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Etangsale A, Bizot L, Betoulle S, Baudin I. [Existing report of the health care of detainees and of the organization of the drug circuit in prisons in France]. Ann Pharm Fr 2024; 82:342-350. [PMID: 38101512 DOI: 10.1016/j.pharma.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/31/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
Since the healthcare system reform in prisons by the law of 18 January 1994, health care for prisoners has depended on the public hospital service. Since the application of this law, hospital pharmacists have been responsible for the health product circuit in the prison. In order to reassess the overall health care of detainees in prison in 2022, a study is being carried out. This study also aims to carry out an inventory of the organization of the drug circuit in prisons in France. In June 2022, a questionnaire was sent by email to pharmacists in charge of supplying health products to one or more prison health units in France. The response rate to the questionnaire is 34 %. The average number of full-time equivalent (FTE) somatic doctors is 1.25. The average FTE pharmacist and pharmacy technician are respectively 0.4 and 0.96. Prescriptions are computerized in 84 % of cases. Therapeutic education and pharmaceutical interviews are carried out in 24 % and 20 % respectively. This study showed an overall improvement in the care of prisoners and the organization of the medication circuit in France compared to the last study. Pharmacists are more present in prisons. However, clinical pharmacy and health promotion actions are insufficiently deployed.
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Affiliation(s)
- Aurélie Etangsale
- Service pharmacie, centre hospitalier d'Angoulême, rond point de Girac, 16959 Angoulême, France.
| | - Laure Bizot
- Service unité sanitaire en milieu pénitentiaire, maison d'arrêt d'Angoulême, 112, rue Saint-Roch, 16000 Angoulême, France
| | - Sylvie Betoulle
- Service unité sanitaire en milieu pénitentiaire, maison d'arrêt d'Angoulême, 112, rue Saint-Roch, 16000 Angoulême, France
| | - Isabelle Baudin
- Service pharmacie, centre hospitalier d'Angoulême, rond point de Girac, 16959 Angoulême, France
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2
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Laviolle B, Degon PF, Gillet-Giraud C, Thiveaud D, Lechat P, Boïko-Alaux V, Fougerou C, Jolly C, Petit A, Rémy-Jouet I, Yven R, Bouret L, Marrauld L, Vaslet MP, Delay V, Gavory AL, Olle F, Langevin J, Forteau L. Comment prendre en compte la dimension éco-responsable des produits de santé tout au long de leur cycle de vie? Therapie 2024; 79:47-60. [PMID: 37993369 DOI: 10.1016/j.therap.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/20/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Bruno Laviolle
- CHU de Rennes, université de Rennes, Inserm, UMR_S 1085 (IRSET), CIC Inserm 1414, 35000 Rennes, France.
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Fall M, Grenet G, Le HH, Kassaï B, Lega JC, Boussageon R, Mainbourg S, Marchant I, Gafsi J, Dieye AM, Gueyffier F. [Does aspirin have a place in primary cardiovascular prevention by the polypill ? Simulation study on a realistic virtual population]. Therapie 2023; 78:667-678. [PMID: 36841655 DOI: 10.1016/j.therap.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND The polypill strategy could become widely accepted in cardiovascular prevention due to reduced costs and its simplicity, which promote compliance. Aspirin is often included as a component of the polypill for primary prevention, but three powerful recent trials failed to show any favorable net benefit even in high-risk subgroups. Our objective is to estimate the net benefit associated with aspirin in primary cardiovascular prevention. METHODS We simulated the impact of different polypill compositions combining pravastatin, ramipril, hydrochlorothiazide, with or without aspirin, on a realistic French virtual population between 35 and 65 years old. We assessed how this impact on myocardial infarction and stroke varied according to gender, diabetes, and arterial hypertension. We identified the subgroup of individuals whose specific benefit from aspirin was greater than twice the risk of serious bleeding it induced. RESULTS The absolute benefit associated with aspirin was reduced by co-prescriptions. No subgroup of women benefited from aspirin, and the subgroup of women with a clear net benefit represented 128 women out of 529,421. Men at high risk of cardiovascular death, or with diabetes and hypertension, had a benefit from aspirin exceeding the risk of bleeding induced, but this risk represented more than half of the benefit. No subgroup analyzed did show a benefit greater than twice the risk of bleeding. The proportion of men whose expected benefit from aspirin was greater than twice the risk of bleeding represented 3% of all men. An optimal polypill strategy in primary prevention between the ages of 35 and 65, combining three drugs but not aspirin, can hope to save two out of three strokes and more than one out of two myocardial infarctions. It would prevent a major cardiovascular accident every 16 to 193 individuals treated according to the subgroups considered. CONCLUSION Until proven otherwise, aspirin has only a limited place in individuals between 35 and 65 years without a cardiovascular history. We showed how simulating therapeutic strategies on a realistic virtual population could be used for best applying available evidence.
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Affiliation(s)
- Mor Fall
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France; Laboratoire de pharmacologie & de pharmacodynamie, UMRED université Iba Der Thiam, BP A967 Thies, Sénégal; Centre hospitalier universitaire Aristide Le Dantec, pharmacie centrale, BP 3001 Dakar, Sénégal
| | - Guillaume Grenet
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France; Service hospitalo universitaire de pharmaco-toxicologie, 69002 Lyon France
| | - Hai-Ha Le
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France
| | - Behrouz Kassaï
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France; Service hospitalo universitaire de pharmaco-toxicologie, 69002 Lyon France
| | - Jean-Christophe Lega
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France
| | - Rémy Boussageon
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France
| | - Sabine Mainbourg
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France
| | - Ivanny Marchant
- Laboratorio de Modelamiento en Medicina, Escuela de Medicina, Universidad de Valparaíso, Viña del Mar, Chile
| | - Johanne Gafsi
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France
| | - Amadou Moctar Dieye
- Service hospitalo universitaire de pharmaco-toxicologie, 69002 Lyon France; Laboratoire de pharmacologie & de pharmacodynamie, université Cheikh Anta Diop, BP 5005 Dakar, Sénégal
| | - François Gueyffier
- Laboratoire de biologie et biométrie évolutive - équipe modélisation des effets thérapeutiques, UMR 5558 université Claude Bernard Lyon 1, 69376 Lyon, France; Pôle de santé publique, Hospices civils de Lyon, 69002 Lyon, France.
