European Society of Clinical Pharmacy (ESCP) Copenhagen 2014

Workshop schedule, for the summaries of the Workshops, see below.

Wednesday, Oct.22; 13.30-15.30

WS04 The workplace as an educational environment for clinical teaching within everyday pharmacy

practice

WS08 Tailored communication in promoting medication intake behaviour

WS10 One Stop Dispensing on a Danish hospital ward - how to convince nurses to dispense

medicine bedside

WS12 The clinical pharmacist as a link in the medication process

WS13 STOPP-START Version 2 - Polypharmacy Care of the Older Person What is the potential

role of a pharmacists

WS17 How to recognize homecare patients who benefit most of clinical pharmacy services

WS18 Safety monitoring of patients on psychiatric pharmacotherapy

WS20 NNT game_ NNT NNH and TUB and their use in developing a pharmaceutical care plan for individual patients

WS22 Challenges in discontinuation of medicine; N-of-1 trials as an individualized treatment

approach

Wednesday, Oct.22, 16.00-18.00

WS01 Writing Original Papers

WS03 The Challenge of Competent Pharmacists in Individualized Pharmaceutical Care Plan

WS06 Medication use in pregnant and breastfeeding women - useful information sources

WS09 From Socrates to Georgetown - Ethical Problems in Pharmacy Practice

WS11 Mismatch between Regulatory Affairs and Clinical Practice

WS19 Workplace learning and assessment in the (post)graduate education of pharmacists

WS21 Pharmacoeconomics a practical approach to assessing the literature

WS23 Health Information Technology and Patient Safety

WS24 CDSCP2 Tackling drug-drug interactions clinical decision support vs clinical pharmacists

Thursday, Oct 23, 13.30-15.30

WS05 Role of the pharmacist to assure efficacy and security of medications in Nursing homes

WS07 Sharing Care of Medicines across Primary and Secondary Care

WS09 From Socrates to Georgetown - Ethical Problems in Pharmacy Practice

WS15 Student-led med review_ A debate- Pharmacy students should receive training in medication

review with real patients

WS16 TDM Workshop _ Therapeutic Drug Monitoring

WS19 Workplace learning and assessment in the (post)graduate education of pharmacists

WS20 NNT game_ NNT NNH and TUB and their use in developing a pharmaceutical care plan for individual patients

WS23 Health Information Technology and Patient Safety

WS25 Supporting development of Advanced Clinical Pharmacy Practice to ensure Patient Safety

Thursday, Oct.23, 16.00-18.00

WS02 Getting abstracts accepted

WS03 The Challenge of Competent Pharmacists in Individualized Pharmaceutical Care Plan

WS08 Tailored communication in promoting medication intake behaviour

WS10 One Stop Dispensing on a Danish hospital ward - how to convince nurses to dispense

medicine bedside

WS14 Developing a patient safety focused systematic review protocol

WS16 TDM Workshop _ Therapeutic Drug Monitoring

WS17 How to recognize homecare patients who benefit most of clinical pharmacy services

WS18 Safety monitoring of patients on psychiatric pharmacotherapy

WS22 Challenges in discontinuation of medicine; N-of-1 trials as an individualized treatment

approach

Friday, Oct.24, 13.30-15.30

WS05 Role of the pharmacist to assure efficacy and security of medications in Nursing homes

WS06 Medication use in pregnant and breastfeeding women - useful information sources

WS07 Sharing Care of Medicines across Primary and Secondary Care

WS11 Mismatch between Regulatory Affairs and Clinical Practice

WS12 The clinical pharmacist as a link in the medication process

WS15 Student-led med review_ A debate- Pharmacy students should receive training in medication

review with real patients

WS21 Pharmacoeconomics a practical approach to assessing the literature

WS24 CDSCP2 Tackling drug-drug interactions clinical decision support vs clinical pharmacists

WS25 Supporting development of Advanced Clinical Pharmacy Practice to ensure Patient Safety

WS01

Successful Scientific Writing: original research papers.

ESCP Communication Committee

Moderator:

Dr. J.W.Foppe van Mil (FESCP), Pharmacy Practice Consultant, member of the ESCP SIG-

MI and of the Communication Committee of ESCP, Editor-in-Chief of the International

Journal of Clinical Pharmacy (previously PWS). Perhaps the workshop will be co-moderated

by another member of the Communication Committee.

Background:

The results of scientific research are only valuable for society, if they can be shared with

others in an understandable written or oral format. There are several possible formats for

written information such as abstracts or scientific articles. Writing research papers that can be

accepted by a peer reviewed journal, can be a challenging experience. There are a number of

important aspects that authors should pay attention to, and that will facilitate acceptance. The

reason behind the different sections of articles will be explained.

This workshop will especially focus on scientific articles in the format for the International

Journal of Clinical Pharmacy but most other scientific journals have similar compulsory

formats.

After an introduction, the participants will study and discuss examples of the different stages

of scientific papers in smaller groups, the selection of appropriate journals and important

issues such as impact factors and authorship.

Learning objectives

After the workshop, the participant should be able to:

- Understand the structure and elements of a quality scientific paper;

- Select an appropriate journal for his publication(s)

- Understand the differences between the different peer reviewed scientific journals;

WS02

Successful Scientific Writing: getting conference abstracts accepted.

ESCP Communication Committee

Moderator:

Dr. J.W.Foppe van Mil (FESCP), Pharmacy Practice Consultant, member of the ESCP SIG-

MI and of the Communication Committee of ESCP, Editor-in-Chief of the International

Journal of Clinical Pharmacy (previously PWS). Perhaps the workshop will be co-moderated

by another member of the Communication Committee.

Background:

There are several possible formats for written scientific information such as abstracts or

scientific articles. Writing a good conference abstract is important because it may lead to

having an (oral) presentation at a conference.

Writing conference abstracts that will be accepted for presentation at a conference, is a

challenging experience. Apart from writing a condensed text, that represents the study well,

there are a number of other important aspects that will facilitate acceptance.

This workshop will focus on abstracts, such as expected by ESCP. But participants will also

discuss more general and ethical considerations about submitting abstracts, such as

authorships and responsibilities.

After an introduction, the participants will study and discuss examples of the different stages

of abstracts in smaller groups.

Learning objectives:

After the workshop, the participant should be able to:

- Understand the structure and elements of a quality conference abstract;

- Select an appropriate conference and presenter for the study

- Understand the differences between the different scientific presentation platforms;

WS03

The Challenge of Competent Pharmacists in Individualized Pharmaceutical Care Plan

ESCP Education Committee

Moderators:

Assist.Prof.Dr. Betl Okuyan, Marmara Univ. Faculty of Pharmacy, Clinical Pharmacy DeptTurkey Coordinator of Clinical Clerkships of Pharmacy Students

Assoc.Prof.Dr. Mesut Sancar, Marmara Univ. Faculty of Pharmacy, Clinical Pharmacy DeptTurkey Coordinator of Clinical Clerkships of Pharmacy Students

Prof.Dr. Fikret Vehbi Izzettin (FESCP), Marmara Univ. Faculty of Pharmacy, Clinical

Pharmacy Dept.Turkey,Head of Clinical Pharmacy Department and Head of Society of Clinical Pharmacy in Turkey

Background: When the competent pharmacists decide to perform pharmaceutical care; which has been

defined as taking professional responsibility of pharmacists as health care professional in

patients medication therapy for achieving definite therapeutic outcomes to promote patients quality of life; they should be ready to find solutions if the medication related problems has

been occurred and they should have skills to predict potential medication related problems.

