aimed to evaluate pharmacists' perception after 2-years implementation and leading of PCP.
A prospective investigational survey from 1st August to 31st December, 2015 from 400 community pharmacies in Champagne-Ardenne Region. Survey focuses on 3 points: first about implementation and leading of PCP; secondly about patient's population description; finally on the global perception by CP about new tasks.
Among n=47, 72% of pharmacists performed VKA PCP. Almost all received appropriate training (96%). Remuneration appears to be insufficient given the time spent for 73%. Ninety-five percent met patient's refusal mainly because of interest lacking or time lacking (54% and 22%, respectively). Pharmacists reported 3 main lacks of knowledges of patients: drugs, which increase drug-drug interaction risk (28%), VKA overdose effects (27%) and VKA-food interactions (23%). Overall view of pharmacist for PCP appears to be positive (81%) in part because of improvement of pharmacist-patient relationship perception for 66%.
Community pharmacists' perception for PCP for patients treated by VKA is broadly positive. However, organizational or economic constraints can lead to a decreasing adherence by pharmacists to PCPs. A global issue about amount of compensation and communications campaigns to patients and others health professionals will be useful in order to reinforced PCP implementation and leading taxonomy.
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