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Fırat P, Dikci S, Can A, Türkoğlu E. Evaluation of medication adherence of glaucoma patients during the COVID-19 pandemic. J Fr Ophtalmol 2023; 46:11-18. [PMID: 36435659 PMCID: PMC9671694 DOI: 10.1016/j.jfo.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate changes in the medication adherence of glaucoma patients during the COVID-19 pandemic and the factors influencing medication adherence. MATERIALS AND METHODS This cross-sectional study included a total of 197 glaucoma patients who were followed for at least six months in the Glaucoma Unit of the Ophthalmology Department of Inonu University, Faculty of Medicine. Patients were given a 28-item questionnaire, including the eight-item Morisky Medication Adherence Questionnaire, to evaluate medication adherence. Demographic and clinical data were recorded. P<0.05 was considered statistically significant. RESULTS Interruption of glaucoma clinic visits during the pandemic was reported by 82 (41.6%) patients. Nonadherence was reported by 56 patients (28.4%) (95% confidence interval: 22.1-34.7). For these patients, the most common reasons for nonadherence were forgetfulness (50%), the inability to receive a prescription for the drug (10.7%) and being busy (10.7%). Factors influencing nonadherence were determined to be younger age, female gender, interruption of glaucoma clinic visits and high-income levels (P˂0.05). CONCLUSION Interruption of glaucoma clinic visits during the COVID-19 pandemic and the resulting inability to have medications prescribed resulted in patient nonadherence with medication use.
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Affiliation(s)
- P.G. Fırat
- Inonu University, Faculty of Medicine, Department of Ophthalmology, Malatya, Turkey
| | - S. Dikci
- Inonu University, Faculty of Medicine, Department of Ophthalmology, Malatya, Turkey,Corresponding author
| | - A. Can
- Inonu University, Faculty of Medicine, Department of Ophthalmology, Malatya, Turkey
| | - E.B. Türkoğlu
- Akdeniz University, Faculty of Medicine, Department of Ophthalmology, Antalya, Turkey
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Beghin D. [Impact of pregnancy on drug pharmacokinetics: What implication in clinical practice?]. Gynecol Obstet Fertil Senol 2022; 50:422-425. [PMID: 35219913 DOI: 10.1016/j.gofs.2022.02.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
Physiological changes that occur during pregnancy in the maternal body can lead to alterations in the response to drugs in the mother. Pregnancy modifies the volume of distribution of drugs, their binding to plasma proteins, the activity of their metabolizing enzymes, and their elimination. However, to date, due to the dynamic and complex processes involved, adjustments to the dosage regimen during pregnancy remain impossible to standardize. Knowledge of these modifications will help to better understand the possible loss of drug efficacy during pregnancy, as well as anticipating the clinical and plasma monitoring of drugs with a low therapeutic margin.
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Affiliation(s)
- D Beghin
- Centre de référence sur les agents tératogènes (CRAT), DMU ESPRIT (épidémiologie et biostatistique, santé publique, pharmacie, pharmacologie, recherche, information médicale, thérapeutique et médicaments), GHU AP-HP Sorbonne université, site Trousseau 26, avenue Dr Netter, 75571 Paris cedex 12, France.
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Davin-Casalena B, Jardin M, Guerrera H, Mabille J, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. The impact of the COVID-19 epidemic on primary care in South-eastern France: implementation of a real-time monitoring system based on regional health insurance system data. Rev Epidemiol Sante Publique 2021; 69:255-264. [PMID: 34454792 PMCID: PMC8818324 DOI: 10.1016/j.respe.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.
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Affiliation(s)
- B Davin-Casalena
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille.
| | - M Jardin
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - H Guerrera
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - J Mabille
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - H Tréhard
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - D Lapalus
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - C Ménager
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - S Nauleau
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - V Cassaro
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - P Verger
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - V Guagliardo
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
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Stoup T, Chenivesse C. [Management of asthma during pregnancy]. Rev Mal Respir 2021; 38:626-637. [PMID: 34052060 DOI: 10.1016/j.rmr.2021.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 02/04/2021] [Indexed: 10/21/2022]
Abstract
Asthma is the most common chronic condition in pregnant women. The risks of complications associated with asthma for the mother, the foetus and the pregnancy are mainly due to uncontrolled asthma and the occurrence of exacerbations. These events are promoted by the patient's difficulty in complying with treatment or by prescription insufficiency for an unjustified fear of teratogenicity. The challenge of the management of asthma during pregnancy is to ensure optimal maternal asthma control in order to prevent foetal hypoxia and thus, reduce the risk of complications. Preventing the occurrence of asthma symptoms and exacerbations, ensuring optimal lung function and managing the risk factors of poor asthma outcomes and comorbidities are the principles necessary to achieve this goal. Because of the low or non-existent risks of the main treatments of asthma for the foetus and the mother, it is widely recommended that all therapies initiated before conception are continued, in particular inhaled corticosteroids, and to adjust the dosage to the minimum effective dose. During the preconception period and throughout pregnancy, coordination of the different healthcare professionals (general practitioner, respiratory specialist and gynecologist) is essential, with the mother-to-be playing a central role in the management of her asthma.
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Affiliation(s)
- T Stoup
- CHU Lille, université Lille, service de pneumologie et immuno-allergologie, centre de référence constitutif pour les maladies pulmonaires rares, 59000 Lille, France
| | - C Chenivesse
- CHU Lille, université Lille, CNRS, Inserm, institut Pasteur de Lille, service de pneumologie et immuno-allergologie, centre de référence constitutif pour les maladies pulmonaires rares, U1019, UMR 9017, Center for Infection and Immunity of Lille (CIIL), CRISALIS, F-CRIN Inserm network, 59000 Lille, France.
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8
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Davin-Casalena B, Jardin M, Guerrera H, J Mabille, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. [The impact of the COVID-19 pandemic on first-line primary care in southeastern France: Feedback on the implementation of a real-time monitoring system based on regional health insurance data]. Rev Epidemiol Sante Publique 2021; 69:105-115. [PMID: 33992499 PMCID: PMC8075812 DOI: 10.1016/j.respe.2021.04.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
Position du problème L’épidémie de COVID-19 du printemps 2020 a fortement affecté le système de soins. Le confinement et les risques d’exposition au coronavirus ont incité les patients à modifier leur recours aux soins. L’objectif était de partager un retour d’expérience sur la mise en place d’un dispositif de surveillance en temps réel de l’activité des médecins libéraux de la région Provence-Alpes-Côte d’Azur, et de l’évolution des remboursements de médicaments prescrits aux assurés du régime général pour le diabète, pour des troubles de la santé mentale et pour certains vaccins. Méthodes Les données ont été extraites à partir des bases régionales de l’Assurance maladie pour les années 2019 et 2020. Elles ont permis de construire des indicateurs en date de soins pour le régime général stricto sensu, calculés de façon hebdomadaire, à partir de la semaine 2. Résultats On constate une chute d’activité des médecins libéraux lors du confinement (−23 % pour les médecins généralistes ; −46 % pour les spécialistes), suivie d’un quasi retour à la normale par la suite. Dans le même temps, les téléconsultations ont connu un véritable essor : elles ont constitué 30 % des actes des médecins libéraux au plus fort de la crise. Le début du confinement a été marqué par un pic d’approvisionnement en médicaments, tandis que la vaccination a fortement diminué (−39 % concernant le vaccin contre la rougeole, les oreillons et la rubéole chez les enfants âgés de moins de 5 ans ; −54 % pour le vaccin contre les papillomavirus humains chez les filles âgées de 10–14 ans). Conclusion L’épidémie de COVID-19 risque d’entraîner d’autres conséquences sanitaires que celles directement imputables à la COVID-19 elle-même. Le renoncement aux soins pourrait causer des retards de soins fortement préjudiciables aux individus et à la collectivité. Ces questions inquiètent les autorités publiques, qui mettent en place des actions visant à inciter les patients à se soigner sans tarder. Mais la crise liée à la COVID-19 a aussi créé des opportunités, telles que le déploiement de la téléconsultation et de la télé-expertise. Bien que partiels, les indicateurs mis en œuvre peuvent permettre aux décideurs publics d’être réactifs et de mettre en place certaines actions afin de répondre aux besoins de santé des populations.