Pharmaceutical care involves the process through which a pharmacist cooperates with a

patient and other professionals in designing, implementing, and monitoring a therapeutic plan

that will produce specific therapeutic outcomes for the patient. Personal and clinical skills are

important in solving and preventing medication related problems. The pharmacist intervention

including efficient patient education and drug monitoring would also improve patients adherence to therapy. Pharmaceutical care plan should be designed according to patients individualized needs. The aim of this workshop is to show the requirements and needs of

competent pharmacist during individualized pharmaceutical care program.

Content and Structure:

30 minutes: Introduction

Introduction of workshop tutors

Explanation of the aim of workshop

Brief information on basic principles of pharmaceutical care

How can we do pharmacist as a competent for providing pharmaceutical care? Needs, tools,

education and training for good pharmaceutical care plan

30 minutes: Group Study

Different cases will be studied by small groups to identify the requirements of pharmacist and

also promote skills of pharmacist to be active in individualized pharmaceutical care plan.

40 Minutes: Presentation of group recommendations for case scenarios.

20 minutes: Evaluation of workshop and conclusion

WS04

The workplace as an educational environment for clinical teaching within everyday

pharmacy practice

ESCP SIG Education & Training

Moderators:

Caroline Souter, Principal Pharmacist, Education, Research & Development, NHS Lothian

and Honorary lecturer University of Strathclyde and

Moira Kinnear, Head of Pharmacy Education, Research & Development NHS Lothian,

Honorary senior lecturer University of Strathclyde and co-ordinator of ESCP Education &

Training SIG

Aim:

This workshop intends to introduce participants to the value of patients as a learning

opportunity and the workplace as an educational environment in which pharmacists can teach

as an integral part of their busy clinical practice.

Learning Objectives:

At the end of the workshop, participants will be able to

Recognise the attributes of an effective clinical teacher-practitioner

Describe different models for providing informal impromptu clinical teaching in the workplace to support professional development of junior pharmacists/students

Describe the challenges and benefits of the workplace as an educational environment in terms of patient, teacher, student and service factors


Introduction (5 mins)

Tasks / Groupwork (20 mins):

Share experiences of clinical teaching within the workplace.

Discuss the challenges and benefits of the workplace as an educational environment in terms of patient, teacher, student and service factors

Discuss the attributes of an effective clinical teacher Feedback (10 mins)

Presentation / video clips (20 mins) Description of models used in impromptu clinical

teaching. Show clips of teaching experiences.

Tasks (30 mins)

Scenarios will be provided to allow participants to practice teaching using these models

Feedback (15 mins)

Summary and Close (5 mins)

WS05

Role of the pharmacist to assure efficacy and security of

medications in Nursing homes

ESCP SIG Geriatrics

Moderators:

Georges L. Zelger, (FESCP), PhD, PD, University of Geneva

Louise Mallet, (FESCP), B.Pharm., Pharm.D., FESCP, Professor, Faculty of pharmacy,

University of Montreal, Clinical pharmacist in geriatrics, McGill University Health Centre

Background:

The organisation of medication delivery system and medication review in

Nursing Homes are often inadequate and unsafe.

Aim:

Create a contract specification for the tasks of a pharmacist in a Nursing

Home


Prioritise the role of the pharmacist in a Nursing home in view of efficacy

and safety of the medication


Critics from patients and families have led politicians responsible for

health care services to reconsider aspects of the medication safety in

Nursing homes. Some countries have published guidelines or

recommendations for medication treatments with the collaboration

between physicians and pharmacists in these structures.

It is important, that pharmacists are aware of the different problems and

take the lead for proposing ways to assure medication safety in Nursing

homes.

The workshop will present different interventions that have been

implemented in some countries.

Participants will contribute to create a contract specification that could

serve as a base for further discussions with nursing home managers

WS06

Medication use in pregnant and breastfeeding women: useful information sources

ESCP SIG Medicine Information

MODERATORS: Charlotte Verrue, Pharmaceutical Care Manager, Multipharma, Brussels, Belgium

Yolande Hanssens (FESCP), Leader SIG Medicine Information

Hamad General Hospital, Pharmacy Department, Doha,Qatar

BACKGROUND:

Often, there is a need to decide if a (future) mother will receive more benefits or more harm

from a given treatment that she might require for a disease.

However, little scientific evidence is available, since pregnant and breastfeeding women are

still often excluded from clinical trials due to potential health risks for the mother and / or

potential harm to the foetus or infant.

Moreover, with an increasing emphasis on breastfeeding, more reliable information sources

are needed in daily pharmacist practice, whether it is in a hospital or primary care setting.

AIM OF THE WORKSHOP: This WS will provide the participants with practical tools and useful information sources for

the pharmaceutical care of pregnant and lactating women.

It will also allow participants to share their information sources with their colleagues.

LEARNING OBJECTIVES:

To appreciate the need for specific medication information in this population.

To get an insight in specific references and dosing tools for these selected patients.

To become familiar with information sources providing relevant details about drug dosing in

pregnant and/or breastfeeding women.

CONTENT & STRUCTURE OF THE WORKSHOP: Introduction and background 15 min

Practical clinical guidance, sources of information 20 min

Case studies in small groups 50 min

Feedback from the groups 25 min

Conclusion & take home messages 10 min

WS07

Sharing Care of Medicines across Primary and Secondary Care

ESCP SIG Integrated Primary Care

Moderators: Dr Simon Hurding, General Practitioner, Medicines Management Team, NHS Lothian,

Edinburgh, Scotland, UK

Katherine Davidson, Senior Clinical Pharmacist, Transplant Unit, Royal Infirmary of

Edinburgh, NHS Lothian, Edinburgh, Scotland, UK

Aim: To encourage and promote group participation for developing skills required for safe shared

care of complex medicines across primary and secondary care. Learning Objectives After

the workshop, participants should be able to:

1. Describe how pharmacists can support and facilitate the safe transfer of prescribing and

monitoring of medicines from acute to home setting.

2. Explore how healthcare professionals can work together with patients to ensure that the

best possible care is provided in the right place.

3. Describe how medicines governance processes can support safe and effective shared care

of medicines.

Background: Shared care arrangements aim to facilitate the seamless transfer of individual patient care

from secondary care to general practice. They are intended for use when medicines, often

prescribed for potentially serious conditions and complex by their very nature, are initiated in

secondary care and then prescribed by GP in primary care. These medicines will often have a

relatively high adverse effect profile and may require specific monitoring. Examples of shared

care arrangements include immunosuppression in solid organ transplantation and disease

modifying anti-rheumatic drugs (DMARDS). Clearly defined processes and good

communication are essential components of shared care. Prescribers must be aware of their

responsibilities when prescribing and primary care prescribers must receive comprehensive

information to allow safe and effective prescribing. Clear communication, effective

collaboration between patients and healthcare professionals and smooth continuity of care are

key elements for a robust healthcare quality strategy. Within NHS Lothian, shared care is

supported through local medicines governance structures. This includes a policy to ensure

clear definitions and roles and responsibilities of the different professionals involved. A

standardised template is used to ensure safe transfer of information which ensures use of

current prescribing information.


