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Mental Health SIG

Colleagues from the ESCP Special Interest Group Mental Health have prepared a very useful leaflet on Optimizing Patient Care: Administering Psychotropic Medications via Enteral Route.

Psychotropic medication users, including inpatient and outpatient individuals such as geriatrics, nursing home and intensive care unit patients, may require enteral feeding tubes (EFTs) when oral intake is
inadequate or gastrointestinal tract access is limited.
The aim of this leaflet is to provide essential information and valuable resources specifically focused on psychotropics administered via the enteral route.

Specific guidelines for psychotropic medications via the enteral route are currently lacking. Therefore, members of the ESCP Mental Health SIG have compiled a list of commonly used resources where you can find information about different medications.
Simply scan the QR code at the bottom of the leaflet to access these resources. If you know of any helpful resources that you have used in your country, please feel free to share them with us (sig.mentalhealth@escpweb.org). Your contribution will be greatly appreciated.

The European Council for Pharmacy Education Accreditation (ECPhA) was officially launched in mid-November. The ESCP is a founding member of ECPhA, together with the European Association of Hospital Pharmacists (EAHP).

ECPhA’s goal is to support improvements in the quality of continuing education in pharmacy practice in healthcare settings across Europe via accrediting live and online lifelong learning events. ECPhA will work in collaboration with national healthcare professional associations and accrediting bodies.

For more information about ECPhA and the accreditation process, please refer to the ECPhA brochure.

The ECPhA team will soon start the process of approaching national accreditation authorities to discuss potential recognition of ECPhA credits. Thus, we are identifying the contact persons in each country with the goal of asking for a first meeting. If you are in a position to have information regarding who within your country should be contacted, please let the ECPhA team (info@ecpha.eu) know so they can start building a contact database.

In addition, ECPhA is seeking pilot reviewers for the accreditation of the events. Reviewers will ensure that the event complies with ECPhA criteria. It is expected that a reviewer will spend around 3-4 hours per event on a voluntary basis for a maximum of 2 events per year. If interested, please email the ECPhA team (info@ecpha.eu) for further information.

10 October 2023 is World Mental Health Day.

The ESCP Special Interest Group Mental Health has prepared a LEAFLET to be used and shared.

It is our pleasure that prof. Derek Stewart, the ESCP President, gave interviews to Dr. Christine Clark from www.pharmacyupdate.online. Click to read, watch & listen:

1. Why join the European Society for Clinical Pharmacy?
2. How ESCP special interest groups forge worldwide links
3. Building best practice in clinical pharmacy
4. How the Oath to Society underpins clinical pharmacy practice
5. What are ESCP developments and aspirations?

Update from the General Committee (by Derek Stewart)

The General Committee is the ESCP leadership body and is responsible for driving the strategy of the society. We now have a vacancy for a position on the General committee. All non-student members will have received an email about this opportunity to make a major impact on ESCP and clinical pharmacy at the global level. Please consider this carefully and submit an application. The deadline is 01 September 2023.

We are delighted that to announce that we have recently signed a collaborative agreement with Polish Society of Clinical Pharmacy, with benefits for both societies. The number of national agreements is increasing; if you are involved with your national clinical pharmacy society and would like to explore partnership, then please get in touch. We continue to progress the establishment of the European Council for Pharmacy Education Accreditation (ECPhA) and will provide updates in future newsletters.

Update from the Education Committee (by Kateřina Malá Ládová)

In Summer 2023, EdCom welcomed a new member from Germany representing ESCP General Commitee. Dr. Martina Hahn will support working of EdCom and connect the visions of GC into EdCom.

The EdCom strategic plan for 2023 is ongoing, especially autumn webinars organized by EdCom are coming. In September, the webinar will be focused on increase awareness for pharmacy professionals on public health disasters and emergencies.

In October, the webinar will be held on behalf of EdCom and is hosting an expert panel discussion focused on:

1) Experiential learning – its integration into the undergraduate curriculum, and strategies to support and optimize its impact;

2) Continuing Professional Development – analysis of the current challenges and opportunities regarding access, implementation and evaluation.

Update from the Special Interest Group (SIG) Council (by Bart Pouls)

In the background ESCP is are working on communication within SIGs to facilitate the sharing and building of ideas on clinical pharmacy. During the conference in Aberdeen, all three SIGs will showcase themselves and have a slot within the program where you can hear what’s happening and become a member too!

Please click here for more information.

During the ESCP Spring Workshop in Antwerp we had the opportunity to hear the results of the work of young colleagues from Latvia and Malta.