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Affiliation(s)
- B Davin-Casalena
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France.
| | - M Jardin
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - H Guerrera
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - J Mabille
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - H Tréhard
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - D Lapalus
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - C Ménager
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - S Nauleau
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - V Cassaro
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - P Verger
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - V Guagliardo
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
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Flamarion E, Reichert C, Sayegh C, de Saint Gilles D, Bariseel R, Arnoux JB, Schmitt C, Poli A, Karras A, Pouchot J, Cheminet G, Penet MA. [Abnormal urine color assessment: The urine wheel]. Rev Med Interne 2021; 43:31-38. [PMID: 33736891 DOI: 10.1016/j.revmed.2021.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/14/2021] [Indexed: 12/17/2022]
Abstract
Looking at the urine for diagnostic purposes, once performed by ancient Egyptians, can still provide some valuable clues in modern medicine. Several diseases have been named after their associated urine color and this underlines the clinical value of visual urine inspection: blue diaper disease, purple urine bag syndrome, black urine disease or porphyria. Abnormal urine color could be challenging for the clinician: it may reveal neoplastic disease (urologic cancer; melanoma), cell lysis (rhabdomyolysis; hemolysis), infection (lymphatic filariasis; malaria), enzyme deficiency (porphyria; alkaptonuria), medication or food intake. In this article, we present the diagnostic approach, the mechanisms involved and the main causes of abnormal urine color.
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Affiliation(s)
- Edouard Flamarion
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France.
| | - Constance Reichert
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France
| | - Caroline Sayegh
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France
| | - David de Saint Gilles
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France
| | - Romane Bariseel
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France
| | - Jean Baptise Arnoux
- Hôpital Necker Enfants Malades, Centre de Référence des Maladies Héréditaires du Métabolisme, APHP-Centre, Université de Paris, France
| | - Caroline Schmitt
- Hôpital Louis Mourier, Centre Français des Porphyries, APHP-Nord, Centre de recherche sur l'inflammation, INSERM U1149, Université de Paris, France
| | - Antoine Poli
- Hôpital Louis Mourier, Centre Français des Porphyries, APHP-Nord, Centre de recherche sur l'inflammation, INSERM U1149, Université de Paris, France
| | - Alexandre Karras
- Hôpital Européen Georges Pompidou, Service de néphrologie, APHP-Centre, Université de Paris, France
| | - Jacques Pouchot
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France
| | - Geoffrey Cheminet
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France
| | - Marie Aude Penet
- Hôpital Européen Georges Pompidou, Service de médecine interne, APHP-Centre, Université de Paris, France
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Abdulrahman SAM, Algethami FK, Qarah NAS, Basavaiah K, El-Maaiden E. Development of non-aqueous titrimetric and spectrophotometric methods for the determination of valganciclovir hydrochloride in bulk drug and tablets. Ann Pharm Fr 2021; 79:489-499. [PMID: 33548279 DOI: 10.1016/j.pharma.2021.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/19/2020] [Accepted: 01/23/2021] [Indexed: 11/17/2022]
Abstract
Two non-aqueous titrimetric and one visible spectrophotometric methods were developed and validated for the determination of valganciclovir hydrochloride (VLGH) in pure drug and tablets. The titrimetric methods were carried out by titrating the VLGH solution in glacial acetic acid with acetous perchloric acid (HClO4) in the presence of mercuric acetate and the end point of this titration was being located either visually (method A) or potentiometrically (method B). The spectrophotometric method (method C) was based on the addition of p-dimethylaminobenzaldehyde (DMAB) solution to VLGH solution and the formed yellow condensation product was measured at 420nm. In titrimetric procedures, both the methods A and B were applicable over the range of 4-20mg VLGH, and the calculations were based on a 1:1 reaction stoichiometry (VLGH:HClO4). In a spectrophotometric method, Beer's law was valid in a concentration range of 5-50 μg/mL VLGH with the corresponding value of molar absorptivity of 4.43×103L/mol cm for method C. The limits of detection (LOD) and quantification (LOQ) for method C were 0.3 and 0.92μg/mL, respectively. The developed methods were successfully applied to the determination of VLGH in tablets, and the results were statistically compared with those of a reference method by applying Student's t-test and F-test. Further, the validity of the developed methods was confirmed by recovery studies via standard addition technique.
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Affiliation(s)
- S A M Abdulrahman
- Department of Chemistry, Faculty of Education and Sciences- Rada'a, Al-Baydha University, Al-Baydha, Yemen
| | - F K Algethami
- Department of Chemistry, Faculty of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - N A S Qarah
- Department of Chemistry, Faculty of Education-Zabid, Hodeidah University, Hodeidah, Yemen.
| | - K Basavaiah
- Former UGC-BSR Faculty Fellow, Department of Chemistry, University of Mysore, Manasagangotri, 570006 Mysuru, India
| | - E El-Maaiden
- Laboratory of Biochemistry and Neurosciences, Department of Biology, University Hassan 1(er), Settat, Morocco
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Marillier M, Sec I, Deguette C, Gorgiard C, Rey-Salmon C. [Population of people placed in police custody, hidden barometer of diverted medicines]. Therapie 2020; 76:229-237. [PMID: 32854954 DOI: 10.1016/j.therap.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/29/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE OF THE STUDY The population of people in police custody is a sentinel niche that is poorly represented in the "usual panels" of public health studies. The aim is to make an overview of their diversion of drugs. PATIENTS AND METHODS A retrospective study based on cases of misuse in a sample of people in custody examined between 2015 and 2016 at the forensic medicine unit of the hospital Hôtel-Dieu-Paris. RESULTS Of the 5149 medical examinations, 302 were for substance use disorder or drug misuse. In 2016, the number of notifications for misuse of clonazepam increased (n=65); the user population appears to be getting younger (average age=23.5 years) and to be supplied mainly by deal (63%). Regarding opioid substitution treatments, the indicators of abuse and diversion are confirmed, while morphine sulfate stands out with a strong deal (>75%), IV injection (62%) and polydrug use, including methadone, cocaine (62%). CONCLUSION From our results, national surveys in general population and studies carried out in the context of deprivation of liberty, people in police custody constitute a real barometer of the parallel market for street drugs. Clinical impacts can be major; a better monitoring is needed. For caregivers, it is also a matter of better identification of misuse, substance use disorder for a future orientation of the patient.