This workshop will focus on the how pharmacists can contribute to shared care at various

stages, including collaborating with the clinical team to prepare and communicate supporting

documentation, participating in the medicines governance committees, and implementing and

supporting adherence. The workshop will be run in an interactive way with a GP and a

pharmacist and will include:

Short presentations

Group work on clinical scenarios

Feedback

WS08

Tailored communication in promoting medication intake behaviour

ESCP SIG Medication Adherence

Moderators:

Dr A (Annemiek) Linn, University of Amsterdam/Amsterdam School of Communication

Research, Amsterdam, Netherlands

Dr BJF (Bart) van den Bemt, Sint Maartenskliniek/Radboud University Medical Centre,

Nijmegen, Netherlands

Background

Communication is a powerful tool to promote successful medication intake behaviour.

Previous research, for example, demonstrated that patients of providers who communicate

well have a 19% higher medication adherence than patients with less effective communicating

providers. Patients have different reasons for not taking the medication as prescribed and

desire different types and amounts of medication related information. Tailored

communication seems a promising strategy when improving medication intake for several

reasons. First, communication strategies that are tailored to the needs of the patients are

related to reduced perceived barriers to medication intake behaviour. Second, high quality

tailored information, as perceived by the patient, can also be beneficial in helping patients to

overcome their concerns and/or perceived need of taking the medication. Third, tailored

information will get more attention and might also be better recalled which leads to improved

medication intake behaviour.

Aim:

This workshop will bring together participants in order to learn more about the theoretical

basis of tailored communication, learn more about communication techniques for tailored

communication and subsequently practice their theoretical knowledge in group sessions with

patient cases.


At the end of the workshop participants:

Know the advantages of tailored communication and know strategies to cope with patients barriers which can be practical or emotional

Is familiar with a communication typology to address barriers to successful medication intake

behaviour (and is able to apply this in practice)

Is able to explore and recognize possible barriers for successful medication intake behaviour

Can use the different communication strategies tailored to patients individual barriers


00.00 Introduction (BvdB)

00.10 Stimulus presentation I communication typology to assess patients barriers for successful intake behaviour and affective communication(AL)

00.20 Group session: participants will practice affective communication techniques to

explore patients barriers for successful intake behaviour (based on patient cases). Plenary feedback round

00.45 Stimulus presentation II Communication strategies to address patients barriers 01:00 Group session: participants will practice communication techniques to improve

patients intake behaviour based on individuals barriers

Plenary feedback round

01.25 Stimulus presentation III Coping with emotional reactions 01.35 Group work: participants will practice communication techniques to improve

participants abilities to cope with emotional reactions. Plenary feedback round

01.50 Summary

02.00 Close

WS09

From Socrates to Georgetown - Ethical Problems in Pharmacy Practice

Moderators:

Professor Alan Greenberg, Wegmans School of Pharmacy, Rochester, New York.

Chairman, Ethics Committee, Israel Pharmacy Association.

Dr. Rudolf P. Dessing (FESCP), Ph.D, Ligusterweg 1, 2202AD Noordwijk,

NETHERLANDS

Background:

Over the past few decades the profession of pharmacy has changed from a product centered to

a more patient orientated profession. This has been accompanied by intense regulation to the

point of claims of over-regulation. Pharmacists are often so concerned with regulation that

they do not relate to ethical issues that arise in their daily practice. Pharmacists are also

insufficiently prepared for the ethical problems arising from their clinical involvement. There

is a need to rectify this imbalance. Pharmacists need to acquire skills in identifying ethical

problems in their daily practice and tools to manage them.

Aim:

The aim of this workshop is to introduce the participants to important values in western

society that are the basis of our ethical principles and recognize different values within

different cultures. Through the understanding of these values ethical problems can be

identified. The participants will also learn methods of analysing problems and formulating

solutions.

Learning Objective:

After this workshop the participants will:

Be able to identify ethical dilemmas that occur in pharmacy practice.

Analyse the dilemma and formulate options for action using the four stage process.

Be able to defend the chosen option.


The workshop will start with an introduction to ethical principles and values as formulated by

philosophers and health professional ethicists. The four stage method of dealing with ethical

problems will be presented. (Appelbe et al. 2002)

Participants will then be divided into small groups, each one dealing with a different problem

taken from common pharmacy practice.

Each group will report on their problem, justify and defend their action through discussion of

the different ethical values learned.

The moderators will summarize the presentations and problems relating to the group

discussions.

WS10

One Stop Dispensing on a Danish hospital ward - how to convince nurses to dispense

medicine bedside?

Moderators:

Morten B. Andersen, The Capital Region Pharmacy, Hvidovre hospital, Denmark

Marie-Louise Duckert, The Capital Region Pharmacy, Hvidovre hospital, Denmark

Helle Mcnulty, The Capital Region Pharmacy, Denmark

Background:

The Danish healthcare sector is constantly challenged to improve the efficiency with the

objective to get the most health value. Clinical pharmacy in Denmark has in recent years

undergone a rapid and comprehensive development. Despite the fact that for a long period

focuses has been on developing and improving the quality of the traditional medication

system, dispensing and administration of drugs remain a resource consuming process during

hospitalization and at discharge. In the health sector numerous initiatives has been made to

reduce the number of medication errors, but only a few are in operation. Patients and their

relatives represent a major unused resource in health care. The patient role is changing and the

focus of today -and tomorrows health care system is patient involvement, patient control and support of the patients own resources also known as "patient empowerment. It now appear to be a good time to rethink a patient centered, cost-neutral and safe medication system. In the

late 1990s the UK started a similar change which resulted in the medication system "One Stop

Dispensing". The name One Stop Dispensing refers to the practice where the dispensing of

medicine, from admission to discharge, is performed in one process. All patients in the UK

are encouraged to bring and use their own medicine when hospitalized and ambulance staff is

trained to bring patients medicine in at admission. At the hospital a pharmacist record an

updated medication history, perform a medication review and check the quality of the

patient's own medicine. The Hospital pharmacy supply medicine in original packages if the

patient is missing usual medication or a new treatment is initiated when hospitalized. At

admission patients always self-administer their own medicine if it is considered possible and

safe. Otherwise patients receive help with their medication bedside. At discharge all

medication from the locked medicine box, follows the patient, usually there is enough for 14

to 21 days. This pilot study was made in collaboration between The Capital Region Pharmacy

and Amager-Hvidovre Hospitals.

Aim:

1) To introduce and test the medication system One-Stop Dispensing on a Danish ward. 2) To

presented

the initial results from the pilot study and reflect professionally on them. 3) To help

constructively in

optimizing the medication process and make the patient more involved in it..


The participants will learn about the medication system One Stop Dispensing - its advantages,

disadvantages and challenges of implementation in an interdisciplinary collaboration on a

ward. In addition,

the participant's innovative thinking and problem-solving will be used to continue

development of the

medication system for use in the clinic.