Anna Gavrilova

Anna has a pharmacist diploma and she is currently pursuing a PhD in clinical pharmacy. Her research focuses on the safety aspects of direct oral anticoagulants among patients with atrial fibrillation. She is primarily involved in academic work, and she teaches courses on “Pharmaceutical Pharmacology” and “Pharmacotherapy in Pharmacist’s Practice” along with her colleagues at Rīga Stradiņš University (Riga, Latvia). Collaborating with her esteemed colleagues in various disciplines, they aim to provide comprehensive education and contribute to the advancement of pharmaceutical knowledge. Their institution established the new Pharmaceutical Education and Research Centre, which significantly promotes their research efforts and enables us to conduct more extensive studies.

The goal of drug therapy is to be safe and effective. During the ESCP Spring Workshop, Anna shared her research findings on the significance of direct oral anticoagulants’ (DOAC) concentration measure assays for patients taking amiodarone simultaneously. It was discovered that, in atrial fibrillation patients receiving amiodarone before scheduled electrical cardioversion, higher-than expected concentrations of DOACs are found for rivaroxaban and edoxaban users. This event provided an excellent opportunity to discuss practical concerns regarding the optimization of medication usage, risk decreasing against bleeding, and providing high-quality care to this patient cohort. The experience has motivated her to further her research to discover objective control mechanisms of long-term DOAC therapy.

Anna´s department has substantial experience in studying adherence problems to antihypertensive therapy. Achieving optimal blood pressure control, the main goal of antihypertensive treatment requires patient cooperation in addition to effective medication. Available evidence suggests that up to 90% of patients with AH may miss treatment, and ~ 50% may discontinue therapy within one year of diagnosis. Their recent survey results indicate that every other patient is non-adherent in Latvia, which is a concerning finding. Prescription databases analytical study also supported these results. However, both of these methods have disadvantages, so they are not commonly utilized in daily clinical practice. Thus, there is a need for more independent methods to measure adherence, such as determining the concentration of an antihypertensive drug or metabolite over a prolonged period of therapy, minimizing the risk of subjectivity.

Anna concluded: “The clinical pharmacy offers numerous advantages in healthcare. By actively involving pharmacists in patient care, clinical pharmacy enhances medication safety and optimizes therapeutic outcomes. Pharmacists with expertise play a pivotal role in medication management, conducting medication reconciliation, identifying and resolving medication-related problems, and providing drug information to healthcare professionals and patients. Interdisciplinary teams promote effective communication and collaboration, resulting in improved patient care. Moreover, it contributes to research and education, expanding the knowledge base and ensuring evidence-based practice. Given our shared interest in patient safety, medication optimization, and adherence, I invite everyone to consider collaborating on future projects and initiatives to further advance clinical pharmacy practice and contribute to the betterment of patient care. Together, we can make a meaningful impact in this field.”

Raquel Formosa

Raquel is 22-year-old Maltese final year pharmacy student reading for a Master in Pharmacy (M.Pharm.) degree at the University of Malta.

During the Spring ESCP Workshop in Antwerp, Belgium, Raquel presented an oral communication reflecting findings from her dissertation, which focused on ‘Pharmacist-Led Personalisation of Antiplatelet Therapy and Outcomes After Percutaneous Coronary Intervention’. The research was conducted under the supervision of Dr Francesca Wirth, Senior Lecturer at the Department of Pharmacy of the University of Malta and Member of the Research Committee of ESCP. The research was undertaken in collaboration with the Department of Cardiology at Mater Dei Hospital, the main acute general hospital in Malta.

There is currently an ongoing dilemma regarding the choice and duration of dual antiplatelet therapy (DAPT) for patients undergoing percutaneous coronary intervention (PCI). The research aimed to assess bleeding risk, optimise antithrombotic therapy and evaluate outcomes in patients undergoing PCI. Two hundred patients undergoing PCI and candidates for DAPT were prospectively recruited for this cohort study. Bleeding risk was determined using the PRECISE-DAPT score, which was not routinely used in local practice. Low bleeding risk patients on oral anticoagulation therapy and all moderate-to-high bleeding risk patients were discussed with the cardiologists for therapy optimisation, taking into account also ischaemic risk. Cardiologists accepted the researcher as part of the team and considered the bleeding risk evaluation proposed by the researcher, where changes in treatment where made as necessary. Patients were followed up over a 1-year period post-PCI for morality, bleeding and ischaemic outcomes. Application of the PRECISE-DAPT score in this setting was innovative, and the research demonstrated that pharmacist-led evaluation of bleeding risk supported cardiologists in the personalisation of antithrombotic therapy post-PCI.