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Affiliation(s)
- Maude Marillier
- Société française de toxicologie analytique Hôpital Raymond Poincaré, service de pharmacologie toxicologie, 92380 Garches, France; Direction des maladies non transmissibles et traumatismes (DMNTT), Santé publique France, 94410 Saint-Maurice, France.
| | - Isabelle Sec
- Unité médico-judiciaire, hôpital Hôtel-Dieu, 75004 Paris, France
| | - Céline Deguette
- Unité médico-judiciaire, hôpital Hôtel-Dieu, 75004 Paris, France
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12
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Castanié M, Juillard-Condat B, Galian C, Giroud JP, Bagheri H. [Analysis of regulatory status changes of drugs in France: 2010-2019]. Therapie 2020; 76:37-47. [PMID: 32828560 DOI: 10.1016/j.therap.2020.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/06/2020] [Accepted: 06/11/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The existence of borderline products between the status of a medicinal product and other less regulated products allows some products to have different statuses or even to change from one status to another. In order to quantify these changes, a review of medicines that have changed from drug status to other statuses (medical device, cosmetic product or food supplement) in France between 2010 and 2019 was performed. METHOD The lists of medicinal products with archived or revoked marketing authorization (MA) from the French National Authority's Register of Medicinal Products were analyzed in order to identify the medicinal products withdrawn from the market between January 1, 2010 and September 30, 2019 that could be considered as products with a "potential for status change". Then, we searched on the official websites of the MA holders and other firms, for a possible return to the market with a different status, marketed by the same firm (self-change of status) or a different firm (hetero-change of status). RESULTS Out of a list of 206 drugs identified as "with potential for status change", we detected a total of 101 status changes, including 36 auto-changes and 65 hetero-changes. These changes mainly concern vitamin or herbal drugs later marketed as food supplements (30 cases of auto-changes and 60 cases of hetero-changes). There are also 6 cases of switching to cosmetic product and 5 cases of switching to medical device. CONCLUSION The existence of no clear distinction between the different statuses of health products facilitates their status changes. The increasing shift from "medicines" to less regulated products, the trivialization of their use by the public and their increasing consumption make them a fundamental issue of social pharmacology, requiring to raise the awareness of consumers and health professionals.
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Affiliation(s)
- Marie Castanié
- INSERM U1027, service de pharmacologie clinique et médicale, centre de pharmacovigilance et de pharmacoépidémiologie, faculté de médecine, centre hospitalo-universitaire de Toulouse, allées Jules-Guesde, 31000 Toulouse, France
| | - Blandine Juillard-Condat
- Faculté de pharmacie, université Toulouse III, centre hospitalo-universitaire de Toulouse, 31000 Toulouse, France
| | - Christian Galian
- Association de défense, d'éducation et d'information du consommateur, 31100 Toulouse, France
| | | | - Haleh Bagheri
- INSERM U1027, service de pharmacologie clinique et médicale, centre de pharmacovigilance et de pharmacoépidémiologie, faculté de médecine, centre hospitalo-universitaire de Toulouse, allées Jules-Guesde, 31000 Toulouse, France.
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13
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Binson G, Cariot A, Venisse N, Di Maio M, Rabouan S, Beuzit K, Dupuis A. [Neonates exposure to parabens through medicines administered to inpatients]. Ann Pharm Fr 2020; 78:343-350. [PMID: 32253021 DOI: 10.1016/j.pharma.2020.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/12/2019] [Accepted: 01/13/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objective of this study was to quantify parabens intake due to drug administration in neonates during hospitalization following their birth. METHOD A monocentric prospective study was performed into a neonatalogy unit to collect all drug prescriptions. An exhaustive list of parabens containing medicines commercialized in France was completed from Theriaque® database. This list was combined with drug prescription to establish an exposure profile to parabens. For each paraben containing medicines, a HPLC-UV assay was performed to determine the average daily intake of paraben received by hospitalized neonates. RESULTS More than 300 medicines commercialized in France contain at least one paraben. A combination of methylparaben and propylparaben was found in most cases. All hospitalized neonates (n=22) were exposed at least once to methylparaben and propylparaben through medicines while 50 % were exposed to ethylparaben. The average daily intake was higher in term newborns (572,0±249,0 versus 414,6±294,1μg/kg/j for methylparaben) but frequency was higher in prematures (65,0 versus 78,6% for methylparaben) as well as cumutives doses (1421,5±758,8 versus 8618,7±7922,3). These doses are lower than toxicological reference values but these latter do not take into account endocrine disrupting effects of these compounds. CONCLUSIONS These results highlight medicines as a high source of exposure to parabens in hospitalized neonates. It should encourage pharmaceutical companies and health professionnal to prioritize therapeutic cares without parabens.
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Affiliation(s)
- G Binson
- Centre d'investigation clinique CIC Inserm 1402, Axe HEDEX (Health-Endocrine Disruptors-EXposome), 6, rue de la Milétrie, 86021 Poitiers, France; Service pharmacie, faculté de médecine et de pharmacie, université de Poitiers, centre hospitalier universitaire de Poitiers, 6, rue de la Milétrie, 86021 Poitiers, France.