1: Introduction to One-Stop Dispensing (10 minutes).

2: Review of the Danish One-Stop Dispensing model and results from the pilot study (15

minutes).

3: Discussion and problem solving in groups (35 minutes).

4: Presentation of the groups solutions (15 minutes).

WS11

Mismatch between Regulatory Affairs and Clinical Practice

Moderators: Professor Hanne Rolighed Christensen, MD, PhD, Head of Department for Clinical

Pharmacology

University Hospital, Bispebjerg , Copenhagen, Denmark

Professor Steffen Thirstrup, MD, PhD , NDA Advisory Services and University of

Copenhagen

Copenhagen, Denmark

Background: Medicines are highly regulated products. This is primarily to ensure that medicines are safe

and efficacious, but also to create a marketplace where the pharmaceutical industry has a

reasonable chance to capitalize its investment in drug development and to stimulate

innovation. The EU Regulation defines among others rules for data-protection (patents), the

scientific requirements to support indications and sets the legal boundaries for obtaining a

marketing authorisation. Moreover, specific regulations are in place for areas such as orphan

medicinal products, advanced therapies, biosimilars and medicines for use in children.

This legal framework is sometimes found to be in opposition to practical clinical used of

medicines or merely to be out of pace with the scientific knowledge in a specific therapeutic

area. As an example, use of medicines outside its approved indication (i.e. off-label) creates

controversies around liability as well as healthcare economics. And although off-label use

must be based on the highest possible level of scientific evidence clinicians struggle with how

to create, collect and transform this evidence into useful clinical guidance when this in fact is

outside the legal framework for medicines. Moreover, the EU paediatric Regulation which

were put in place to stimulate the development of medicines for children can in some

circumstances have the opposite effect forcing doctors into more off-label prescribing.

Aim: Discuss and reflect on controversial topics in daily clinical practice as a result of how

medicines are regulated.

Learning Objectives: Exchange clinical experience and enable the participants to identify clinical problems related

to regulatory decision and create solutions on a higher, more informed, level.

Content and Structure: Interactive session with short plenary lectures and group wise discussions based on

controversial cases from real life

WS12

The clinical pharmacist as a link in the medication process

Moderators:

Rikke Nrgaard Hansen, M.Sc. Pharm.

Annette Nissen Gubi, M.Sc. Pharm.

Tina Buch, M.Sc. Pharm.

The Pharmacy of the Capital Region of Denmark, Pharmacy Department North at North

Zealand Hospital, Hillerd, Denmark

Background:

Hospital wards have different resources and expectations for pharmaceutical services. The

constellation of pharmaceutical professionals can therefore appear in different forms, for

example, full time pharmacist assistance without additional pharmaconomist assistance, full

time pharmacist assistance with additional pharmaconomist assistance and fulltime

pharmaconomist assistance with additional pharmacist assistance. The pharmaceutical service

may imply fields as dispensing and administration of medication, discharge conversations

with patients and quality assurance of the medication process.

Lack of flow in the medication process may resolve in waste of time for healthcare

professionals, which are costly and compromise patient safety. Pharmacists can act as a link

between different healthcare professionals to improve patient safety due to the pharmacist's

constant focus on medicine and quality of the medication process. In a hospital ward, the

pharmacist can act both as a sparring partner and an inspector. The pharmacist may have

different roles depending on which healthcare profession the pharmacist collaborates with.

The collaboration with healthcare professionals evolves as the role of the pharmacist

maintains defined. The pharmacists visibility is part of the development of the cooperation with other healthcare professionals. Through this the pharmacist's professional competencies

can be fully utilized.

Aim: The aim of the workshop is to illustrate and discuss different ways in which a pharmacist as a

relatively new profession in the clinic can contribute to the optimization of flow in the

medication process from admission to discharge through collaboration with different

healthcare professionals and thereby increase patient safety and quality of the medication

process. This including discussion of the pharmacist's role as an inspector vs. sparring partner,

the visibility of the pharmacist, setting, time available and the aim of the pharmacist's

presence.


Be aware of how pharmacists can work as a link in the medication process and thereby contribute to the optimization of flow in the medication process.

Could relate to how the function as a link and a quality person contributes to patient safety.

Be able to assess when you, as a pharmacist, are an inspector and when you are a sparring partner and how to use this actively and in relation to other healthcare

professionals.

Have knowledge of the importance of communication with different groups of healthcare professionals and the role as a link in the communication between the

different groups of healthcare professionals.

Be aware of the importance of the pharmacists visibility.

Be aware of the model of the pharmaceutical service (consider options and opting-out) depending on aim, setting, time available and collaborators.


The workshop will take place through the combination of presentation in a plenary session,

group discussion and plenary discussion.

The workshop appeals to pharmacists who need to establish themselves in a health care

system where pharmacists are a relatively new profession.

WS13

STOPP/START Version 2 - Polypharmacy, Care of the Older Person, What is the

potential role of a pharmacists?

Moderators: Dr. Stephen Byrne, Professor of Clinical Pharmacy Practice at the School of Pharmacy,

University College Cork, Ireland.

Mr Shane Cullinan, Research Pharmacist (PhD candidate working with Prof Byrne)

Background:

Inappropriate medication use is extremely prevalent among older people, particularly in those

presenting with acute illness. Certain medicines are considered potentially inappropriate in

older individuals because of the higher risk of adverse drug events or disease / drug

interactions. These observations have formed the core for various sets of criteria for

potentially inappropriate medication in older people, the most cited of which are Beers criteria and STOPP/START criteria. This research group have updated their criteria in the last

6 months and version 2 will be published during the summer period of 2014. This workshop

will compare the findings from peer reviewed studies using both of the updated Beers and

STOPP criteria, and demonstrate via cases studies and discussion the role of pharmacist in the

identification of potentially inappropriate medicines by the applications of validated screening

tools within a structured medication review / care plan. We will draw on the expertise of the

workshop participants to identify and prioritise interventions to address the needs of the older

patient.


To understand the significance of potential inappropriate prescribing and identify opportunities for the pharmacist to implement validated screening tools in their

everyday practice.

To understand the significance of potential inappropriate prescribing via the examination of cases studies and discussion groups.

To ensure that older patients receiving multiple pharmacotherapies receive optimal pharmaceutical care.

Content and structure:

30 minutes - Review of screening tools and key publications.

45 minutes - Small group review of case scenarios (each group will be allocated 2 out of a possible total of 6 scenarios i.e. allowing approximately 20 minutes per case).

40 minutes feedback / general discussion with regards to the application of the validated screening tools and the prioritisation of pharmaceutical interventions.