Disseminating research as an oral presentation in this year’s ESCP workshop was a valuable opportunity for Raquel, especially since it was her first time participating and disseminating research in an international forum. Raquel valued the insightful feedback received from the workshop attendees and it was an enriching experience which she will cherish. From a networking perspective, she made new connections with international peers in the field of pharmacy. It is definitely an experience that should not be missed, and young researchers are encouraged to become members of ESCP, submit research abstracts and attend activities organised by ESCP!

We are happy we can introduce the research of our members. This time we introduce the research of Ugur Balaban from Turkey.

Ugur works as a research assistant in the Department of Clinical Pharmacy, Faculty of Pharmacy at Hacettepe University in Ankara. His research interests include drug pharmacokinetics/pharmacodynamics during therapeutic plasma exchange and renal replacement therapies, therapeutic drug monitoring, and antimicrobials. Currently, Ugur and the team from Department of Clinical Pharmacy, work on questionnaire study. They aim to contribute to the existing literature and increase awareness among clinicians regarding antimicrobial treatment practices in patients undergoing therapeutic plasma exchange.

Therapeutic plasma exchange (TPE), a therapeutic procedure in which blood of the patient is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a suitable replacement fluid (e.g., human albumin, fresh frozen plasma). TPE aims to remove disease-associated pathogenic elements from the patient’s plasma, including autoantibodies, toxins and cytokines.

It is important to note that TPE not only removes pathogenic elements from the plasma but can also result in the removal of drugs. There are no definitive guidelines about antimicrobial drug removal by TPE or the appropriate antimicrobial drug dosing in patients undergoing concurrent TPE. Based on this, the purpose of this questionnaire study is to highlight treatment practices in patients receiving antimicrobial drug treatment and undergoing concurrent TPE, as well as clinicians’ knowledge and attitudes. The questionnaire is primarily aimed at physicians working in the departments of infectious diseases and clinical microbiology, as well as intensive/critical care. Furthermore, physicians from other departments are also encouraged to participate.

We as a clinical pharmacists could help Ugur and his team with distributing the questionnaire among a wide range of physicians we are collaborating with by sharing the link. For more information contact Ugur directly: ugurbalaban@hacettepe.edu.tr

Ugur Balaban, Prof. Dr. S. Kutay Demirkan, and Dr. Emre Kara (Faculty of Pharmacy at Hacettepe University in Ankara)

In April, ESCP welcomed participants from 19 countries to its international workshop ‘Advancing clinical pharmacy and care in diabetes and cardiovascular comorbidities’ in Antwerp (Belgium).

The program for the 2-day workshops had four plenary sessions.

• Philip Newland-Jones discussed the future and forefront of type 2 diabetes management to optimize care and reduce future risk of complications.
• Alia Gilani shared her experiences as senior diabetes clinical pharmacist working in a UK general practice setting within an area of high deprivation and diversity. Developing innovative services she managed to provide care to hard-to-reach groups.
• Frederik Verbrugge provided an update in cardiovascular co-morbidities prevention with an extensive overview of must-read scientific papers underlining both preventive measures (smoking cessation, limit salt intake, …) as well as pharmacological and surgical treatment options.
• Goos Laverman presented the Diabetes and Lifestyle Cohort Twente (DIALECT) as example of an integrated approach to reach treatment targets in persons with type 2 diabetes.

In the four workshops, participants discussed the following topics: safe use of injectables and devices in diabetes patients, lifestyle and personalized diabetes treatment in primary care, tackling inequalities in medication management and medication review and management of diabetes in patients with multimorbidity.

The integrated management including preventive and lifestyle measures as well as pharmacological and nutritional management focusing on all aspects of our (multimorbidity) patients is key.

Spring arrived just in time to create a nice atmosphere for walks both in lunch break as well as to welcome participants to the city hall of Antwerp for the reception. We were welcomed by the city with local beers and received a private guided tour of the city hall.

Thank you to all speakers and participants for sharing your knowledge and skills, for sharing your own work by presenting a poster/oral communication, for networking and for being in Antwerp! Hope to see you again at one of our future events.
Text: Siska Desplenter, President of ESCP Spring Workshop 2023. Photos: © Bart Heleven

The February issue of the International Journal of Clinical Pharmacy is now available at this link.
Check out the great selection of reviews, papers, commentaries and much more.

Included in this issue is an ESCP Best Practice paper from Wales in the UK, Mantzourani E, Brooks O, James D, et al. Development, implementation and evaluation of the digital transformation of renal services in Wales: the journey from local to national. International Journal of Clinical Pharmacy. 2023;45:4-16.

Remember that ESCP members receive free access to the journal.