| | - A Cariot
- Centre d'investigation clinique CIC Inserm 1402, Axe HEDEX (Health-Endocrine Disruptors-EXposome), 6, rue de la Milétrie, 86021 Poitiers, France; Service pharmacie, faculté de médecine et de pharmacie, université de Poitiers, centre hospitalier universitaire de Poitiers, 6, rue de la Milétrie, 86021 Poitiers, France
| | - N Venisse
- Centre d'investigation clinique CIC Inserm 1402, Axe HEDEX (Health-Endocrine Disruptors-EXposome), 6, rue de la Milétrie, 86021 Poitiers, France
| | - M Di Maio
- Pédiatrie, réanimation et néonatalogie, centre hospitalier universitaire de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nîmes, France
| | - S Rabouan
- Centre d'investigation clinique CIC Inserm 1402, Axe HEDEX (Health-Endocrine Disruptors-EXposome), 6, rue de la Milétrie, 86021 Poitiers, France; Service pharmacie, faculté de médecine et de pharmacie, université de Poitiers, centre hospitalier universitaire de Poitiers, 6, rue de la Milétrie, 86021 Poitiers, France
| | - K Beuzit
- Service pharmacie, faculté de médecine et de pharmacie, université de Poitiers, centre hospitalier universitaire de Poitiers, 6, rue de la Milétrie, 86021 Poitiers, France
| | - A Dupuis
- Centre d'investigation clinique CIC Inserm 1402, Axe HEDEX (Health-Endocrine Disruptors-EXposome), 6, rue de la Milétrie, 86021 Poitiers, France; Service pharmacie, faculté de médecine et de pharmacie, université de Poitiers, centre hospitalier universitaire de Poitiers, 6, rue de la Milétrie, 86021 Poitiers, France
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14
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Duwez M, Szymanski G, Carre M, Mallaret M, Lepelley M. [Idiosyncratic drug-induced agranulocytosis: 7 year-analysis in a French university hospital]. Ann Pharm Fr 2020; 78:230-241. [PMID: 32248952 DOI: 10.1016/j.pharma.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Idiosyncratic drug-induced agranulocytosis is a rare but potentially serious haematological disorder. The pathophysiological mechanisms are complex and poorly understood. We aimed at investigating agranulocytosis drug related causes from the myelograms with "myeloid maturation arrest" performed in our university hospital over the last seven years. METHODS A retrospective analysis of myelograms collected for agranulocytosis was performed from 1st January 2010 to 31th December 2016. We used the method of Bégaud et al. for drug causality assessment. RESULTS Among the 104 myelograms analysed, 41 agranulocytosis were drug-induced, whose 28 were idiosyncratic. Among these 28 cases, 26 different drugs were involved. Agranulocytosis was a known adverse reaction in the summary of the product characteristics for 24 drugs, mainly associated with undetermined frequency (n=7). Mean onset latency was 38.1 days after starting the drug (calculated for n=23 cases) and granulocyte growth factors were used in 50% of cases without shortening the mean delay of blood count recovery. Bone marrow presented hypereosinophilia in 29% of cases. Pharmacovigilance reporting rate was 48%. CONCLUSION A "maturation arrest" in the myelogram is not pathognomonic for idiosyncratic drug-induced agranulocytosis. This rare event require multidisciplinary care involving haematologists, biologists and pharmacovigilance experts. Agranulocytosis reporting rate was high compared with usual adverse drug reaction reporting rate (5 to 10%), probably related to the potential severity of this event.
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Affiliation(s)
- M Duwez
- Département de pharmacie, CHU de Grenoble-Alpes, 38000 Grenoble, France.
| | - G Szymanski
- Laboratoire d'hématologie, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - M Carre
- Clinique universitaire d'hématologie, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - M Mallaret
- Centre régional de pharmacovigilance, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - M Lepelley
- Centre régional de pharmacovigilance, CHU de Grenoble-Alpes, 38000 Grenoble, France
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15
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Bertrand D, Piedeloup I, Mattoug S, Liabeuf S, Gras-Champel V. [Evaluation and impact of "pregnancy" pharmaceutical pictograms among 281 women]. Therapie 2020; 75:449-58. [PMID: 31831186 DOI: 10.1016/j.therap.2019.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/08/2019] [Accepted: 11/19/2019] [Indexed: 11/22/2022]
Abstract
In France, since 2017 new pharmaceutical pictograms appeared on drugs with a potentieal risk during pregnancy. This apposition, left to the discretion of marketing authorization holders, has uncertain consequences for women's reactions to them. The present survey is the first one interested in the opinion of the women concerned (pregnant or of childbearing age) as well as on the interpretation that they make of it. The survey answers enhanced that the pregnancy pictogram is an initiative welcomed by women who estimate that it secures drug intake. However, we demonstrate a poor understanding of the message conveyed by these pictograms (more than 50 % think they concern breastfeeding and more than 10 % fertility) and inappropriate behavior towards them (more than 80 of women pregnant stopped or decreased their medication immediately, without medical advice). The survey also highlights the need for information of women concerned by these pictograms and the limited information given by health professionals on this subject. It seems urgent to revise the law, to limite the use of these pictograms that appear to be too broad, incoherent and sometimes unjustified. In addition, public information seems an essential issue when focusing on these new pharmaceutical pictograms.
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16
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Denis H, Davoine C, Bermudez E, Grosjean G, Schwager M, Ifrah N, Dahan M, Negellen S. [Specific immunotherapies in the treatment of cancers]. Bull Cancer 2019; 106:37-47. [PMID: 30638899 DOI: 10.1016/j.bulcan.2018.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/06/2018] [Accepted: 12/16/2018] [Indexed: 11/22/2022]
Abstract
The offer of anti-cancer drugs has recently been disrupted by the introduction of checkpoint inhibitors on the market. Currently, one anti-CTLA-4, two anti-PD-1 and two anti-PD-L1 are authorized in the European Union, in seven different types of cancer. The clinical development of these therapies is still in full swing: in July 2017, more than 1 500 clinical trials were evaluating anti-PD-1, anti-PD-L1 and anti-CTLA-4 drugs in about twenty different locations and this number continues to increase. In the short term in France, other immunotherapies, the CAR-T cells, will complete this therapeutic arsenal. These immunotherapies appear as a real revolution in the treatment of some cancers. Nevertheless, many issues are associated with these therapies, particularly regarding the identification of good responders, the proper use of these drugs including the management of therapeutic strategies and safety profile, as well as the organization of care. In addition, the expenses associated with ipilimumab, nivolumab and pembrolizumab are substantial and almost tripled in one year, going from 120 million euros in 2015 to more than 340 million euros in 2016. This raises the question of the ability of the current healthcare system to maintain equitable access to innovation and best treatments for all patients. For all these reasons, the French National Cancer Institute decided to dedicate its thematic annual report on these innovative immunotherapies, targeting in particular checkpoint inhibitors and CAR-T cells, in order to produce an inventory of current data and an analysis regarding the different issues associated with these therapies.
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Allenet B, Lehmann A, Baudrant M, Gauchet A. [We have to stop talking about "non compliant" patients but rather about patients with difficulties of medication adherence]. Ann Pharm Fr 2018; 76:489-498. [PMID: 30196933 DOI: 10.1016/j.pharma.2018.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/10/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
Medication adherence can be defined as the link between "what the patient implements" and "what the patient and his doctor have decided together after negotiating without constrains". This definition should be put into perspective with the chronology of the disease and the way the patient experiences it. Counselling actions should always be adapted to the situation and negotiated with the patient, all along the process of care. This article proposes a model for this process and offers options pour tailored counselling. Key elements for pharmacist's practice are: simplify the prescription; communicate with the patient according to his stage of acceptation of the disease; get adequate training for motivational interviewing.