5 minutes to spare for overrun

WS14

Bridging the gaps: developing a patient safety focused systematic review protocol

Moderators:

Katie MacLure, MSc, BSc (Hons), DipSysPrac, PgCert, MBCS, AFHEA

Researcher, School of Pharmacy & Life Sciences, Robert Gordon University, Aberdeen,

Scotland

Dr Vibhu Paudyal, BPharm, MSc, PG Cert, PhD, SRPharmS, Lecturer in Pharmacy Practice

& Clinical Pharmacy, School of Pharmacy & Life Sciences, Robert Gordon University,

Aberdeen, Scotland

Advisor: Professor Derek Stewart, PgCert, BSc (1st), MSc, PhD, MRPharmS

Professor of Pharmacy Practice, School of Pharmacy & Life Sciences, Robert Gordon

University, Aberdeen, Scotland

Background:

The World Health Organization describes patient safety as, the coordinated efforts to prevent

harm, caused by the process of health care itself.1 A 2009 European Parliament directive

made clear the priority to, support the establishment and development of national policies

and programmes on patient safety.2 Evidence based practice is fundamental to the

development and delivery of patient safety policies underpinned by cumulative science.3-5

Systematic reviews adopt a rigorous and reproducible approach aimed at reducing bias and

errors during the identification, appraisal and synthesis of relevant studies.3 Pharmacists can

benefit from gaining experience of the processes involved in undertaking and reporting

systematic reviews, considering where application of high quality findings can bridge the

evidence gaps and so promote safety and efficacy of pharmaceutical interventions. A well

formulated protocol is an essential component of a systematic review but it can be daunting to

write and requires a skilled, supportive team to share relevant expertise.6

Aim:

The aim of this workshop is to give pharmacy practitioners experience of developing a patient

safety focused systematic review protocol in a supportive environment. It provides extended

learning for those who may have previously attended our systematic review workshop (ESCP

2013) but will be equally valuable to those without prior learning.


On completion of the workshop, the participants will be able to:

1. Evaluate and reflect on the role of evidence based practice to inform patient safety policy

2. Appreciate the role and essential components of a well written systematic review protocol

3. Reflect on experience and confidence gained from developing a systematic review

protocol, as a team, in the workshop setting

4. Outline options for registering a systematic review protocol.


The moderators will draw on their experience and expertise to encourage interaction and

participation through small group based activities using a range of well-developed and

tailored workshop and take home materials.

Introductions including an:

Overview of the workshop and brief presentation on the role of systematic reviews in

evidence based practice

Activities (facilitated in small groups):

What should be there: elements of a systematic review protocol

What we want to know: formulating a systematic review question

Writing the protocol as a team: designing a systematic review protocol based on a

given patient safety background and question

Presentations and feedback

Each group presents their systematic review protocol

Feedback and reflection on the process

Guidance on registering a systematic review protocol

References

1. World Health Organization (2014) Ten Facts on Patient Safety. Available from:

http://www.who.int/features/factfiles/patient_safety/en/ [Accessed 10 January 2014]

2. European Commission (2009) Council Recommendation on patient safety, including

prevention and control of healthcare associated infections. Available from:

http://ec.europa.eu/health/patient_safety/policy/index_en.htm [Accessed 10 January

2014]

3. Higgins JPT, Green S (editors) (2011) Cochrane Handbook for Systematic Reviews of

Interventions Version 5.1.0. Available from: www.cochrane-handbook.org [Accessed 07

March 2013]

4. Mays N, Pope C, Popay J (2005) Systematically reviewing qualitative and quantitative

evidence to inform management and policy-making in the health field. Review Journal of

Health Services Research & Policy, 10 Supplement 1:49-50

5. Lavis J, Davies H, Oxman A, Denis JL, Golden-Biddle K, Ferlie E, 2005. Towards

systematic reviews that inform health care management and policy-making. Journal of

Health Services Research & Policy, 10 Supplement 1: pp. 35

6. Centre for Review and Dissemination (2009) CRDs guidance for undertaking reviews in

health care. University of York: CRD

WS15

A debate: Pharmacy students should receive training in medication review with real patients.

Moderator:

Mr. Richard Adams, Pharmacist and Educator, University of East Anglia, Norwich, UK

Background:

There is abundant evidence that whilst medicines are central to the healthcare of millions of

people, the outcomes are reduced due to prescribing errors, lack of monitoring and adverse

drug reactions. This is compounded by the failure by patients to take medicines as agreed with

their doctor.

In many countries medication review, in a variety of forms, has been introduced to both

provide information to the patient and to obtain information from them and the medical record

in order to improve health outcome via medicines.

However, few countries provide significant training to undergraduate pharmacy students with

real patients, relying more on experience in the workplace.

N.B. The moderator has undertaken research in this area which forms part of his thesis, with

publications planned soon.

Aim:

This workshop will take the form of a short talk, a discussion on methods and then a debate to

decide if pharmacy students should receive training with real patients in medication review.

Learning outcomes:

knowledge of the evidence base regarding experiential teaching of pharmacy students.

knowledge of different methods of experiential learning,

an exchange of opinions from the debate,

knowledge of the factors contributing to an effective student placement.


A short presentation outlining current evidence base surrounding experiential learning for

pharmacy students with respect to medication review with patients.

(15 minutes)

In two groups, participants will debate and define the best method of implementing an

experiential learning curriculum for pharmacy students. Groups, with guidance, will:

agree student learning outcomes,

decide what is needed from the placement host, students, patients, medical practices and universities,

agree if the scheme could provide benefit (to whom?).

Then the groups will debate the topic of experiential learning with patients.

Preparation time will be provided.

Groups will learn equally from arguing for or against the proposal and will hear the arguments

of the other team.

The Debate instructions and structure:

1. Opening Statements

2. Oral Arguments Presenting the factual evidence that supports the teams position.

3. Short team discussion to prompt the speaker

4. Rebuttal Arguments Counter evidence to highlight weaknesses in the oppositions argument.

5. Summaries Summarizing the key points presented. Concluding with a persuasive argument that will

win the debate.

A summary of the group findings will be provided.

WS16

Therapeutic Drug Monitoring

Moderator: Khidir, Mohamed Elhassan Mohamed, MSc Clinical Pharmacy, Mafraq Hospital, Abu Dhabi,

United Arab Emirates

Background:

Therapeutic Drug Monitoring (TDM) involves measuring drug concentrations in plasma,

serum or blood. This information is used to individualize dosage so that drug concentrations

can be maintained within a target range. Drug concentration at the site of action cannot be

routinely measured, but the desired or adverse effects may correlate better with plasma or

blood concentrations than they do with dose. For a few drugs, concentration measurements

are a valuable surrogate of drug exposure, particularly if there is no simple or sensitive

measure of effect.

TDM involves not only measuring drug concentrations, but also the clinical interpretation of

the result. This requires knowledge of the pharmacokinetics, sampling time, drug history and

the patients clinical condition.

Aim: TDM aims to promote optimum drug treatment by maintaining serum drug

concentration within a therapeutic range. TDM is a practice applied to a small group of drugs in which there is a direct relationship between concentration and response. TDM aims

to enhance drug efficacy, reduce toxicity or assist with diagnosis.


Define the term Therapeutic Drug Monitoring

Describe some common clinical applications of TDM

List factors which may affect serum drug concentrations and which should be considered

when interpreting TDM results

Describe and calculate the basic pharmacokinetic profiles such as clearance renal and

hepatic), half-life, volume of distribution and elimination rate constant.

