Medication reconciliation (MR) aims at preventing medication errors at care transitions. It is a complex, time-consuming, cognitively demanding pharmacological task. We have developed a decision support system, EzMedRec, to assist retroactive MR at hospital admission.
View Article and Find Full Text PDFPotentially inappropriate prescribing of direct oral anticoagulants is frequent with the most common errors being dosage, administration, and duration of therapy. We developed RecosDoc-MTeV, a documentary-based clinical decision support system (CDSS) for the management of direct oral anticoagulant prescription to prevent and treat venous thromboembolism. Simultaneously, the network of Parisian public hospitals (AP-HP, France) developed narrative clinical practice guidelines (CPGs) and a companion smartphone application to enhance medication and patient safety related to direct oral anticoagulant prescription.
View Article and Find Full Text PDFIntroduction: The active clinical research programme of trabectedin continues to improve knowledge on the therapeutic activity and toxicity of the drug in the treatment of soft tissue sarcomas (STS). In contrast, limited number of data is available on its use outside of clinical trials.
Patients And Methods: We retrospectively analysed efficacy and safety of trabectedin when given in daily practice to patients with advanced/recurrent STS.
Introduction: Levofloxacin , the l-isomer of ofloxacin has become one of the cornerstones of antibiotic therapy of pyelonephritis since its introduction in the 1990s, thanks to its exceptional pharmacokinetic (PK) and pharmacodynamic (PD) profile, broad-spectrum antibacterial action and satisfactory tolerance. However, the emergence of widespread fluoroquinolone resistance over the past decade, has prompted to re-examine its place in the treatment of urinary tract infection.
Areas Covered: This review covers the medical literature in any language through December 2012, on 'levofloxacin'.
Background: Duloxetine is effective in the management of stress urinary incontinence (SUI) in women but has been poorly evaluated in the treatment of SUI following radical prostatectomy (RP).
Objective: To establish the superiority of duloxetine over placebo in SUI after RP.
Design, Setting, And Participants: We conducted a prospective, randomised, placebo-controlled, double-blind, monocentric superiority trial.
Few elderly cancer patients are included in clinical trials, resulting insuffisant data of the effectiveness and tolerance of anticancer drugs in this patient population. The aim of this study was to analyse the studies concerning the effectiveness and tolerance of chemotherapy prescribed for elderly patients treated for colorectal, breast and lung cancer. The data of this population showed that the older patients are less likely to receive chemotherapy than the younger.
View Article and Find Full Text PDFPurpose: This randomized, 2 x 2 factorial study compared a semimonthly regimen (fluorouracil [FU] and leucovorin [LV] semi-monthly is LV5FU2) with a monthly regimen of FU and LV (mFU/LV) as well as 24 weeks versus 36 weeks of each regimen as adjuvant treatment of stage II and III colon cancer.
Patients And Methods: LV5FU2 was administered semimonthly for 2 days as racemate (dl) or levogyre (l-; 200 or 100 mg/m(2)) as a 2-hour infusion, followed by 400 mg/m(2) FU bolus and a 600-mg/m(2) FU 22-hour continuous infusion. FU and LV were administered monthly (mFU/LV) for 5 days as dl- or l-LV 15-minute infusion, followed by a 400 mg/m(2) FU 15-minute infusion.
Introduction: Heparin-induced thrombocytopenia (HIT) is a serious immune complication of heparin therapy and presents a risk of severe thromboembolic events. Withdrawal of heparin together with administration of an alternative antithrombotic agent is always necessary in patients with suspected HIT. Diagnosis of this complication, however, is often difficult, particularly in hospitalized patients.
View Article and Find Full Text PDFAnticancer drugs off label used in Tenon hospital were analysed by a panel of 12 experts not working at Tenon hospital. They distinguished 3 groups of off-label prescribing according to scientific evidence, labelling anticancer drugs alternative in presence and patient's characteristics: justified off label used (62%), unjustified off label used (26%) and prescriptions for which no consensus had been reached between the experts (12%). Nineteen per cent of unjustified off label used had labelling alternative and 7% did not have anticancer drugs labelling alternative.
View Article and Find Full Text PDFA practice survey was performed in Tenon hospital on 396 consecutive patients treated for solid tumors during 4 weeks in november 2002. 33% of anticancer drugs were off label used. The wording heterogeneity of the different anticancer drugs approved labeling and the lack of anticancer drugs in a number of cancers can explain those results.
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