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Affiliation(s)
- B Allenet
- Pôle pharmacie, UF pharmacie clinique, unité transversale d'éducation du patient de l'Arc Alpin, CHU de Grenoble, université Grenoble-Alpes, ThEMAS TIMC-IMAG (UMR CNRS 5525), CS 10217, 38043 Grenoble Cedex 9, France.
| | - A Lehmann
- Pôle pharmacie, UF pharmacie clinique, unité transversale d'éducation du patient de l'Arc Alpin, CHU de Grenoble, université Grenoble-Alpes, ThEMAS TIMC-IMAG (UMR CNRS 5525), CS 10217, 38043 Grenoble Cedex 9, France
| | - M Baudrant
- Pôle pharmacie, UF pharmacie clinique, unité transversale d'éducation du patient de l'Arc Alpin, CHU de Grenoble, université Grenoble-Alpes, ThEMAS TIMC-IMAG (UMR CNRS 5525), CS 10217, 38043 Grenoble Cedex 9, France
| | - A Gauchet
- Laboratoire inter universitaire de psychologie, PC2S, EA 4145, université Grenoble-Alpes, 38400 Saint Martin d'Hères, France
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Fathallah N, Ouni B, Mokni S, Baccouche K, Atig A, Ghariani N, Azzabi A, Denguezli M, Slim R, Ben Salem C. [Drug-induced vasculitis]. Therapie 2018; 74:347-354. [PMID: 30173896 DOI: 10.1016/j.therap.2018.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/12/2018] [Accepted: 07/17/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Drug-induced vasculitis is reported in almost 10-20 % of vasculitis. Several drugs may be incriminated in their occurrence. Our study aimed to study the epidemiological, clinical, histopathological and evolutionary characteristics of drug-indced vasculitis from a series of cases and to specify the different drugs involved. METHODS We conducted a retrospective study during the period from January 2006 to December 2015 from the cases notified to the regional pharmacovigilance center of Sousse, Tunisia. The diagnosis was established according to the criteria proposed by the group of the American college of rheumatology (ACR). RESULTS Our study included thirteen cases of drug-induced vasculitis over a ten-year period, with an mean incidence of 1.3 new cases per year. Mean age of patients was 40.84 years. The mean delay from the treatment onset was 14.46 days with extremes ranging from 5 days to six weeks. Most patients had pure skin involvement. Association with other extracutaneous complaints was present in five cases. Cutaneous biopsy was performed in all patients showing a pathological pattern of leukocytoclastic vasculitis, associated with fibrinoid necrosis, extravasation of red blood cells and allergic capillaritis. The outcome was favorable for all patients. The offending drugs in our series were amoxicillin, pristinamycin, rifampicin, fluconazole, metformin, glimepiride, phenobarbital, gabapentin, fenofibrate, ibuprofen, allopurinol, rituximab and tinzaparin. CONCLUSION Anamnestic, clinical, biological and histopathological findings allow the early recognition of drug-induced vasculitis. Adequate treatment prevents systemic spreading and a worse prognosis.
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Affiliation(s)
- Neila Fathallah
- Département de pharmacologie, faculté de médecine de Sousse, université de Sousse, avenue Md Karoui, 4002 Sousse, Tunisie.
| | - Bouraoui Ouni
- Département de pharmacologie, faculté de médecine de Sousse, université de Sousse, avenue Md Karoui, 4002 Sousse, Tunisie
| | - Sana Mokni
- Département de dermatologie, CHU Farhat Hached, 4002 Sousse, Tunisie
| | - Khadija Baccouche
- Département de rhumatologie, CHU Farhat Hached, 4002 Sousse, Tunisie
| | - Amira Atig
- Département de médecine Interne, CHU Farhat Hached, 4002 Sousse, Tunisie
| | - Najat Ghariani
- Département de dermatologie, CHU Farhat Hached, 4002 Sousse, Tunisie
| | - Awatef Azzabi
- Département de néphrologie, CHU Sahloul, 4002 Sousse, Tunisie
| | - Mohamed Denguezli
- Département de dermatologie, CHU Farhat Hached, 4002 Sousse, Tunisie
| | - Raoudha Slim
- Département de pharmacologie, faculté de médecine de Sousse, université de Sousse, avenue Md Karoui, 4002 Sousse, Tunisie
| | - Chaker Ben Salem
- Département de pharmacologie, faculté de médecine de Sousse, université de Sousse, avenue Md Karoui, 4002 Sousse, Tunisie
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Serre A, Eiden C, Gourhant V, Laureau M, Perier D, Giraud I, Sebbane M, Peyrière H. [Involvement of addictovigilance in emergency department for the detection of abuse and dependence cases: 3 years of experience]. Therapie 2018; 73:501-509. [PMID: 30017376 DOI: 10.1016/j.therap.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Due to the increase of hospitalization at emergency department (ED) related to psychoactive substances use (PSU), the addictovigilance center of Montpellier has been integrated into the URGEIM program for the detection of iatrogenic events at the ED. The objective of the present work was to analyze spontaneous reports (SR) collected via the URGEIM program. METHODS Analysis of spontaneous reports related to PSU at the ED of the Montpellier University Hospital, collected through the URGEIM program, between January 2014 and December 2016. RESULTS During the study period, 160 SR were collected through the URGEIM program on 1118 SR collected by the Addictovigilance center over the period: 40SR/342 in 2014, 46 SR/303 in 2015 and 74 SR/473 in 2016. Most patients were male (70%) and the mean age at admission was 33 years old. A total of 240 psychoactive substances were identified with 160 illicit substances (66.6%) [cocaine 38.1%, cannabis 30.6%] and 80 medications (33.3%) [buprenorphine 22.5%, benzodiazepines 20% and methadone 18.8%]. Mental and behavioral disorders (20.0%), general health problems associated with substance use (17.5%), cardiovascular diseases (13.1%) and infectious diseases (12.5%) were the main reported effects. The duration of emergency stay was inferior to 12hours in 63.1% of cases and greater than 24hours in 12.5% of cases. In 69.4% of cases, the event was considered as serious. The outcome was unknown for 6.9% of patients. CONCLUSION The number of SR from ED has increased over the study period, with the notification of serious and worrying cases, and the possibility of setting up actions. The deployment of addictovigilance within clinical services is a significant factor for notification and quality of care.
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Affiliation(s)
- Anaïs Serre
- Département de pharmacologie médicale et toxicologie, centre d'addictovigilance, hôpital Lapeyronie, centre hospitalier universitaire, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - Céline Eiden
- Département de pharmacologie médicale et toxicologie, centre d'addictovigilance, hôpital Lapeyronie, centre hospitalier universitaire, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - Vincent Gourhant
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Marion Laureau
- Département de pharmacie clinique et dispensation, pharmacie, centre hospitalier universitaire, 34295 Montpellier, France
| | - Damien Perier
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Isabelle Giraud
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Mustapha Sebbane
- Département des urgences, centre hospitalier universitaire, 34295 Montpellier, France
| | - Hélène Peyrière
- Département de pharmacologie médicale et toxicologie, centre d'addictovigilance, hôpital Lapeyronie, centre hospitalier universitaire, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
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Parent G, Mottet N, Mairot P, Baudier F, Carel D, Goguey M, Riethmuller D, Limat S. [Prescribed and dispensed in the third trimester of pregnancy drugs: What practices and risks?]. J Gynecol Obstet Hum Reprod 2016; 45:754-759. [PMID: 26481682 DOI: 10.1016/j.jgyn.2015.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 09/09/2015] [Accepted: 09/15/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of the study was to describe the prescribing of drugs to pregnant women during the third trimester of pregnancy. PATIENTS AND METHODS The retrospective analysis is interested by pregnant women from August 2009 to April 2011, living in Franche-Comté. The used data are recorded in the database of the French Health Insurance Service. Drugs prescribing were analyzed and classified according to three categories: drugs that are contraindicated, not recommended drugs and drugs that are used. This classification is based on two databases: the Summaries of Product Characteristics of Vidal 2010 and data from the National Security Agency of Medicines. The potential exposure of patients was pointed out. RESULTS On 15,027 patients, 80% had a prescription. Six percent of prescriptions containing drugs not recommended and 1% drugs that contraindicated. Therapeutic classes identified are analgesics, anti-infective drugs and medicines supplementing with vitamins and minerals. Contraindicated drugs (10%) are NSAIDs, rubella vaccine, cyclins and ACE inhibitors and ARBs. Approximately 2.7% of women were potentially exposed to these drugs. DISCUSSION AND CONCLUSION Despite the recommendations of the ANSM, some drugs that are contraindicated are prescribed for pregnant women in their third trimester of pregnancy. In the absence of studies, the decision must be made on a case by case basis by assessing the risk-benefit ratio. Particular care is to bring about the drugs taken in self-medication. Information and advice are key steps to avoid incidents.