Design dosage regimens for drugs such as aminoglycosides and vancomycin

Monitoring and adjusting doses for Aminoglycosides, vancomycin, phenytoin and digoxin

Describe the role of the clinical pharmacist in TDM

Content and Structure: This is a power point presentation of the workshop materials plus practical cases and hands

on. The content of this workshop will be:

Introduction of TDM and indications

Basic pharmacokinetic principles explanations with examples: include Clearance (renal

clearance explaining different methods for creatinine clearance calculations and hepatic

clearance), volume of distribution, elimination rate constant and half-life.

Describe how to design dose regimens for aminoglycosides (conventional versus single daily

dosing). Monitoring patients on aminoglycosides and adjusting doses with practical examples

and problems.

Designing dose regimens for vancomycin and pharmacokinetic level monitoring and adjusting

doses.

Describe the pharmacokinetic principles for phenytoin, level monitoring and adjusting doses

Describe the pharmacokinetic principles for digoxin to avoid toxicity and maximize the

therapeutic benefit of the drug.

Elaborating on the role of clinical pharmacist in TDM.

WS17

How to recognize homecare patients who benefit most of clinical pharmacy services?

Moderators:

Carita Linden-Lahti, Acting Chief Pharmacist, City of Lahti, Finland

Sini Kuitunen, Project Pharmacists, City of Lahti, Finland

Background:

All over the Europe population structure is getting more aged. From patient perspective and

because of limited health care resources, the emphasis of the care should be in homecare

instead of long-term hospitals. Medication of geriatric homecare patient should be reviewed

regularly but because of limited medical and clinical pharmacy resources, there is a need to

recognize more effectively those patients who need medication review most. In City of Lahti

we have a multiprofessional clinical pharmacy project to exploit Resident Assessment

Instrument (RAI) and screen those patients who may have adverse reactions, inappropriate

medication or other problems with their medication.

Aim:

The aim of this workshop is to recognize geriatric homecare as important area of clinical

pharmacy services and hear about different services that workshop participants have in their

countries. In workshop participants will also define those factors that may help to find patients

who benefit most of the services and outline ways to screen the factors.


Understand the need for clinical pharmacy services in homecare.

Be familiar with different clinical pharmacy services in homecare.

Recognize factors that indicate medication problems in homecare patient.

Perceive the information sources that may be available for screening the factors and

identifying the patients.


Introduction to topic and Finnish Model (30 min)

Round table introduction and existing homecare services in the countries of the workshop

participants (20 min)

Group working about the screening factors and information sources (40 min)

Conclusions (30 min)

WS18

Safety monitoring of patients on psychiatric pharmacotherapy

Moderator:

Mirjam Simoons, Department of Clinical Pharmacy, Wilhelmina Hospital Assen, The

Netherlands

Background:

Adverse effects associated with psychiatric pharmacotherapy vary with agent, dose and

patient. Symptoms range from common to very rare and mild to life threatening. Adverse

effects, such as metabolic dysregulation which occurs frequently in patients treated with

antipsychotic drugs are important causes of non-adherence and discontinuation of treatment.

Suboptimal treatment in psychiatric patients is of particular importance because these patients

already have an increased risk of somatic comorbidities, sleeping disorders, overweight,

smoking behaviour, an unhealthy diet and lack of physical exercise. Furthermore, they also

have a higher risk of morbidity due to a decreased tendency to use professional care, a

decreased perception of illness and more unmet care needs than the general population.

Because of these features, this group of patients is vulnerable for adverse effects and drug

interactions.

Structural monitoring of parameters related to such adverse effects aims at detecting and

treating dysregulation of established risk factors such as weight gain, aberrant glucose levels

and QTc-prolongation. However, despite national and international guidelines on monitoring

for some groups of psychotropic drugs (for example lithium, antipsychotics), monitoring

discipline is rather low worldwide. Improvement programmes consisting of a national patient

safety alert or publication of a national consensus statement have shown to be marginally

effective. To improve monitoring in daily psychiatric practice more active safety monitoring

programmes have to be implemented. Pharmacists can support these programmes with their

knowledge of adverse effects and drug interactions.

Aim:

- To explain the importance of safety monitoring during psychiatric pharmacotherapy. - To discuss relevant safety monitoring parameters and their monitoring frequencies

during psychiatric pharmacotherapy.

- To emphasize the importance of medication reconciliation in safety monitoring.


- To gain insight in the potential involvement of pharmacists in safety monitoring programmes during psychiatric pharmacotherapy.


In this workshop relevant safety monitoring parameters and their monitoring frequencies will

be discussed using cases in which different psychiatric drugs are prescribed alone and in

several combinations with other drugs. Also the importance of medication reconciliation in

this respect will be emphasized. With every case, each participant has to show a card with one

of four possible monitoring strategies and there will be a short discussion about the optimal

monitoring strategy and the potential role of a pharmacist.

WS19

Workplace learning and assessment in the (post)graduate education of pharmacists

Moderators:

Henk Buurma, PhD, PharmD

SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands; Director of post-

graduate education Community Pharmacists, KNMP, The Hague, The Netherlands.

Annemieke-Floor-Schreudering, PharmD

SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands; Departments of

Clinical Pharmacy and IQ Healthcare, University Medical Centre St Radboud, Nijmegen, The

Netherlands; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht

Institute for Pharmaceutical Sciences, Utrecht University, The Netherlands.

Background:

The CanMEDS Framework is an educational framework identifying and describing the key

competencies of a healthcare professional in seven roles: Medical/Pharmaceutical Expert,

Communicator, Collaborator, Manager, Health Advocate, Scholar, and Professional. This

framework has been adapted around the world in medicine profession and other professions,

including pharmacy. This move towards a competency-based approach in residency education

has resulted in a concurrent move to workplace learning with workplace-based assessment

tools. Since 2012 this framework is used in the postgraduate education for community

pharmacy specialists in the Netherlands.

Aim:

To provide participants with knowledge and tools to establish workplace learning with

assessment for (post)graduate pharmacists.


- Participants understand the CanMeds Framework and applicability in workplace learning. - Participants are able to define and select entrustable professional activities (EPAs) to

assess the competencies on the workplace.

- Participants are able to define task areas of pharmacists. - Participants have knowledge of several tools for assessing entrustable professional

activities (EPAs) in order to ultimately assess the CanMeds competencies.


1. General introduction: workplace learning and assessment a. The CanMeds competencies b. Entrustable professional activities (EPAs)

2. Exercise 1: Defining EPAs We will identify activities of clinical pharmacists. We will define the entrustable

professional activities (EPAs) and make a selection of EPAs. 3. Exercise 2: Linking EPAs and task areas of the clinical pharmacist

All activities of pharmacists can be grouped into task areas. We will allocate the defined

EPAs to predefined task areas of the clinical pharmacist. 4. Exercise 3: Linking EPAs and competencies

To assess all seven CanMeds competencies there need to be a link between competencies

and EPAs. We will practice to connect EPAs with competencies. 5. Tools for assessing EPAs in order to ultimately assess the CanMeds competencies

6. Take home messages

References:

1. Frank JR. The CanMEDS 2005 Physician Competency Framework. Better standards. Better physicians. Better care. Ottawa: The Royal College of Physicians and Surgeons of

Canada; 2005. Available from:

http://www.royalcollege.ca/portal/page/portal/rc/canmeds/framework (Accessed on 6

March 2014)

2. Ten Cate O. Trust, competence, and the supervisors role in postgraduate training. BMJ 2006;333:748-51

3. Cate O ten. Entrustability of professional activities and competency-based training. Med Educ 2005;39:1176-77

4. Education Plan Advanced Community Pharmacist Education Programme. Available from: http://www.knmp.nl/downloads/opleiding-en-registratie/opleiding-registratie-openbaar-

apothekers/regelingen-en-besluiten/OpleidingsprogrammaENGMarnix.pdf (Assessed on 6

March 2014).