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Affiliation(s)
- G Parent
- Pôle pharmaceutique, CHRU, 3, boulevard Fleming, 25000 Besançon, France.
| | - N Mottet
- Pôle Mère-Enfant, CHRU, 3, boulevard Fleming, 25000 Besançon, France
| | - P Mairot
- Pôle pharmaceutique, CHRU, 3, boulevard Fleming, 25000 Besançon, France
| | - F Baudier
- Observatoire du médicament et des innovations thérapeutiques (OMEDIT) de Franche-Comté, Agence régionale de santé, 3, avenue Louise-Michel, 25000 Besançon, France
| | - D Carel
- Observatoire du médicament et des innovations thérapeutiques (OMEDIT) de Franche-Comté, Agence régionale de santé, 3, avenue Louise-Michel, 25000 Besançon, France
| | - M Goguey
- Observatoire du médicament et des innovations thérapeutiques (OMEDIT) de Franche-Comté, Agence régionale de santé, 3, avenue Louise-Michel, 25000 Besançon, France
| | - D Riethmuller
- Pôle Mère-Enfant, CHRU, 3, boulevard Fleming, 25000 Besançon, France
| | - S Limat
- Pôle pharmaceutique, CHRU, 3, boulevard Fleming, 25000 Besançon, France; Observatoire du médicament et des innovations thérapeutiques (OMEDIT) de Franche-Comté, Agence régionale de santé, 3, avenue Louise-Michel, 25000 Besançon, France
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21
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Drancourt P, Atkinson S, Lebel D, Bussières JF. [Assessment of perception about medication reconciliation among healthcare professionals at Saint-Justine hospital]. Ann Pharm Fr 2016; 74:304-16. [PMID: 26739918 DOI: 10.1016/j.pharma.2015.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 11/16/2015] [Accepted: 11/19/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Our main objective is to assess nurses and doctors perception about medication reconciliation. METHODS This is a descriptive and cross-sectional study. We have created three surveys, one for each health worker (nurses, doctors, resident, pharmacists). Each survey consists of single or multi-choice closed questions. A four-point Likert scale was used to collect the perception. Descriptive statistics have been calculated. RESULTS A total of 114 nurses, 98 doctors and residents and 26 pharmacists from all care services, replied to the survey. The majority of doctors (58%), pharmacists (60%) and nurses (52%) recognized the relevance and utility of medication reconciliation in healthcare safety. However, few healthcare professionals (6% of doctors, 13% of nurses et 46% of pharmacists) know that medication reconciliation is a required organizational practice. Only 25% of doctors always consult the best possible medication history after a patient admission while the majority do not use it because of unreliability issues. So, there have been some major changes to optimize medication reconciliation process in our hospital. CONCLUSION This study shows a increasing interest to medication reconciliation by healthcare professionals. However, the use of medication reconciliation remains marginal.
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Affiliation(s)
- P Drancourt
- Unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, 3175, Côte-Sainte-Catherine, H3T 1C5 Montréal, QC, Canada
| | - S Atkinson
- Unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, 3175, Côte-Sainte-Catherine, H3T 1C5 Montréal, QC, Canada
| | - D Lebel
- Unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, 3175, Côte-Sainte-Catherine, H3T 1C5 Montréal, QC, Canada
| | - J-F Bussières
- Unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, 3175, Côte-Sainte-Catherine, H3T 1C5 Montréal, QC, Canada; Faculté de pharmacie, université de Montréal, CP 6128, succursale Centre-ville, H3C 3J7 Montréal, QC, Canada.
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Caruba T, Chevreul K, Zarca K, Cadier B, Juillière Y, Dubourg O, Sabatier B, Danchin N. Annual cost of stable coronary artery disease in France: A modeling study. Arch Cardiovasc Dis 2015; 108:576-88. [PMID: 26433733 DOI: 10.1016/j.acvd.2015.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 05/13/2015] [Accepted: 06/04/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few studies have analyzed the cost of treatment of chronic angina pectoris, especially in European countries. AIM To determine, using a modeling approach, the cost of care in 2012 for 1year of treatment of patients with stable angina, according to four therapeutic options: optimal medical therapy (OMT); percutaneous coronary intervention with bare-metal stent (PCI-BMS); PCI with drug-eluting stent (PCI-DES); and coronary artery bypass graft (CABG). METHODS Six different clinical scenarios that could occur over 1year were defined: clinical success; recurrence of symptoms without hospitalization; myocardial infarction (MI); subsequent revascularization; death from non-cardiac cause; and cardiac death. The probability of a patient being in one of the six clinical scenarios, according to the therapeutic options used, was determined from a literature search. A direct medical cost for each of the therapeutic options was calculated from the perspective of French statutory health insurance. RESULTS The annual costs per patient for each strategy, according to their efficacy results, were, in our models, €1567 with OMT, €5908 with PCI-BMS, €6623 with PCI-DES and €16,612 with CABG. These costs were significantly different (P<0.05). A part of these costs was related to management of complications (recurrence of symptoms, MI and death) during the year (between 3% and 38% depending on the therapeutic options studied); this part of the expenditure was lowest with the CABG therapeutic option. CONCLUSION OMT appears to be the least costly option, and, if reasonable from a clinical point of view, might achieve appreciable savings in health expenditure.
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Affiliation(s)
- Thibaut Caruba
- AP-HP, hôpital européen Georges-Pompidou, Pharmacie, 20, rue Leblanc, 75015 Paris, France.
| | - Karine Chevreul
- AP-HP, Hôtel-Dieu, URC Eco, 1, place du parvis Notre-Dame, 75004 Paris, France; Inserm, ECEVE, U1123, Paris, France
| | - Kevin Zarca
- AP-HP, Hôtel-Dieu, URC Eco, 1, place du parvis Notre-Dame, 75004 Paris, France
| | - Benjamin Cadier
- AP-HP, Hôtel-Dieu, URC Eco, 1, place du parvis Notre-Dame, 75004 Paris, France
| | - Yves Juillière
- CHU Nancy-Brabois, Institut Lorrain du cœur et des vaisseaux, cardiologie, 54500 Vandœuvre-lès-Nancy, France
| | - Olivier Dubourg
- AP-HP, hôpital Ambroise-Paré, cardiologie, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - Brigitte Sabatier
- AP-HP, hôpital européen Georges-Pompidou, Pharmacie, 20, rue Leblanc, 75015 Paris, France; Inserm, centre de recherche des cordeliers, UMR 1138, équipe 22, 75006 Paris, France
| | - Nicolas Danchin
- AP-HP, hôpital européen Georges-Pompidou, cardiologie, 20, rue Leblanc, 75015 Paris, France; Université René-Descartes, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France
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Andersson KE. Current and future drugs for treatment of MS-associated bladder dysfunction. Ann Phys Rehabil Med 2014; 57:321-8. [PMID: 24954496 DOI: 10.1016/j.rehab.2014.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 05/19/2014] [Indexed: 11/23/2022]
Abstract
A majority of patients diagnosed with multiple sclerosis (MS) will develop lower urinary tract symptoms (LUTS) during the course of the disease. Even if antimuscarinic (anticholinergic) treatment is currently the mainstay of conservative treatment of neurogenic detrusor overactivity (NDO), including MS-induced NDO, extensive data regarding their effectiveness and safeness are lacking. When antimuscarinic medications fail to prove efficacious, a further option is intradetrusor injections of onabotulinumtoxin A. In several studies, more than half (and up 76%) of the patients treated with onabotulinumtoxin A experienced significant improvement in symptoms or even achieved complete continence. Cannabis extracts have shown some promise but has still not gained wide acceptance as an effective treatment. Over the last few years many new disease-modifying drugs that have been approved and introduced for treatment of MS. These drugs may have effects not only on the MS disease process, but also on the disease symptoms, including LUTS. However, MS is not primarily a bladder disease and treatment of the underlying pathophysiology should be the main goal of treatment. Since most of the urology drugs are targeting LUTS, these drugs should be regarded as "adds on" to treatments modifying the underlying disorder. Considering that most of these drugs have not been studied specifically with respect to efficacy on LUTS, and since they are not without significant side effects, it seems important that if and when they are going to be used for treatment of bladder symptoms should be a joint decision between the neurologist and urologist taking care of the patient.
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Badoum G, Toloba Y, Thiombiano R, Ouédraogo G, Ouédraogo M. [Attitude of private pharmacists in the dispensation of asthma drugs]. Rev Mal Respir 2013; 32:18-23. [PMID: 25618200 DOI: 10.1016/j.rmr.2013.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/29/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Despite recommendations, asthma remains poorly controlled in many countries. Asthmatic patients see pharmacy staff regularly to obtain medications. The aim of this study was to evaluate the attitude of pharmacists in Burkina Faso about dispensing asthma drugs. METHOD A self-administered anonymous questionnaire was used to collect data in a descriptive cross-sectional study related to pharmacists' attitudes in the management of asthma in the city of Ouagadougou (November 2010-June 2011). RESULTS The rate of participation of pharmacists in the study was 82.4%. Of the pharmacists surveyed, 70.1% reported having received asthma patients both during acute asthma exacerbations and when stable. Only 9% of pharmacists insisted on a prescription when asthma patients came to the pharmacy without one. A total of 73.6% of pharmacists explained and demonstrated how to use the spray to the patients. Among pharmacists who demonstrated how to use devices, only 6.7% actually checked patients' technique. Inhaler technique demonstration was done verbally in 68.8% of case. Among pharmacists, 34.5% reported a good mastery of inhaler techniques. CONCLUSION The techniques for dispensing asthma drugs are not well established among pharmacists and therefore the provision of continuous medical education to pharmacists is important.
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Affiliation(s)
- G Badoum
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
| | - Y Toloba
- Service de pneumologie, CHU Point G, Bamako, Mali
| | - R Thiombiano
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - G Ouédraogo
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - M Ouédraogo
- Service de pneumologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso
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Abstract
The medical treatment of allergic rhino-conjunctivitis involves different classes of drugs administered locally or by general route. They belong to three main classes, antihistamines, steroids and mast cell stabilizers. Since it is a relatively benign and also highly common disease, treatment options are limited by possible, even mild, side effects and by cost efficacy restriction. In the more severe forms of the condition, treatment efficacy remains unsatisfactory.
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Affiliation(s)
- R Harf
- Service de pneumologie A, pavillon médical, centre hospitalier Lyon sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
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Amari ASG, Ouattara S, Koffi AA. [Descriptive study of the regulation N°06/2010/CM/UEMOA on procedures followed for registration of pharmacticals for human use in UEMOA member states]. Mali Med 2012; 27:6-12. [PMID: 30049073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to describe Regulation No 06/2010/CM/UEMOA on procedures for Registration of Pharmaceuticals for human use in UEMOA member states to facilitate their implementation in the national legislation of each Member State. METHODS Our study material was composed of the national laws of member states of UEMOA, the texts adopted at Community level relating to community management mechanisms of the drug in West Africa, and in particular regulations No 02/2005/CM/UEMAO on the harmonization of drug regulation in the member states of the UEMOA and No. 06/2010/CM/UEMOA. These texts were analyzed, their scope appreciated, and their origin studied. RESULT The Regulation No 06/2010/CM/UEMOA describes all the procedures for obtaining a marketing authorization for a medicinal product in the Member States of the UEMOA. This regulation establishes a committee in charge of the technical evaluation of dossiers of application for approval and a national committee in charge of the drug definitive opinion on the request for approval, where the Minister of Health is the administrative authority issuing the marketing authorization. CONCLUSION The regulation makes a great UEMOA standardization of procedures for drug approval and guarantees the safety and quality of medicines circulating in the UEMOA.
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Affiliation(s)
- A S G Amari
- Pharmacien, Docteur es-Sciences Pharmaceutiques (spécialité: Droit pharmaceutique), Enseignant-Chercheur en Législation pharmaceutique à l'UFR Sciences Pharmaceutiques et Biologiques de l'Université de Cocody Abidjan - Pharmacien chargé de la réglementation et du contentieux à la Direction de la Pharmacie et du Médicament (DPM) du Ministère de la Santé de Côte d'Ivoire. BPV 34 Université de Cocody-Aidjan.
| | - S Ouattara
- Pharmacien, membre du secrétariat de la cellule pour l'harmonisation de la Réglementation et de la Coopération Pharmaceutiques (CHRCP) de l'UEMOA
| | - A A Koffi
- Pharmacien, Enseignant-chercheur au département de Galénique et législation pharmaceutique à l'UFR des Sciences Pharmaceutiques et Biologiques de l'Université de Cocody-Abidjan
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