WS20

NNT, NNH and TUB and their use in developing a pharmaceutical care plan for individual patients

Moderators:

Adrianne Faber, SIR Institute for Pharmacy Practice and Policy, Leiden, the Netherlands

Anne J. Leendertse, Department of General Practice, Julius Center, University Medical Centre

Utrecht, the Netherlands; and Apotheek Zenderpark IJsselstein, the Netherlands

Background:

Providing pharmacotherapy according to guidelines increasingly means the addition of more

medications to reach disease specific targets. Performing a medication review in patients with

multimorbidity and polypharmacy usually leads to several drug therapy problems concerning

appropriate prescribing and safety issues. When might it be best to discontinue medications

that are appropriate on the basis of guidelines? How much will these therapies contribute to

the goals of therapy you and your patient want to achieve from pharmacotherapy? And does

the potential benefits outweigh the risk of adverse drug effects?

To develop a pharmaceutical care plan we propose a model that builds on the principles of

appropriate prescribing and includes the consideration of remaining life expectancy, goals of

care, and potential benefits of pharmacotherapy and potential harm of pharmacotherapy. We

use epidemiological measure and implement them in our clinical decisions for an individual

patient. We use TUB (time until benefit), NNT (numbers needed to treat) and NNH (numbers

needed to harm) to prioritize the possible interventions and establish a care plan that meets the

pharmaceutical needs of the patient.

Aim:

The aim of the workshop is to provide clinical pharmacists with tools that may help guide

decisions about the use of medications that are more concordant with the possible benefits of

the pharmacotherapy in the context of patients needs, life expectancy and goals of care.


After this workshop participants should be

- Familiar with terminology of epidemiological measures NNT, NNH and TUB;

- Able to find or derive NNT, NNH and TUB from literature;

- Reproduce NNT, NNH and TUB of common drug therapies;

- Able to use NNT, NNH and TUB in clinical reasoning;

- Able to apply NNT, NNH and TUB in patient cases with multimorbidities and

polypharmacy to prioritise the possible interventions and establish a care plan that

meets the pharmaceutical needs of the patient.

Content and Structure: During the workshop the clinical pharmacists will be given information about the

epidemiological terms of NNT, NNH and TUB, will learn several values of NNT, NNH and

TUB of several common drug therapies in a game and will apply them in cases. The

participants will be encouraged to bring their own cases.

Introduction:

- Case of elderly patient with multimorbidity and polypharmacy: detecting potential

drug related problems and prioritize

- Introducing NNT, NNH and TUB

Playing the NNT-Game (in small groups)

Discussion:

- Take a look again at the case study from the introduction

- Discuss own cases or cases from the workshop moderators

Summary:

- The workshop will end up with a summary and take home messages

WS21

Pharmacoeconomics: a practical approach to assessing the literature

Moderator: Katherine Lyseng-Williamson: editor of the Adis journal Drugs & Therapy Perspectives

Background:

The cost, and cost effectiveness, of pharmacological and other therapies play an increasingly

important part in the selection of appropriate care by health care providers and policy makers.

Pharmacoeconomic studies attempt to assess cost and clinical benefits of alternative

healthcare interventions to provide a decision-making framework; they should not be about

reducing costs, but should be about maximising net benefits. However, appropriate

interpretation of such studies is often limited by a lack of knowledge of the meaning of

pharmacoeconomic terms and how to determine the strengths and weaknesses of such

analyses.

Aim:

To enable participants to interpret pharmacoeconomic analyses and their relevance to their

clinical practice using the recent (2013) CHEERS (Consolidated Health Economic Evaluation

Reporting Standards) Statement.


To understand basic pharmacoeconomic terms and their relevance

To recognize the key factors that should be included in a pharmacoeconomic analysis

To be able to use a simple assessment system to evaluate the value of any pharmacoeconomic analysis to clinical practice

Content and Structure: The workshop will define basic pharmacoeconomic terms, discuss the key factors necessary

for a good pharmacoeconomic analysis, and present a simple assessment system based on the CHEERs statement. The assessment system will then be used analyse a recently published

pharmacoeconomic analysis.

WS22

Challenges in discontinuation of medicine, N-of-1 trials as an individualized treatment

approach

Moderators: Dr. Hanna M. Seidling, Anette Lampert, University Hospital Heidelberg, Department of

Clinical Pharmacology and Pharmacoepidemiology, Cooperation Unit Clinical Pharmacy,

Heidelberg, Germany

Background: Usually randomized controlled trials are considered at the top of hierarchy of evidence for a

drugs efficacy. However, even when a relevant randomized controlled trial generates a definite answer, it is

not automatically applicable to an individual patient. For instance, if a clinician is uncertain

about the efficacy of a given therapy, yet the patient insists on taking the drug, it might be

challenging to convince the patient to discontinue the medicine. For such questions N-of-1

trials can provide the necessary evidence whether a given drug is effective in an individual

patient and still needed or not. The specific feature is that an N-of-1 trial is a cooperative

venture between the patient and the health care providers, because the patients own data is used to tailor his own therapy, which likely encourages him to become involved in the

management of his own condition. Keeping in mind the contemporary focus on individualized

medicine, clinical pharmacists should seize the opportunity to promote N-of-1 trials for

individualized health care.

Aim: Introduction of the study design and subsequent development of a distinct study protocol for a

given medication that participants can potentially use in their respective setting.

Learning objectives: How to conduct an N-of-1 trial with particular emphasis on the pharmacists role in an interdisciplinary approach for an individualized treatment decision (e.g. drug withdrawal).

Content and structure: Introduction of the study design

(presentation by the moderators, 10 min)

Development of a study protocol on the basis of the presented

methods. The case will be given, as will be the needed material in

terms of relevant publications or other informational material

(group work, 40 min).

Presentation of different study protocols to the plenum and

ascertaining the pharmacists role in the conceptualization and implementation of N-of-1 trials.

(group discussion, 40 min)

WS23

HEALTH INFORMATION TECHNOLOGY AND PATIENT SAFETY

MODERATORS:

Mara Guerreiro, PharmD, PhD, Invited Associate Professor (ISCSEM) & Invited Professor

(ESEL),Portugal

Sarah P. Slight, MPharm, PhD, PGDip, Senior Lecturer in Pharmacy Practice, University of

Durham, UK, Research Scholar, Brigham and Womens Hospital, Boston, MA, US

BACKGROUND:

Health Information Technology (Health IT) has been recognised by the World Health

Organisation as one of the most rapidly growing areas in health and an essential part of how

we diagnose, monitor and treat patients. Information technology can play a major role in

improving safety for many patients. The introduction of computerized physician order entry

(CPOE) with clinical decision support (CDS) can increase the likelihood of catching and

preventing medication-related errors, and associated adverse events.(1) Computerized tools

can also improve communication between clinicians, provide access to online reference

sources, assist with calculations and monitoring, and improve compliance with preventive

service protocols.(2,3) Whilst these systems have considerable potential, realising these

benefits is far from straightforward. Research has shown that these technologies can be

extremely disruptive, altering many aspects of healthcare professionals routine working practices and patients experience of care.(4) This can result in unintended consequences, which often develop over time as potential threats to patient safety.(5) It is therefore important

that such systems are carefully selected, implemented, modified and used to maximise the

chances of benefits for patients. This is a timely workshop for clinical pharmacists and, of

course, other healthcare professionals. Only by giving thoughtful consideration to the design

features, use and implementation of CPOE systems,(6,7) will our hospitals and primary care

practices be in a better position to realise their potential benefits.

AIM:

To discuss the benefits and challenges of using CPOE and CDS systems in practice.

LEARNING OBJECTIVES:

By the end of the workshop participants should be able to:

Define CPOE and CDS;

Describe how CPOE systems and other types of Health IT can help prevent medication errors;

Describe the design features of computerised drug-drug interaction alerts;

Discuss the vulnerabilities and unintended consequences of CPOE systems;

Discuss challenges related to implementation and possible strategies to address these

challenges.

CONTENT AND STRUCTURE:

The workshop will give an overview of concepts regarding CPOE and CDS. Then the

evidence underpinning these functionalities will be briefly presented.

Participants will subsequently be split in groups and asked to discuss (1) the use of

CPOE/CDS systems in hospital and ambulatory settings, (2) the reasons why prescribers

might chose to override CDS alerts, (3) the vulnerabilities of CPOE systems to different types

of medication errors, (4) possible implementation issues and ways to address them.

The participants will reconvene and the groups responses will be discussed in light of recommendations for implementation.

The workshop will finish with a wrap-up session.

References

1. Bates DW. Using information technology to reduce rates of medication errors in

hospitals. BMJ. 2000;320(7237):788-91.

2. Bates DW, Gawande AA. Improving safety with information technology. N

Engl J Med. 2003;348(25):2526-34.

3. Slight SP, Seger DL, Nanji KC, Cho I, Maniam N, Dykes PC, Bates DW. Are

We Heeding the Warning Signs? Examining Providers Overrides of

Computerized Drug-Drug Interaction Alerts in Primary Care. PLoS ONE 8(12):

e85071. doi:10.1371/journal.pone.0085071

4. Cresswell K, Morrison Z, Crowe S, Robertson A, Sheikh A. Anything but

engaged: user involvement in the context of a national electronic health record

implementation. Inform Prim Care. 2011;19(4):191-206.

5. Ash JS, Berg M, Coiera E. Some unintended consequences of information

technology in health care: The nature of patient care information system-related

errors. J Am Med Inform Assn. 2004 Mar-Apr;11(2):104-12.

6. Slight SP, Franz C, Olugbile M, Brown H, Bates DW, Zimlichman E. The

Return On Investment Of Implementing A Continuous Monitoring System In

General Medical-Surgical Units. Critical Care Medicine, in press

7. Slight SP, Quinn C, Avery AJ, Bates DW, Sheikh A. A qualitative study

identifying the cost categories associated with Electronic Health Record

implementation in the UK. J Am Med Inform Assoc 2014;0:16

WS24

Tackling drug-drug interactions: clinical decision support vs. clinical pharmacists

Moderators:

Stephane Steurbaut, PharmD PhD, Research group Clinical Pharmacology & Clinical

Pharmacy (KFAR), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090

Brussels, Belgium, Professor in Pharmaceutical Care and Clinical Pharmacy

Pieter Cornu, PharmD, PhD Candidate, Research group Clinical Pharmacology & Clinical

Pharmacy (KFAR), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090

Brussels, Belgium

Drug-drug interaction and Clinical Decision Support specialist

Background:

Drug-drug interactions (DDIs) are an important cause of adverse drug events and compromise

patient safety. Different approaches can be used to reduce unwanted DDIs. Common

approaches are the use of clinical decision support systems within electronic prescribing

systems and screening by clinical pharmacists, or a combination of both.

Aim:

The aim of this workshop is to investigate and discuss different approaches for tackling DDIs

in clinical practice. Starting from practical examples, participants are invited to reflect on the

pros and cons of these approaches. In addition, expertise will be shared amongst the

participants by learning what systems are in place in their countries/the settings in which they

work.


Learn about different approaches for tackling drug-drug interactions in clinical practice

Important dos and donts for drug-drug interaction screening with clinical decision support Learn from one approach to improve the other

Theoretical versus practical relevance of drug-drug interactions


After an introduction providing background information on different approaches to tackle

DDIs, a discussion will be initiated focusing on the prerequisites and

advantages/disadvantages of these approaches. Subsequently, starting with practical examples

from our setting, participants will be invited to share experiences from within their settings

and countries in order to learn from each other how specific situations are handled. Special

emphasis will go to assessing the clinical relevance of drug-drug interactions in clinical

practice, and briefly, also to incorporating this assessment in clinical decision support rules.

At the end of the workshop important aspects will be summarized.

WS25

Supporting development of Advanced Clinical Pharmacy Practice to ensure Patient

Safety

Moderators:

Lilian M. Azzopardi, Department of Pharmacy, Faculty of Medicine and Surgery University

of Malta, Malta

Sam Salek, School of Pharmacy and Pharmaceutical Sciences, Cardiff University, UK

Anthony Serracino-Inglott, Department of Pharmacy, Faculty of Medicine and Surgery

University of Malta, Malta

Alan Lau, College of Pharmacy, University of Illinois, Chicago, USA

Background: As drug therapy becomes more complex, pharmacists interventions to ensure patient safety

during patient care require the development of advanced clinical pharmacy skills that go

beyond the basic general pharmacy education. These advanced skills can be applied in patient

care in different settings including hospital, community and domiciliary care. Models of

education including academic professional programmes are available to support pharmacists

develop advanced clinical pharmacy practice.

Aim: To explore pharmacists perception of their needs to develop advanced clinical pharmacy

practice and to characterize models of postgraduate programmes aimed at supporting

development of advanced clinical pharmacy practice that have an impact on patient care and

ensuring patient safety.


Identify areas for improvement of practice where advanced clinical pharmacy skills are

required

Adopt reflection strategies to classify educational models

Identify competences that support advanced clinical pharmacy practice


An introduction to the concept of advanced clinical pharmacy practice will be presented.

Workshop participants will reflect on needs to develop advanced clinical pharmacy skills,

describe competences and characterize aspects of educational programmes. They will have

the opportunity to look at examples of programmes and discuss essential features.

Participants will be able to identify and assess the impact of inclusion of case-studies and real

practice scenarios within the programmes. Participants will also have the opportunity to

analyse the significance of translational research in clinical pharmacy.

European Society of Clinical Pharmacy (ESCP) Copenhagen 2014

Documents

Transcript of European Society of Clinical Pharmacy (ESCP) Copenhagen 2014